.. '-'

‘The Chatelaine, April, 1929

it is below three and a half pounds, but- tocks and neck being well attended to.

To Prevent Infection

NE must remember that these infants

have very low resistance. The quicker the prevention of infection is assured by isolation, the better. Visitors are only too anxious to see a tiny baby and are apt to look upon it as a toy. They little realize what they are doing and cannot fully appreciate the reasons why a strict isolation should be adhered to. Anyone might bring this little tender plant a germ that would mean its death in a few days, and yet he would never realize that, although perfectly well himself, he could carry fatal infection. Absolute cleanliiiess in everything con- nected with the baby is imperative: clean hands, clothes, protection from flies (mos- quito netting v, cleanliness of feeding utensils and the mother’s nipples. Never allow other children to go near the baby.

The attendant iriust wear a clean gown which is taken off before leaving the room; she must wear a mask, should have well- kept, short nails and be abso/u/e/y free from colds. Remember that more infection is carried by the hands than in any other way.

Feeding

HERE we have a very difficult problem. It is essential to have mother’s milk, which may have to be diluted with boiled water to begin with. It is somewhat im- possible to lay down any set rules regarding the feeding of these infants, as their natural adaptability and certain other compensating factors differ so in individual cases. It is sometimes several weeks before they can learn to feed consistently, while others learn good suction in a day or two. (I do not know of anything that calls for greater patience and attention to detail than the feeding of these bairns.)

The baby should be fed in the crib. No pains should be spared to secure mother’s milk. There is usually someone near who has a baby on the breast who will donate. Even a little breast milk helps. The neces- sary means of securing natural feeding by the mother, however, should be pursued with the greatest vigor and zest. In the meantime, investigate the home from which the foster mother’s milk comes and boil it in a double boiler for three minutes.

Frequency and amount of feeding depends entirely on the size of the infant and the degree of prematurity. If the baby is able to take from one to one and a quarter ounces at a feeding during the first week, it is usually not necessary to feed oftener than every three hours with one night feeding. The total amount which he is able to take at one time without exhaustion usually decides the number of feedings in twenty- four hours. A careful record of the actual amount should be kept. If you are writing for instructions, include this information in your letter.

Because a baby sleeps, that is no reason to believe that he does not need food. Prematures, more than any other babies, will sleep, in fact, will hardly waken even when being fed. On the other hand, not more than half an hour should be taken over one feed or you will exhaust the baby. The night feed is usually discontinued when the baby is able to take the required amount for growth and development in six feeds instead of seven. Then work‘ on to five feeds, or four, according to conditions.

The intake of fluid is very important and it is no guide to wait for the usual signs of hunger or thirst in a premature, who soon suffers from lack of fluid. Three ounces to every pound of weight should be your guide; that is, if a baby is three pounds he needs nine ounces of fluid; four pounds. twelve ounces in twenty-four hours, and so on. In feeding, see that the baby’s tongue is under the nipple. It freClue_nt1Y Cllflgs 10 the roof of the mouth, preventing 511Ct10n-

Kind of Food THERE is no comparison in the rapidity

of progress between a premature breast- fed and one who is unnaturally fed. The

one is soon weeks ahead of the otherfl Every effort should be made to establish, mother’s milk. ‘

Let me quote two cases to you. Baby No. l was born two and a half pounds -- small but healthy. The mother’s breasts- were ordered to be bound and bella donna plasters applied, “because the baby could not live." This wee mite struggled on for four months on artificial food —-cow's milk, . water and “sugar to taste." (I wonder what a premature “taste" is?) With the first slight infection, this baby died, where- as if breast-fed it would have had ten times 1 the chance of living. A baby that lives for } four months should not (lie, yet even nature cannot struggle on forever.

In contrast to this, let us take baby No. i 2. Baby No. 2 was born two and a quarter 1 pounds and came out of hospital one and three quarter pounds. He was supervised; by a doctor and public health nurse, was» breast—fed and had proper premature care. This baby gained eight ounces regularly,’ every week for nearly seven months. Inl six weeks time the baby was able to be‘ taken up by the mother and fed. At eight l weeks time after arrival home, the baby was ‘ on five feedings a day, sleeping all night.

This baby at fifteen months was an average baby of thirteen months, and is stilll progressing favorably. The mother had three other children, was poor in this world's goods, but rich in common sense. It was winter, but the mother, being a good manager and co-operating with those who wished to help her, was repaid admirably for all her care and attention. She says she . realizes she would perhaps never have been T able to do it, had her baby been artificially fed.

[Waking Baby’s Crib

THE crib should be lined throughout with brown paper, all edges overlapping; over this should be fastened light flannel in the winter and cotton in the summer. On the bottom should be laid an enveloping blanket which reaches to the baby's head. On this is laid a hard mattress. Around the sides and at foot of this the hot water bags are placed. Next is laid a soft stuffed mattress. A blanket covers this, pro- tected (after about three weeks) by a small sheet of rubber covered with a napkin. A flat pillow is provided. The baby rests here under a cuddling blanket. The enveloping blanket folds over, leaving the baby’s head free. There should be a cotton covering to protect the face from the blanket.

I Clothing

THE premature should have a very soft silk muslin shirt to wear next the skin; after this a soft woollen shirt, preferably hand-knitted, a flannel petticoat hanging from the shoulders, and a flannel night- dress. This latter should have sleeves long enough to cover the hands unless glovelets are worn. These are really better, for they can be changed. All clothes open down the back, wide enough to be wrapped over and long enough to tuck over the feet. A bonnet should always be worn until the baby is five pounds in weight.

In Karitane Homes in New Zealand and Mothercraft Homes in Australia, we always said the baby knew when he wanted his bonnet ofi'—usually when he cried loud enough to be heard outside.

SOME people ask: “Are these babies worth saving? Will they be mentally deficient? Will they develop properly?” I have yet to see the premature baby who is not worth saving. One of the biggest, healthiest and brightest soldiers I met over- seas was a premature baby of three pounds!

Never forget, “the tender plant requires the moist warmth of the conservatory until such time as his acclimatization is com- plete.”

It is impossible to give general instruc- tions in feeding, but if you are anywhere away from a doctor or medical organization we shall be pleased to help you. A sketch

To travel in May seems early but there are many distinct advantages ~the rates in most classes are lowest of the year~there’s a better choice of accommodation—there are rig crowtds demanding to be served, hence you I'€C€lVE.' a warmer welcome an 8753 er personal attention——and “May-June weather” in practically every country is ideal —balmy days of mid-Spring filled with bright sunshine and flowers. Conducted or Independent Tour itineraries can be arranged to meet any requirement. Plan now to sail on one of these dates and secure the most for your travel dollars.

Montreal-Quebec-Belfast~G1asgow—Liverpool

REGINA May 4, June 1 LAURENTIC May 11 DORIC May 18

Montreal-Quebec-Southampton-Havre—London

CALGARIC May 2 MEGANTIC May 16

For complete details, rates, etc. phone, write or call personally

55 King St. E., Toronto McGill Building, Montreal

Canada Bldg., Saskatoon 224 Portage Ave., Winnipeg

Land Building. Calgary St. Paul Bldg., Halifax

Pacific Bldgh. Vancouver 108 Pr. William St., Saint John or Local Steamship Agents

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