Chapter I · THE BABY

CHAPTER I

THE BABY

Chiropractic has nothing to do with obstetrics, but the chiropractor should be informed on the subject of child hygiene. It must be remembered that our idea is not to substitute here for the services of the obstetrician, a food diet for the infant when the mother is unable to nurse her child. The proper application of Chiropractic will eventually enable the mother, who might otherwise be unable to do so, to nurse her baby.

The child is the most helpless of the animal kingdom and requires special attention. This must come through the observation of Nature’s laws and an educated adaptation by means of substituting the educated mind of the adult for that of the infant.

Feeding

The child that is normal will give little trouble since Nature has made provision for all processes necessary to maintain the normal functions of the body. In order that these processes be maintained it is necessary to have food, proper environment, and sufficient exercise. When the mother is able to nurse the babe the problem of nourishment is solved. If the mother is unable to nurse the child and if the condition which makes this impossible is of such long standing that adjustments will not get results on the mother within the nursing period of her child, then the question of baby food should be left to the obstetrician who can prescribe the proper diet.

If the child has difficulty in digesting the food, adjustments should be given to enable Innate to bring about the proper adaptation. The bottle fed baby will require more care than the breast fed baby. Special care must be exercised to keep the bottles and other receptacles in a proper sanitary condition. This can be done by boiling them. Great care must be taken that the nipples used on the bottle are not allowed to become sour and otherwise unhygienic.

Cows’ milk may be used for bottle fed babies, but the most rigid sanitary measures should be used in producing and delivering the milk. There are many baby foods on the market, but the prescribing of food for the bottle-fed baby does not come within the scope of the chiropractor. This should be left to the obstetrician who has specialized in this work. It is not within the scope of Chiropractic to prescribe the kind of food that a bottle-fed baby needs, but the chiropractor must realize the importance of the right kind of food and the necessity for a proper innate adaptation to the kind of food given. Proper feeding is necessary for normal development, although it alone will not insure proper growth and development. The digestive organs must work normally and there must be proper coördinate action between the glands of the body. For this proper balance to be maintained there must be a normal transmission of mental impulses to all parts of the body.

The child that is getting a properly balanced ration and still is not developing normally should receive immediate attention at the hands of a competent chiropractor. No phase of the chiropractor’s work brings such gratifying results as the care of infants and babies, yet in no other phase will he find so much to baffle him. If the child is unable to digest the food then adjustments should be given.

Sleep

The infant requires much sleep and for the first two or three days this sleep will be very deep. The ordeal of labor is very trying on the infant and in cases involving great labor difficulty the first sleep of the infant may be so profound that it may appear to be coma. This may last for several hours, but if there are no convulsions or contractures there is no occasion for alarm; otherwise, this might indicate an incoördination in the brain.

After this first deep sleep, and especially after the first month, the infant will not sleep so soundly, although the sleep will be quiet. The deep, heavy sleep of childhood will be observed after the second or third year. The healthy infant sleeps almost all the time during the first few weeks, usually from twenty to twenty-two hours out of twenty-four. After that and for the first six or eight months, he sleeps from sixteen to eighteen hours out of the twenty-four. The healthy infant a few weeks old will awaken only when disturbed or when hungry. A child one year of age should have at least fourteen hours of sleep and more would not be excessive. This sleep should be taken about twelve hours at night and the balance during the day. A child two years of age requires about the same amount. At four years, eleven to twelve hours may be sufficient. Up to six years of age the child should take a daily nap. Ten to eleven hours’ sleep is considered sufficient from the age of six to ten years. The youth up to sixteen or seventeen years of age should have not less than nine hours of sleep and even more will not be excessive.

The nervous mechanism of the infant is a very delicate organization and often the fond parents do the child an injustice by not giving due consideration to the environment surrounding him the first year of life. The greatest development of the brain takes place during the first two years. To have the proper development of the nervous system there must be a quiet environment and the elimination of anything that will excite the child or tend to create nervousness. If the child is unduly susceptible to noise and is irritable and nervous, cries out or is too easily startled, there is a cause for this and a very careful analysis should be given and the causative subluxations found and adjusted immediately. The nervousness may be due to some disorder such as gastric, intestinal indigestion, poor elimination or directly to a cervical subluxation.

Playing violently with the young child should not be indulged in. It is a common failing of parents to want the baby to make a good appearance and therefore he is often stimulated to laughter by means that are detrimental to his health. This should not be done.

Exercise

The need for exercise is quite apparent and this need is as great in the infant as in the adult. Proper exercise is important from the standpoint of hygiene and we will readily realize this when we observe the provisions which have been made in Nature to take care of this very important process. The child gets his exercise from the natural instincts in his nature to run and play. His curiosity performs an important function in this respect. This keeps him running about to investigate the things about him. This takes care of the child that is thrown in a natural environment where there is plenty of room for him to run and play indoors and out, but it does not take care of the infant and the child in the city or apartment who gets the proper amount of exercise only where there is special provision made for it.

The infant gets his exercise by kicking, therefore the clothing should not be too tight. If it is, it prevents this natural exercise which is an adaptation on the part of Innate Intelligence. It is advisable to place the nude baby on his back for a few minutes at a time, preferably following the bath. In this way he can kick to his heart’s content. Crying is another means of exercise open to the child. The lusty cry of the infant is an advantage enabling the expansion of the lungs and the exercising of the abdominal muscles, the diaphragm and other structures that would otherwise get very little exercise. Of course attention must be given the crying child to see that there is nothing wrong. The crying may be the result of pain or discomfort from the clothing, but it does not take a mother or nurse long to recognize the different cries.

The child gets a certain amount of exercise from the handling which he receives. A child that is left in the crib and does not get the proper handling will be fretful and will not do well. Of course the infant must not be handled roughly and at no time should he be disturbed from sleep. The child who is given opportunity to exert himself and who receives the proper exercise through handling will relish his milk, digestion will be normal, other things being equal, and in every way he will present a more healthful appearance.

Children old enough to creep will get a sufficient amount of exercise in this way. Precautions must be taken, however, that the child is not allowed to remain on the floor when there are drafts or when the floor is cold as it is likely to be in winter in homes that are not provided with furnace heat. It must be remembered that the child is very curious and is likely to get hurt unless properly protected. He should not be restrained in creeping and he should be permitted to spend some time romping on the floor each day. Children should not be encouraged to stand when too young since the weight of the body tends to produce bow-legs.

Outdoor exercise should be provided for the children at an early age. This should include every sort of exercise and play. It is an advantage to have systematic games, for this not only gives a regular amount of exercise but also has an influence on the mind of the child which will aid in forming regular and systematic habits of thought and action. In early childhood there need be no difference in the exercise of the two sexes. It is necessary only to regulate the amount of exertion for the more delicate children. In this respect competitive games may tend to stimulate children to play too hard in an effort to win. Especially is the delicate child likely to overdo since no child likes for other children to know that he is not as physically fit as his playmates. There are no objections from a hygienic standpoint, for the exercise to be sufficiently strenuous to produce muscular fatigue, but it must never be so strenuous or so prolonged as to produce muscular exhaustion. The exercise should develop all parts of the body. In this way there will be a symmetrical body development.

Playroom

In stormy weather and in winter time when children can not get outdoors they should get exercise indoors. In practically every home a room could be fitted up as a playroom or nursery. It need not be elaborate and could be a bedroom used for a playroom during the day. This room should be well lighted and not kept too warm. The right temperature is about 55° F. Since an abundance of light is necessary the room should not be on the north, for the direct rays of the sun are to be desired and some provision should be made to admit them. All drafts must be avoided, yet a sufficient amount of air must be admitted so as to prevent the air from becoming vitiated. The best method of accomplishing this is by means of ventilators placed in the windows. Occasionally the doors and windows should be opened and the room thoroughly aired. This should be done while the children are absent from the room.

The furniture in the playroom should be substantial and of such a character that it can easily be cleaned and kept in a sanitary condition.

Sleeping Rooms or Nurseries

When it is possible in a home a room should be set aside for the nursery. This room should be well lighted, properly ventilated, and the heat and humidity should be carefully regulated. This room is to be the chief home of the infant for the first few months. Therefore it should meet the needs of the infant. It should receive the direct rays of the sun during the day. No processes, such as preparation of food, or washing of diapers, for example, should be permitted in this room. As far as possible gas plates, heaters, or gas lights should be avoided.

The nursery should not be kept too warm. A temperature of 70° F. is proper during the day. During the first few weeks it should not be allowed to drop below 65° F. through the night. For children over two months of age the temperature during the night may go as low as 60° F. but not below 50° F.

It is more sanitary for the infant to have a separate bed. Both mother and babe will rest better and there will not be the tendency for the baby to nurse too frequently during the night. The infant should be placed in a crib without rockers. A basket or bassinet is very convenient and sanitary. The sides of the bassinet may be lined and this will prevent drafts and assist materially in keeping the baby warm. The pillow should be small and soft. It is advisable to change the position of the child occasionally while sleeping. It must be remembered that the child is unable to turn should he become cramped or should he become tired from lying in one position. The average mother knows how to take care of her child in a general way and nurses have had special training in this respect, but these simple necessities should not be beneath the notice of the chiropractor. Especially is this of importance in determining the cause of irritability in the infant. Attention must be given to skin irritation, especially resulting from carelessness in the changing of the diaper and in keeping the body of the child otherwise clean. It is not, however, the intention of the author to present in this text complete instruction in the care of infants except from the general viewpoint of hygiene. The chiropractor is not to be a nurse, but he must know the rules of hygiene since there are many conditions of infancy which result from a violation of these rules.

After the first week or two the infant should be taken out of doors if it is in the summer. The open air is healthful for the young children and they should be kept outdoors a part of each day. The eyes must be protected from the sun and the head from the wind. The child, of course, should be properly dressed for out of doors. At first the child must be kept out only a few minutes, since sufficient time must be allowed for adaptation to take place, or in other words, for the child to become accustomed to the change. Before children are taken out the first time it is well to get them accustomed to the change by opening the doors and windows of the room that there may be a gradual cooling of the temperature. The child born in the fall or winter must not be deprived of fresh air even though the weather will not permit the outside airing. The child may be dressed as for an outdoor airing, then the doors and windows opened. Great care must be exercised or the child will take cold.

Control of Bowels and Bladder

While the chiropractor will have little if anything to do in advising mothers how to train their children to answer the “call of Nature,” yet he should be familiar with methods that are suggested for such training and certainly he should recognize the importance from a hygienic standpoint of such regular habits. It might be stated here that the normal movement of the young infant’s bowels should be at least twice a day.

At a very early age children learn to evacuate the bowels when placed upon a nursery chair. This requires a great deal of patience and regularity on the part of the mother or nurse. Even at the early age of three months the child may be trained to such a degree that the napkin will seldom be soiled from the movements of the bowels. This saves an enormous amount of work and certainly is more pleasant for the child, and much more sanitary. There is, however, another advantage having the young child form this regular habit; it is very probable that a habit formed this early will be followed the entire life, and thus the tendency for the educated mind to neglect this very important innate function will be averted. The best time to place the child upon the nursery chair is immediately following feeding.

Training the child to empty the bladder at stated times is more difficult, although with patient and intelligent effort this may be accomplished. Many children at the age of one year are able to indicate when they desire to empty the bladder. This adds materially to the comfort of the child and certainly makes it very much easier to care for him. Some mothers are able to dispense with the diapers during the day by the time the child is a year old and some even at an earlier age. If there is no special effort put forth to train the child in this respect it will be necessary to keep him in diapers as late as two and a half years. After this age the child should have no difficulty in holding the urine during the night. If there is such difficulty adjustments should be given to correct the cause for the nocturnal enuresis.

Growth and Development

Since growth of the child is the best evidence of health, some attention should be given it and should there be any arrest in development the cause should be carefully determined. Arrested progress always indicates that something is wrong and therefore adjustments are needed. Although normal growth does not prove perfect health by any means, yet if the child is not growing and properly developing he is not enjoying proper health.

Weight

From observation made of a great number of cases by authorities the average weight for girls at birth is a little over seven pounds, while that of boys is about seven and a half pounds. Some weigh more, some less. There is a loss of weight the first three days, this being greatest the first day. After the third day the child begins gradually to increase in weight and by the tenth day will have gained all that was lost the first three days, reaching the birth-weight about the tenth day. The artificially fed babies gain more slowly, even though they may be perfectly healthy and vigorous. The greatest increase that is made in the weight of children the first year is during the first three months. Normally the average child will gain from five to six ounces each week during the first six months, but only about half this much the second six months. The data given here must be considered only as an average, no standard can be set, but the variation must be within certain limits, otherwise it will be indicative of abnormality.

During the first two years the weight of children is considered with reference to age, but after this it is studied with relation to height. This latter method is much more accurate. The age, however, must always enter into the consideration, for of two children of the same height but of different ages the older should be the heavier. There is much less variation in weight with reference to height than with reference to age. Normal weight differs with different individuals and is governed by various conditions so that a stated weight can not be decided upon as normal in all cases. The degree of deviation from the average weight that one may experience and still be within the normal range is a matter of opinion. If the weight of the child is more than 10% below the average for his height it is a fair indication that there is a lack of proper nutrition, either because he does not have proper food or because the tissues can not assimilate the nutrition due to interference with transmission. In a case of this kind the child should be carefully analyzed and adjusted. The disturbance may be in the digestive tract or due to an impairment in the serous circulation.

Children twelve years of age and over gain less regularly and more spasmodically. For this reason there will be a greater degree of variation at this age. The weight may fall as much at 12% below the average and still the child not be considered underweight, or as much as 20% above the average before being considered overweight. If an observation of the weight is to be of any value it must be made over a period of time. The important thing is to observe whether or not there has been a gain in weight over that period of time. Loss of weight over a period of time indicates that Innate is compelled to draw upon the physical in her processes and that there is no new material with which to replace the old. This is a warning from Innate that should be heeded. The following table will give the idea of the average weight for the given height of the child.

This table is based upon a general average taken from various authentic sources and is for the purpose of giving the chiropractor a general basis upon which to make observations in growing children. The average weight is given with relation to the average height and approximate age from the second to the sixteenth year of life inclusive.

Separate weights have not been given for boys and girls. The average weight of boys is about two pounds heavier than that of girls at the same age up to about the thirteenth year. From fourteen to sixteen years of age the average weight of girls is from three to ten pounds above that of boys. The greatest increase in the weight of girls takes place between the thirteenth and fourteenth year, while with boys this increase is between the sixteenth and seventeenth year.

APPROXIMATE AVERAGE AVERAGE

AGE HEIGHT WEIGHT

2 yrs. 2 ft. 9½ in. 27.5 lbs.

3 ” 3 ” 0 ” 32.2 ”

4 ” 3 ” 4 ” 37.3 ”

5 ” 3 ” 5 ” 40.5 ”

6 ” 3 ” 7 ” 44.2 ”

7 ” 3 ” 9 ” 48.6 ”

8 ” 3 ” 11 ” 54.0 ”

9 ” 4 ” 1 ” 58.8 ”

10 ” 4 ” 3 ” 64.8 ”

11 ” 4 ” 5 ” 70.6 ”

12 ” 4 ” 7 ” 77.2 ”

13 ” 4 ” 9 ” 90.3 ”

14 ” 5 ” 0 ” 101.9 ”

15 ” 5 ” 2 ” 111.5 ”

16 ” 5 ” 3 ” 118.8 ”

The following table compiled by A. B. Hender, M. D., D. C., Ph. C., Dean of the Faculty of The Palmer School of Chiropractic, gives the average weight of the child from birth to one year of age. Dr. Hender has had years of experience as an obstetrician, and is well known to the chiropractic profession. These statistics are compiled by him from personal observation made of over 5,000 children, covering a period of over twenty-five years of active practice as an obstetrician.

AGE WEIGHT AGE WEIGHT

1st mo. 7 to 10 lbs. 7th mo. 14 to 17 lbs.

2nd ” 8 ” 11 ” 8th ” 15 ” 18 ”

3rd ” 10 ” 13 ” 9th ” 17 ” 19 ”

4th ” 12 ” 14 ” 10th ” 18 ” 20 ”

5th ” 13 ” 15 ” 11th ” 19 ” 21 ”

6th ” 13 ” 16 ” 12th ” 20 ” 24 ”

Height

The same thing can be said about height as about weight of children. There is no standard, since there are so many variations to consider, but there is a general average. The average length of the infant at birth is about twenty and one-half inches. The average normal growth the first year is about nine inches. Growth in height of the child does not indicate much in the way of nutrition, since a child may grow in height and at the same time lose in weight. The greatest growth in height is made at the time of puberty. Girls begin this rapid growth about twelve years of age and will mature more rapidly than boys, since boys do not begin this rapid growth until the thirteenth or fourteenth year; but, in the fifteenth year the boys will be taller than the girls.

Growth in height is not retarded by malnutrition to the same degree as is weight. The average growth of the normal child during the second year is about four inches; for the third year a little less; for the fourth year still a little less, about three inches. Bowditch tells us that after the fifth year the average growth is about two inches a year up to the time of puberty.