Healthy Child Care

Disorder of the stomach and bowels is one of the most fruitful sources of the diseases of infancy. Only prevent their derangement, and, all things being equal, the infant will be healthy and flourish, and need not the aid of physic or physicians.

There are many causes which may give rise to these affections; many of them appertain to the mother's system, some to that of the infant. All are capable, to a great extent, of being prevented or remedied. It is, therefore, most important that a mother should not be ignorant or misinformed upon this subject. It is the prevention of these affections, however, that will be principally dwelt upon here; for let the mother ever bear in mind, and act upon the principle, that the prevention of disease alone belongs to her; the cure to the physician. For the sake of clearness and reference, these disorders will be spoken of as they occur:

To the infant at the breast.
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The infant's stomach and bowels may become deranged from the breast-milk becoming unwholesome. This may arise from the parent getting out of health, a circumstance which will be so manifest to herself, and to those more immediately interested in her welfare, that it is only necessary just to allude to it here. Suffice it to say, that there are many causes of a general kind to which it may owe its origin; but that the most frequent is undue lactation, and the effects both upon mother and child fully dwelt upon.

Anxiety of mind in the mother will cause her milk to be unhealthy in its character, and deficient in quantity, giving rise to flatulence, griping, and sometimes even convulsions in the infant. A fit of passion in the nurse will frequently be followed by a fit of bowel complain in the child. These causes of course are temporary, and when removed the milk becomes a healthy and sufficient for the child as before.

Sudden and great mental disturbance, however, will occasionally drive away the milk altogether, and in a few hours. A Mrs. S., aet. 29, a fine healthy woman, of a blonde complexion, was confined of a boy. She had a good time, and a plentiful supply of milk for the child, which she continued to suckle till the following January, a period of three months, when her milk suddenly disappeared. This circumstance puzzled the medical attendant, for he could not trace it to any physical ailment; but the milk never returned, and a wet-nurse became necessary. In the following spring the husband of this lady failed, an adversity which had been impending since the date when the breast-milk disappeared, upon which day the deranged state of the husband's affairs was made known to the wife, a fact which at once explained the mysterious disappearance of the milk.

Unwholesome articles of diet will affect the mother's milk, and derange the infant's bowels. Once, I was called to see an infant at the breast with diarrhoea. The remedial measures had but little effect so long as the infant was allowed the breast-milk; but this being discontinued, and arrow-root made with water only allowed, the complaint was quickly put a stop to. Believing that the mother's milk was impaired from some accidental cause which might now be passed, the infant was again allowed the breast. In less than four-and-twenty hours, however, the diarrhoea returned. The mother being a very healthy woman, it was suspected that some unwholesome article in her diet might be the cause. The regimen was accordingly carefully inquired into, when it appeared that porter from a neighbouring publican's had been substituted for their own for some little time past. This proved to be bad, throwing down, when left to stand a few hours, a considerable sediment; it was discontinued; good sound ale taken instead; the infant again put to the breast, upon the milk of which it flourished, and never had another attack.

In the same way aperient medicine, taken by the mother, will act on the child's bowels, through the effect which it produces upon her milk. This, however, is not the case with all kinds of purgative medicine, nor does the same purgative produce a like effect upon all children. It is well, therefore, for a parent to notice what aperient acts thus through her system upon that of her child, and what does not, and when an aperient becomes necessary for herself, unless she desire that the infant's bowels be moved, to avoid the latter; if otherwise, she may take the former with good effect.

Again; the return of the monthly periods whilst the mother is a nurse always affects the properties of the milk, more or less, deranging the stomach and bowels of the infant. It will thus frequently happen, that a few days before the mother is going to be unwell, the infant will become fretful and uneasy; its stomach will throw up the milk, and its motions will be frequent, watery, and greenish. And then, when the period is fully over, the milk will cease to purge. It is principally in the early months, however, that the infant seems to be affected by this circumstance; for it will be generally found that although the milk is certainly impaired by it, being less abundant and nutritious, still, after the third or fourth month it ceases to affect the infant. Is then a mother, because her monthly periods return after her delivery, to give up nursing? Certainly not, unless the infant's health is seriously affected by it; for she will generally find that, as the periods come round, by keeping the infant pretty much from the breast, during its continuance, and feeding him upon artificial food, she will prevent disorder of the child's health, and be able in the intervals to nurse her infant with advantage. It must be added, however, that a wet- nurse is to be resorted to rather than any risk incurred of injuring the child's health; and that, in every case, partial feeding will be necessary at a much earlier period than when a mother is not thus affected.

The milk may also be rendered less nutritive, and diminished in quantity, by the mother again becoming pregnant. In this case, however, the parent's health will chiefly suffer, if she persevere in nursing; this, however, will again act prejudicially to the child. It will be wise, therefore, if pregnancy should occur, and the milk disagree with the infant, to resign the duties of a nurse, and to put the child upon a suitable artificial diet.

The infant that is constantly at the breast will always be suffering, more or less, from flatulence, griping, looseness of the bowels, and vomiting. This is caused by a sufficient interval not being allowed between the meals for digestion. The milk, therefore, passes on from the stomach into the bowels undigested, and the effects just alluded to follow. Time must not only be given for the proper digestion of the milk, but the stomach itself must be allowed a season of repose. This evil, then, must be avoided most carefully by the mother strictly adhering to those rules for nursing.

The bowels of the infant at the breast, as well as after it is weaned, are generally affected by teething. And it is fortunate that this is the case, for it prevents more serious affections. Indeed, the diarrhoea that occurs during dentition, except it be violent, must not be subdued; if, however, this is the case, attention must be paid to it. It will generally be found to be accompanied by a swollen gum; the freely lancing of which will sometimes alone put a stop to the looseness: further medical aid may, however, be necessary.



At the period of weaning.
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There is great susceptibility to derangements of the stomach and bowels of the child at the period when weaning ordinarily takes place, so that great care and judgment must be exercised in effecting this object. Usually, however, the bowels are deranged during this process from one of these causes; from weaning too early, from effecting it too suddenly and abruptly, or from over-feeding and the use of improper and unsuitable food. There is another cause which also may give rise to diarrhoea at this time, independently of weaning, viz. the irritation of difficult teething.

The substitution of artificial food for the breast-milk of the mother, at a period when the digestive organs of the infant are too delicate for this change, is a frequent source of the affections now under consideration.

The attempt to wean a delicate child, for instance, when only six months old, will inevitably be followed by disorder of the stomach and bowels. Unless, therefore, a mother is obliged to resort to this measure, from becoming pregnant, or any other unavoidable cause, if she consult the welfare of her child, she will not give up nursing at this early period.

Depriving the child at once of the breast, and substituting artificial food, however proper under due regulations such food may be, will invariably cause bowel complaints. Certain rules and regulations must be adopted to effect weaning safely, the details of which are given elsewhere.

If too large a quantity of food is given at each meal, or the meals are too frequently repeated, in both instances the stomach will become oppressed, wearied, and deranged; part of the food, perhaps, thrown up by vomiting, whilst the remainder, not having undergone the digestive process, will pass on into the bowels, irritate its delicate lining membrane, and produce flatulence, with griping, purging, and perhaps convulsions.

Then, again, improper and unsuitable food will be followed by precisely the same effects; and unless a judicious alteration be quickly made, remedies will not only have no influence over the disease, but the cause being continued, the disease will become most seriously aggravated.

It is, therefore, of the first importance to the well-doing of the child, that at this period, when the mother is about to substitute an artificial food for that of her own breast, she should first ascertain what kind of food suits the child best, and then the precise quantity which nature demands. Many cases might be cited, where children have never had a prescription written for them, simply because, these points having been attended to, their diet has been managed with judgment and care; whilst, on the other hand, others might be referred to, whose life has been hazarded, and all but lost, simply from injudicious dietetic management. Over-feeding, and improper articles of food, are more frequently productive, in their result, of anxious hours and distressing scenes to the parent, and of danger and loss of life to the child, than almost any other causes.

The irritation caused by difficult teething may give rise to diarrhoea at the period when the infant is weaned, independently of the weaning itself. Such disorder of the bowels, if it manifestly occur from this cause, is a favourable circumstance, and should not be interfered with, unless indeed the attack be severe and aggravated, when medical aid becomes necessary. Slight diarrhoea then, during weaning, when it is fairly traceable to the cutting of a tooth (the heated and inflamed state of the gum will at once point to this as the source of the derangement), is of no consequence, but it must not be mistaken for disorder arising from other causes. Lancing the gum will at once, then, remove the cause, and generally cure the bowel complaint.

The especial province of the mother is the prevention of disease, not its cure. When disease attacks the child, the mother has then a part to perform, which it is especially important during the epochs of infancy and childhood should be done well. I refer to those duties which constitute the maternal part of the management of disease.

Medical treatment, for its successful issue, is greatly dependent upon a careful, pains-taking, and judicious maternal superintendence. No medical treatment can avail at any time, if directions be only partially carried out, or be negligently attended to; and will most assuredly fail altogether, if counteracted by the erroneous prejudices of ignorant attendants. But to the affections of infancy and childhood, this remark applies with great force; since, at this period, disease is generally so sudden in its assaults, and rapid in its progress, that unless the measures prescribed are rigidly and promptly administered, their exhibition is soon rendered altogether fruitless.

The amount of suffering, too, may be greatly lessened by the thoughtful and discerning attentions of the mother. The wants and necessities of the young child must be anticipated; the fretfulness produced by disease, soothed by kind and affectionate persuasion; and the possibility of the sick and sensitive child being exposed to harsh and ungentle conduct, carefully provided against.

Again, not only is a firm and strict compliance with medical directions in the administration of remedies, of regimen, and general measures, necessary, but an unbiased, faithful, and full report of symptoms to the physician, when he visits his little patient, is of the first importance. An ignorant servant or nurse, unless great caution be exercised by the medical attendant, may, by an unintentional but erroneous report of symptoms, produce a very wrong impression upon his mind, as to the actual state of the disease. His judgment may, as a consequence, be biased in a wrong direction, and the result prove seriously injurious to the welldoing of the patient. The medical man cannot sit hour after hour watching symptoms; hence the great importance of their being faithfully reported. This can alone be done by the mother, or some person equally competent.

There are other weighty considerations which might be adduced here, proving how much depends upon efficient maternal management in the time of sickness; but they will be severally dwelt upon, when the diseases with which they are more particularly connected are spoken of.

It is highly important that a mother should possess such information as will enable her to detect disease at its first appearance, and thus insure for her child timely medical assistance. This knowledge it will not be difficult for her to obtain. She has only to bear in mind what are the indications which constitute health, and she will at once see that all deviations from it must denote the presence of disorder, if not of actual disease. With these changes she must to a certain extent make herself acquainted.

Signs of health.
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The signs of health are to be found, first, in the healthy performance of the various functions of the body; the regular demands made for its supply, neither in excess or deficiency; and a similar regularity in its excretions both in quantity and appearance.

If the figure of the healthy infant is observed, something may be learnt from this. There will be perceived such an universal roundness in all parts of the child's body, that there is no such thing as an angle to be found in the whole figure; whether the limbs are bent or straight, every line forms a portion of a circle. The limbs will feel firm and solid, and unless they are bent, the joints cannot be discovered.

The tongue, even in health, is always white, but it will be free from sores, the skin cool, the eye bright, the complexion clear, the head cool, and the abdomen not projecting too far, the breathing regular, and without effort.

When awake, the infant will be cheerful and sprightly, and, loving to be played with, will often break out into its merry, happy, laugh; whilst, on the other hand, when asleep, it will appear calm, every feature composed, its countenance displaying an expression of happiness, and frequently, perhaps, lit up with a smile.

Just in proportion as the above appearances are present and entire, health may be said to exist; and just in proportion to their partial or total absence disease will have usurped its place.

We will, however, for the sake of clearness examine the signs of disease as they are manifested separately by the countenance, the gestures, in sleep, in the stools, and by the breathing and cough.

Of the countenance.
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In health the countenance of a thild is expressive of serenity in mind and body; but if the child be unwell, this expression will be changed, and in a manner which, to a certain extent, will indicate what part of the system is at fault.

The brows will be contracted, if there is pain, and its seat is in the head. This is frequently the very first outward sign of any thing being wrong, and will occur at the very onset of disease; if therefore remarked at an early period, and proper remedies used, its notice may prevent one of the most fearful of infantile complaints "Water in the Head."

If this sign is passed by unheeded, and the above disease be threatened, soon the eyes will become fixed and staring, the head hot, and moved uneasily from side to side upon the pillow, or lie heavily upon the nurse's arm, the child will start in its sleep, grinding its teeth, and awake alarmed and screaming, its face will be flushed, particularly the cheeks (as if rouged), its hands hot, but feet cold, its bowels obstinately costive, or its motions scanty, dark-coloured, and foul.

If the lips are drawn apart, so as to show the teeth or gums, the seat of the pain is in the belly. This sign, however, will only be present during the actual existence of suffering; if, therefore, there be any doubt whether it exist, press upon the stomach, and watch the eifect on the expression of the countenance.

If the pain arise simply from irritation of the bowels excited from indigestion, it will be temporary, and the sign will go and come just as the spasm may occur, and slight remedial measures will give relief.

If, however, the disease be more serious, and inflammation ensue, this sign will be more constantly present, and soon the countenance will become pale, or sallow and sunken, the child will dread motion, and lie upon its back with the knees bent up to the belly, the tongue will be loaded, and in breathing, while the chest will be seen to heave with more than usual effort, the muscles of the belly will remain perfectly quiescent.

If the nostrils are drawn upwards and in quick motion, pain exists in the chest. This sign, however, will generally be the accompaniment of inflammation of the chest, in which case the countenance will be discoloured, the eyes more or less staring, and the breathing will be difficult and hurried; and if the child's mode of respiring be watched, the chest will be observed to be unmoved, while the belly quickly heaves with every inspiration.

Convulsions are generally preceded by some changes in the countenance. The upper lip will be drawn up, and is occasionally bluish or livid. Then there may be slight squinting, or a singular rotation of the eye upon its own axis; alternate flushing or paleness of the face; and sudden animation followed by languor.

These signs will sometimes manifest themselves many hours, nay days, before the attack occurs; may be looked upon as premonitory; and if timely noticed, and suitable medical aid resorted to, the occurrence of a fit may be altogether prevented.

The state of the eyes should always be attended to. In health they are clear and bright, but in disease they become dull, and give a heavy appearance to the countenance; though after long continued irritation they will assume a degree of quickness which is very remarkable, and a sort of pearly brightness which is better known from observation than it can be from description.

The direction of the eyes, too, should be regarded, for from this we may learn something. When the infant is first brought to the light, both eyes are scarcely ever directed to the same object: this occurs without any tendency to disease, and merely proves, that regarding one object with both eyes is only an acquired habit. But when the child has come to that age when the eyes are by habit directed to the same object, and afterwards it loses that power, this circumstance alone may be looked upon as a frequent prelude to disease affecting the head.

Of the gestures.
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The gestures of a healthy child are all easy and natural; but in sickness those deviations occur, which alone will often denote the nature of the disease.

Suppose an infant to have acquired the power to support itself, to hold its head erect; let sickness come, its head will droop immediately, and this power will be lost, only to be regained with the return of health; and during the interval every posture and movement will be that of languor.

The little one that has just taught itself to run alone from chair to chair, having two or three teeth pressing upon and irritating the gums, will for a time be completely taken off its feet, and perhaps lie languidly in its cot, or on its nurse's arm.

The legs being drawn up to the belly, and accompanied by crying, are proofs of disorder and pain in the bowels. Press upon this part, and your pressure will increase the pain. Look to the secretions from the bowels themselves, and by their unhealthy character your suspicions, in reference to the seat of the disorder, are at once confirmed.

The hands of a child in health are rarely carried above its mouth; but let there be any thing wrong about the head and pain present, and the little one's hands will be constantly raised to the head and face.

Sudden starting when awake, as also during sleep, though it occur from trifling causes, should never be disregarded. It is frequently connected with approaching disorder of the brain. It may forebode a convulsive fit, and such suspicion is confirmed, if you find the thumb of the child drawn in and firmly pressed upon the palm, with the fingers so compressed upon it, that the hand cannot be forced open without difficulty. The same condition will exist in the toes, but not to so great a degree; there may also be a puffy state of the back of the hands and feet, and both foot and wrist bent downwards.

There are other and milder signs threatening convulsions and connected with gesture, which should be regarded: the head being drawn rigidly backwards, an arm fixed firmly to the side, or near to it, as also one of the legs drawn stifly upwards. These signs, as also those enumerated above, are confirmed beyond all doubt, if there be present certain alterations in the usual habits of the child: if the sleep is disturbed, if there be frequent fits of crying, great peevishness of temper, the countenance alternately flushed and pale, sudden animation followed by as sudden a fit of languor, catchings of the breath followed by a long and deep inspiration, all so many premonitory symptoms of an approaching attack.

Of the sleep.
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The sleep of the infant in health is quiet, composed, and refreshing. In very early infancy, when not at the breast, it is for the most part asleep in its cot; and although as the months advance it sleeps less, yet when the hour for repose arrives, the child is no sooner laid down to rest, than it drops off into a quiet, peaceful slumber.

Not so, if ill. Frequently it will be unwilling to be put into its cot at all, and the nurse will be obliged to take the infant in her arms; it will then sleep but for a short time, and in a restless and disturbed manner.

If it suffer pain, however slight, the countenance will indicate it; and, as when awake, so now, if there is any thing wrong about the head, the contraction of the eye-brow and grinding of the teeth will appear; if any thing wrong about the belly, the lips will be drawn apart, showing the teeth or gums, and in both instances there will be great restlessness and frequent startings.

Of the stools.
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In the new-born infant the motions are dark coloured, very much like pitch both in consistence and appearance. The first milk, however, secreted in the mother's breast, acts as an aperient upon the infant's bowels, and thus in about four-and-twenty hours it is cleansed away.

From this time, and through the whole of infancy, the stools will be of a lightish yellow colour, the consistence of thin mustard, having little smell, smooth in appearance, and therefore free from lumps or white curded matter, and passed without pain or any considerable quantity of wind. And as long as the child is in health, it will have daily two or three, or even four, of these evacuations. But as it grows older, they will not be quite so frequent; they will become darker in colour, and more solid, though not so much so as in the adult.

Any deviation, then, from the above characters, is of course a sign of something wrong; and as a deranged condition of the bowels is frequently the first indication we have of coming disease, the nurse should daily be directed to watch the evacuations. Their appearance, colour, and the manner in which discharged, are the points principally to be looked to. If the stools have a very curdy appearance, or are too liquid, or green, or dark-coloured, or smell badly, they are unnatural. And in reference to the manner in which they are discharged, it should be borne in mind, that, in a healthy child, the motion is passed with but little wind, and as if squeezed out, but in disease, it will be thrown out with considerable force, which is a sign of great irritation. The number, too, of stools passed within the four-and- twenty hours it is important to note, so that if the child does not have its accustomed relief, (and it must not be forgotten that children, although in perfect health, differ as to the precise number,)

Of the breathing and cough
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The breathing of a child in health is formed of equal inspirations and expirations, and it breathes quietly, regularly, inaudibly, and without effort. But let inflammation of the air-tubes or lungs take place, and the inspiration will become in a few hours so quickened and hurried, and perhaps audible, that the attention has only to be directed to the circumstance to be at once perceived.

Now all changes which occur in the breathing from its healthy standard, however slight the shades of difference may be, it is most important should be noticed early. For many of the complaints in the chest, although very formidable in their character, if only seen early by the medical man, may be arrested in their progress; but otherwise, may be beyond the control of art. A parent, therefore, should make herself familiar with the breathing of her child in health, and she will readily mark any change which may arise.

Whenever a child has the symptoms of a common cold, attended by hoarseness and a rough cough, always look upon it with suspicion, and never neglect seeking a medical opinion. Hoarseness does not usually attend a common cold in the child, and these symptoms may be premonitory of an attack of "croup;" a disease excessively rapid in its progress, and which, from the importance of the parts affected, carrying on, as they do, a function indispensably necessary to life, requires the most prompt and decided treatment.

The following observations of Dr. Cheyne are so strikingly illustrative, and so pertinent to my present purpose, that I cannot refrain inserting them: "In the approach of an attack of croup, which almost always takes place in the evening, probably of a day during which the child has been exposed to the weather, and often after catarrhal symptoms have existed for several days, he may be observed to be excited, in variable spirits, more ready than usual to laugh than to cry, a little flushed, occasionally coughing, the sound of the cough being rough, like that which attends the catarrhal stage of the measles. More generally, however, the patient has been for some time in bed and asleep, before the nature of the disease with which he is threatened is apparent; then, perhaps, without waking, he gives a very unusual cough, well known to any one who has witnessed an attack of the croup; it rings as if the child had coughed through a brazen trumpet; it is truly a tussis clangosa; it penetrates the walls and floor of the apartment, and startles the experienced mother, 'Oh! I am afraid our child is taking the croup!' She runs to the nursery, finds her child sleeping softly, and hopes she may be mistaken. But remaining to tend him, before long the ringing cough, a single cough, is repeated again and again; the patient is roused, and then a new symptom is remarked; the sound of his voice is changed; puling, and as if the throat were swelled, it corresponds with the cough," etc.

How important that a mother should be acquainted with the above signs of one of the most terrific complaints to which childhood is subject; for, if she only send for medical assistance during its first stage, the treatment will be almost invariably successful; whereas, if this "golden opportunity" is lost, this disease will seldom yield to the influence of measures, however wisely chosen or perseveringly employed.

From the first moment the infant is applied to the breast, it must be nursed upon a certain plan. This is necessary to the well-doing of the child, and will contribute essentially to preserve the health of the parent, who will thus be rendered a good nurse, and her duty at the same time will become a pleasure.

This implies, however, a careful attention on the part of the mother to her own health; for that of her child is essentially dependent upon it. Healthy, nourishing, and digestible milk can be procured only from a healthy parent; and it is against common sense to expect that, if a mother impairs her health and digestion by improper diet, neglect of exercise, and impure air, she can, nevertheless, provide as wholesome and uncontaminated a fluid for her child, as if she were diligently attentive to these important points. Every instance of indisposition in the nurse is liable to affect the infant.

And this leads me to observe, that it is a common mistake to suppose that, because a woman is nursing, she ought therefore to live very fully, and to add an allowance of wine, porter, or other fermented liquor, to her usual diet. The only result of this plan is, to cause an unnatural degree of fulness in the system, which places the nurse on the brink of disease, and which of itself frequently puts a stop to the secretion of the milk, instead of increasing it. The right plan of proceeding is plain enough; only let attention be paid to the ordinary laws of health, and the mother, if she have a sound constitution, will make a better nurse than by any foolish deviation founded on ignorance and caprice.

The following case proves the correctness of this statement:

A young lady, confined with her first child, left the lying-in room at the expiration of the third week, a good nurse, and in perfect health. She had had some slight trouble with her nipples, but this was soon overcome.

The porter system was now commenced, and from a pint to a pint and a half of this beverage was taken in the four and twenty hours. This was resorted to, not because there was any deficiency in the supply of milk, for it was ample, and the infant thriving upon it; but because, having become a nurse, she was told that it was usual and necessary, and that without it her milk and strength would ere long fail.

After this plan had been followed for a few days, the mother became drowsy and disposed to sleep in the daytime; and headach, thirst, a hot skin, in fact, fever supervened; the milk diminished in quantity, and, for the first time, the stomach and bowels of the infant became disordered. The porter was ordered to be left off; remedial measures were prescribed; and all symptoms, both in parent and child, were after a while removed, and health restored.

Having been accustomed, prior to becoming a mother, to take a glass or two of wine, and occasionally a tumbler of table beer, she was advised to follow precisely her former dietetic plan, but with the addition of half a pint of barley-milk morning and night. Both parent and child continued in excellent health during the remaining period of suckling, and the latter did not taste artificial food until the ninth month, the parent's milk being all-sufficient for its wants.

No one can doubt that the porter was in this case the source of the mischief. The patient had gone into the lying-in-room in full health, had had a good time, and came out from her chamber (comparatively) as strong as she entered it. Her constitution had not been previously worn down by repeated child-bearing and nursing, she had an ample supply of milk, and was fully capable, therefore, of performing the duties which now devolved upon her, without resorting to any unusual stimulant or support. Her previous habits were totally at variance with the plan which was adopted; her system became too full, disease was produced, and the result experienced was nothing more than what might be expected.

The plan to be followed for the first six months. Until the breast- milk is fully established, which may not be until the second or third day subsequent to delivery (almost invariably so in a first confinement), the infant must be fed upon a little thin gruel, or upon one third water and two thirds milk, sweetened with loaf sugar.

After this time it must obtain its nourishment from the breast alone, and for a week or ten days the appetite of the infant must be the mother's guide, as to the frequency in offering the breast. The stomach at birth is feeble, and as yet unaccustomed to food; its wants, therefore, are easily satisfied, but they are frequently renewed. An interval, however, sufficient for digesting the little swallowed, is obtained before the appetite again revives, and a fresh supply is demanded.

At the expiration of a week or so it is essentially necessary, and with some children this may be done with safety from the first day of suckling, to nurse the infant at regular intervals of three or four hours, day and night. This allows sufficient time for each meal to be digested, and tends to keep the bowels of the child in order. Such regularity, moreover, will do much to obviate fretfulness, and that constant cry, which seems as if it could be allayed only by constantly putting the child to the breast. A young mother very frequently runs into a serious error in this particular, considering every expression of uneasiness as an indication of appetite, and whenever the infant cries offering it the breast, although ten minutes may not have elapsed since its last meal. This is an injurious and even dangerous practice, for, by overloading the stomach, the food remains undigested, the child's bowels are always out of order, it soon becomes restless and feverish, and is, perhaps, eventually lost; when, by simply attending to the above rules of nursing, the infant might have become healthy and vigorous.

For the same reason, the infant that sleeps with its parent must not be allowed to have the nipple remaining in its mouth all night. If nursed as suggested, it will be found to awaken, as the hour for its meal approaches, with great regularity. In reference to night-nursing, I would suggest suckling the babe as late as ten o'clock p. m., and not putting it to the breast again until five o'clock the next morning. Many mothers have adopted this hint, with great advantage to their own health, and without the slightest detriment to that of the child. With the latter it soon becomes a habit; to induce it, however, it must be taught early.

The foregoing plan, and without variation, must be pursued to the sixth month.

After the sixth month to the time of weaning, if the parent has a large supply of good and nourishing milk, and her child is healthy and evidently flourishing upon it, no change in its diet ought to be made. If otherwise, however, (and this will but too frequently be the case, even before the sixth month) the child may be fed twice in the course of the day, and that kind of food chosen which, after a little trial, is found to agree best.

The first set of teeth, or milk-teeth as they are called, are twenty in number; they usually appear in pairs, and those of the lower jaw generally precede the corresponding ones of the upper. The first of the milk-teeth is generally cut about the sixth or seventh month, and the last of the set at various periods from the twentieth to the thirtieth months. Thus the whole period occupied by the first dentition may be estimated at from a year and a half to two years. The process varies, however, in different individuals, both as to its whole duration, and as to the periods and order in which the teeth make their appearance. It is unnecessary, however, to add more upon this point.

Their developement is a natural process. It is too frequently, however, rendered a painful and difficult one, by errors in the management of the regimen and health of the infant, previously to the coming of the teeth, and during the process itself.

Thus, chiefly in consequence of injudicious management, it is made the most critical period of childhood. Not that I believe the extent of mortality fairly traceable to it, is by any means so great as has been stated; for it is rated as high as one sixth of all the children who undergo it. Still, no one doubts that first dentition is frequently a period of great danger to the infant. It therefore becomes a very important question to an anxious and affectionate mother, how the dangers and difficulties of teething can in any degree be diminished, or, if possible, altogether prevented. A few hints upon this subject, then, may be useful. I shall consider, first, the management of the infant, when teething is accomplished without difficulty; and, secondly, the management of the infant when it is attended with difficulty.

Management of the infant when teething is without difficulty. ------------------------------------------------------------

In the child of a healthy constitution, which has been properly, that is, naturally, fed, upon the milk of its mother alone, the symptoms attending teething will be of the mildest kind, and the management of the infant most simple and easy.

Symptoms:- The symptoms of natural dentition (which this may be fairly called) are, an increased flow of saliva, with swelling and heat of the gums, and occasionally flushing of the cheeks. The child frequently thrusts its fingers, or any thing within its grasp, into its mouth. Its thirst is increased, and it takes the breast more frequently, though, from the tender state of the gums, for shorter periods than usual. It is fretful and restless; and sudden fits of crying and occasional starting from sleep, with a slight tendency to vomiting, and even looseness of the bowels, are not uncommon. Many of these symptoms often precede the appearance of the tooth by several weeks, and indicate that what is called "breeding the teeth" is going on. In such cases, the symptoms disappear in a few days, to recur again when the tooth approaches the surface of the gum.

Treatment:- The management of the infant in this case is very simple, and seldom calls for the interference of the medical attendant. The child ought to be much in the open air, and well exercised: the bowels should be kept freely open with castor oil; and be always gently relaxed at this time. Cold sponging employed daily, and the surface of the body rubbed dry with as rough a flannel as the delicate skin of the child will bear; friction being very useful. The breast should be given often, but not for long at a time; the thirst will thus be allayed, the gums kept moist and relaxed, and their irritation soothed, without the stomach being overloaded. The mother must also carefully attend, at this time, to her own health and diet, and avoid all stimulant food or drinks.

From the moment dentition begins, pressure on the gums will be found to be agreeable to the child, by numbing the sensibility and dulling the pain. For this purpose coral is usually employed, or a piece of orris-root, or scraped liquorice root; a flat ivory ring, however, is far safer and better, for there is no danger of its being thrust into the eyes or nose. Gentle friction of the gums, also, by the finger of the nurse, is pleasing to the infant; and, as it seems to have some effect in allaying irritation, may be frequently resorted to. In France, it is very much the practice to dip the liquorice-root, and other substances, into honey, or powdered sugar-candy; and in Germany, a small bag, containing a mixture of sugar and spices, is given to the infant to suck, whenever it is fretful and uneasy during teething. The constant use, however, of sweet and stimulating ingredients must do injury to the stomach, and renders their employment very objectionable.

During infancy.
---------------

cleanliness is essential to the infant's health. The principal points to which especial attention must be paid by the parent for this purpose are the following:

At first the infant should be washed daily with warm water; and a bath every night, for the purpose of thoroughly cleaning the body, is highly necessary. To bathe a delicate infant of a few days or even weeks old in cold water with a view "to harden" the constitution (as it is called), is the most effectual way to undermine its health and entail future disease. By degrees, however, the water with which it is sponged in the morning should be made tepid, the evening bath being continued warm enough to be grateful to the feelings.

A few months having passed by, the temperature of the water may be gradually lowered until cold is employed, with which it may be either sponged or even plunged into it, every morning during summer. If plunged into cold water, however, it must be kept in but a minute; for at this period, especially, the impression of cold continued for any considerable time depresses the vital energies, and prevents that healthy glow on the surface which usually follows the momentary and brief action of cold, and upon which its usefulness depends. With some children, indeed, there is such extreme delicacy and deficient reaction as to render the cold bath hazardous; no warm glow over the surface takes place when its use inevitably does harm: its effects, therefore, must be carefully watched.

The surface of the skin should always be carefully and thoroughly rubbed dry with flannel, indeed, more than dry, for the skin should be warmed and stimulated by the assiduous gentle friction made use of. For this process of washing and drying must not be done languidly, but briskly and expeditiously; and will then be found to be one of the most effectual means of strengthening the infant. It is especially necessary carefully to dry the arm-pits, groins, and nates; and if the child is very fat, it will be well to dust over these parts with hair-powder or starch: this prevents excoriations and sores, which are frequently very troublesome. Soap is only required to those parts of the body which are exposed to the reception of dirt.

During childhood.
----------------

When this period arrives, or shortly after, bathing is but too frequently left off; the hands and face of the child are kept clean, and with this the nurse is satisfied; the daily ablution of the whole body, however, is still necessary, not only for the preservation of cleanliness, but because it promotes in a high degree the health of the child.

A child of a vigorous constitution and robust health, as he rises from his bed refreshed and active by his night's repose, should be put into the shower-bath, or, if this excites and alarms him too much, must be sponged from head to foot with salt water. If the weather be very cold, the water may be made slightly tepid, but if his constitution will bear it, the water should be cold throughout the year. Then the body should be speedily dried, and hastily but well rubbed with a somewhat coarse towel, and the clothes put on without any unnecessary delay. This should be done every morning of the child's life.

If such a child is at the sea-side, advantage should be taken of this circumstance, and seabathing should be substituted. The best time is two or three hours after breakfast; but he must not be fatigued beforehand, for if so, the cold bath cannot be used without danger. Care must be taken that he does not remain in too long, as the animal heat will be lowered below the proper degree, which would be most injurious. In boys of a feeble constitution, great mischief is often produced in this way. It is a matter also of great consequence in bathing children that they should not be terrified by the immersion, and every precaution should be taken to prevent this. The healthy and robust boy, too, should early be taught to swim, whenever this is practicable, for it is attended with the most beneficial effects; it is a most invigorating exercise, and the cold bath thus becomes doubly serviceable.

If a child is of a delicate and strumous constitution, the cold bath during the summer is one of the best tonics that can be employed; and if living on the coast, sea-bathing will be found of singular benefit. The effects, however, of sea-bathing upon such a constitution must be particularly watched, for unless it is succeeded by a glow, a feeling of increased strength, and a keen appetite, it will do no good, and ought at once to be abandoned for the warm or tepid bath. The opinion that warm baths generally relax and weaken, is erroneous; for in this case, as in all cases when properly employed, they would give tone and vigour to the whole system; in fact, the tepid bath is to this child what the cold bath is to the more robust.

In conclusion: if the bath in any shape cannot from circumstances be obtained, then cold saltwater sponging must be used daily, and all the year round, so long as the proper reaction or glow follows its use; but when this is not the case, and this will generally occur, if the child is delicate and the weather cold, tepid vinegar and water, or tepid salt water, must be substituted.

What we should do?
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1, Always keep the baby neat and clean.

2, Cut the nails properly with utmost care.

3, Wet nappy should be removed and parts should be cleaned with soap.

4, Take care of the genitals because fungal infection is common in that area. Parts should be kept dry.

5,Care of the scalp is very important.Fungal infections, dermatitis ect can be prevented by proper cleaning.

6,Tight dress can cause irritation, hence dress should be loose and should allow entry of air.

7,Room should have sufficient light and ventilation.It should be free from dust and insects.

8,Seperate bed preferably water proof is needed for kids .It should be arranged near mother's bed.

9, Always keep some music making toys near the baby.

10, While carrying the baby support the head with hand.Since the neck muscles are weak sudden fall of head can be dangerous.

11, Mothers milk is the best nutrition for the baby,it also gives emotional attachment.Breast milk should be given as per the babies need preferably in mother sitting position.Proper cleaning of nipple is also necessary.Mother should take good nutritious diet throughout lactating period.

12, If there is some contraindication for breast feeding cows milk can be given.Feeding bottle should be cleaned with warm water and should be kept dry till next use.

13, Cows milk should be boiled and cooled.Some diseases like bovine tuberculosis,brucellosis ect spread through raw milk.

14, Some children are allergic to some substances like food,milk,dress,cosmetics ect.. Try to find out the material causing allergy and avoid such things.

15, Mosquito nets should be used regularly.Diseases like malaria,dengue ,filariasis,yellow fever and ect spread through mosquito bites. Mosquito bite can also produce skin eruptions with some allergic reactions.It also disturbes sound sleep.

16, A calm atmosphere should be maintained for a good sleep.Compared to adults infants need more sleep.It is said that growth hormone secretion is activated during sleep.

17, Growth developement,behavioral developement,motor developement,personal social developement,language developement ect should be noted down in relation to age. However parents need not be over anxious because slight variations are seen from individual to individual.

18,Assessment of growth by measuring height and weight is necessary.

19, In the early months of life infant may defecate after every feed.Proper toilet training should be given when the infant grows.The infant can be placed on the toilet seat by the age of ten months.

20, The toilet seat (potty seat) should be cleaned with antiseptic liquid before and after use.It should not be shared by other children.

21, If the baby shows some signs of distress like excessive crying,convulsions,fever with rigor,stiffness of neck,frequent vomiting and diarrhoea,bluish discolouration of the body,difficult breathing with grunting, ect pay attention and consult your doctor.

22,A first aid box should be kept in the room ,which should contain sterile cotton,dressing materials,antiseptic lotion and ointment and forceps.Seperate book should be maintained to note down the phone numbers of doctors, ambulance,police ect.

23,Child's medicines should be kept in seperate box.Information regarding dose and mode of administration should be written in a paper and affixed on the box.

24, while driving keep the baby in seperate seat belt.

25, When you are going out with the baby keep an identity card with your phone number and address inside his small pocket.

26, When the infant starts walking always accompany him to prevent a fall and injuries thereby.

27, In emergencies take the first aid measures and take the victim to nearby hospital.

Choking :--The baby may swallow some solid objects and cause obstruction. Immediately make the baby to lie on the abdomen in head low position and press the abdomen backwards and towards the chest. Stroking the upper back is also useful. If no result call a trained person to take the material with the help of forceps.

Accidental poisoning:-- Try to takeout the poisonous subatance and induce vomiting (except kerosine & acids). Wash the body with water to reduce absorption through skin.Identify the pioson and take the victim to the hospital.

Burns:--First of all remove the source of heat and put clean cold water.Burned cloaths should not be removed immediately. Cover the wound with sterile cotton and take to nearby hospital.

Wounds :--Clean the wound with clean water and stop the bleeding by compressing,raising the wound above the level of heart or use a tourniquet to compress blood vessels. Then dress the wound with sterile cotton and bandage and consult a doctor.

Drowning in bath tub:--Take the baby immediately and keep in head low position ,press the abdomen gentely or give a mouth to mouth sucking till the air way is clear. Give mouth to mouth breathing and cardiac massage and take the victim to the hospital.

Electric shock:--Stop the source of current. Then observe the victim,if no breathing give mouth to mouth breath along with cardiac massage and take to the hospital.

28, And the last but not the least, give your child maximum care, love and support to make him healthy and happy for ever.


What we should not do?
----------------------


1, Never shake the baby, it can cause damage to the brain.

2,Don't keep any small articles near the baby .

3,Sharp pointed articles like pen, pencil, ect should not be given to kids.

4,Avoid entry of water in to the ear while giving a bath.

5,Food should not be given forcibly when the baby is crying or coughing continuously.

6,Should not overfeed the baby.

7,Articles like mosquito repellents ,moth balls,ink,gum,medicines,ect should be kept away.

8,Avoid tight cloathings.

9,Should not be placed near the edge of the bed.

10,Should not give the baby to strangers and avoid close contact with others.

11,All electrical instruments should be kept away,and bed should not be arranged near electrical sockets and wires.

12,Kitchen is a dangerous place for children.Don't keep them alone in the kitchen.

13,Water level in the bath tub should be minimum and don't go for any other works(to attent phone call or calling bell ect) when the baby is in the tub.

14,Avoid smoking inside the house.

15,Should not allow pet animals to be in very close contact with the kids.(anti rabies injections should be given to pets and cut their nails properly)

16,When the child starts walking should not be kept alone on the upstairs and should not allow them to climb the steps.

17,Strong light should be avoided in the room.

18,When you are travelling don't give the food articles given by co passengers.

19,Baby should not be allowed to crawl on the soil.

20,If you are sick or someone else is sick be away from the kids.

21,Dont take the baby to hospital wards,crowded market places and polluted dusty areas.

22,Table lamp should not be kept near the kids,this will attract insects at night and cause problems.

23,Others medicine should not be given to the children.

24,Medicine which has crossed the expiery date should not be used.

WHAT TO DO WHEN YOUR KIDS CRY ?

Crying is a physiological process in the life of a baby.All normal babies cry to communicate with others.Sine they can't express their feelings in words crying is the only way for communication. If any uncomfortable feeling comes they simply cry.Normally babies cry in situations like hunger,wetting,too heat or cold,tight cloaths,pain ect. Some kids need the presence of somebody otherwise will cry simply.Crying without any cause is habitual in some babies. Eventhough crying is considered as normal it may worry the family members.Since the reasons for crying ranges from simple causes to serious causes it should not be ignored and hence exact cause has to be identified and managed accordingly.

The following are some points which should be considered while dealing with a crying baby.

1, It is dangerous to shake the baby vigorously.

2,Tight cloaths can cause irritation hence it should be removed.

3,If the room is hot put the fan and open the windows.

4,If the nappy is wet remove it and after cleaning the parts make it dry with a soft towel.

5,Pat her back or stroke her head slowly and let her here your soothing sound.

6,Give breast milk and make her quiet.

7,If the climate is cold cover her in soft towel.

8,Rock her gently in your arms and walk slowly in the room.

9,Take a music making doll and let her listen.

10,Try a pacifier or help her for thumb sucking.

11,If no response change her position.

12,Walk outdors with her.

13,Put her on the cradle and rock gently.

14,If no response ask somebody to carry the baby.


Even after all these steps the baby goes on crying see for the following signs.
( Probable cause is given after every sign)

1,Press her abdomen gently,she may twist or resist you:---Colic

2,Pull her ear gently she may become worse or push your hands away:---Earache.

3,Feel her temperature with the back of your hands:--Fever due to any infection.

4,Examine the skin from head to foot:--Eruptive disease,nappy rash,measles,vesicles,allergy ect.

5,See the nose for any discharge:--Coryza.

6,Move the head gently to feel any neck stiffness:--Meningitis,head injury ect.

7,Keep your ear near her chest to hear any rattling sound:--Increased mucus in wind pipes.
(pneumonia,bronchiolitis,asthamatic bronchitis ect)
8,Examine the anal orifice:--Anal erosion,rectal polyp,crawling of worms.

9,Examine the genitalia:--Any discharge or erosion.

10,In male baby see the testicles which may be swollen or tender:--Orchitis,torsion of testes.

11,also notice the body movements and see for any convulsions,rigors,vomiting,cough,laboured breathing ect.

If you see the above signs or any other abnormal signs consult your doctor for proper treatement.

Exercise is essentially important to the health of the infant. Its first exercise, of course, will be in the nurse's arms. After a month or two, when it begins to sleep less during the day, it will delight to roll and kick about on the sofa: it will thus use its limbs freely; and this, with carrying out into the open air, is all the exercise it requires at this period. By and by, however, the child will make its first attempts to walk. Now it is important that none of the many plans which have been devised to teach a child to walk, should be adopted the go-cart, leading-strings, etc.; their tendency is mischievous; and flatness of the chest, confined lungs, distorted spine, and deformed legs, are so many evils which often originate in such practices. This is explained by the fact of the bones in infancy being comparatively soft and pliable, and if prematurely subjected by these contrivances to carry the weight of the body, they yield just like an elastic stick bending under a weight, and as a natural consequence become curved and distorted.

It is highly necessary that the young and experienced mother should recollect this fact, for the early efforts of the little one to walk are naturally viewed by her with so much delight, that she will be apt to encourage and prolong its attempts, without any thought of the mischief which they may occasion; thus many a parent has had to mourn over the deformity which she has herself created.

It may be as well here to remark, that if such distortion is timely noticed, it is capable of correction, even after evident curvature has taken place. It is to be remedied by using those means that shall invigorate the frame, and promote the child's general health (a daily plunge into the cold bath, or sponging with cold salt water, will be found signally efficacious), and by avoiding the original cause of the distortion never allowing the child to get upon his feet. The only way to accomplish the latter intention, is to put both the legs into a large stocking; this will effectually answer this purpose, while, at the same time, it does not prevent the free and full exercise of the muscles of the legs. After some months pursuing this plan, the limbs will be found no longer deformed, the bones to have acquired firmness and the muscles strength; and the child may be permitted to get upon his feet again without any hazard of perpetuating or renewing the evil.

The best mode of teaching a child to walk, is to let it teach itself, and this it will do readily enough. It will first crawl about: this exercises every muscle in the body, does not fatigue the child, throws no weight upon the bones, but imparts vigour and strength, and is thus highly useful. After a while, having the power, it will wish to do more: it will endeavour to lift itself upon its feet by the aid of a chair, and though it fail again and again in its attempts, it will still persevere until it accomplish it. By this it learns, first, to raise itself from the floor; and secondly, to stand, but not without keeping hold of the object on which it has seized. Next it will balance itself without holding, and will proudly and laughingly show that it can stand alone. Fearful, however, as yet of moving its limbs without support, it will seize a chair or anything else near it, when it will dare to advance as far as the limits of its support will permit. This little adventure will be repeated day after day with increased exultation; when, after numerous trials, he will feel confident of his power to balance himself, and he will run alone. Now time is required for this gradual self-teaching, during which the muscles and bones become strengthened; and when at last called upon to sustain the weight of the body, are fully capable of doing so.

Exercise during childhood.
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When the child has acquired sufficient strength to take active exercise, he can scarcely be too much in the open air; the more he is habituated to this, the more capable will he be of bearing the vicissitudes of the climate. Children, too, should always be allowed to amuse themselves at pleasure, for they will generally take that kind and degree of exercise which is best calculated to promote the growth and development of the body. In the unrestrained indulgence of their youthful sports, every muscle of the body comes in for its share of active exercise; and free growth, vigour, and health are the result.

If, however, a child is delicate and strumous, and too feeble to take sufficient exercise on foot, and to such a constitution the respiration of a pure air and exercise are indispensable for the improvement of health, and without them all other efforts will fail, riding on a donkey or pony forms the best substitute. This kind of exercise will always be found of infinite service to delicate children; it amuses the mind, and exercises the muscles of the whole body, and yet in so gentle a manner as to induce little fatigue.

The exercises of horseback, however, are most particularly useful where there is a tendency in the constitution to pulmonary consumption, either from hereditary or accidental causes. It is here beneficial, as well through its influence on the general health, as more directly on the lungs themselves. There can be no doubt that the lungs, like the muscles of the body, acquire power and health of function by exercise. Now during a ride this is obtained, and without much fatigue to the body. The free and equable expansion of the lungs by full inspiration, necessarily takes place; this maintains their healthy structure, by keeping all the air-passages open and pervious; it prevents congestion in the pulmonary circulation, and at the same time provides more completely for the necessary chemical action on the blood, by changing, at each act of respiration, a sufficient proportion of the whole air contained in the lungs, all objects of great importance, and all capable of being promoted, more or less, by the means in question.

Introduction:

Crying is a normal event in the lives of all babies.When a baby comes out of the woomb the first thing to do is crying.By the first cry he will take some air in to the lungs for the first time in their life.After delivery if the baby doesnot cry then it should be initiated by slightly pinching or gently strocking the feet.From this it is clear that the healthy baby should cry and it is a normal physiological event ,still some times it can upset the mother or family members.

We all know that a baby can't tell his needs or troubles in words. The only way for him to communicate with others is by crying.Babies show some other signs like feet kicking,hand waving and head turning ect.But the best way to take the attention of others is by crying.

Excessive crying may not have a firm definition because the crying habit changes from baby to baby and some babies can be calmed easily but some are difficult to sooth.If crying is distressing for the mother and home nurse it can be called excessive.Many a times baby become quiet by giving breast milk or by carrying with a gentle rocking.Sudden onset of excessive crying means baby is distressed and needs attention.The causes of crying extends from simple reasons to life threatening conditions.Hence crying of a baby should not be ignored.


Most of the time it is difficult to find the cause of the cry .Common causes are discussed here for awareness.

Common reasons for crying:

1,Hunger:--

A hungry baby will cry till he gets the milk. Here the old saying comes true'crying baby gets the milk'.

2,Wetting:--

Urination and defecation causes some discomfort and results in crying till his parts are cleaned and made dry .

3,Company:--

Majority of the kids need somebody near. If they feel lonely they cry.When their favourite doll slips away from the grip they cry for help.

4,Tired:--

When the baby is tired after a journey and unable to sleep just cry simply.They feel tired in uncomfortable sourroundings and due to unhealthy climate.

5,Heat & cold:--

If they feel too hot or too cold they become restless and cry. Child is comfortable in a room with good ventilation.

6,Tight cloathing:--

Tight cloaths especially during warm climate is intolerable for kids.Tight elastic of the the dress can also produce soreness in the hip region.

7,Dark room:--

When the baby wakes up from sleep he needs some dim light.If there is darkness he will disturb the sleep of parents by crying.Ofcourse he will be irritated by strong light resulting in cry.

8,Mosquito:--

Yes,these creatures disturb the sleep by their blood sucking and make the baby to cry.

9,Nasal blocking:--

Child may not be able to sleep when there is a cold and go on crying till the passage is open.

10, Phlegm in throat:--

This also causes difficult breathing resulting in cry.Often a typical sound can be heard with each breath.

11,General aching:--

Generalised body ache with restlessness is seen in flu and prodromal stages of some infectious diseases can result in continuous cry.

12,Habitual cry:---Some babies cry without any real cause ending the parents in agony.Many a times doctor is called for help.

13,Nappy rash:-- If a tight and wet nappy is kept for a long time results in this conditon.
Rash can also be due to some allergic reaction to the elastic material of the nappy. When the rash appears it causes soreness and baby become sleepless and cry. All other skin lesions like eczema,ecthyma ,candidiasis ect also causes same problems.

14,Earache:--

Ear infection is common in wet climate.The infection may spread from the throat.Ear infection can result in rupture of ear drum causing discharge of pus.Eareache usually becomes worse at night when lying down.Child will become restless with cry and may not allow you to touch the ear.Some children with earache rub the affected ear frequently.

15,Colic:--

When the baby cry continuously most of us diagnose it as colic.This roblem is still a topic for debate because exact cause for colic is not known and diagnosis is also difficult to confirm.Colic may be associated with rumbling and distention of abdomen.Child often feels better when lying on abdomen.Some children may not allow you to touch the abdomen.If the child cries continuously doctors help is needed.

16,Infections:--

All infections causes some kind of pain or irritation resulting in cry.Infection may be anywhere in the body.Usually it is associated with fever, redness and swelling.

17,Reactions to certain food:--

It is said that one man's food is another man's poison. Some food articles can produce some allergic reactions.Allergy is manifested in the form of redness, breathlessness,gastric symptons and continuous cry.

18,Hard stools:--

Constipated babies with hard stools may cry when they get the urge for stool.Some children hesitate to pass stool because of pain .

19,Gastro esophagial reflex:--

Here baby cries with spilling of food after feeding.If this continues it may be due to gastroesophageal reflex.This is due to failure of the lower part of esophagus to close after food causing regurgitation from the stomach.It is difficult to diagnose this condition and can be confirmed by giving antireflex medicines.

20, Dentition:--

During dentition child becomes restless with crying.Often associated with gastric troubles and diarrhoea.

Some rare reasons
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1,Bowel obstruction:--

Bowel obstruction is associated with severe pain and vomiting.Abdomen is distended with rumbling sound.Baby is constipated with absence of flatus.

2,Septicemia:--

Invasion of pathogenic micro organisms in to the blood is called septicemia.Fever is associated with this condition.

3,Torsion of testes in male kids:--

When a male baby cries continuously his scrotum should be examined.Torsion of the testes produce severe pain which will be worse by touching the affected testes.When the testes is pressed upwards pain is releived.If this is not treated properly it can damage the affected testes due to lack of blood supply.

4,Meningitis:--

Initially there may not be fever,hence crying baby with alternate vacant stare and irritability should not be ignored.Fontanel is bulging. Neck rigidity and seizures may appear later.


5,Retention of urine:--

Children with retention of urine will have agonising pain making them restless.

7,Major injuries:--

Major injury to any parts of the body causes pain.Occasionally children will fall while arrying and results in head injury.Head injury is associated with reflex vomiting and convulsions.