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Preventable Diseases of Children (II)

SAVE THE BABIES-HEALTH AND DISEASE-DISEASES OF THE EYES- DIGESTIVE DISTURBANCES-SOOTHING SIRUP-SYMPTOMS OF COMMUNICABLE DISEASES-INFANTILE PARALYSIS-CEREBRO- SPINAL MENINGITIS-DIPHTHERIA-SCARLET FEVER-MEASLES -CHICKENPOX-WHOOPING EASES SAVE THE BABIES A normal, well born baby is hard to kill. Nature intends that every such baby shall be well and strong, and grow to maturity. Yet the census shows that of the two and onehalf million babies born every year in the United States, one-half die before they reach their twenty-third year. One-fourth never reach their fifth birthday; one-eighth, or nearly one-third of a million, die within the first year of life. One-third of all deaths occur under the fifth year of age; one-fifth, during the first year of life. The chance of living a week is less for a new born child than for a man of ninety. The chance of living a year is less than for a man of four score.

Since the rise of the germ theory of disease, wonderful discoveries have been made by the high power microscope as to the effects of germ life upon human health. It has now been proved that a large part of the mortality among infants is due to preventable causes. Much of this death rate is due to dirt. By this is not necessarily meant uncleanliness in the ordinary sense of dirt which can be seen, but a lack of sanitary precautions in the scientific sense, resulting in dirt invisible to the naked eye but which under the microscope is seen to contain millions of COUGH-MUMPS-PARASITIC DISinjurious bacteria. The best proof of the vitality of infants is that so many do live and grow up in spite of the unsanitary conditions with which they are surrounded, and the poisonous milk and other substances they are compelled to swallow.

Now that science has shown that Save the babies. so many deaths among infants are preventable, a nation-wide campaign to save the babies has been set on foot. A special effort has been made to discover the sanitary and other rules that must be followed by mothers to keep their babies well, and cause them to thrive and grow strong. The following is a collection of these rules as laid down by the public health authorities throughout the United States. It contains the latest and most authentic scientific information obtainable.

What Kills Babies? - Out of every hundred deaths under two years of age, thirty-five are the result of improper food and feeding. About ninety-five per cent of these are avoidable. Twenty-six are due to accidents and defects at birth. About one-half are avoidable. Eighteen are caused by impure air diseases (pneumonia and bronchitis); seventy-five per cent avoidable. Two are caused by tuberculosis and six by acute contagious diseases. All of these are avoidable. The remainder are due to miscellaneous causes, many of which could be and ought to be avoided.

The two principal factors which multiply the deaths of infants are the denial of its birthright-its mother's breasts and the heat of summer. In other words, the bottle feeding of infants in warm weather is what causes the death rate to run extremely high. Ten times as many bottlefed babies succumb to diarrheal diseases as breast-fed babies. When the mother from necessity or convenience takes away the natural food of the child-her own breasts-she takes from it nine-tenths of its chance of life. Hot weather in itself has little to do with the death rate of infants from diarrhea, as breast-fed children do not show much, if any, increase of death rate during the summer months. The two factors that bring about the high death rate, namely, bottle feeding and the hot season, combine to produce a single condition, namely, milk containing a dangerous quantity of injurious bacteria or germs. When the child takes nourishment from its mother's breast it gets a practically sterile or germfree food. When it is fed modified cow's milk or other artificial food from a bottle, especially in hot weather, it may be, and often is, swallowing a quick or slow poison.

This, however, is wholly preventable if proper sanitary precautions to insure strict scientific, cleanliness are observed.

HEALTH AND DISEASE Fontanelles. - In the middle line from before backwards on the top of a baby's head in the early weeks of his life, are two openings or soft places not yet covered with bony formation. The one in front is called the "anterior fontanelle." This closes in five or six weeks. But the larger one, just back of the forehead, is usually not closed until the child is a year and a half old or a little older.

If widely open as the time for closure approaches, or if the closure is much delayed, it may indicate rickets or other serious diseased condition.

In such cases the advice of the family physician should be had. Respiration. - Trustworthy information about respiration, pulse and temperature are a great help in judging when to send for the doctor. The normal standards are given below.

But remember that the action of a baby's lungs and heart is quickly accelerated by exercise or by excitement. And respiration, pulse and temperature are often much affected by causes which are comparatively Both the pulse-rate and respiration are more regular and slower in sleep than while awake.

There is a progressive decrease in the rapidity of the pulse and respiration from infancy to adult life. trivial.

Approximately, the number of respirations per minute at different ages are:

At birth, 35 or more 66 1 year, 27 66 " 6 " 22 " 12 " 20 2 years, 25 In adult life, 15 to 17 In serious illness, as, for instance, in pneumonia, young children may breathe as rapidly as 60 to 80 times in the minute.

Pulse. The rate of the pulse in health at different ages is:

PREVENTABLE DISEASES OF CHILDREN In the first month, 120 to 140 110 to 120 At 1 year, " 2 years, 66 6 66 66 12 66 In adult life, 100 to 110 90 to 95 80 to 88 72 or lower.

These are the rates while at rest.

During infancy a rise of twenty, thirty or more beats per minute is not uncommon as the result of slight effort or disturbance. In the serious acute diseases, as in scarlet fever or pneumonia, the pulse may run to 160, 180, or higher.

Temperature. A training in motherhood should include the use of the clinical thermometer so that correct observations on the temperature and its variations may reveal indications of the approach of serious conditions.

Buy a good clinical thermometer at your drug store. Or ask your physician to get one for you and explain to you how to use it.

The normal temperature of the human body is about 98° F. In early infancy, it is slightly higher than from later childhood on. The temperature of 100° indicates the presence of fever; 102° to 103° constitutes moderate fever; 104° to 105° shows a high fever; above 105° means a very high and very dangerous fever.

DISEASES OF THE EYES Ophthalmia Neonatorum (Infantile Blindness). - About 15 per cent of all cases of total blindness are caused by inflammation of the eyes in new-born babies. This disease is always due to an infection entering the eyes of the baby at the time of, or shortly after birth. It may be almost always prevented by proper care and by early and correct treatment. If precautions are not taken, and the disease develops and runs its course unchecked, the sight is totally destroyed, often within a fortnight. For All Mothers. -All women during pregnancy should thoroughly perform daily external cleansing with soap and water and a clean wash cloth. Should the pregnant woman have any irritating discharges, or even profuse white discharge, she should be instructed to immediately consult her physician or the nearest dispensary.

For All Children. - Immediately after the delivery of the head, and before the delivery of the body, the eyelids should be carefully cleaned by means of absorbent cotton or a soft linen cloth, dipped into warm water that has been boiled or boric acid (saturated) solution. A separate cloth should be used for each eye, and the lids washed, from the nose outward, free from all mucus, blood or discharges. All wipes should be burned after using. No opening of the lids should be attempted. At this time also the lips and nose should be wiped free of mucus in like manner, and the little finger, wrapped with a piece of moist linen, should be passed into the child's mouth and any accumulated mucus removed by an outward sweep of the finger. As soon after birth as possible, the eyelids should be again wiped clean of mucus, and two drops of a one per cent solution of nitrate of silver should be dropped into each eye. One application only of the silver solution should be made.

Ordinarily no further attention should be given the eyes for several hours.

The silver nitrate solution is best kept in a dark-colored bottle with a ground glass stopper. The neck of the bottle should measure about half an inch in diameter. The glass rod used is six inches long, very smooth and round at each end. The silver solution will keep for many months, but it is best to renew it about once in six weeks.

Each time that the child is bathed, the eyes should be first wiped clean, as above described, with the boric acid solution. The hands of the person charged with the care of the child must be washed with soap and dried with a clean towel before the eyes of the child are touched. Every- : thing that is brought near the eyes must be, in every instance, absolutely clean.

The cotton that is used on the eyes of the child must, in every instance, be immediately burned after using.

The water, towels, old linen and the cotton that have been used on the mother must, under no circumstances, be applied to the child. The air of the bedroom must be kept as pure as possible, and the linen should never be dried in the sick room.

Inflammation of the Eyes.-Should the lids become red and swollen, or gummed along their borders, or should a mattery discharge be mixed with the tears as the child sleeps or cries, call an oculist or a physician. immediately, or take the child to the nearest dispensary. Each hour of delay adds to the danger. While waiting, bathe the child's eyes every half hour with pledgets of cotton dipped in a warm solution of boric acid. Open the lids wide and allow the warm solution to flood the eyes and wash out any matter which may have gathered there.

All of those in the home should be warned of the danger of catching the disease by getting the matter into their own eyes. Do not fondle the child. Take care that nothing which has been used about its eyes or face shall be used for any other purpose.

Do not listen to those who say it will amount to nothing, or to those who say to bathe the eyes of the child with the mother's milk. Such advice is bad. The milk is a means of spreading the germs of this disease.

The slightest delay may result in blindness.

Trachoma.- This is an infectious disease of the eyelids which often results in total blindness. It occurs chiefly among children who are brought up under unsanitary conditions. Contributory causes are lack of cleanliness and lack of proper nourishment. It may be communicated from one person to another by the use of a common towel, by interchanging or lending handkerchiefs, or by the contact of infected hands among children at play. This disease is most prevalent among school children and in institutions, work-shops, army camps and other places where large numbers of persons are herded together and toilet or other facilities are used in common.

Any symptoms of redness, or inflammation of the eyes, or granulation of the eyelids should be brought to the attention of a physician, especially if accompanied by pain, sensitiveness to light, swelling or discharge. About 15 per cent of all cases of preventable blindness are due to this disease. Diligent effort should be made to prevent it from spreading.

When a case occurs, all possibility of the infection of other persons should be eliminated. The patient should have separate towels, wash basins and the like set apart for individual use.

Children with this disease should be excluded from the public schools until the acute stage is over. Under proper treatment, if taken in its early stages, blindness can ordinarily be prevented.