OUR BABIES

Hauraki Plains Gazette, Volume 50, Issue 3056, 31 March 1941, Page 3

OUR BABIES

THOSE UNDER WEIGHT SPECIAL CARE NEEDED MUST BE SUFFICIENTLY WARM Most people know that when a baby is premature—that is, born before its time —it should be kept warm and should have special care and attention; but many mothers do not realise that if a full-time baby is under weight it also ought to be carefully safeguarded. These small babes born at full time will dwindle away through lack of knowledge and attention in this direction. The mother .thoughtlessly baths > her baby in the ordinary way, despite its small size, and the baby thus exposed daily loses weight and its vitality.

One cannot lay down hard-and-fast rules with regard to the care of a baby of a particular age and weight, because much depends on the condition of the child, but in all cases where babies are decidedly below ; the average weight at birth very special attention should be

given to all the essentials for health (see “Feeding and Care of Baby”), and particularly to keeping the baby sufficiently warm. We advise mothers to consult the Plunket nurse in all such cases, and she will advise

what is best. I Premature ,Babies Babies born before their time and classified as “prematures” generally weigh less than five and a-half pounds. Those who weigh less than two pounds seldom live. Every premature baby needs special care and attention from the very instant of birth, even though not much under weight and not obviously weak and debilitated. On the other hand, a badly nourished or unhealthy baby born at full time may be as difficult to rear as a healthy

baby born before its time. In practice all babies who are small and debilitated at birth are classed with prematures and need more or less similar attention. The following remarks on prematures may therefore be regarded as applying also to weaklings bom .at full time. The frail and feeble hold on life of the premature baby is due mainly to there, being very little readily available fuel stored up in the body at the time of birth and want of heat-regulating power. These deficiencies cause the body temperature to fall rapidly, and dangerously below what is needed to sustain life, unless special steps are taken, directly the premature is born, to minimise the escape of heat by completely enveloping the body in warm wrappings and to supply warmth from the outside by warming the room and by the use of hot bottles. Of course, these requirements would be greatly modified in hot weather. Wherever possible everything needed for conserving and supplying heat should be in readiness before baby is born, the main requirements being:

1. Wicker cradle or deep dress basket. The sides should be lined with brown paper, blanket or flannel. 2. Mattress and soft chaff shakedown, blanketing, and soft wraps. 3. Three hot water bottles (preferably rubber, but any form of bottle may be used for emergency) . 4. Warm olive oil and cotton wool. While all the above are not needed except for prematures and weaklings, they should be in readiness at the time of childbirth, because many a newborn would benefit greatly by the immediate use of what has been indicated, and these provisions made ahead would save many lives. An attentive, specially skilled, capable nurse can ensure the success of nearly every baby; she can save practically every child who 'is fit to live. Practical Details for Prematures

The bed is made as for a normal baby, with the addition of an extra lining of brown paper and flannel to our list of requirements. The baby will keep warm if snugly tucked into this cosy nest three or four inches below the level of the rim-.

The baby should not be bathed, but should be oiled all over with warm olive oil, then dressed in a soft muslin vest, two woollen singlets (one with long sleeves), flannel nightgown, and a soft shawl, also a woollen bonnet with a muslin lining. If the above garments are not in readiness a wrapping of cotton wool lined with gauze may be used. Instead of the ordinary napkin of Turkish towelling it is much better to use a pad of cotton wool, enveloped in a few thicknesses of gauze, held in place by a napkin.

Each time the napkin is changed the buttocks and adjacent parts should be cleansed with warm olive oil. The baby should be reoiled every other day. It is not advisable to sponge until a normal temperatuie is being maintained and strength and weight increasing.

The room and garments should be well warmed beforehand, and the changing must be done expeditiously. Dawdling at any stage robs the baby of heat, saps its strength and resistive power, and makes . it very liable to catch infective colds—the bane of prematures. Further, all such checks tend to prevent gain in weight, however well the feeding may be done.

Premature babies should be handled as little as possible, but they need turning from side to side regularly (at intervals of four to six hours) to prevent congestion of the lungs. Temperature of Room and of Cradle For the newly-born premature baby the temperature of the room should be between 65 and 70 degrees Fahr. This should be gradually lowered to between 65 to 60 degrees as the condition of the child permits. The warmth of the room must not be kept up at the expense of freshness, as is frequently the case. Warm, moist, muggy air, of course, is very enervating; but the air should not be unduly dry—about two-thirds saturated is best. Three hot water bags (in flannel covers), filled alternately one each hour, should be placed one at each side underneath the outer blanket, and the third between the chaff shake-down and the mattress at the foot end of the cradle. The temperature of the water in the side bags at the time of filling should be 160 degrees Fahr., and that of the foot bag 180 degrees. This should maintain a “cradle heat” between 85 and 95 de'grees, as ascertained by means of a dairy thermometer placed between the blanket and the baby’s clothing and midway between the side bags and kept there. Gradually lower the artificial heat supply as baby’s own internal fires and powers of heat regulation improve. Temperature of Baby

If the rectal temperature is taken every four hours, and later every eight hours, undue fluctuations can be prevented by regulating the cradle heat. Few prematures survive if their rectal temperature is allowed to fall appeciably below 95 degrees Fahr. A fairly constant temperature of 98 to 99 degrees Fahr, (with an extreme range of 97 to 100 degrees) is the ideal, and this can be assured by reasonable vigilance. No greater fluctuation should take place, especialy no fall below 97 degrees. The wider the range, the greater the strain on the organism. Next week we will discuss the feeding of the premature baby.