OUR BABIES.

Otago Witness, Issue 2914, 19 January 1910, Page 71

OUR BABIES.

By Htgeia, Published under the auspices of the Society for the Health of Women and Children. “ It is wiser to put up a fence at the top of a precipice than to maintain. an ambulance at the bottom.” SUMMER DIARRHOEA. Every summer brings to babies a special curs© in th© form of virulent diarrhoea, whileh kills many ar.d brings more or less permanent weakness and debility to a very large number of infants. These epidemics generally commence in January, and prove most, fatal during February and early March. The victims are nearly all bottleand it is found, as a rule, that the babies selected by the disease have not been thriving for some weeks previous to the attack. Indigestion, due to unsuitable food and irregular feeding, is the main predisposing cause. The following letter, which was published in th© Otago Daily Times nearly' three years ago (February 2, 1807), should prove enlightening and helpful. The summer season of 1907 was very hot and dry—indeed, very similar to the present one, — and there was a large amount of sickness and .death among little children. LETTER. »Sir, — The severe epidemic of diarrhoea now prevailing throughout the country on account of the prolonged drought is a matter of grave moment to babies, and I trust that you will grant me space to give a few hints which may be of some service to mothers. Summer diarrhoea, which is the one outstanding cause of maiming and death in young babies, is due to the irritation and poisoning caused by fermentation and l putrefaction taking- place in the contents of the intestines. The obvious remedy is, first, to clear the bowels of offensive material; then to give only such feed as will be very readily digested, and, above all, to -withhold the giving of anything which is known to promote the growth of putrefactive microbes. THE CURSE OF IGNORANCE. However simple and obvious these principles may seem, the difficulty of getting theni carried out in practice is almost insuperable in many cases. The most widespread and fatal ignorance and prejudice exist among mothers in regard to certain aspects of feeding and nutrition. There are many mothers whom on© can scarcely bring to realise that there may be more real solid food In a pint of perfectly clear, colourless solution that- looks ilk© pure water than is contained in a pint of new milk. How many women realise that when you have skimmed the cream ofil milk the skim milk which remains still contains more than two-thirds of the solid nutrient constituents of new milk; or, again, how many realise that a pint of skim milk .contains as much solid food l as half a pound of beef steak? Not only is there absolute ignorance of such essential matters, but women as a rule are utterly incredulous when told that the temporary withholding of food is often the best and may be the only way of keeping a child from rapidly losing weight and strength. All through infancy th© tendency of mothers is to give what they call solid food (biscuits, rusks, patent foods, etc.) when milk alone is enough and all that a baby should have. And when milk —even simple humanised milk • —ceases for the time being to be a proper food, as in cases of diarrhoea, it is equally difficult to persuade the mother to bo guided by knowledge and reason. In connection with the ordinary ©apply of humanised milk, we are constantly met with th© dse;re of women to unreasoningly add something to an already complete food. Th© mother asks for another tablcspoonful or ounce of cream, quite ignorant of the fact that if her request be complied with the fat will be raised to 6 or mors per cent., and will almost certainly upset digestion. Human milk contains only 4 per cent, of fat, and that in a more easily-digested form than the fat of cows’ milk, her.ee the percentage of fat in humanised milk should be kept lower rather than higher. The general tendency' of mothers and nurses is to overfeed babies. One .cannot too strongly impress the fact that irritable hunger and ravenousncs.s are generally due to indigestion induced by giving- too _ much <-r too strong feed, and giving it _ too often, especially to giving food at irregular intervals with a view to quieting the baby. TREATMENT. Perhaps the following quotation from recently-published lectures on “Diseases of Children,” by Robert Hutchison, of the London 'Hospital and the Great Ormond Street Hospital for Sick Children, may help to bring home conviction to those of much ignorance and little faith. Dr Hutchison is recognised as a leading authority of the day on dietetics, and has made exhaustive analysis and practical ■trials of foods for infants. He says when dealing with the treatment of diarrhoea ;—“Put not your faith in drugs. Your watchwords in the treatment of acute diarrhoea in an infant must be two —one is STARVATION, the other is ELIMINATION. If you bear in mind these two great indications, you will never go far wrong in the treatment of your case. “A word about each of these indications. You'must STARVE THE CHILD because you do not wish to furnish any further pabulum for the growth of micro-organisms; and milk in particular you must withhold, for there is reason to believe that milk .in euch oases is actually poisonous. In a ease of acute diarrhoea, whatever you do you must stop milk. With regard to elimination., your idea should be, in the first place, to remove as far as you can those organisms which are still growing in the alimentary canal, and, in the second place, to get rid of their poisons. .... “How are you to carry out those indications in practice? “ STARVATION is easily carried out oy withholding food. You need 1 never be afraid to starve young children in the matter of solid food. It ns said that infants bear starvation badly. That may bo true of chronic under-feeding, but babies will .stand the complete withdrawal of all nourishment for two or three, or even more, -ebesrs without any disadvan •

tage, and indeed l often with great benefit, provided always that you fulfil two conditions. The- first of these is that the child is kept warm. Children stand starvation badly simply because, they lose so much heat from their surfaces, a fact which is true of all young animals. And

the second condition is that water must on no account be withheld. Children stand the withdrawal of fluid very badly indeed. So when I say that they axe to bo starved it means that they are to

be given nothing which .can bo described as nourishment, but they must have abundant liquid : and in such cases as wo speak of that may take the form _of boiled water. If the case is not doing well, you can continue starvation for two or even three days. _ As the symptoms abate you may begin to give a little nourishment in the shape of whey, but the thing which you should give last, and be most careful about giving, is casein of milk, because, that is what oces harm more than anything else.”

Memo, by Hygeia Recent German investigations tend to show further that only minute proportions of fat are permissible in infantile diarrhoea, hence great caution should be observed in advancing the fat also, for fear of bringing on a relapse. In the light of the above quotation, perhaps over-anxious mothers may lie more easily persuaded in future not to become alarmed because the humanised milk first sent out or recommended in cases of delicacy or sickness is not of the full strength. Get the baby well, and weight and growth will soon take care of themselves. STARVATION NOT STARVATION. In order to emphasise his point, Dr Hutchison uses the word STARVATION, ' though in reality what he advises has the reverse effect—except that the microbes are starved 1 by withholding curd. During the course of diarrhoea the child is worse than starved so long as he takes ordinary food, because he not only fails to absorb the material supplied, but is drained ct his own solid substance and structure. The flux brought about by irritation and poisoning' due to the fermentation and putrefaction of what would in. normal conditions serve as food (that is, would be absorbed and go to build up and increase the weight of the body) not only carries away the food introduced, bub also steals material from every tissue ef the living organism, and tends to. bring about rapid emaciation and l prostration. In the ordinary course of indigestion and diarrhoea of children extreme measures are not necessary. If tli© mother can be induced to give only water for twelve hours, so much the better for' the child; but where extreme prejudice exists we sometimes find it worse than useless- to. press the matter, though the relief and comfort of the child are obvious where the point can be carried. Curiously enough, it is often found more difficult to get a highlyeducated woman to act reasonably in such matters than on© less confident of her own knowledge, and therefore more trustful and ready to learn ; and 1 almost universally on© finds fathers much easier to convince than mothers. HOME ECONOMICS. I need scarcely point out the healing of all this on Mr Studholme’s project for the teaching of Domestic Economics! throughout the colony—that is, the teaching of girls to do well everything connected with the home, and essential in this wav for the health and happiness of themselves and those who may .com© to be associated with or dependent on thorn; and the. teaching of these thongs in a simple practical way, together -with th© interesting why and wherefore. I am, etc., F. Truby King. February 1, 1907.

Memo, by Hygeia:—l think that this last paragraph will be specially interesting >o our readers, as having been published in the Otago Daily Times nearly three years ago, whan Mr Studholmc’e scheme was under consideration by Canterbury College. It may possibly have some effect in the direction of broadening the minds of a few carping critics in the medical profession, who have done their utmost to musreprer,snt Mr Studholme’s aims, and who have left no stone unturned to prevent his_ generous and far-seeing efforts from coming to fruition. POSTCRIPT. p.S,—The above explanations .and advice afford no valid excuse to any mother for failing to call in a doctor as soon as possible. There is no disease of infancy more amenable to timely treatment than diarrhoea, and no disease more liable, to become intractable and to lead to fatal results if the right course is not promptly pursued. When Dr Hutchison insists on proper dieting being the first consideration, ar.d says, “Put not your faith in drugs,” he doe® not mean that drugs are of no importance. On the contrary, he clearly recognises the value of medicinal treatment—not merely the preliminary dose of cantor oil which most mothers ar.d nurses give, but other measures which are. special to particular cases, and in this way quite outside the scene of any general instructions. Speaking from my own experience, I should say unhesitatingly that, while the basis of’ treatment for, all cases of diarrhoea must be proper feeding, there are few cases which do not derive marked benefit from the timelv use of appropriate medicine as well. — F. T. K.