Now, all that I have said about nursing grown-up people applies a great deal more to nursing baby. For instance, baby will suffer from a close room when you don't feel that it is close.* If baby sleeps even for a few hours, much more if it is for nights and nights -- in foul air, baby will, without any doubt whatever, be puny and sickly, and most likely have measles or scarlatina, and not get through it well.
Baby will feel want of fresh air more than you. Baby will feel cold much sooner than you. Above all, baby will suffer more from not being kept clean (only see how it enjoys being washed in nice luke-warm water). Baby will want its clothes and its bed clothes changed oftener than you. Baby will suffer more from a dirty house than you. Baby must have a cot to itself; else it runs the risk of being over-laid or suffocated. Baby must not be covered up too much in bed, nor too little. The same when it is up. And you must look after these things. Mother is perhaps too busy to see whether baby is too much muffled up or too little.
You must take care that baby is not startled by loud sudden noises; all the more you must not wake it in this way out of its sleep. Noises which would not frighten you, frighten baby.
And many a sick baby has been killed in this way.
You must be very careful about its food; about being strict to the minute for feeding it; not giving it too much at a time (if baby is sick after its food, you have given it too much). Neither must it be under fed. Above all, never give it any unwholesome food, nor anything at all to make it sleep, unless the doctor orders it.
If you knew how many, even well-to-do, babies I have known who have died from having had something given to make them sleep, and "keep them quiet," -- not the first time, nor the second, nor the tenth time perhaps, -- but at last.
I could tell you many true stories, which have all happened within my own knowledge, of mischief to babies from their nurses neglecting these things.
Here are a few.
1. Baby, who is weaned, requires to be fed often, regularly, and not too much at a time.
I knew a mother whose baby was in great danger one day from convulsions. It was about a year old. She said she had wished to go to church; and so, before going, had given it its three meals in one. Was it any wonder that the poor little thing had convulsions!
I have known (in Scotland) a little girl, not more than five years old, whose mother had to go great distances every day, and who was trusted to feed and take care of her little brother, under a year old. And she always did it right. She always did what mother told her. A stranger, coming into the hut one day (it was no better than a hut), said, "You will burn baby's mouth." "Oh no," she said, "I always burn my own mouth first."
2. When I say, be careful of baby, I don't mean have it always in your arms. If the baby is old enough, and the weather warm enough for it to have some heat in itself, it is much better for a child to be crawling about than to be always in its little nurse's arms. And it is much better for it to amuse itself than to have her always making noises to it.
The healthiest, happiest, liveliest, most beautiful baby I ever saw was the only child of a busy laundress. She washed all day in a room with the door open upon a larger room, where she put the child. It sat or crawled upon the floor all day with no other play-fellow than a kitten, which it used to hug. Its mother kept it beautifully clean, and fed it with perfect regularity. The child was never frightened at anything. The room where it sat was the house-place; and it always gave notice to its mother when any body came in, not by a cry, but by a crow. I lived for many months within hearing of that child, and never heard it cry day or night. I think there is a great deal too much of amusing children now; and not enough of letting them amuse themselves.
Never distract a child's attention. If it is looking at one thing, don't show it another; and so on.
3. At the same time, dulness and especially want of light, is worse for children than it is for you.
A child was once brought up quite alone in a dark room, by persons who wished to conceal its being alive. It never saw any one, except when it was fed; and though it was treated perfectly kindly, it grew up an idiot. This you will easily guess.
Plenty of light, and sun-light particularly, is necessary to make a child active, and merry, and clever. But, of all things, don't burn baby's brains out by letting the sun bake its head when out, especially in its little cart, on a hot summer's day.
Never leave a child in the dark; and let the room it lives in be always as light as possible, and as sunny. Except, of course, when the doctor tells you to darken the room, which he will do in some children's illnesses.
4. Do you know that one-half of all the nurses in service are girls of from five to twenty years old!** You see you are very important little people. Then there are all the girls who are nursing mother's baby at home; and, in all these cases, it seems pretty nearly to come to this, that baby's health for its whole life depends upon you, girls, more than upon anything else.
I need hardly say to you, What a charge! For I believe [1868: that] you, all of you, or nearly all, care about baby too much not to feel this nearly as much as I do. You, all of you, want to make baby grow up well and happy, if you knew how.
So I say again, --
5. The main want of baby is always to have fresh air.
You can make baby ill by keeping the room where it sleeps tight shut up, even for a few hours.
You can kill baby when it is ill by keeping it in a hot room, with several people in it, and all the doors and windows shut.
The doctor who looks after the Queen's children says so.
This is the case most particularly when the child has something the matter with its lungs and its breathing.
I found a poor child dying in a small room, tight shut up, with a large fire, and four or five people round it to see it die. Its breathing was short and hurried; and it could not cough up what was choking its lungs and throat -- mucus it is called. The doctor, who was a very clever man, came in, set open door and window, turned everybody out but one, and stayed two hours to keep the room clear and fresh. He gave the child no medicine; and it was cured simply by his fresh air. A few hours will do for baby, both in killing and curing it, what days will not do for a grown-up person.
Another doctor found a child (it was a rich one) dying in a splendid close room, nearly breathless from throat-complaint. He walked straight to the window and pulled it open; "for," he said, "when people can breathe very little air, they want that little good." The mother said he would kill the child. But, on the contrary, the child recovered.
6. Take you care not to let a draught blow upon a child, especially a sick child.
Perhaps you will say to me, "I don't know what you would have me do. You puzzle me so. You tell me, don't feed the child too much, and don't feed it too little; don't keep the room shut up, and don't let there be a draught; don't let the child be dull, and don't amuse it too much." Dear little nurse, you must learn to manage. Some people never do learn management. I have felt all these difficulties myself; and I can tell you that it is not from reading my book that you will learn to mind baby well, but from practising yourself how best to manage to do what other good nurses (and my book, if you like it,) tell you.
But about the draughts.
It is all nonsense what some old nurses say, that you can't give baby fresh air without giving it a chill; and, on the other hand, you may give baby a chill which will kill it (by letting a draught blow upon it when it is being washed, for instance, and chilling its whole body, though only for a moment), without giving it fresh air at all; and depend upon this, the less fresh air you give to its lungs, and the less water you give to its skin, the more liable it will be to colds and chills.
If you can keep baby's air always fresh in doors and out of doors, and never chill baby, you are a good nurse.
A sick baby’s skin is often cold, even when the room is quite close. Then you must air the room, and put hot flannels or hot bottles (not too hot) next baby's body, and give it its warm food.
But I have often seen nurse doing just the contrary; namely, shutting up every chink and throwing a great weight of bed-clothes over the child, which makes it colder, as it has no heat in itself.
You would just kill a feverish child by doing this.
A children's doctor, very famous in London, says that when a sick child dies, it is just as often an accident as not; that is, people kill it by some foolish act of this kind, just as much as if they threw it out of window. And he says, too, that when a sick child dies suddenly, it is almost always an accident. It might have been prevented. It was not that the child was ill, and so its death could not be helped, as people say.
He tells us what brings on these sudden deaths in sick children: -- Startling noises; chilling the child's body; wakening it suddenly; feeding it too much or too quickly; altering its posture suddenly, or shaking it roughly; frightening it. And to this you may add (more than anything else, too), keeping it in foul air, especially when asleep, especially at night, even for a few hours, and even when you don't feel it yourself. This is, most of all, what kills babies.
Baby's breathing is so tender, so easily put out of order. Sometimes you see a sick baby who seems to be obliged to attend to every breath it draws, and to "breathe carefully," in order to breathe at all; and if you disturb it rudely, it is all over with baby. Anything which calls upon it for breath may stop it altogether.
7. Remember to keep baby clean. I can remember when mothers boasted that their "children's feet had never been touched by water; no, nor any part of them but faces and hands;" that somebody's "child had had its feet washed, and it never lived to grow up, &c."
But we know better now. And I dare say you know that to keep every spot of baby's body always clean, and never to let any pore of its tender skin be stopped up by dirt or unwashed perspiration is the only way to keep baby happy and well. It is a great deal of trouble; but it is a great deal more trouble to have baby sick.
The safest thing is to wash baby all over once or twice a day; and to wash it besides whenever it has had an accidental wetting. You know how easily its tender skin gets chafed.
There may be danger in washing a child's feet and legs only. There never can be in washing it all over. Its clothes should be changed oftener than yours, because of the greater quantity baby perspires. If you clothe baby in filth, what can you expect but that it will be ill! Its clothes must never be tight, but light and warm. Baby, if not properly clothed, feels sudden changes in the weather much more than you do. Baby's bed-clothes must be clean oftener than yours..
Now, can you remember the things you have to mind for baby! There is --
1. Fresh air.
2. Proper warmth.
3. Cleanliness for its little body, its clothes, its bed, its room, and house.
4. Feeding it with proper food, at regular times.
5. Not startling it or shaking either its little body or its little nerves.
6. Light and cheerfulness.
7. Proper clothes in bed and up.
And management in all these things.
I would add one thing. It is as easy to put out a sick baby's life as it is to put out the flame of a candle. Ten minutes' delay in giving it food may make the difference.
** Nightingale has the following table of nurses' ages in Great Britain:
|Nurses||All Ages||Under 5 Years||5-||10-||15-||20-||25-||30-||35-||40-||45-||50-||55-||60-||65-||70-||75-||80-||85 and Upwards|
|Nurse (not Domestic Servant)||25,466||...||...||...||...||624||817||1,118||1,359||2,223||2,748||3,982||3,456||3,825||2,542||1,568||746||311||147|
|Nurse (Domestic Servant)||39,130||...||508||7,259||10,355||6,537||4,174||2,459||1,681||1,468||1,206||1,196||833||712||369||204||101||25||16|
Obviously, the concept of nursing has changed greatly since then. The style of writing Nightingale uses in this section is probably influenced by the very young nurses she is writing for.