KidandTeen

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.

During infancy.
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For three or four weeks after birth the infant sleeps more or less, day and night, only waking to satisfy the demands of hunger; at the expiration of this time, however, each interval of wakefulness grows longer, so that it sleeps less frequently, but for longer periods at a time.

This disposition to repose in the early weeks of the infant’s life must not be interfered with; but this period having expired, great care is necessary to induce regularity in its hours of sleep, otherwise too much will be taken in the day-time, and restless and disturbed nights will follow. The child should be brought into the habit of sleeping in the middle of the day, before its dinner, and for about two hours, more or less. If put to rest at a later period of the day, it will invariably cause a bad night.

At first the infant should sleep with its parent. The low temperature of its body, and its small power of generating heat, render this necessary. If it should happen, however, that the child has disturbed and restless nights, it must immediately be removed to the bed and care of another female, to be brought to its mother at an early hour in the morning, for the purpose of being nursed. This is necessary for the preservation of the mother’s health, which through sleepless nights would of course be soon deranged, and the infant would also suffer from the influence which such deranged health would have upon the milk.

When a month or six weeks has elapsed, the child, if healthy, may sleep alone in a cradle or cot, care being taken that it has a sufficiency of clothing, that the room in which it is placed is sufficiently warm, viz. 60 degrees, and the position of the cot itself is not such as to be exposed to currents of cold air. It is essentially necessary to attend to these points, since the faculty of producing heat, and consequently the power of maintaining the temperature, is less during sleep than at any other time, and therefore exposure to cold is especially injurious. It is but too frequently the case that inflammation of some internal organ will occur under such circumstances, without the true source of the disease ever being suspected. Here, however, a frequent error must be guarded against, that of covering up the infant in its cot with too much clothing throwing over its face the muslin handkerchief and, last of all, drawing the drapery of the bed closely together. The object is to keep the infant sufficiently warm with pure air; it therefore ought to have free access to its mouth, and the atmosphere of the whole room should be kept sufficiently warm to allow the child to breathe it freely: in winter, therefore, there must always be a fire in the nursery.

The child up to two years old, at least, should sleep upon a feather bed, for the reasons referred to above. The pillow, however, after the sixth month, should be made of horsehair; for at this time teething commences, and it is highly important that the head should be kept cool.

During childhood.
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Up to the third or fourth year the child should be permitted to sleep for an hour or so before its dinner. After this time it may gradually be discontinued; but it must be recollected, that during the whole period of childhood more sleep is required than in adult age. The child, therefore, should be put to rest every evening between seven and eight; and if it be in health it will sleep soundly until the following morning. No definite rule, however, can be laid down in reference to the number of hours of sleep to be allowed; for one will require more or less than another.Regularity as to the time of going to rest is the chief point to attend to; permit nothing to interfere with it, and then only let the child sleep without disturbance, until it awakes of its own accord on the following morning, and it will have had sufficient rest.

The amount of sleep necessary to preserve health varies according to the state of the body, and the habits of the individual. Infants pass much the greater portion of their time in sleep. Children sleep twelve or fourteen hours. The schoolboy generally ten. In youth, a third part of the twenty-four hours is spent in sleep. Whilst, in advanced age, many do not spend more than four, five, or six hours in sleep.

It is a cruel thing for a mother to sacrifice her child’s health that she may indulge her own vanity, and yet how often is this done in reference to sleep. An evening party is to assemble, and the little child is kept up for hours beyond its stated time for retiring to rest, that it may be exhibited, fondled, and admired. Its usual portion of sleep is thus abridged, and, from the previous excitement, what little he does obtain, is broken and unrefreshing, and he rises on the morrow wearied and exhausted.

Once awake, it should not be permitted to lie longer in bed, but should be encouraged to arise immediately. This is the way to bring about the habit of early rising, which prevents many serious evils to which parents are not sufficiently alive, promotes both mental and corporeal health, and of all habits is said to be the most conducive to longevity.

A child should never be suddenly aroused from sleep; it excites the brain, quickens the action of the heart, and, if often repeated, serious consequences would result. The change of sleeping to waking should always be gradual.

The bed on which the child now sleeps should be a mattress: at this age a feather bed is always injurious to children; for the body, sinking deep into the bed, is completely buried in feathers, and the unnatural degree of warmth thus produced relaxes and weakens the system, particularly the skin, and renders the child unusually susceptible to the impressions of cold. Then, instead of the bed being made up in the morning as soon as vacated, and while still saturated with the nocturnal exhalations from the body, the bed-clothes should be thrown over the backs of chairs, the mattress shaken well up, and the window thrown open for several hours, so that the apartment shall be thoroughly ventilated. It is also indispensably requisite not to allow the child to sleep with persons in bad health, or who are far advanced in life; if possible, it should sleep alone.

In an effort to keep children motivated and safe, the U.S. Government
sets aside a good amount of fund for financing after school programs every
year. A report by the U.S. Department of Education and Justice points out
that after school programs are very effective and is in the interests of
the society as a whole. Interestingly, it was found that Americans liked
providing school-based after school-programs in their community.

Other than safety, boredom and loneliness, the poor performance of many
students also led to the need for after-school programs that are based on
the school curriculum. Children coming from low-income families were found
to lag behind in reading and grammar after a long break in the summer.
Statistics prove that if school-going children are left unsupervised after
their school, the chances of poor grades and drop out are considerably
higher. The funds provided by the Government will allow rural and
inner-city schools to provide activities during the summer, over the
weekends and after school. These activities will take place in a
drug-free, safe and supervised environment.

Positive augmentation of critical skills is the prime focus of these
school-based after school activities. Thus they enhance the skill level of
the child. Most school-based programs offer assistance in math tutoring,
reading, comprehension and problem solving. Many programs provide engaging
activities that seek to prepare the students for college. Hands-on
experience is provided for children who want to invest in a career in
teaching. Access to telecommunication and technology and involvement in
music and art are other benefits of these programs. This becomes
invaluable, especially in low-income sectors where such activities are
considered to be a luxury.

As far as children are concerned, the snacks provided in after school
programs are an added incentive. School sponsored after school programs
are entitled to receive funds for snacks. The National School Lunch
Program is designed to do just this. Free or reduced price snacks will be
provided for children from schools that apply for it. The CACFP reimburses
expenditure depending upon the child’s income status. But this is
applicable only till the age of 13. The funding that schools get depends
upon the area in which they are situated. A low-income area gets more
funding. Supper can be served to children below the age of 19. Longer
programs can provide both supper and a snack. With the participation of
non-profit private organization, it is possible to feed deserving school
children breakfast, supper and a snack.

After school programs can be divided into 3 broad categories: academic,
recreational and social. Balanced development takes place when there is
compatibility between the physical, mental as well as the educational
achievements of the child.As the name suggests recreational after school
programs are based on a sport or recreation. Some of the more common
physical activities include football, swimming and basketball.Some clubs
offer programs like gymnastics, trekking and hiking. In this case,
youngsters are often given a short class in first-aid class also.

Recreational after school programs offer children an opportunity to let
off some steam and to destress themselves. The closed classroom atmosphere
and a day full of textbooks and writing cause the child to repress his
natural enthusiasm. He curbs his energy when he is required to sit quietly
in class and learn. Physical activity is an all-time low during such
times. This physical lethargy and inaction is countermanded by
recreational activities. Growing concerns of obesity and child diabetes
make it necessary for children to indulge in some strenuous exercises that
will allow them to work up some sweat.

Unlike educational programs, recreational programs do not tax the
mental processes. But, they do aid the learning process by making the
child more active. A child who is physically active is mentally fit, and
is able to focus his thoughts on the work at hand. Additionally,
recreational programs teach discipline, mechanics of teamwork and fair
play. These are important lessons in the growing process.

As more and more nuclear families emerge, the child faces greater
isolation. Many children shuttle between their classroom and their
bedrooms and do not have any meaningful relationships outside these.
Recreational programs offer ample avenues for socialization. This is a
place the child can go to and play even when his neighbor is not the most
welcoming. The Boy / Girl Scout programs are excellent recreational after
school programs. Lately, survival classes and camps have devised to
combine important survival skills with sports and games to educate
children on how to handle emergencies.

Like any good after school program, recreational programs are designed to
give children a safe area where they can indulge in some group activities
that interest them. This is one of the most effective ways to keep kids
out of the streets and out of trouble. But, one has to be careful when
enrolling children for recreational classes. The age of the child, his
temperament and his physical caliber has to be taken into account before
you choose the right program for your child.

In a world that is slowly but surely turning away from books and getting
glued to monitors or television screens, the importance of developing a
passion for reading cannot be overlooked. Reading is a habit and should be
established when the child is relatively young. What can you do to foster
this habit?

Enroll your child for reading classes:
There are many well structured after school reading classes that aim to
draw the children to books. They help kids with diction, idioms and
phrases. For young children, these classes can be fun with animated
characters and pictures. Illustrated picture books, rhymes, silly songs
and pretend stories all attract the young child. Use creativity to capture
the child’s vivid imagination.

Pique your child’s interest:
If your child has a favorite character, pick a series of books that
features this character. For my son, it was Spiderman. Thanks to friendly
neighborhood spidey, my son latched on to comics fairly early in his
childhood.

Build a home-library:
A skill like reading cannot be learnt in isolation. Do not leave all the
hard work to the after school program. Pick up books that you think your
child will like. The Internet is also a rich resource of reading games
that will attract little children to the fine art of reading.

With the growing interest in after school programs shown by the Government
as well as parents, new and hitherto unheard of programs are being
explored. In an attempt to make a child aware of his responsibilities as
an individual and as a citizen, these after school programs make use of a
child’s natural curiosity and his irrepressible energy.

Investigative Skills:
In some schools in Kernersville, children are developing their
investigative skills. Children meet with adults who introduce them to the
details of fake non-violent crimes. They take notes, visit the scene and
gather information. Students learn to listen to alibis, collect
fingerprints and gather any other pieces of evidence. According to the
principal, these activities challenge her students’ problem solving
skills. Children learn to think critically and to form informed judgments.

Fisheries and sciences:
In North Carolina, children who are interested get a chance to win a
scholarship through their after school activity. Here, students are given
a chance to face hands-on fisheries science experiments in a freshwater or
marine setting. Professionals, educators and experts from the world of
Fisheries act as mentors. Students accepted into the program get a $3,000
scholarship.

The above examples go to show that after school activities are becoming
serious. They are slowly morphing into important parts of a child’s
education and moving away from the fun-and-frolic-only programs of the
past.

With children becoming the primary focus of society, ways and means to
ensure their safety and development are being researched. The Government
too has pooled in to make a success of such programs. Here are some of the
reasons why after school programs have become so popular:

1) Preventing Juvenile Delinquency, crime and violent victimization:
About 10% of juvenile crimes happen between 3 P.M. – 4 P.M. Children need
to be kept safe and out of trouble at such times
2) Preventing alcohol, drug and tobacco use.
Risk-taking behavior that seeks to establish superiority in a clan is
mostly seen in ‘latchkey’ children. Children in their pre-teens, if they
have a meaningful relationship with a mentor, are less likely to indulge
in these kinds of destructive behavior
3) Decreases appetite for Television:
An average child watches about 23 hours of TV per week. When enrolled for
some activity, the child utilizes his mental and physical skills to meet
challenges.
4) Improving academic achievements
5) Improving school attendance:
More confidence in self and increased interest in school leads to greater
attendance in school. A program that helps children with their homework
also gives the child a much-needed feeling of self-achievement.
6) Improved behavior and inter-personal skills
Children who attend after school activities handle conflict better and
cooperate more with authority figures.
7) Closer family and community ties.

Several studies are expressing a growing concern that after school
programs are pressurizing kids to do too much too soon. They point out
that when a child’s afternoon is filled with classes, trips, sports and
other forms of organized activities, kids do not really get the time to be
just kids. They are even being deprived of the cherished family time.

Undoubtedly, there are children who are being burdened with a schedule
that places too much demand on their time. This leads to increased levels
of stress on the child and the family. As regular studies cannot be
ignored, children are almost always on the run to achieve more. Such
children are really bearing a burden that is too heavy for their frail
little shoulders.

In an ideal world, all children would go home directly after school to
loving and caring parents who are waiting for the children to come home.
But the social and economic realities show that many children have to
attend after school courses because there is no one available at home. For
such children, these classes are a boon.

Parents should however restrain themselves from reading too much into
these activities. After school programs are complimentary in nature. They
give additional support. Therefore, their importance should also be
limited.

When children are literally up to their gills with the learning and sport
activities in school, it may seem superfluous to enroll them for after
school activities. In spite of this, after school programs are sprouting
up in large numbers and most of these are booked full. This shows that
there is a real need for after school activities.

The unavailability of parental supervision is the leading cause for the
surge in after school programs. It is seen that many children spend about
20-25 hours a week unsupervised and alone at home. And as the saying
goes, “An idle mind is a devil’s workshop”. Children who are left alone
to contend with too much free time invariably fall into the wrong
company. Drug abuse, alcohol, tobacco and crime come knocking at their
doors sooner rather than later. Parents enroll children to various after
school programs to keep them occupied in a productive manner. This way,
the kids are free to enjoy themselves in a supervised activity.

Crime is considered to be at its peak during the after school hours,
between 3- 4 p.m. During such a time, children need protection. Getting
the children together under one roof and encouraging them to participate
in a group activity is protection enough. It diverts the children from
ennui too.

Obesity is a matter of growing concern in this country. It is noticed
that more and more children are becoming couch potatoes. After school,
many of them relax on the sofa with packets of chips, cool drinks or
chocolates while they watch T.V. 30 % of the kids below the age of 19 are
considered overweight, and about 15% of these are obese. An after school
program ensures that the child shakes off his lethargy and keeps himself
busy. This also helps to reduce the child’s fascination for T.V and
computer games.

After school activities that promote social awareness develop the
individual’s sense of social responsibility. It is seen that these sorts
of programs not only keep kids out of trouble, but also help to produce
responsible citizens. To that extent, they are valuable building blocks
in a child’s personality.

Times are changing and parents want their children to excel in academics
as well as in other activities. This may be a reflection of the parent’s
unfulfilled desire to excel – a remnant from his own childhood. Whatever
the reason, parents today encourage their children to enroll themselves
in various programs and develop the various facets of their
individuality. Children too seem to be comfortable learning many things
at the same time, and gain satisfaction from this.

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.