10 years 51 " 64 " } {Gained 2 in. and 6 lbs.

11 years 53 " 70 " } {a year.

12 years 55 " 79 " } 13 years 57 " 88 " } 14 years 59 " 100 " } {Gained 2 inches and 15 years 61 " 109 " } {about 9 lbs. a year.

16 years 63 " 117 " }

GENERAL DEVELOPMENT

The accompanying ill.u.s.tration (Fig. 14), taken from Dr. Yale, represents the developmental changes at one, five, nine, thirteen, seventeen, and twenty-one years. Each figure is divided into four equal parts, and as we watch the development from the baby who at one year, as Dr. Yale says, is four heads high, at the age of twenty-one the legs and the trunk have much outgrown the growth of the head, so that at this age the head is only two-thirteenths or less of the whole length of the body. The legs have grown more rapidly and equal one-half the entire body length. The trunk has not kept pace with the legs, for as you will see from the diagram the line reaches the navel of the child in one year, while in the adult it is much lower. The rapid growth of the legs is accomplished after nine years of age.

[Ill.u.s.tration: Fig. 14. Developmental Changes]

The proportions of the head, chest, and abdomen are exceedingly important in the growing child. At the end of the first year the head, chest, and abdomen are about uniform in circ.u.mference. The head may measure one-fourth of an inch more, but the chest and abdomen should both measure eighteen inches in circ.u.mference at this time. Should the head or the abdomen be two inches larger than the chest; the attention of the physician should be called to it, for either are indicative of conditions that should be carefully investigated.

NORMAL BREAST WEANING

As a general rule the normal, healthy, breast-fed baby is given a feeding of a bottle each day after he is ten months old. These bottles are increased in number until, by the time the baby is a year old, he is gradually weaned from the breast. Should the ninth month of baby's life arrive in the hot summer months we urge the mothers to continue breast feeding, with possibly the addition of some fruit juices, as noted elsewhere, until early autumn. Under no circ.u.mstances should the baby be weaned and compelled to use cow's milk during the season of the year when the risks of contamination are greatest. If the baby is nursed up to the close of his first year he hardly need be trained to use the bottle, but may take his food from a cup. From one to two months should always be consumed in weaning the baby, unless sudden weaning is necessitated by ill health, as noted elsewhere. The baby should have, if possible, from thirty to forty days to accustom himself to cow's milk exclusively.

If the child is weaned slowly there should be no trouble with the b.r.e.a.s.t.s, but in the instance of sudden weaning the mother should restrict her liquids, put on a tight breast binder, and for a day or two should take a dose of a saline cathartic, which will a.s.sist in taking care of the liquids and thus decrease the secretion of milk.

NORMAL BOTTLE WEANING

If the bottle food is agreeing with the baby he should be allowed to use it up to the end of the first year when he will be given whole milk with possibly the addition of a little lime water. We see no reason why the child should give up his bottle during the second year unless other food is refused--unless he will not accept other food than from his bottle--and if you are convinced that he has formed the "bottle habit," then the milk should be put into a tiny cup or gla.s.s, and he should learn to sip it along with his solid foods; but if he takes his other foods without any hesitancy, then we know no reason why he should not take his milk in this comfortable manner from his bottle at least two or three feedings each day.

If you desire to wean him from his bottle, serve the first part of it with a spoon from a cup or gla.s.s and then give him the remainder in the bottle. The beautiful picture of a big, robust baby lying on his back, knees flexed, both hands holding his beloved bottle still lingers in my mind as one of the pleasant memories of my lad's babyhood days, and at the close of the second year, when the beloved bottle was left behind, I believe I missed something as well as did the lad.

I recall no difficulty with his taking the food from a cup. The success of all normal weanings is due entirely to the fact that it is done gradually and slowly, and under no circ.u.mstances should it be roughly and abruptly attempted--particularly in case of the bottle feeding.

TRAINING THE BOWELS AND BLADDER

Reference is made to this subject in another part of this book--where we went into the detail of keeping the daily record of these physiological occurrences--and it was found that the bowels moved and the bladder was emptied at about the same time each day. Any mother, caretaker, or nurse, who will take the time to keep a daily record of the hours of defecation and urination, will observe the time carefully and will catch the child on nearly every occasion before an accident occurs. Often as early as four months the bowels will move in an infant's chamber at regular times each day. The nurse or mother places this receptacle in her lap and holds the child gently and carefully upon it. A little later it can be made to sit on a special chair prepared for the purpose, and at eight or nine months by careful training the urination can be controlled, and by the end of the first year the diapers ought to be discontinued.

If the child has not learned to control the bladder by the age of two years, medical attention should be called to the fact and remedial measures inst.i.tuted.

BABY'S SPEECH

The baby should begin to talk at one year. He early learns to say "mamma" and "papa," and gradually adds nouns to his vocabulary, so that at eighteen months the normal child should have a vocabulary of one hundred to one hundred and fifty words. As he nears the two-year mark, he has acquired a few simple verbs and he can possibly put three words together, such as, "Willie wants drink." p.r.o.nouns come in late, as we all recall that the young child usually speaks of himself by his own name.

Children are born mimics. If you talk baby talk to them, they will talk baby talk back. For instance, a well known author told us just the other day that for many years no other name was given to the sewing machine in his house but the word "mafinge," and not until he went to school did he correct the word "bewhind," for in the nursery he learned the line "wagging their tails bewhind them." Baby talk is very cunning, and often the adult members of the family pick it up and keep it up for years, and only when they are exposed in public, as one mother was on a suburban platform by her four-year-old lad shouting, "Mamma, too-too tain tumin, too-too tain tumin," do they sense their responsibility and realize how difficult it is to form new habits.

This poor mother tried in vain to have her little fellow say, as did another little lad two and one-half years old, "Mother, the train's coming; let's get on."

Many words of our beloved language at best are hard to understand; so let us speak correct English to the little folks and they will reward us by speaking good English in return.

If at two years the child makes no attempt at speech, suspicions should be aroused concerning mutism or other serious nervous defects.

Medical advice should be sought.

DEFECTIVE SPEECH

All guttural tones which may be occasioned by adenoids or enlarged tonsils, all lisping, stuttering, or defective speech of all words should be taken in hand at the very start, as they are usually overcome by constant repet.i.tion of the correct manner of speaking the particular word in question. Children of defective speech need special training, and should in no way be allowed rapidly to repeat little nursery rhymes, as oftentimes this rapid repet.i.tion of rhymes by a child with hereditary nervous defects may occasion stuttering or stammering later on.

CALISTHENICS

Special exercise should not be forced upon young children. Physical culture, along with many other things intended for sedentary adults, should never be forced upon little folks who get all of the exercise they need in the many journeys they take building their blocks, sailing their boats, tearing down imaginary houses, making imaginary journeys--from morning until night the little feet are kept busy--never stopping until the sandman comes at sleepy time. Do not yourself attempt to stimulate a child who seems backward. Consult your physician. You had much better put a child out to grow up in the yard by himself with his sandpile than to force calisthenics or advance physical training upon him.

BOW LEGS AND WALKING

Do not attempt to hasten nature in aiding the child to walk. Let him creep, roll, slide, or even hunch along the floor--wait until he pulls himself to his feet and gradually acquires the art of standing alone.

If he is overpersuaded to take "those cute little steps" it may result in bow legs, and then--pity on him when he grows up. Sometimes flat foot is the result of early urging the child to rest the weight of the body upon the undeveloped arch. A defect in the gait or a pigeon toe is hard to bear later on in life. A certain amount of pigeon-toeing is natural and normal. If the baby is heavy he will not attempt to walk at twelve months. He will very likely wait until fourteen or fifteen months. The lighter-weight children sometimes walk as early as eleven months, but they should all be walking at eighteen months, and if not, it is usually indicative of backward mentality.

If the training of the bowels and bladder will replace the diapers with drawers, the baby will attempt to walk sooner than when enc.u.mbered with a bunglesome bunch of diaper between the thighs. The little fellow runs alone at sixteen months and thoroughly enjoys it, and the wise mother will pay no attention to the small b.u.mps which are going to come plentifully at this particular time.

SUMMARY OF BABY'S DEVELOPMENT

He discovers his hands at three or four months. At six months he sits alone, plays with simple objects, grasps for objects, and laughs aloud from the third to the fifth month. He says "goo goo" at four or five months. At one year he should stand with support, listen to a watch tick, follow moving objects, know his mother, play little games, such as rolling a ball, should have trebled his birth weight, and have at least six teeth, and should use three words in short sentences. At eighteen months he should say "mamma" spontaneously, walk and run without support, should have quite a vocabulary, should be able to perform small errands like "pick up the book," and should have twelve to sixteen teeth. At two years he should be interested in pictures, able to talk intelligently, and know where his eyes, nose, mouth, hands, and feet are. At three years, he should enumerate the objects in a picture, tell his surname, and repeat a sentence with six words.

In the case of a premature baby or a very delicate child, or as a result of a prolonged illness or a very severe sickness, such as spinal meningitis, the time of these mental and physical developments may all be postponed, while rickets, which will be spoken of later, is often the cause of late sitting, late standing, and late walking.

DIET AFTER THE FIRST YEAR

Milk is the princ.i.p.al article of diet during the second year. It should be given with regularity at distinct intervals of four meals a day. It may be given from the nursing bottle, unless the child has acquired the bottle habit and refuses to eat anything else but the food from his bottle, in which case it should be given from a cup.

Beginning with the sixth month, aside from his milk, be it breast milk or bottle milk, he is to be given orange juice once each day as well as the broth from spinach and other vegetables. This is necessary to give the child certain salts which are exceedingly essential to the bottle baby.

At the close of the year when he is taking whole milk he should be given arrowroot cracker, strained apple sauce, prune pulp, fig pulp, mashed ripe banana (mashed with a knife), a baked potato with sauce or gravy (avoiding condiments), and a coddled egg. Fruit juices may be added to the diet, such as grape, pineapple, peach, and pear juice.

Later in the second year he may be given stale bread and b.u.t.ter, and for desserts he may have cup custard, slightly sweetened junket, and such fruit desserts as baked apple and baked pear.

We do not think it is necessary to give children much meat or meat juices. We appreciate that there is a diversity of opinion upon this subject, but we do not hesitate to say that in the families where meat is little used, the children seem to grow up in the normal manner with sound healthy bodies, sometimes having never tasted it. When meat is used, it should be well cooked to avoid contamination with such parasites as tapeworm and trichina; it should also be well chewed before swallowing, as many of the intestinal disturbances of the older children are due to the swallowing of unmasticated food such as half-chewed banana, chunks of meat, rinds of fruit, and the skins of baked potatoes.

Let the children's diet be simply planned, well cooked, thoroughly masticated, and above all things have regular meal hours, and no "piecing" between meals; and if the mother begins thus early with her little fellow, she will be rewarded some later day by hearing him say to some well-meaning neighbor, who has just given him a delicious cookie or a bit of candy: "Thank you, I will keep it until meal time."

Children learn one of the greatest lessons of self control in following the teaching that nothing should pa.s.s the lips between meals but water or a fruit-ade. Children in the second year require four meals a day, one of which is usually only the bottle or a cup of milk.

These meals are usually taken at six, ten, two, and six in the evening. Oftentimes this early six o'clock meal is just a bottle or cup of milk, as may also be the evening meal.

CANDY

Now, a word about candy. Pure candy is wholesome and nourishing. It is high in calorific value, and children should be allowed to have it if it does not enter the stomach in solutions stronger than ten or fifteen per cent. We can see at a glance that chocolate creams, bonbons, and other soft candies should never be given to children.

Candies that they can suck, such as fruit tablets, stick candy, sunshine candy, and other hard confections that are pure, and free from mineral colorings and other concoctions such as are commonly used in the cheaper candies, may safely be given at the close of the meals--but never between meals.

All such articles as tea, coffee, beer, soft candies, condiments, pastries, and fried foods, should be positively avoided in the case of all children under five and six years of age.