An essay upon nursing and the management of children, from their birth to three years of age. By W. Cadogan, Fellow of the College of Physicians, late physician to the Foundling-Hospital. ; In a letter to a governor. ; Published by order of the general committee for transacting the affairs of the said hospital.

An essay upon nursing and the management of children, from their birth to three years of age. By W. Cadogan, Fellow of the College of Physicians, late physician to the Foundling-Hospital. ; In a letter to a governor. ; Published by order of the general committee for transacting the affairs of the said hospital.

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SIR,

IT is with great pleasure I see at last the preservation of Children become the care of Men of Sense: it is certainly a matter that well deserves their attention, and, I doubt not, the Public will soon find the good and great effects of it. The FOUNDLING HOSPITAL may be of more use to the world, than was perhaps at first imagined by the promoters of it; it will be a means not only of preventing the murder of many, but of saving more, by introducing a more reasonable and more natural method of nursing. In my opinion, this business has been too long fatally left to the management of Women, who cannot be supposed [Page]to have proper knowledge to fit them for such a task, notwithstanding they look upon it to be their own province. What I mean is, a philosophic knowledge of Nature, to be acquired only by learned observation and experience, and which therefore the unlearned must be incapable of. They may presume upon the examples and transmitted customs of their Great grandmothers, who were taught by the Physicians of their unenlightened days; when Physicians, as appears by late discoveries, were mistaken in many things, being led away by hypothetical reasonings to entertain very wild conceits, [...] which they were greatly bewildered themselves, and misled others to believe I know not what strange unaccountable powers in certain herbs, roots, and drugs; and also in some superstitious practices and ceremonies; for all which notions, their being no real foundation in Nature, they ought to be looked upon as the effects of ignorance, or the artifices of designing Quacks; who found their account in pretending to great knowledge of their occult qualities, and imposing upon the credulous. The art of Physic has been much improved within this last century; by observing and following Nature more closely, many useful discoveries have [Page]been made, which help us to account for things in a natural way, that before seemed mysterious and magical; and which have consequently made the practice of it more conformable to reason and good sense. This being the case, there is great room to fear, that those Nurses who yet retain many of these traditional prejudices, are capitally mistaken in their management of Children in general, and fancying that Nature has left a great deal to their skill and contrivance, often do much harm where they intend to do good. Of this I shall endeavour to convince them, by shewing how I think children may be clothed, fed, and managed, with much less trouble to their Nurses, and infinitely greater ease, comfort, and safety, to the little ones.

THE Foundlings under the care of the Hospital, I presume, will be bred in a very plain, simple manner: they will therefore infallibly have more health, beauty, strength, and spirits; I might add understanding also, as all the faculties of the mind are well known to depend upon the organs of the body; so that when these are in good order, the thinking part is most alert and active; the contrary, when they [Page]are disturbed or diseased. When these advantages appear in favor of Children so brought up, as I am confident in time they will, it may serve to convince most Nurses, Aunts, Grandmothers, &c. how much they have hitherto been in the wrong, what mischief is done to Children, and what multitudes are destroyed or spoiled, as well by cramming them with cakes, sweetmeats, &c. till they foul their blood, choak their vessels, pall the appetite, and ruin every faculty of their bodies; as by cockering and indulging them, to the utter perversion of their naturally good temper, till they become quite froward and indocile.

When a man takes upon him to contradict received opinions and prejudices sanctified by time, it is expected he should bring valid proof of what he advances. The truth of what I say, that the treatment of Children in general is wrong, unreasonable, and unnatural, will in a great measure appear, if we but consider what a puny valetudinary race most of our people of condition are; chiefly owing to bad nursing, and bad habits contracted early. But let any one, who would be fully convinced of this matter, look over the BILLS OF MORTALITY; [Page]there he may observe, that almost half the number of those who fill up that black list, die under five years of age: so that half the people that come into the world, go out of it again before they become of the least use to it, or themselves. To me this seems to deserve serious consideration; and yet I cannot find, that any one man of sense and public spirit has ever attended to it at all; notwithstanding the maxim in every one's mouth, that a multitude of inhabitants is the greatest strength and best support of a Commonwealth. The misconduct to which I must impute a great part of the calamity, is too common and obvious to engage the idle and speculative, who are to be caught only by very refined researches; and the busy part of mankind, where their immediate interest is not concerned, will always overlook what they see daily; it may be thought a natural evil, and so is submitted to without examination. But this is by no means the case; and where it is entirely owing to mismanagement, and possibly may admit of a remedy, it is ridiculous to charge it upon Nature, and suppose that infants are more subject to disease and death than grown persons; on the contrary, they bear pain and disease much better, fevers especially (as is plain [Page]in the case of the small-pox, generally most favorable to Children) and for the same reason that a twig is less hurt by a storm than an oak. In all the other productions of Nature, we see the greatest vigour and luxuriancy of health, the nearer they are to the egg or the bud; they are indeed then most sensible of injury, and it is injury only that destroys them. When was there a lamb, a bird, or a tree, that died because it was young? These are under the immediate nursing of unerring Nature, and they thrive accordingly. Ought it not therefore to be the care of every Nurse and every Parent, not only to protect their Nurselings from injury, but to be well assured that their own officious services be not the greatest the helpless creatures can suffer?

IN the lower class of Mankind, especially in the country, disease and mortality are not so frequent, either among the adult or their children. Health and posterity are the portion of the poor, I mean the laborious. The want of superfluity confines them more within the limits of Nature: hence they enjoy blessings they feel not, and are ignorant of their cause. The Mother who has only a few rags to cover her child loosely, and little more than her own breast to [Page]feed it, sees it healthy and strong, and very soon able to shift for itself; while the puny insect, the heir and hope of a rich family, lies languishing under a load of finery that overpowers his limbs, abhorring and rejecting the dainties he is crammed with, till he dies a victim to the mistaken care and tenderness of his fond Mother. In the course of my practice, I have had frequent occasion to be fully satisfied of this, and have often heard a mother anxiously say, ‘The Child has not been well ever since it has done puking and crying.’ These complaints, though not attended to, point very plainly to their cause. Is it not very evident, that when a Child rids its stomach several times in a day, that it has been over-loaded? when it cries, from the incumbrance and confinement of its cloaths, that it is hurt by them? While the natural strength lasts (as every Child is born with more health and strength than is generally immagined), it cries at or rejects the superfluous load, and thrives apace: that is, grows very fat, bloated, and distended beyond measure, like a house-lamb. But in time, the same oppressive cause continuing, the natural powers are overcome, being no longer able to throw off the unequal [Page]weight; the Child, not now able to cry any more, languishes and is quiet. The misfortune is, these complaints are not understood! it is swaddled and crammed on, 'till after gripes, purging, &c. it sinks under both burdens into a convulsion-fit, and escapes any farther torture. This would be the case with the lamb, was it not killed when it is full fat.

THAT the present method of nursing is wrong, one would think needed no other proof than the frequent miscarriages attending it, the death of many, and ill health of those that survive. But the persuading you of it may be a needless task; if you have ever thought about it, I doubt not but you are already convinced it is so. However, since you desire my sentiments upon the subject, taking it for granted you think with me, that most of our Nurses are in a wrong method, I will endeavour, in as few words as possible, to tell you what I think a right one.

YOU perceive, Sir, by the hints I have already dropped, what I am going to complain of is, that Children in general are over-cloathed and over-fed; and fed and cloathed improperly. [Page]To these causes I impute almost all their diseases. But to be a little more explicit. The first great mistake is, that they think a new-born infant cannot be kept too warm: from this prejudice they load and bind it with flannels, wrappers, swathes, stays, &c. which all together are almost equal to it's own weight; by which means a healthy Child in a month's time is made so tender and chilly, it cannot bear the external air; and if, by any accident of a door or window left carelessly open too long, a refreshing breeze be admitted into the suffocating atmosphere of the lying-in bedchamber, the child and Mother sometimes catch irrecoverable colds. But, what is worse than this, at the end of the month, if things go on apparently well, this hot-bed plant is sent out into the country to be reared in a leaky house, that lets in wind and rain from every quarter. Is it any wonder the child never thrives afterwards? The truth is, a new-born Child cannot well be too cool and loose in its dress; it wants less cloathing than a grown person in proportion, because it is naturally warmer, as appears by the thermometer, and would therefore bear the cold of a winter's night much better than any adult person whatever. There are [Page]many instances, both antient and modern, of infants exposed and deserted, that have lived several days. As it was the practice of antient times, in many parts of the world, to expose all those whom the parents did not care to be incumbered with; that were deformed, or born under evil stars; not to mention the many Foundlings picked up in LONDON streets. These instances may serve to shew, that Nature has made Children able to bear even great hardships, before they are made weak and sickly by their mistaken Nurses. But, besides the mischief arising from the weight and heat of these swaddling-cloaths, they are put on so tight, and the Child is so cramped by them, that its bowels have not room, nor the limbs any liberty, to act and exert themselves in the free easy manner they ought. This is a very hurtful circumstance; for limbs that are not used will never be strong, and such tender bodies cannot bear much pressure: the circulation restrained by the compression of any one part, must produce unnatural swellings in some other; especially as the fibres of infants are so easily distended. To which doubtless are owing the many distortions and deformities we meet with [Page]every-where; cheifly among Women, who suffer more in this particular than the Men.

IF Nurses were capable of making just observations, they might see and take notice of that particular happiness, which a Child shews by all its powers of expression, when it is newly undressed. How pleased! how delighted! it is with this new liberty, when indulged for a few minutes with the free use of its legs and arms. But this is not to last long; it is swaddled up as before, notwithstanding all its cries and complaints.

I WOULD recommend the following dress: A little flannel waistcoat, without sleeves, made to fit the body, and tie loosely behind; to which there should be a petticoat sewed, and over this a kind of gown of the same material, or any other that is light, thin, and flimsey. The petticoat should not be quite so long as the Child, the gown a few inches longer; with one cap only on the head, which may be made double, if it be thought not warm enough. What I mean is, that the whole coiffure should be so contrived, that it might be put on at once, and neither bind nor press the head at all: the linen [Page]as usual. This I think would be abundantly sufficient for the day; laying aside all those swathes, bandages, stays, and contrivances, that are most ridiculously used to close and keep the head in its place, and support the body. As if nature, exact Nature, had produced her chief work, a human creature, so carelessly unfinished as to want those idle aids to make it perfect. Shoes and stockings are very needless incumbrances; besides that they keep the legs wet and nasty, if they are not changed every hour, and often cramp and hurt the feet: a child would stand firmer, and learn to walk much sooner without them. I think they cannot be necessary till it runs out in the dirt. There should be a thin flannel shirt for the night, which ought to be every way quite loose. Children in this simple, pleasant dress, which may be readily put on and off without teazing them, would find themselves perfectly easy and happy, enjoying the free use of their limbs and faculties, which they would very soon begin to employ when they are thus left at liberty. I would have them put into it as soon as they are born, and continued in it till they are three years old; when it may be changed for any other more genteel and fashionable: though I could wish [Page]it was not the custom to wear stays at all; not because I see no beauty in the sugar-loaf shape, but that I am apprehensive it is often procured at the expence of health and strength of body. There is an odd notion enough entertained about change, and the keeping of children clean. Some imagine that clean linen and fresh cloaths draw, and rob them of their nourishing juices. I cannot see that they do any thing more than imbibe a little of that moisture which their bodies exhale. Were it, as is supposed, it would be of service to them; since they are always too abundantly supplied, and therefore I think they cannot be changed too often, and would have them clean every day; as it would free them from stinks and sournesses, which are not only offensive, but very prejudicial to the tender state of infancy.

THE feeding of Children properly is of much greater importance to them than their cloathing. We ought to take great care to be right in this material article, and that nothing be given them but what is wholesome and good for them, and in such quantity as the body calls for towards it's support and growth; not a grain more. Let us consider what Nature directs in [Page]the case: If we follow Nature, instead of leading or driving it, we cannot err. In the business of Nursing, as well as Physic. Art is ever destructive, if it does not exactly copy this original. When a Child is first born, there seems to be no provision at all made for it; for the Mother's milk, as it is now managed, seldom comes till the third day; so that according to this appearance of Nature, a Child would be left a day and a half, or two days, without any food. Were this really the case, it would be a sufficient proof that it wanted none; as indeed it does not immediately; for it is born full of blood, full of excrement, it's appetites not awake, nor it's senses opened; and requires some intermediate time of abstinence and rest to compose and recover the struggle of the birth and the change of circulation (the blood runing into new channels), which always puts it into a little fever. However extraordinary this might appear, I am sure it would be better that the Child was not fed even all that time, than as it generally is fed; for it would sleep the greatest part of the time, and, when the milk was ready for it, would be very hungry, and suck with more eagerness; which is often necessary, for it seldom comes freely at first. But let me endeavor [Page]to reconcile this difficulty, that a Child should be born thus apparently unprovided for. I say apparently, for in reality it is not so. Nature neither intended that a Child should be kept so long fasting, nor that we should feed it for her. Her design is broke in upon, and a difficulty raised that is wholly owing to mistaken management. The Child, as soon as it is born, is taken from the Mother, and not suffered to suck till the Milk comes of itself; but is either fed with strange and improper things, or put to suck some other Woman, whose Milk flowing in a full stream, overpowers the new-born infant, that has not yet learnt to swallow, and sets it a coughing, or gives it a hiccup: the mother is left to struggle with the load of her milk, unassisted by the sucking of the Child. Thus two great evils are produced, the one a prejudice to the Child's health, the other the danger of the Mother's life, at least the retarding her recovery, by causing what is called a milk-fever; which has been thought to be natural, but so far from it, that it is entirely owing to this misconduct. I am confident from experience, that there would be no fever at all, were things managed rightly: were the Child kept without food of any kind 'till it was hungry, which it is impossible it [Page]should be just after the birth, and then applied to the Mother's breasts; it would suck with strength enough, after a few repeated trials, to make the milk flow gradually, in due proportion to the Child's unexercised faculty of swallowing, and the call of it's stomach. Thus the Child would not only provide for itself the best of nourishment, but, by opening a free passage for it, would take off the Mother's load, as it increased, before it could oppress or hurt her; and therefore effectually prevent the fever; which is caused only by the painful distention of the lacteal vessels of the breasts, when the milk is injudiciously suffered to accumulate. Here let me describe a case of pure Nature, in order to illustrate this material point yet farther. When a healthy young Woman lies-in of her first Child, before the operations of Nature have been perverted by any absurd practices, her labor would be strong, and, as I have chosen to instance in the case of a first Child, perhaps difficult; but in a few minutes after her delivery, she and her Child if it be not injured, would fall into a sweet sleep of six or seven hours: the Mother, if no poisonous opiate has been unnecessarily given her, would awake refreshed, the Child hungry. A little thin broth with bread, or some such light food, [Page]should then be given her; and soon after the Child be put to suck. In one hour or two the milk would infallibly flow; and, if nothing else be given it, the Child would grow strong, and she recover perfectly in a few days. This is the constant course of nature, which is very little attended to, and never followed. The general practice is as soon as a Child is born, to cram a dab of butter and sugar down it's throat, a little oil, panada, caudle, or some such unwholsome mess. So that they set out wrong, and the Child stands a fair chance of being made sick from the first hour. It is the custom of some to give a little roast pig to an infant, which, it seems, is to cure it of all the Mother's longings. Much nonsence has been propagated, and believed, about Womens longings, without any foundation in truth and nature. I wish these matters were a little more enquired into, for the honor of the sex, to which many imperfections of this kind are imputed, which I am sure it does not lie under.

HERE I may be asked, What is to be done with the Child born sick, that, instead of sleeping, cries incessantly from the birth, and is hardly to be quieted by any means? Let good [Page]care be taken that it is not hurt by the dressing, or rather let it not be dressed at all, but wrapped up in a loose flannel. If notwithstanding this precaution, it still continues crying; instead of feeding it, for it is certainly a preposterous thing to think of feeding a Child because it is sick, though possibly this may stop its mouth for a little while; let it be applied to the Mother's breast, perhaps it may bring the milk immediately; which would be the best medicine for it in such a case; or the nipple in its mouth may quiet it, though it does not bring it. And it is certainly better it should be quieted without food than with it, which must necessarily make it worse. Sometimes indeed the child may be so very ill, that it will not even attempt to suck. In such a case, which I think can happen but rarely, where Children are unavoidably to be dry nursed, let the physic I shall recommend a little farther on, be given, a little every hour, 'till it takes effect; still attempting to bring it to suck the Mother's milk, which is the best Physick or food it can take.

WHEN a Child sucks it's own Mother, which, with a very few exceptions, would be [Page]best for every Child and every Mother, Nature has provided it with such wholsome and suitable nourishment; supposing her a temperate Woman, that makes some use of her limbs, it can hardly do amiss. The Mother would likewise, in most hysterical nervous cases, establish her own health by it though she were weak and sickly before, as well as that of her offspring. For these reasons I could wish, that every Woman that is able, whose fountains are not greatly disturbed or tainted, would give suck to her Child. I am very sure, that forcing back the milk, which most young Women must have in great abundance, may be of fatal consequence: sometimes it endangers life, and often lays the foundation of many incurable diseases. The reasons that are given for this practice are very frivolous, and drawn from false premises; that some Women are too weak to bear such a drain, which would rob them of their nourishment. This is a very mistaken notion; for the first general cause of most peoples diseases is, not want of nourishment as here imagined, but too great a fulness and redundancy of humours; good at first, but, being more than the body can employ or consume, they stagnate, degenerate, and the whole mass becomes corrupt, and produces many diseases. [Page]This is confirmed by the general practice of Physicians, who make holes in the skin, perpetual blisters, issues, &c. to let out the superfluity. I would therefore leave it to be considered, whether the throwing back such a load of humour, as a Woman's first milk, be most likely to mend her constitution, or make her complaints irremediable. The Mother's first milk is purgative, and cleanses the Child of it's long-hoarded excrement; no Child, therefore, can be deprived of it without manifest injury. By degrees it changes its property, becomes less purgative, and more nourishing; and is the best and only food the Child likes, or ought to have for some time. If I could prevail, no Child should ever be crammed with any unnatural mixture, till the provision of Nature was ready for it; nor afterwards fed with any ungenial alien diet whatever, at least for the first three months: for it is not able to digest and assimilate other aliments sooner. I have seen very healthy fine Children, that never eat or drank any thing whatever but the Mother's milk for the first ten or twelve months. Nature seems to direct this, by giving them no teeth 'till about that time. There is usually milk enough with the first Child; sometimes more than it can [Page]take: it is poured forth from an exuberant, overflowing urn, by a bountiful hand, that never provides sparingly. The call of Nature should be waited for to feed it with any thing more substantial, and the appetite ever precede the food; not only with regard to the daily meals, but those changes of diet, which opening, increasing life requires. But this is never done in either case, which is one the greatest mistakes of all Nurses. Thus far Nature, if she be not interrupted, will do the whole business perfectly well; and there seems to be nothing left for a Nurse to do, but to keep the Child clean and sweet, and to tumble and toss it about a good deal, play with it, and keep it in good humour.

WHEN the Child requires more solid sustenance, we are to enquire what, and how much, is most proper to give it. We may be well assured, there is a great mistake either in the quantity or quality of Childrens food, or both, as it is usually given them; because they are made sick by it; for to this mistake I cannot help imputing nine in ten of all their diseases. As to quantity, there is a most ridiculous error in the common practice; for it is generally supposed, [Page]that whenever a Child cries, it wants victuals; and it is accordingly fed, ten, twelve, or more times in a day and night. This is so obvious a misapprehension, that I am surprized it should ever prevail. If a Child's wants and motions be diligently and judiciously attended to, it will be found that it never cries but from pain: now the first sensations of hunger are not attended with pain; accordingly a Child (I mean this of a very young one) that is hungry, will make a hundred other signs of its want, before it will cry for food. If it be healthy and quite easy in it's dress, it will hardly ever cry at all. Indeed these signs and motions I speak of are but rarely to be observed; because it seldom happens that Children are ever suffered to be hungry. In a few, very few, whom I have had the the pleasure to see reasonably nursed, that were not fed above two or three times in four and twenty hours, and yet were perfectly healthy, active, and happy; I have seen these signals, which were as intelligible as if they had spoken.

THERE are many faults in the quality of their food: it is not simple enough. Their paps, panada's, gruels, &c. are generally enriched with sugar, spice, and sometimes a drop of [Page]wine; neither of which they ought ever to taste. Our bodies never want them: they are what luxury only has introduced, to the destruction of the health of mankind. It is not enough that their food be simple, it should be also light. Several people, I find, are mistaken in their notions of what is light; and fancy that most kinds of pastry, puddings, custards, &c. are light, that is, light of digestion. But there is nothing heavier in this sense than unfermented flour and eggs boiled hard, which are the chief ingredients of those preparations. What I mean by light, to give the best idea I can of it, is any substance that is easily separated, and soluble in warm water. Good bread is the lightest thing I know; the power of due fermentation, in which consists the whole art of making it, breaks and attenuates the tenacious particles of the flour, so as to give it these qualities I mention, and make it the fittest food for young Children. Cowes milk is also simple and light, and very good for them; but it is injudiciously prepared: it should not be boiled, for boiling alters the taste and property of it, destroys it's sweetness, and makes it thicker, heavier, and less fit to mix and assimilate with the blood. [Page]But the chief objection is, that their food is wholly vegetable, the bad consequence of which is, that it will turn sour in their stomachs. The first and general cause of all the diseases of infants, is manifestly this acescent quality of all their food. If any of these vegetable preperations I have named, be kept in a degree of heat equal to that of a Child's stomach, it will become sour as vinegar in a few hours time. These things are therefore very improper to feed a Child wholly with. Some part of it's diet should be contrived to have a contrary tendency; such as we find only in flesh, which is the direct opposite to acid, and tends to putrefaction. In a due mixture of these two extremes, correcting each other, consists that salubrity of aliment our nature seems to require. As we are partly carnivorous animals, a child ought not to be fed wholly upon vegetables. The Mother's milk, when it is perfectly good, seems to be this true mixture of the animal and vegetable properties, that agrees best with the constitution of a Child; readily passes into good blood, requiring but a gentle exertion of the powers of circulation to break and subdue it's particles and make them smooth and round, and easily divisible. I would advise [Page]therefore, that one half of infants diet be thin light broths, with a little bread or rice boiled in them; which last is not so acescent as any other kind of meal or flour. These broths should be made with the flesh of full-grown animals, because their juices are more elaborate; especially if they have never been confined to be fatted. The juices of a young ox, taken from the plough, make the finest flavoured and most wholsome soup. I believe it is for the same reason, the flesh of all wild animals has a higher taste than that of tame, saginated ones, and is therefore most agreeable to the palate of the luxurious: but this is to be understood of those creatures that feed on corn or herbage. The other part of Childrens diet may be a little toasted bread and water boiled almost dry and then mixed with fresh milk, not boiled*. This without sugar, spice, or any [Page]other pretended amendment whatever, would be perfectly light and wholsome, of sufficient nourishment, something like milk from the cow, with the additional strength and spirit of bread in it. Twice a day, and not oftener, a sucking Child should be fed at first; once with the broth, and once with the milk thus prepared. As to the quantity at each time, it's appetite must be the measure of that; it's hunger should be satisfied, but no more; for Children will always eat with some eagerness full as much as they ought: therefore it must be very wrong to go beyond that, and stuff them 'till they spew, as the common method is. They should not be laid on their backs to be fed, but held in a sitting posture, that swallowing may be easier to them, and that they may the more readily discover when they have had enough. When they come to be about TEN or TWELVE MONTHS old, and their appetite & digestion grows strong, they may be fed three times a day; which, I think, they ought never to exceed their whole lives after. By night I [Page]would not have them fed or suckled at all, that they might at least be hungry in the morning. It is this night feeding that makes them so overfat and bloated. If they be not used to it at at first, and, perhaps, awaked on purpose, they will never seek it; and if they are not disturbed from the birth, in a week's time they will get into a habit of sleeping all or most part of the night very quietly; awaking possibly once or twice for a few minutes when they are wet, and ought to be changed. Their meals, and in my opinion, their sucking too, ought to be at stated times, and the same every day; that the stomach may have intervals to digest, and the appetite return. The Child would soon be quite easy & satisfied in the habit; much more so, than when taught to expect food at all times, and at every little fit of crying and uneasiness. Let this method be observed about a TWELVE-MONTH, when, and not before, they may be weaned; not all at once, but by insensible degrees; that they may neither feel, nor fret at the want of the breast. This might be very easily managed, if they were suffered to suck only at certain times. Were this plan of nursing literally pursued, the Children kept clean and sweet, tumbled and tossed about a good deal, [Page]and carried out every day in all weathers, I am confident, that in six or eight months time most Children would become healthy and strong, would be able to sit up on the ground without support, to divert themselves an hour at a time, to the great relief of their Nurses, would readily find the use of their legs, and very soon shift for themselves.

IF it be asked, whether I mean this of children in general, and that weakly ones, born of unhealthy parents, should be treated in the same manner; I answer, that it is not so common for Children to inherit the diseases of their parents, as is generally imagined; there is much vulgar error in this opinion; for people that are very unhealthy seldom have Children, especially if the bad health be of the female side; and it is generally late in life when chronic diseases take place in most Men, when the business of love is pretty well over: certainly Children can have no title to those infirmities, which their parents have acquired by indolence and intemperance long after their birth. It is not common for people to complain of ails they think hereditary, 'till they are grown up; that is, 'till they have contributed to them by their own irregularities [Page]and excesses, and then are glad to throw their own faults back upon their Parents, and lament a bad constitution, when they have spoiled a very good one. It is very seldom that young Children are troubled with family-distempers: indeed, when we find them affected with scrophulous or venereal complaints we may reasonably conclude the taint to have been transmitted to them; but these cases are very rare in comparison of the many others that are falsly, and without the least foundation, imputted to Parents, when the real cause is either in the complainants themselves, or bad nursing that has fixed them early in wrong habits. In one sense many diseases may be said to be hereditary, prehaps all those of malformation; by which I mean not only deformity and distortion, but all those cases where the fibres and vessels of one part are weaker in proportion than the rest; so that upon any strain of the body, whether of debauch or too violent exercise, the weak part fails first, and disorders the whole. Thus complaints may be produced similar to those of the Parent, owing in some measure to the similitude of parts, which possibly is inherited, like the features of the face; but yet these diseases might never have appeared, but for the immediate acting cause, the violence done [Page]to the body. Most distempers have two causes; the one a particular state of the solids and fluids of the body, which dispose it to recive certain infections and impulses; the other, the infection or impulse itself. Now what I contend for is, that though this predisponent state or habit of the body be heritable, yet the diseases incident to these wretched heirs may be avoided, by preventing the active cause; which may be done in many cases by a due attenton to the non-naturals, as they are called; in plainer words, by a temperate, active life: in Children, by good nursing. Therefore I conclude, that instead of indulging and enfeebling yet more, by the common methods, Children so unhappily born; that which I am recommending, together with the wholsome milk of a healthy Nurse, is the best, the only means to remedy the evil, and by which alone they may by degrees be made healthy and strong. And thus, in a generation or two of reasonable temperate persons, every taint and infirmity whatever, the king's-evil and madness not excepted, would be totally worn out.

THE plain natural plan I have laid down is never followed, because most Mothers, of any [Page]condition, either cannot, or will not undertake the troublesome task of suckling their own Children; which is troublesome only for want of proper method; were it rightly managed, their would be much pleasure in it, to every Woman that can prevail upon herself to give up a little of the beauty of her breast to feed her offspring; though this is a mistaken notion, for the breasts are not spoiled by giving suck, but by growing fat. There would be no fear of offending the husband's ears with the noise of the squalling brat. The Child, was it nursed in this way, would be always quiet, in good humour, ever playing, laughing, or sleeping. In my opinion, a Man of sense cannot have a prettier rattle (for rattles he must have of one kind or other) than such a young Child. I am quite at a loss to account for the general practice of sending infants out of doors, to be suckled or dry-nursed by another Woman, who has not so much understanding, nor can have so much affection for it as the Parents; and how it comes to pass, that people of good sense and easy circumstances will not give themselves the pains to watch over the health and welfare of their Children; but are so careless as to give [Page]them up to the common methods, without considering how near it is to an equal chance, that they are destroyed by them. The antient custom of exposing them to wild beasts, or drowning them, would certainly be a much quicker and more humane way of dispatching them. There are some, however who wish to have Children, and to preserve them, but are mistaken in their cares about them. To such only I would address myself, and recommend it to every Father to have his Child nursed under his own eye, to make use of his own reason and sense in superintending and directing the management of it; nor suffer it to be made one of the mysteries of the Bona Dea, from which the Men are to be excluded. I would advise every Mother that can, for her own sake, as well as her Child's to suckle it. If she be a healthy Woman, it will confirm her health; if weakly, in most cases it will restore her. It need be no confinement to her, or abridgment of her time; four times in four and twenty hours will be often enough to give it suck; letting it have as much as it will take out of both breasts at each time. It may be fed and dressed by some handy reasonable servant, that will submit to be directed; whom likewise it may sleep with. No [Page]other Woman's milk can be so good for her Child; and dry-nursing I look upon to be the most unnatural and dangerous method of all; and, according to my observation, not one in three survives it. To breed a Child in this artificial manner, requires more knowledge of Nature, and the animal oeconomy, than the best Nurse was ever mistress of, as well as more care and attention than is generally bestowed on Children; the skill of a good Physician would be necessary to manage it rightly. I am very glad this is not the method of the Hospital: I believe there is not the least colour of objection to any part of the management of that most useful and excellent charity, as far as it depends upon the directors of it. Sending the Children out to Country-nurses, under the care of Inspectors, is undoubtedly the best method they could take; but how far these Nurses and their Inspectors (who, I suppose, are to be some good Gentlewomen in the neighbourhood) may be persuaded out of their old forms, to treat their Nurselings a little more reasonably, is matter of much doubt. I fear they will be too tenacious of their prejudices, as well as opinionated of their skill, to be easily convinced they are in the wrong; and who shall undertake the task? [Page]However, I despair not of seeing a reformation one day or other; and to contribute to it as as much as lies in my power, I will give you my opinion as to the precautions necessary to be taken in the choice of these Nurses; and likewise a few reasons why the Children, entrusted to their care, should be treated some-what differently from those who are nursed in a more natural way, and suck their own Mothers. I make no doubt, but great care is taken, that the Nurses recommended to the Hospital be clean and healthy Women. But this is not enough; the preference should be given to the middle-aged; because they will have more milk than the very young, and more and better than the old. This is a material consideration, as I suppose they have each her own Child to suckle besides. Those between twenty and thirty are certainly of the best age. But what I think of the utmost consequence is, that great regard should be had to the time of their lying-in, and those procured, if possible, who have not been bro't to bed above two or three months. The reason of this is, that Nature intending a Child should suck about a twelvemonth, the milk seldom continues good much longer. About that time, Women in general, though they give suck, are [Page]apt to breed again: some, indeed, that are very sanguine, will breed sooner; these, notwithstanding their milk, are apt to be troubled with the catamenia, which disturb it greatly; and therefore are not so proper to be made Nurses of. But, whether they breed or not, it is my opinion, that after a year's time, or thereabouts, however it may agree with the Child that has sucked it from the first, their milk will become stale and vapid, at least very unfit for a new-born infant; that if it be deprived of it's own Mother's milk, ought undoubtedly to have what is most like it; the newer it is, the more suitable in all respects to it's tender nature. Yet it is a common thing for a Woman to suckle two or three Children successively with the same milk.

A NURSE ought to have great regard to her diet: it is not enough that she be sober and temperate, her food should consist of a proper mixture of flesh and vegetables: she should eat one hearty meal of unsalted flesh-meat every day, with a good deal of garden stuff and a little bread. Thin broth or milk would be best for her breakfast and supper. Her drink should be small beer, or milk and water; but upon no account should she ever touch a drop [Page]of wine or strong drink, much less any kind of spirituous liquors: giving ale or brandy to a Nurse is, in effect, giving it the Child; and it is easy to conclude what would be the consequence.

THE Children, likewise, thus sent out, require a particular treatment. The plan I would lay down, could I prevail, should be that of Nature, excluding Art and foreign aid entirely. But when this is broke in upon, a little adventitious skill becomes indispensably necessary; that if we are not perfectly right in following closely the design of Nature, we may co-operate a little, and not be totally wrong in counter-acting it, as is too often the case. What I mean is, that every Child, not allowed the Mother's first milk, whether it be dry-nursed, or suckled by another Woman, should be purged in a day or two after the birth; and this purging continued for some time: not by regular doses of physick, that may operate all at once; but some lenient laxative should he contrived, and given two or three times a day, so as to keep the Child's body open for the first nine days, or fortnight; lessening the quantity insensibly, 'till it be left [Page]off. It should be so managed, that the operation of the artifical physick may resemble that of the natural. This is so material, that, for want of it, most Children within the first month break out in pimples all over; the Nurses call it the red-gum, and look upon it to be a natural thing, and that the children will be unhealthy that have it not. So indeed they will be in all likelihood; and it is better that these foulnesses, which become acrid and hot by remaining too long in the body, should be discharged through the skin; than not at all; or that they should be lodged in the blood, or fall upon the vitals, to lay the foundation of numberless future evils; but it is chiefly owing to the neglect of this method at first. A Child that sucks it's own mother, unless it be greatly over-fed, or kept too hot, will never be troubled with this humour at all. If the Children that are brought to the Hospital be not above a month old, and if it be found, upon enquiry, that they have not sucked their own Mothers, something of this kind prescribed them would not be too late and improper. The following form may be used: Take manna, pulp of cassia, of each half an ounce; dissolve them in about three ounces of thin broth. Let the [Page]Child take two spoonfuls three times a day, varying the quantity according to the effect; which, at first, ought to be three or four stools in four and twenty hours.

ORDERS should be given these Nurses to keep the Children awake by day, as long as they are disposed to be so, and to amuse and keep them in good humour all they can; not to lull and rock them to sleep, or to continue their sleep too long; which is only done to save their own time and trouble, to the great detriment of the Childrens health, spirits, and understanding. With regard to feeding them, as it is not likely they should have milk enough to support two, their own, and the Hospitial-child; it is best they should begin immediately according to the method I have recommended, if they or their inspectors can be persuaded to think it right; which however, I would not have understood so strictly, but it might sometimes be a little varied, preserving only the intention, I would advise, however, if it be thought proper, now and then, to give them, as they grow up, a little bread and butter perfectly sweet and fresh, and allowed but in very small quantity; otherwise it will be apt to turn bitter [Page]and rancid in the stomach, and foul all the juices of the body. A Child may be allowed any kind of mellow fruit, either raw, stewed, or baked; roots of all sorts, and all the produce of the kitchen-garden. I am sure all these things are wholesome and good for them, and every one else, notwithstanding the idle notion of their being windy, which they are only to very debauched stomachs; and so i [...] milk; but no Man's blood wants the cleansing refreshing power of milk more than his, whose stomach, used to inflammatory things of high relish, will not bear the first chill of it. To Children, all this kind of food, taken in moderation, is perfectly grateful and salutary. Some may think that they carry into the stomach the eggs of future worms; but of this I am not very apprehensive; for I believe there are few things we eat or drink, that do not convey them. But then they can never be hatched in a healthy inside, where all the juices are sweet and good, and every gland performs it's office: the gall in particular, would destroy them: bullocks gall has been found to be a good and safe vermifuge. It is my opinion, we swallow the eggs of many little animals, that are never [Page]brought into life within us, except where they find a fit nest or lodgment in the acid phlegm or vitiated humours of the stomach and bowels. Were these totally discharged every day, and the food of yesterday employed in nourishment, and the superfluity thrown off to the last grain, no worms could ever breed or harbour in our vitals. As soon as the Children have any teeth, at six or eight months they may by degrees be used to a little flesh-meat; which they are always very fond of, much more so at first, than of any confectionary or pastry wares, with which they should never debauch their taste.

BREEDING teeth has been thought to be, and is fatal to many Children; but I am confident this is not from Nature: for it is no disease, or we could not be well in health 'till one or two and twenty, or later. Teeth are breeding the greatest part of that time; and it is my opinion, the last teeth give more pain than the first, as the bones and gums they are to pierce, are grown more firm and hard. But, whatever fever, fits, or other dangerous symptoms seem to attend this operation of Nature, healthy Children have sometimes bred their teeth without [Page]any such bad attendants; which ought to incline us to suspect the evil not to be natural, but rather the effect of too great a fulness, or the corrupt humours of the body put into agitation by the stimulating pain the tooth causes in breaking its way out. This, I believe, never happens without some pain, and possibly a little fever; but if the blood and juices be perfectly sweet and good, and there be not too great a redundancy of them, both will be but slight, and pass off imperceptibly, without any bad consequence whatever. The chief intention of the method I am recommending is, to preserve the humours of the body in this state; and therefore, if it succeeds, Children so managed will breed their teeth with less pain and danger than are commonly observed to attend this work of Nature.

AS I have said, that the first and general cause of most of the diseases infants are liable to is the acid corruption of their food; it may not be amiss just to mention an easy and certain remedy, or rather preventative, if given timely, at the first appearance of predominating acid; which is very obvious from the crude, white, or green stools, gripes and purgings occasioned [Page]by it. The common method, when these symptoms appear, is to give the pearl-julep, crab's eye, and the testaceous powders; which, though they do absorb the acidities, have this inconvenience in their effect, that they are apt to lodge in the body, and bring on a costiveness, very detrimental to infants, and therefore require a little manna, or some gentle purge, to be given frequently to carry them off. Instead of these, I would recommend a certain fine insipid powder, called Magnesia alba, which, at the same time that it corrects and sweetens all sournesses, rather more effectually than the testaceous powders, is likewise a lenient purgagative, and keeps the body gently open. This is the only alkaline purge I know of, and which our dispensatories have long wanted. I have taken it myself, and given it to others for the heart-burn, and find it to be the best and most effectual remedy for that complaint. It may be given to Children from one to two drams a day, a little at a time, in all their food, 'till the acidities be quite overcome, and the concomitant symptoms disappear entirely. I have often given it with good and great effect, even when the Children have been far gone in diseases first brought on by prevailing acid.

[Page]IT is always easier to prevent diseases than to cure them; and as neither Children, nor indeed grown persons, are ever seized with chronic diseases suddenly, the progress of decaying health being perceptibly gradual, it is no difficult matter for a Physician of common skill to observe the first step towards illness, and to foretel the consequence, in all those whose habit of life is well known to him. But to Parents and Nurses in general, these observations may not occur; I will therefore point out a few certain signs and symptoms, by which they may be assured that a Child's health is decaying, even before it appears to be sick. If these are neglected, the evil increases, grows from bad to worse, and more violent and apparent complaints will follow, and perhaps end in incurable diseases, which a timely remedy, or a slight change in the diet and manner of life, had infallibly prevented. The first tendency to disease may be observed in a Child's breath. It is not enough the breath be not offensive; it should be sweet & fragrant like a nosegay of fresh flowers, or a pail of new milk from a young cow that feeds upon the sweetest grass of the spring; and this as well at first waking in the morning, as all day long. It is always so with Children [Page]that are in perfect delicate health. As soon, therefore, as a Child's breath is found to be either hot or strong, or sour, we may be assured that digestion and surfeit have fouled and and disturbed the blood, and now is the time to apply a proper remedy, and prevent a train of impending evils. Let the Child be restrained in it's food; eat less, live upon milk or thin broth for a day or two; be carried, or walk if it is able, a little more than usual in the open air. Let a little of this powder, or any other proper physick, be given; not that I would advise physic to be made familiar, but one dose administerd now would prevent the necessity of a great many, that might afterwards be prescribed with much less good effect.

IF this first symptom of approaching illness be overlooked, the Child, who, if it was healthy, would lie quiet as a log all night, will have disturbed sleep, restlessness, terrifying dreams; will be talking, starting, kicking and tumbling about; or smiling and laughing, as is common with very young Children when they are griped, and the Nurses say they see and converse with Angels. After this will follow loss of appetite and complexion, check of growth, decay of strength, cough, consumption; or else [Page]colicks, gripes, worms, fits, &c. diseases that require all the skill of a good Physician; and happy for them, if the utmost he can employ will restore them to any degree of lasting health.

THERE is one thing more which I forgot to mention in it's proper place, and therefore I must take notice of it here; that is, the degree of exercise proper for Children. This is of more consequence that all the rest; for without it, all our care in feeding and cloathing will not succeed to our wishes: but when by due degrees a Child is brought to bear a good deal of exercise without fatigue, it is inconceivable how much impropriety and absurdity in both those articles it will endure unhurt. A Child, therefore, should be pushed forwards, and taught to walk as soon as possible. A healthy Child a year old will be able to walk alone. This we may call the aera of their deliverance; for this great difficulty surmounted, they generally do well, by getting out of the Nurse's hands to shift for themselves. And here I must endeavour to correct a great mistake, which is, that most people think it wrong to put weakly Children upon their legs, especially if they are the least bent or crooked; but whoever will [Page]venture the experiment will surely find, that crooked legs will grow in time strong and straight by frequent walking, while disuse will make them worse and worse every day. As they grow daily more and more able, let their walks be gradually increased, 'till they can walk two miles on a stretch without weariness; which they will be very well able to do before they are three years old, if they are accustomed to it every day. To lead them such a walk should be imposed as an indispensible task upon their maids; for to them it will be the highest pleasure; so far from a burden to them, that if they perform the daily duty, they will, from the impulse of their own active vigour, be found running, leaping and playing, all day long. Thus, a dull, heavy Child may be made playful and sprightly, a weakly one healthy and strong, and confirmed in good habits and perpetual health.

THERE are some other little niceties, that, were they observed in the nursing of Children, would be of some use to them, such as making them lie straight in bed, I do not mean extended like a corpse, but that their limbs may be free and easy. I have sometimes seen Children [Page]a year or two old lie doubled up in bed as in the womb, especially in cold weather, and from the constraint of their posture fall into profuse sweats. This will be prevented if they are laid straight, and sleep relaxing all the muscles of the body, the knees will naturally be bent a little. They should be taught to use both hands alike; for employing one more than the other, will not only make the hand and arm so used, but also that side of the body, bigger than the other. This is sometimes the cause of crookedness. It would likewise not be amiss to forward their speaking plain, by speaking plain distinct words to them, instead of the namby-pamby stile, and giving them back their own broken inarticulate attempts; by which means, I believe, some Children scarcely speak intelligibly at seven years of age. I think they cannot be made reasonable creatures too soon.

THESE few loose thoughts on the subject of nursing Children, I send you for your private satisfaction, if they be lucky enough to give you any. I have neither time nor patience to think of form and order, or supporting them [Page]by affected demonstrations taken from mechanical principles and powers. All I have endeavoured is to be intelligible and useful; and therefore I have avoided, as much as possible, all terms of art; together with learned quotations, as often produced out of vanity, and to show deep reading, as for the sake of proof. If you think it may be of any use to publish this Letter, I am not unwilling it should appear; if not, do with it what you please. I deliver it up as a FOUNDLING, to be disposed of as you think proper. I shall only add, by way of persuasive to those who may be inclined to make trial of the method I recommend, that I am a Father, and have already practised it with the most desirable success.

FINIS.

George-street, Hanover-square, 17 July, 1769.

P. S. IT is now above twenty years since I wrote the foregoing essay, and though I have made a few alterations, it was only to explain those passages that contained any apparent difficulty or obscurity; I have never yet found [Page]cause to alter essentially any one opinion delivered in it. I have thro' the whole industriously laboured at the greatest plainess and simplicity, and yet my meaning has been much mistaken. Some have very strangely expected to find in it the general cure of Childrens diseases, though it be professedly wrote only to prevent them, by establishing good health; a very different thing (whatever people may think) from the cure of diseases. Sick or weak Children, whether such by Nature or made such by bad Nursing, cannot perhaps be brought immediately into the habits here recommended, but must first be cured of their maladies by a skilful physician, who, if he be also an honest man, will introduce these or similar habits of management, to continue them in health and strength. But in treating their diseases, as well as in nursing them I am very sure many capital errors are committed. I object greatly in particular to the frequent use of antimonial and mercurial medicines; which, tho' they give sometimes a little temporary releif, by discharging crude and phlegmatic humours, killing worms, &c. I am very confident a repeated use of them breaks the blood, relaxes the fibres, [Page]and is every way destructive to the constitution of Children. Present relief seems to be all that is desired, and therefore all that is intended by medication; the slow but permanent effects of good habits few have patience to expect. Others have neglected essentials, to lay stress only upon trifles: A Lady of great sway among her acquaintance told me not long ago, with an air of reproach, that she had nursed her Child according to my book, and it died. I asked, if she had suckled it herself? No. Had it sucked any other woman? It was dry-nursed. Then Madam, you cannot impute your misfortune to my advice, for you have taken a methed quite contrary to it, in the most capital point. Oh but, according to my direction, it had never worn stockings. Madam, Children may die, though they do or do not wear stockings.

Notes

*

The LONDON Bakers are suspected of putting Alum in their bread, which would be very pernicious to Infants; therefore rusks, or the biscuits called tops-and-bottoms, or rice may be used instead of it. These will not turn sour so soon as common bread; which quality is undoubtedly an objection to using much of it, especially when Children are weakly. The safest and best method in my opinion is not to feed them at all; at least till they are six or eight months old. The finest Children I ever saw lived wholly upon sucking till after that age.

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[Page]

AN ESSAY UPON NURSING AND THE MANAGEMENT of CHILDREN, FROM Their BIRTH to THREE YEARS of Age.

BY W. CADOGAN, FELLOW of the COLLEGE of PHYSICIANS, Late PHYSICIAN to the FOUNDLING-HOSPITAL.

In a LETTER to a GOVERNOR.

Published by Order of the GENERAL COMMITTEE for transacting the Affairs of the said Hospital.

THE TENTH EDITION.

Revised and Corrected by the AUTHOR.

LONDON, Printed: BOSTON, Re-printed for COX and BERRY, in King-Street. MDCCLXXII.

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Title statement

An essay upon nursing and the management of children, from their birth to three years of age. By W. Cadogan, Fellow of the College of Physicians, late physician to the Foundling-Hospital. ; In a letter to a governor. ; Published by order of the general committee for transacting the affairs of the said hospital.

Cadogan, William, 1711-1797.

Publication

Publisher

Text Creation Partnership,

Place of publication

Ann Arbor, MI :

Date

2008-09.

ID [DLPS]

N09700

ID [TCP]

N09700

ID [STC]

Evans 12344

ID [NOTIS]

APY4884

ID [IMAGE-SET]

12344

ID [EVANS-CITATION]

99032039

Availability

This keyboarded and encoded edition of the work described above is co-owned by the institutions providing financial support to the Early English Books Online Text Creation Partnership. This Phase I text is available for reuse, according to the terms of Creative Commons 0 1.0 Universal. The text can be copied, modified, distributed and performed, even for commercial purposes, all without asking permission.

Series

Early American Imprints, 1639-1800 ; no. 12344.

Notes

(Evans-TCP ; no. N09700)

Transcribed from: (Readex Archive of Americana ; Early American Imprints, series I ; image set 12344)

Images scanned from Readex microprint and microform: (Early American imprints. First series ; no. 12344)

Source

— An essay upon nursing and the management of children, from their birth to three years of age. By W. Cadogan, Fellow of the College of Physicians, late physician to the Foundling-Hospital. ; In a letter to a governor. ; Published by order of the general committee for transacting the affairs of the said hospital., Cadogan, William, 1711-1797.. The tenth edition. /.

Extent

52, [4] p. ; 21 cm. (8vo)

London, printed: Boston, re-printed for Cox and Berry, in King-Street.,. [Boston] :: MDCCLXXII. [1772]. (Bookseller's advertisements, [4] p.)

Creation

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