[Leaflet issued by New York City Department of Health.]

TEN REASONS WHY A MOTHER SHOULD NURSE HER BABY.

1. One death out of every five which occur at all ages is that of a baby under 1 year of age.

2. In the city of New York during 1910, 4,794 babies under 1 year of age died from bowel trouble, and 9 out of every 10 of these babies were bottle fed.

3. Out of the 16,213 babies under 1 year of age who died from all causes in New York city during 1910, one-third died before they were 1 month old.

4. A large proportion of these babies would have lived if they had been nursed by their mothers.

5. Mother's milk is the only safe food for a baby during the first six months of its life. If the weather is warm the baby should not be weaned until it is at least 9 months old. Cow's milk or prepared food can never equal breast milk as the proper food for the baby.

6. Breast-fed babies rarely have bowel trouble. Bottle-fed babies rarely escape having it, particularly during warm weather.

7. Babies fed on breast milk show the best development; the teeth will appear at the proper time, the muscles and bones will be stronger, and walking will not be delayed.

8. A breast-fed baby is not so likely to have bronchitis or croup, and if attacked by any disease has a much better chance of living than a bottle-fed baby.

9. Pneumonia in babies is fatal more often in bottle-fed babies than in breast-fed babies.

10. Your baby will have the best chance of living that you can give it if it is breast fed.

Surely these facts are worth considering before deciding not to nurse your baby.

Issued by order of the board of health.

54

[Circular issued by the Pennsylvania Department of Health.]

FORM 20.

SAVE THE BABIES.

RULES TO BE OBSERVED IN THE CARE AND MANAGEMENT OF INFANTS DURING THE SUMMER.

The hot weather of this season of the year is extremely dangerous to the lives of infants and young children, not only because of the depressing effects of high atmospheric temperature in general, but more especially because of the effect of hot weather upon all perishable articles of food, among which cow's milk holds the first place.

It is therefore highly important that cow's milk to be used for infant's food should be the purest and freshest that you can afford to buy. During the hot weather ice is absolutely necessary for the preservation of milk, and all milk used for food should be cooled by ice as soon as it comes from the cow and should be kept next to the ice until ready to be used. A little money spent for ice may prevent illness and its much greater expense for medicine, nursing, and medical attendance. As water is often a carrier of disease it is safest to use only boiled water for drinking or the preparation of a baby's food. The following rules will aid you in keeping your baby well during the hot weather:

Breast feeding.-Every mother should endeavor to nurse her baby. Breast milk is the natural food of the newborn baby. There is no other food that can compare with it. A breast-fed baby has a much greater chance of living than a bottle-fed baby.

Immediately after birth do not give any kind of artificial food to the baby, while waiting for the breast milk to come. Put the baby to the breast every four hours, and give nothing else but water that has been boiled. The baby needs nothing else, and will not starve. After the milk comes into the breast nurse the baby every two hours during the day and two or three times at night.

Don't nurse the baby whenever he cries; a moderate amount of crying helps to develop the lungs. Babies who are nursed irregularly, or whenever they cry, are likely to get indigestion and then cry the harder from pain. Nurse regularly and the baby will soon learn to expect its nursing only at the proper intervals. Give the baby a little boiled water several times a day.

After the baby is 2 months old lengthen the time between feeding to 2 or 3 hours, with only one or two feedings at night.

Do not wean the baby as long as he is gaining and never do so except by advice of your doctor. Do not follow the advice of friends or neighbors about weaning. If the baby remains well but after a time stops gaining in weight, do not think that your milk is of no value, but consult your doctor about adding one or two bottles to help you out.

Bottle feeding.-If it becomes necessary to feed the baby either entirely or only in part upon the bottle, remember that the greatest cleanliness is necessary in all details of the feeding. As soon as a bottle is finished, it should be thoroughly washed with cold water, then cleansed with hot water and borax (1 teaspoonful to a pint of water) and put aside for further cleansing, before being used again. If you have only a few bottles and it becomes necessary to use the same bottle for the next feeding, boil it for a few minutes before putting fresh food into it. Never let the baby nurse from the remains of a bottle which he has not finished at once. Take it away from the crib, pour out the milk, and cleanse at once. Stale milk curds sticking to the inside of a bottle after a few hours become poisonous and may contaminate fresh milk coming in contact with them. It is better to have as many bottles as the number of the baby's daily feedings, so that all the bottles can be boiled together before the food is prepared in the morning.

Nipples. The simpler the nipple the safer for the baby. Do not use complicated nipples, and under no circumstances buy a bottle with a long rubber tube attached to the nipple. It can not be kept clean and will certainly cause bowel trouble. After the bottle is finished the nipple should be removed at once, turned inside out over the finger and scrubbed with cold water and a brush kept only for this purpose. After use, always boil the brush.

The cleansed nipple should be kept in fresh borax water (1 teaspoonful of borax to a pint of water) in a covered glass. Rinse the nipple in boiling water before using it.

Do not put the nipple into your own mouth to find out whether the milk is warmed enough. Let a few drops of the milk fall on your wrist; if it feels too hot to your wrist it is too hot for the baby's mouth.

No general instructions can be given about the preparation of a milk mixture for your baby. Each baby needs a combination suited to his digestion. The mixture upon which some other baby is thriving may be too strong or too weak for your baby. Let the doctor tell you how to mix the food. If it is necessary to use cream in the mixture do not buy cream-it is likely to be stale-but get it by pouring off half a pint from the top of a quart bottle of milk, after cleansing the lip of the bottle.

Do not be guilty of constantly changing food for the baby as mothers are apt to do through the advice of "good" neighbors. Follow the instructions of your doctor.

During the summer the baby's food should be brought to a scald after it is prepared. It should then be poured into the clean bottles, corked with baked clean cotton wool and kept next the ice until needed. Do not heat a bottle when you go to bed and keep it in bed until nursing time, because you do not want to go to the ice box for it and heat it when the baby needs it. This is a certain way to make the baby sick.

Bowel movement.-A bottle-fed baby should have at least one and not more than two or three bowel movements a day. If the milk is clean to start with and has been kept cold, and all the feeding utensils cleaned as you have just been told, the baby's movements should be yellow in color, and not too hard to be passed

easily. If the movements become greenish in color, but not more frequent than two or three a day, give one or two teaspoonsful of castor oil. If the color does not improve after the oil has worked off, consult your doctor. At this time he will be able to prevent the serious bowel trouble with which the baby is threatened. If the movements remain green in color and increase in number to five or six or more in the 24 hours, your baby is beginning to have bowel trouble, or summer diarrhea. Stop milk at once, give pure boiled water instead and call the doctor. It may not be too late.

Do not begin milk feeding again until the doctor orders it. You will not starve your baby by stopping the milk; every drop of milk that goes into his mouth after this warning simply adds to the poison already there. You will cause serious or fatal illness by keeping up milk food after the bowels become loose and the movements green in color.

Vomiting.-A bottle-fed baby should not vomit if its food is pure and properly adjusted to its needs. If vomitings occur it is usually a sign of approaching illness, either of one of the serious diseases of childhood, or more commonly in hot weather, of summer diarrhea. Vomiting due to this cause may be the first sign of trouble and the bowels may not become loose until several days later. If vomiting is repeated, stop milk feeding, give boiled water, cool or of the temperature at which the milk is given, and consult your doctor at once. Clothing.--Do not put too much clothing on the baby in summer. During the hottest weather, remove most of the clothes; a thin loose shirt and a diaper are sufficient during the day and on very hot, close nights.

Never use clothing made with tight waistbands. Petticoats and skirts should be supported by straps over the shoulders.

Bathing. Bathe the baby every day. In hot weather a quick sponging all over later in the day will give comfort and make him sleep better. Wash the baby each time the diaper is changed and dry the parts thoroughly before using powder. Wash all soiled diapers and boil them. Never use a dried wet diaper without first washing it.

Flies. Be careful to exclude flies from the baby's bottle and food and do not allow them to light on the baby's lips while sleeping. Flies carry disease to thousands of infants every summer.

Fresh air. Fresh air is as important for the baby's health as fresh food. During the summer, keep the baby out of doors as much as possible. Keep the baby out of the kitchen; he may get a "sunstroke" from too much heat indoors.

Eruptions of the skin. If the baby has an eruption or breaking out of the skin, consult a doctor. Do not think that every rash is prickly heat; it may be some serious disease like scarlet fever, measles, smallpox, or chickenpox.

If a baby is worth having it's worth saving. Half of the babies that die in Pennsylvania each summer could be saved by following the advice given in this circular.

Issued May 15, 1909.

[Circular issued by Pennsylvania Department of Health.]

FORM 20B.-Italian.

SALVATE I BAMBINI.

CONSIGLI E SUGGERIMENTI PER LA CURA DEI BAMBINI DURANTE L'ESTATE.

Il caldo della stagione estiva è assai pericoloso per la vita dei bambina di tenera età, specialmente per i neonati, non tanto per le conseguenze dell' alta temperatura in generale, quanto, ed in modo speciale, per l'effetto che il caldo può avere su tutti quei cibi che possono andare soggetti a decomposizione. Fra questi, il latte di vacca occupa il primo posto.

E, di conseguenza, d'importanza massima che il latte di vacca che voi destinate all' allattamento dei bambini sia il più puro ed il più fresco che i vostri mezzi vi permattano di comprare. Durante la stagione calda, il ghiaccio è assolutamente necessario per mantenere fresco il latte. Questo, quando viene usato come cibo, deve essere raffreddato col ghiaccio non appena munto dalla vacca e deve essere tenuto in ghiaccio fino al momento in cui è usato. Pochi soldi spesi per un po' di ghiaccio possono tener lontane le malattie e qualunque spesa per visite mediche, medicinali o altro da esse derivanti. Siccome l'acqua, spesso e volentieri, è veicolo d'infezione e, quindi di malattie, si deve usare soltanto acqua bollita, quando deve essere bevuta, oppure una qualunque altro preparazione speciale per bambini.

I seguenti consigli e suggerimenti vi aiuteranno a mantenere i vostri bambini in buone condizioni di salute durante il caldo dell' estate:

Allattamento. Ogni madre deve fare il possibile di allattare da sè il proprio bambino. Il latte materno è il cibo naturale del neonato e non vi è alcun altro cibo che può reggere al paragone. Un bambino che ha succhiato il latte dal seno materno ha molte più possibilità di vita di qualunque altro bambino allattato col biberon. Al bambino appena nato non date mai cibo artificiale. Avvicinatelo alla mammella ogni quattro ore e non dategli altro che acqua che sia stata ben bollita. Il neonato non ha bisogno di piu' e siate pur sicuri che esso non morrà certamente per mancanza di nutrimento. Non appena la mammella à colma di latte, allattate il neonato ogni due ore, durante il giorno, e due o tre volte durante la notte.

Non allattate il neonato ogniqualvolta esso piange o grida.— Il piangere moderato è una delle funzioni che, nel neonato, contribuisce ad accrescere lo sviluppo dei suoi polmoni. Quei bambini ai quali il latte non vien dato regolarmente oppure ad ogni minimo accenno di pianto, possono spesso andar soggetti ad indigestione ed alle sue conseguenze. Allattate il bambino regolarmente e vedrete ch'esso