OUR BABIES.

North Otago Times, Volume CV, Issue 13931, 13 July 1917, Page 8

OUR BABIES.

{ \ \ (By Eygela.) 1 Published tinder the ausplcea of tho Hoyal Now Zoalaiid Society for the Health of Women and Children, "It is wiser to put up a fence at the to;' of a precipice than to maintain an ambulance at the bottom." OAMARU. : Plmiket Nurse Roy. Rooms: Tecs street; 'Phoxn* No. 3fi7. Secretary: Mrs L/E. Haines, e/o Bank of New Zealand, Oainaru. CONSTIPATION TN BREAST-FED' BABIES. . (Continued.)

Last week we gave some extracts from three letters from ■mothers, each of whom was experiencing difficulty in

overcoming constipation in h-.'r breastfed infant. We. dealt v.kh' the use of the enema, and then described the method of performing abdominal massage for the treatment of constipation, emphasising the fact that the mas-age must be done efficiently if it is to be really effective.

The following is the case \vj promised to describe illustrating the combination of massage and the enema:— Case Illustrating the Combined Use of Massage and tho Enema.

Some years ago a breast-ted baby was brought Io us suffering from the most obstinate coustipation. A trained General Hospital nurse was in attendance, but she had had little experience with babies. The .nurse was asked to massage the abdomen bef)re resorting to an enema. We were surprised to find that the nurse began to manipulate the abdomen without any rational sys'em, exercising pressure iit a direction tlie reverse of the course in which the bowel-contents have to

move, and not using pressure deep enough to be at all effective in any ease, A skilled expect then did the massage for a minute or iwo, and as no movement took place an ounce of normal saline (see page' 112 under Eueme, "Feeding and Care of Baby") was injected. This produced no result. After waiting about live minutes massage was tried again. Still no result. An injection of about 2oz

was then given, ami after it massage proved perfectly effective. The whole time occupied from beginning to eud was, perhaps, a quarter of an hour, and the baby suffered no discomfort, and did not crv.

In this case perfect regularity was induced within the week by the simple means we have described, though every other measure failed. How To Do Abdominal MaJfage.

It is so important that mothers should have a clear picture of how abdominal massage should be gone about that we feel impelled to summarise the method of .manipulation again, first asking our readers to turn up page 4 of "Feeding and Care of Baby," and to look carefully ar diagram A while reading the following description;— A sausage-like tube starts just above the outer part of the right groin and runs upwards to the margin of the rib, then curves away across the abdomen above the navel until it reaches the rib in the left flank, where it curves round sharply, and descends to reach the left groin; it then passes downwards and backwards to join the rectum, from which the motions arc expelled.

The, main point is to manipulate tho abdomen (following round the horseshoe of the largo iijtcstinc- as described above), pressing gently and yet. firmly and deeply, the lingers eventually Mniost touching the back wall-of the abdomen on the right side, Jf. this'pressure were, exercised without allowing for the breathing, the child would struggle and mist at- - oifftc,' aiid the. wall of the abdomen would become

quite stiff; but if the pressure-is .gently and tactfully applied mainly with each intake of tjie breath (wheu the abdomen naturally slackens), it is quite easy to use continuous pressure in successive waves, as it were, gradually getting deeper and deeper, without arousing the opposition of the muscles, Of course, the hand, doing the massage must be warmed, and it is well to dip the fingers in warmed olive oil, though

'opinions vary with regard to this,

What we want to impress on our readers is that, to be effective for the relief of constipation, massage should be definitely and skilfully carried out. The technique, however, is quite simple, and it can be easily learned from a competent inessense. At the same time it is a mistake to suppose that simple surface rubbing of the abdomen with the fingers, carried out in the right direction even by some.unskilled person, is useless. Any such rubbing and kneading of the abdomen tends to increase the activity of tho movements of'the bowel. Indeed, io a lesser extent, massage of the limbs tends in the same direction, because constipation is generally associated more or less with insufficient tone and activity 'of the whole system, and rubbing of any kind acts as a general stimulus, OLIVE OTL, In addition to careful attention to all the hygienic essentials, which my correspondents seem to have carried out well, there is not much more to be said, except that, besides giving fruit juice, half a teaspoonful of' the best olive oil might be tried, and this might be gradually increased until a.mode-rate-sized teaspoonful was taken, This should be given before the last feeding in the evening. Olive oil is generally extremely well borne by babies, and if agrees with them where ihere may be difficulty with cream. In any case, the giving of cream .for constipation, though sometimes recommended, is not desirable—indeed, the presence of too much butter-fat is liable to aggravate matters, giving rise to wdiat is known as "fat constipation,"

RATIONAL METHODS. T am sure that the renders of this column will realise that the rational way to deal with a tendency to constipation, whether in the case of a baby or an nduP, is to get the individual into the best possible all-round health ami vigour, neglecting none of the essentials mentioned on pages 1 and 2 of the society's book, The commonest mistake is trying merely one thing at a time where yon want the cumulative effect of a number of factors used in moderation, such as.massage, fruit juice, olive oil, etc, none of which might bring about the 'desired result if used by itself. CONTINUE NURSING BABY. Our Queensland correspondent asks if we flunk she is right in continuing to nurse her baby without the aid of

bottles, We have not the slightest doubt on this point, A .mother should never resort to bottle-feedingj. unless for some absolute, and iinqu'cstionablc reason, such, for instance,:' as tuberculosis, or because the supply of breast milk cannot lie b/ought up to. the .required quantity. But even then the baby should be suckled regularly every fcodiiig-tiuic, and the deficiency made up by bottle. (See pages (>, 10, and !i7 to :">!), "Feeding and Care of Baby"). We sympathise and concur with our correspondent's view that a v mother ought to do everything in her power to ensure a good start in life for her children—ami 'nothing can compare with the advantages of breast-feeding.