OUR BABIES

Te Awamutu Courier, Volume 62, Issue 4403, 17 March 1941, Page 8

OUR BABIES

“Hygeia.”)

(By “

Published under the auspices of the Royal New Zealand Society for the Health of Women and Children.— Plunket Society.

(“ It is wiser to put up a fence a* the top of the precipice than to main, tain an ambulance at the bottom.”)

SMALL BABIES AND PREMATURES.

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 guarded. These small babies 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 thusf 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. PREMATURE BABIES. Babies born before their time and classified as “ prematures ” generally weigh less than five and a half lbs. Those who weigh less than two lbs 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 born 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 un in the body at the time of birth and want of heatregulating 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 bfown 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 child-birth, because many a new-born babv would benefit greatly by the iir,(mediate 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 norma 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 m,uslin 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 1 napkin is changed the buttocks and adjacent, parts should be cleansed, with warm olive oil.

The baby should be re-oiled every other day. It is not advisable to sponge until a normal temperature 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 weigh 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 filled nlfernatnlv one each

hour, should be placed one at each side underneath the outer blanket and the third between the chaff shakedown 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 degrees, 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 allowed to fall appreciably below 95 degrees Fahr. A fairly constant temperature of 93 to 99 degrees Fahr, (with an extreme range of 97 to 100 degrees) is the ideal, and this can be assured b" reasonable vigilance. No greater fluctuation should take place, especially no fall below 97 degrees The wider the ranve the greater the strain on the organism. Next week we will discuss the feeding of the premature baby.