FREQUENCY OF BATHS

To begin with, we never bathe either a baby or an adult immediately after a full meal. From one hour to one and one half hours should intervene.

The frequency of baths depends somewhat upon the season of the year, the vitality of the child, and the warmth of the home.

We have seen many infants who were bathed too often. The vitality expended upon the necessary reaction following a tub bath was too much for the little fellow; the daily bath was stopped and a semi-weekly bath subst.i.tuted, much to the gain of the child. Of course in this instance the hands, face, and b.u.t.tocks received a daily sponging.

The oil bath may be administered daily. In robust children the tub bath may be a daily affair; while in pale, anemic little folks, the tub bath is perhaps better given twice a week. In hot summer days a sponge bath may be given many times a day.

BEST HOUR FOR BATHING

Again this depends upon several factors; the warmth of the house or apartment, the vitality of the child, and the kind of bath to be administered.

An oil bath may be given any time--often it may be administered entirely under the bed clothes, only care must be taken to keep oil from the blankets.

Many of our mothers prefer to give the tub bath at five o'clock in the afternoon, when the house is thoroughly warm, and the child is thereby prepared for the long night's sleep. Before dressing in the morning an oil bath or rub may be given in such cases.

If the forenoon is selected as the time for bathing the child, then an hour just before the mid forenoon meal is the best. In either event, be regular about it--do it at the same time every day. Let the caretaker attend to her many duties, and, as far as possible, mothers, bathe your baby yourself. The folds of the skin, the creases in the neck, the clenched fists, must all receive particular care, and no one in all the world will ever care as you--the mother--cares.

SOAP AND WATER

Select a soap free from irritants and excess of alkalis. There are few kinds that equal the old-fashioned, white castile soap our grandmothers used.

Very hard water which makes the skin rough and sore may be improved by boiling, but if possible subst.i.tute rain water for it. A flannel bag tied over the faucet and changed each day will help to clarify muddy water, provided the stream flows gently through it.

ROUTINE OF THE TUB BATH

Just as we directed the nurse or caretaker to stand while the oil rub or sponge bath was given, so we admonish the mother to stand while the tub bath is given. First, get everything in readiness for the bath as directed for the oil bath, and then the baby's tub setting on the securely cleated slats placed across the top of the family tub may be filled with water by means of a hose attached to the faucet. The temperature should be 100 F. when baby is dipped in to be rinsed.

The head and face toilet are identical with that described before, and with the baby undressed and wrapped in a warm towel placed inside the warm blanket on the pillow or comfort as before mentioned, we proceed with a good lather of castile soap and water to lather the baby's body all over--under the arms, the neck, chest, groins, thighs, b.u.t.tocks, legs, feet, and between the toes, while the genitals also receive their share of attention. The foreskin of the boy baby is gently pushed back and cleansed thoroughly; while the v.u.l.v.a of the little girl baby, having first been swabbed with boracic acid, is now gently lathered and cleansed. Now grasp the ankles and legs with the right hand and support the upper back and neck and shoulders with the left and gently lower the baby into the water in a semi-reclining position (See Fig. 13). The water should cover the shoulders. Keep a good firm supporting left hand under the head, neck, and shoulders, and with the right, rinse all soap from the body.

[Ill.u.s.tration: Fig. 13. Supporting the Baby for the Bath]

After this is thoroughly done, lift the baby out onto a fresh warm towel inside the warm blanket on the pillow, and remain standing, while you gently pat (never rub) the baby dry. All the little folds, creases, and places between fingers and toes, are carefully patted _dry_, and where any two skin surfaces rub together put on a bit of talc.u.m.

The dressing takes place in the manner already described--first the shirt, then the band (sewed on), the diaper, stockings, skirt, and gown.

Please note that the soap bath is contra-indicated (should not be given) in case of eczema.

BABY'S DAILY RUB

This soap bath should be administered for cleanliness only, and should be given twice a week. If a tub bath is to be given on other days, after the routine head and face toilet, the baby is simply dipped into the water and the soft skin gently rubbed.

If the sponge or tub bath is given in the afternoon just before the long sleep at night, then the oil rub should take place before the mid-forenoon meal; and likewise, if the sponge or tub bath is given during the mid forenoon, then the oil rub or dry hand rub is given before the going-to-bed time. The rub should be a daily procedure for the first two years. Nothing rougher than the soft palm of the hand should be rubbed on baby's soft skin.

USE AND ABUSE OF TALc.u.m

Babies have come to my clinic with _cakes_ of talc.u.m under their arms, and particularly between their thighs and in the crease of the b.u.t.tocks. Here the well-meaning but thoughtless mother had reasoned, "a little is good; more is better" which is not always the case.

Talc.u.m is not used to replace careful drying, and it should never be found in quant.i.ties on the baby's skin any more than you would expect to find quant.i.ties of face powder caked in the creases of the neck or behind the ears of an adult. The skin is first cleaned, then patted entirely dry, and, as a finishing touch, a bit of talc.u.m is put on by means of a puff.

TONIC AND MEDICATED BATHS

Tonic baths are usually given to older children when they are able to enter into the sport and frolic of a cool bath. Baths are called tonic because they call forth from the body a reaction--a sort of circulatory rebound. This rebound or reaction brings the blood to the skin, increases the circulation, and tones up the nerves. The room should be properly warmed and, if necessary, some form of exercise be continued after the bath to prevent the chill that sometimes follows a poorly administered bath.

In the case of the anemic child, after six months of age, the mother's hand dipped in cold water may briskly rub the chest and back until it glows or becomes red. The child should enjoy this bath. Never frighten a child by throwing cold water on it or by giving it a too sudden cold plunge; great harm may be permanently done by these efforts to "toughen the baby."

The simple medicated baths may be administered according to the following directions:

_Salt._ Use half a teacup of common salt or sea salt to each gallon of water. The salt should first be dissolved in a cup of warm water to prevent the sharp particles from p.r.i.c.king the skin. The doctor sometimes orders a salt bath.

_Starch._ Add a cup of ordinary, cooked laundry starch for every gallon of water in the bath.

_Soda._ A soda bath requires two tablespoons of ordinary baking soda to a gallon of water, dissolving it in a little water before adding it to the bath.

_Bran._ Make a cotton bag of cheesecloth or other thin material, six inches square. Fill loosely with bran. Soak the bag in the bath water, squeezing it frequently until the water becomes milky.

Starch, soda, and bran baths are often used in place of the ordinary soap and water bath when the skin is inflamed, as in cases of chafing or p.r.i.c.kly heat.

FEAR OF BATHS

Force and harshness are not likely to cause baby to overcome very much of the fear of a tub bath. Patience, perseverance, and purposeful diversion of mind will bring sure results.

In the case of a very young baby, have a helper stretch a towel across the filled baby tub, lay the baby in it, with its head well supported, and then gently lower the towel into the water, keeping the head out.

(Most anyone would fear an all-over ducking, if he had ever been completely ducked into water by a careless or mischievous friend).

In the case of older children, celluloid ducks, fish, or boats may float about on the water, and the entire bath be forgotten by the little fellow's enjoyment of "his boats."

OUT OF DOOR BATHING

Although a baby under two years should never be given a sea bath, a word of caution about sea bathing for young children may not be amiss. The cruelty with which well-meaning parents treat young, tender children by forcibly dragging them into the surf, a practice which may be seen at any seaside resort in the summer, can have no justification. The fright and shock that a sensitive child is thus subjected to is more than sufficient to undo any conceivable good resulting from the plunge. On the other hand, a child who is allowed to play on the warm sand and becomes accustomed to the water slowly and naturally will soon learn to take delight in the buffeting of the smaller waves, but he should not be permitted to remain more than a minute or two in the water, and should be thoroughly dried, dressed immediately, and not left to run about the beach in wet clothing.

MILK CRUST

Any roughness on the scalp must receive immediate attention. This roughness, or milk crust, is entirely avoidable; it is the result of acc.u.mulated oil and dirt. When it has formed a complete crust or cake, it may quickly become eczematous and require a physician's advice; however, in the beginning, at the first sight of brown patches or roughness, oil the scalp thoroughly at night with vaseline or cold cream, which should be gently rubbed off in the morning.

This vaseline or cold cream should be applied repeatedly, several nights in succession, followed by the morning's gentle rubbing and daily washing of the head. Often the washing with water must be entirely avoided; only sweet oil or vaseline being used in those cases where the crusting seems to be persistent.