CARE OF THE MOUTH AND FIRST TEETH.--Boiled cooled water should be used to cleanse the mouth every morning after the bath. A soft piece of sterile gauze should used for this purpose. The mother must guard against using too much force in cleaning the mouth of an infant.

The milk teeth should receive attention. If they are allowed to become dirty they will become carious and cause bad breath and neuralgia.

Teeth of this character are a menace to health because they harbor germs and in this way infect the mouth and cause stomach troubles. Teeth that are carious should be filled or removed.

CARE OF THE SKIN.--The skin of a baby, because of its delicate character, is susceptible to the slightest changes in the weather or to the condition of the digestive organs. Babies are frequently subject to rashes, intertrigo, excoriations, eczema, and other skin affections. It is much easier to prevent these conditions than to cure them.

Cleanliness, not only in giving a daily efficient bath, but in every other respect, is essential. Castile soap only should be used, and no rubbing indulged in, simply mopping the parts with gauze well saturated with soapy water. All napkins should be removed as soon as soiled. If the skin is easily chafed the child should be bathed in salt water or water in which bran is mixed as explained in the chapter on bran baths.

The baby should be well powdered with a good quality of toilet powder.

Ordinary starch, or talc.u.m, or the stearate of zinc is suitable. Fat infants should be powdered in all the skin folds; otherwise they are sure to chafe.

CARE OF THE GENITAL ORGANS.--The mother should make it a habit to remove any dirt from the genitals of the baby during the morning bath. Fecal matter sometimes gets into the folds of the female baby; this should be removed promptly. In older female children, dirt and dust get into the genitals which often has to be removed carefully with a soft piece of cloth. An exceedingly chronic form of inflammation is often seen in poor children because of neglect of these parts.

In male babies the mother must daily push back the foreskin and clean under it. If this is not done the natural secretion will gather there and cause much trouble. If the foreskin is long, the child should be circ.u.mcised; if it is not long it must be pushed back daily for a number of weeks; otherwise it will contract and it may be necessary to operate on it at a later date. If this is not faithfully attended to the prepuce will become adherent, the child becomes nervous and irritable, and it may become addicted to self-abuse at a very early date--simply because the mother is derelict in the performance of her duty. If you are afraid to do your duty, don't neglect it, ask the doctor to show you just what has to be done and just how it should be done. You will find it to be a simple matter when you know how, as most things are.

AMUSING BABY.--Mothers should understand that it is not necessary to amuse a baby under one year of age. Their nervous systems are not ready for any such sport. To excite a baby to laughter is to subject it to a shock which may injure it. The healthy development of the brain of a child demands quiet and restful surroundings. It should sleep, eat, and be allowed to amuse itself in a natural way.

TEMPERATURE IN CHILDREN.--The normal temperature in a child varies more than it does in an adult. The rectal range may be between 98 and 99.5 F. and may be normal to that particular child. A rectal temperature of 97.5 F. or of 100.5 F. is of no importance unless it continues.

The best place to take the temperature in a child is the r.e.c.t.u.m and the next best place is in the groin. The temperature will always be from a half to a full degree higher in the r.e.c.t.u.m than in the groin. The thermometer should be left in the r.e.c.t.u.m for two minutes, and in the groin for five minutes.

The temperature in a child is a very fair guide as to the severity of the disease. It must be remembered, however, that a child will develop a temperature of two or three degrees from a very slight cause. It is not the height of the fever that is significant, but rather the duration of the fever that is important. A fever of 102 F. in a child may only mean a slight indigestion which will wholly disappear after a laxative is given, while the same degree of temperature in an adult usually means something much more serious. The degree of the temperature therefore should not occasion unnecessary worry; if, however, it continues and if the child shows other signs of illness, it may be regarded as indicating an abnormal condition which should be immediately found out. A temperature of 100 F. to 102 F. usually means a mild illness, and one of 104 F. or over, a serious sickness.

It is not advisable that the ordinary mother should possess a clinical thermometer. There are many occasions when a child will have a fever which should not cause any worry; if the mother gets the thermometer habit, she will many times occasion unnecessary calls of the physician only to learn that they are false fears.

THE TEETH.--There is no definite time at which the first teeth appear.

They usually come between the sixth and eighth months. They may not, however, come until much later; or they may come earlier than the sixth month; and yet the child may be perfectly healthy. They come as a rule in the following order:

1. The two lower middle teeth, 6 to 8 months.

2. The four upper middle teeth, 8 to 10 months.

3. One on each side of two lower middle teeth, 8 to 12 months.

4. One on each side, above and below, back of above teeth (four in all), 12 to 15 months.

5. The next one on each side, above and below, back of those already in (four in all), 18 to 24 months.

6. The four back teeth on each side, above and below, 24 to 30 months.

At 1 year a child should have 6 teeth

At 1-1-2 years a child should have 12 teeth

At 2 years a child should have 16 teeth

At 2-1-2 years a child should have 20 teeth

They may not come in the above regular order even in well children. The upper front teeth may come first. If the child is sickly there may be marked irregularity in the order in which they appear. Twenty teeth comprise the first set.

THE PERMANENT TEETH.--This set consists of thirty-two teeth. They begin about the sixth year and they are usually not complete until the twentieth year. They appear in the following order:

First molars 6 years Incisors 7 to 8 years Bicuspids 9 to 10 years Canines 12 to 14 years Second molars 12 to 15 years Third molars 17 to 25 years

CARE OF THE TEETH.--The teeth should be given attention as soon as they appear. It is an excellent custom to wash the teeth and gums twice daily with a piece of clean absorbent cotton rolled round the finger of the mother and dipped in a saturated solution of boracic acid. This should be done up to the second year. After the second year a soft brush should be used and the teeth thoroughly cleaned morning and night with pure castile soap or a powder. The teeth of every child should be examined by a dentist every six months. All cavities should be filled with a soft filling. The milk teeth should not decay, but should fall out, or be forced out by the second set. A child should be taught to gargle early and a mouth wash should be used morning and night.

DENt.i.tION.--As a general rule the process of teething is accompanied by some symptoms. There may be fever, restlessness, and loss of appet.i.te; though in many cases there are absolutely no symptoms. Some children seem to teethe hard, others easily. The same child may have some teeth without pain, and with others it may suffer severely. The condition of the child at the time, its age, and the season of the year undoubtedly have an influence. Children who are sickly and puny may have much difficulty while teething.

The degree of sickness varies quite considerably. There may only be, as stated above, slight fever, restlessness, with loss of appet.i.te; or there may be, in addition to these symptoms, a p.r.o.nounced fermentative diarrhea, which may lead to serious intestinal diseases; frequently there is a cough. This is more apt to be the case if the child is teething during the hot season.

TREATMENT.--When dent.i.tion affects the child's disposition it is a good plan to reduce the feeding in quant.i.ty and quality for the time being.

If the child is bottle-fed, two ounces can be taken out of each bottle and one ounce of boiled water added. If the child is breast-fed, he should be given two ounces of warm, boiled water before each feeding, and the actual feeding time at the breast shortened.

Rubbing the gum over the erupting tooth with a clean cloth may aid in helping it through. If the child is very restless and has lost sleep, the cloth may be moistened with brandy and water. Lancing the gum, though it is seldom done now-a-days, is justified in a few cases.

Teething is not the cause of actual disease as was once thought, but it must be remembered that a child whose vitality is reduced by fever, restlessness, loss of appet.i.te, loss of sleep, and irregular bowels, is more susceptible to disease than when enjoying robust health.

Sometimes a child will have a fever for one or two weeks during a hard dent.i.tion. There is apt to be more or less intestinal indigestion and fermentation at this time and as a consequence actual intestinal disease may develop. To avoid such a possibility it is an excellent plan to give an occasional dose of castor oil to clean thoroughly the whole intestinal ca.n.a.l. This should be done irrespective of the condition of the bowel, because frequently a diarrhea is caused by retained fermenting products.

Mothers must not acquire the habit of attributing all symptoms to the teething process simply because the child is teething. It must be remembered that a child may get a disease, or an ailment, while teething, that has nothing to do with teething. If this is neglected, serious consequences may result. Many children have lost their lives by a mother's carelessness in this way. Be on the safe side, consult your doctor; let him a.s.sume the responsibility.

HOW TO WEIGH THE BABY.--The test of weight is one of the most satisfactory we possess as an indication of physical progress and health. It is not an absolute test, but it may safely be relied upon.

The fattest baby is not necessarily the healthiest. A gradual and a uniform increase is a satisfactory growth. At birth a baby weighs, on an average, from seven to eight pounds, though some babies weighing less are equally healthy. The normal and customary gain is from four to six ounces every week after birth.

The baby should be weighed about the same time of the day each week, and before a meal.

The average weight of a male child at different ages is as follows:

Birth 7-1/2 lbs.

3 weeks 8 lbs.

1 month 8-1/2 lbs.

3 months 12 lbs.

4 months 13-1/2 lbs.

5 months 15 lbs.

6 months 15-1/2 lbs.

7 months 17 lbs.

9 months 19 lbs.

1 year 21 lbs.

1-1/2 years 23 lbs.

2 years 26-1/2 lbs.

3 years 31-1/2 lbs.

4 years 35-1/2 lbs.

5 years 40 lbs.

6 years 45 lbs.

7 years 49 lbs.

8 years 54 lbs.

9 years 59 lbs.

10 years 65-1/2 lbs.

A female child weighs about one-fifteenth less than a male child, as a rule.