OUR BABIES.

Gisborne Times, Volume XXVIII, Issue 2716, 22 January 1910, Page 4 (Supplement)

OUR BABIES.

(By “Hygeia.”)

Published under the auspices of the Society for the Promotion of the Health of Women and Children.

SUADMER DIARRHOEA

Every summer brings to babies a special curse in the lor.m of virulent diarrhoea, which kills many and 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 bottle-fed, and 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 the “Otago Daily Times” nearly three years ago (February 2, 1907), should prove enlightening and helpful. The summer season of 1307 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 putrefaction taking place in the contents of the intestines. Tlio obvious remedy is, first, to clear the bowels of offensive material; then to give only such food 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. Howeve r simple and obvious tliec-e principles may seem, the difficulty of getting them 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 one can scarcely bring to realise that there .may be more real solid food in a pint of perfectly clear, colorless solution that looks like pure water than is contained in a pint of new milk. How many women realise that when you have skimmed the cream off milk the skim milk which remains still contains more than twothirds of the solid nutrient constituents of new liiilk; or, again, how many realise that a pint of skim milk contains as much solid food as half a pound of beef steak? Not only is there absolute ignorance of such essential, matters, hut 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 the 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, ic is equally difficult to persuade the mother to be guided by knowledge and reason. In connection with the ordinary supply of humanised milk, we are constantly met with tlie desire of women to unreasonably add something to an already complete food. The mother asks for another tablespoonful or ounce of cream, quite ignorant of the fact that if her request bo complied with tlie fat will bo raised to 6 or more per cent., and will almost certainly upset digestior.. Human milk contains only 4 per cent, of fat, and that in a more easily-digested form than the fat of cows’ milk, hence the percentage of fat in humanised milk should be kept lower rather than higher. The general tendency cf mothers and nurses is to overfeed babies. One cannot too strongly impress the fact that irritable hunger and ravenousness are generally duo to indiges tion induced by giving too much or too strong food, 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-pnblislied lectures on “Diseases of Children,” by Robert ■Hutchison, of the London Hospital and the Great Ormond Street Hospital for Sick Childrefi, may help to bring home conviction to those of much ignorance and little faith. Dr Hutchison is recognised as a leading authority of the clay bn dietetics, and has made exhaustive analysis and practical trials of foods for infants. He says when dealing with tlie 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 ELIAIINATION. 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 j*ou 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 such cases is actually poisonous. In a case 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, ahd, in the second place, to get rid of their poisons. “How are you tq carry out those indications in practice? “STARVATION is easily carried out by withholding food. You need never be afraid to starve young children in .the matter of solid food. It is said that infants hoar starvation badly. That may be true o.f chronic underfeeding, but babies nvill stand the complete withdrawal of all ; nourishment for two or three, or even more, days without, any disadvantage, and indeed often with groat 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 wa-

ter must on no account be withhold. Children stand the withdrawal of fluid very badly indeed. So when I say that they are to bo starved it means that they are to be given nothing which can bo described as nourishment, hut they must have abundant liquid; and in such cases as we 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 throe 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 the casein of milk, because' that is what does harm more than anything else.” * Memo, by Hygeia : —Recent Gorman 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 be 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 wliat he advises has tlie reverse effect—except that tl )e microbes are starved by withholding curd. During tlio course of diarrhoea the child is worse thf. ■: starved re long as lie takes ordinary food, because lie not only fails to’ absorb the material supplied, but is drained of his own solid substance and structure. The ilux brought about by irritation and poisoning due to the fermentation and putrefaction of what would in. normal conditions serve as food (that is, would bo absorbed and go to build up and increase the weight of the body) not only carries away the food introduced, but also steals material from every tissue of the living organism, and tends to bring about rapid emaciation and prostration. In the ordinary course of indigestion and diarrhoea of children extreme measures are not necessary. Ii : the mother can ho induced to give only water for twelve hours, so much the batter for the child; but where extreme prejudice exists wo sometimes find it worse than useless to 'press the matter, though the relief and comfort of the child are obvious where tlie point can be carried. Curiously enough it is often found more difficult to get a liighlj'-educated women to act reasonably in such matters than one less confident of her own knowledge, and. therefore more trustful and ready to learn ; and almost universally one finds fathers much easier to convince than mothers. HOME ECONOMICS. I need scarcely point out the bearing of all this on Mr Studholme’s project for the teaching of Domestic Economics throughout tlie colony—that is, the teaching of girls to do well everything connected with the homo, and essential in this way for the health and happiness of themselves and those who may come to lie associated with or dependent on-them; and the teaching of these things in a simple jnractical way, together <with the interesting why and wherefore.—l am, etc., F. TRUUY KING. February 1, 1907. Memo, by Hygeia:—l think that this last paragraph will be specially interesting to our readers, as having been published in th e “Otago Daily Times” nearly three years ago, when Mr Studholme’s 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 misrepresent Air Studholme’s aims, and who have left no stone unturned to prevent • Ills generous and far-seeing efforts from coming to fruition. POSTCRIPT. P.S. —The above explanations and advice afford no valid excuse to anj* 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, and says, “Put not. your faith in drugs,” lie does 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 castor oil which most mothers and nurses give ? but other measures which arc special to particular cases, and in this way quite outside the scope 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 oases which do not derive marked benefit from the timely use of appropriate medicine as well.—F.T.K.