CHAPTER VI.
OUTDOOR DRESS AND EXERCISE FOR YOUNG CHILDREN.
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I CAN easily imagine how, after reading the foregoing, where I advocate short clothes for even the youngest infants, many a lady exclaimed, "Why, how absurd a baby so dressed would look lying in the nurse's arms when it went out for a walk!" Very likely; but that question does not concern me in the slightest degree; for I do not approve of babies being carried out in the nurses' arms at all. I will give my reasons for this rather startling proposition in as few words as possible. When infants are carried in the streets, they are generally in unnatural and injurious positions, as with the head hanging over the arm, so that a spectator fears the neck may be dislocated, or with the feet turned inwards, &c. They are usually carried on the left arm of the nurse, and affectionately hugged so closely to her, that the right arm of the child is pressed against its chest. The chest-walls of infants partaking of the gristly and easily bent nature of all infants' bones, the side of the chest is pressed inwards, lessening the lung capacity. Then, also, the child's head leans naturally to one side, so that the muscles of that side are contracted, while those of the other side are lengthened, and this is a not unfrequent cause of the hideous deformity known as wry neck. The head hanging over the arm impedes the breathing, and a still further danger is incurred by this position in the risk of the neck being dislocated by a chance knock or push from a passer-by. A case of death from a sudden jerk to one side of an infant's head is mentioned by Hufeland. A tendency to squint is often encouraged by the custom of carrying a child always on the same side, or of suckling it always from one breast.
The nurse, too, finding the child heavy, and that she gets tired, curtails its outings, and instead of spending several hours in the air, as it ought, the time dwindles down. Then, again, if the child is carried, it may inhale the exhalations of the nurse's body, which are not always of the sweetest, and of her clothes, which are not always of the cleanest.
If it is decided that a baby must be carried, care must be taken to avoid these dangers. It should lie as straight as possible along the nurse's arm, and her elbow should project beyond its head to protect it from accident. It must not be carried in a sitting posture until it is about five months old. As, if it is carried so too early, the spine is overtaxed, and the pressure on the chest caused by the hand supporting it is likely to be injurious. It must be borne in mind that the bones of a young infant are little more than gristle, and are liable to bend, and so become deformed. After about five months the sitting posture may be allowed for a few minutes at a time, if there is no suspicion of rickets, and if the child seems to like it. Care must be taken, too, in carrying a child, that no part of its body be compressed in any way. Moreover, the arm on which it is carried must be changed from time to time, otherwise deformity may result from leaning always on one side, or a tendency may be contracted to turn the eyes in one direction or squint.
However, I consider that from almost the earliest age infants ought to be taken out in perambulators, and, if they are properly dressed, I feel sure that there need be no fear of their thus being more liable to take cold than if they were carried. When I speak of perambulators, I do not mean the old-fashioned and, unfortunately, still very common kind, with a seat and a strap across to keep the baby in; where the head most often hangs over the side of the machine, or the body tends to collapse in a heap on the floor of it. These may truly be called "infernal" machines, which seem to have been invented especially for the purpose of producing deformity. I mean those light, four-wheeled carriages which are now happily coming into vogue, which have a sort of mattress at the bottom for the infant to lie upon, and seats which can be put in, so that older children can sit up comfortably, the wheels of which are cased in india-rubber, so that the vibration when they are in motion shall be as slight as possible. I do not, however, approve of the usual way in which the child is placed in these carriages, with its back to the movement. This practice, doubtless, originated in the idea that if the child faces the nurse, she is better able to see, in common parlance, "what it is up to;" but this benefit is not sufficiently great to warrant possible brain injuries resulting from its unnatural position during movement. The natural position in moving is with the face forwards, as in walking, and that the opposite position is injurious is sufficiently strongly suggested by the discomfort which it causes even to grown people. Painful or uncomfortable sensations are always a danger signal, and if, being experienced by an adult in the above circumstances, they point to some harm that is being done, how much greater must the injury be in the case of infants, whose nervous systems are so much more unstable. The child, then, should invariably be placed facing the movement; and the hood, which has its back to the movement, should be raised to protect it from the draught caused by the motion of the carriage through the air. The wind is apt to "take away the breath" of a tiny child and draughts may give colds to bigger ones. In rainy weather a second hood can be raised over the child, or an umbrella held over it; but little infants should not be taken out in the rain.
A pillow should be laid in the perambulator to make a bed for baby, with a little pillow at the top to support its head; the infant should then be laid on it as if put to bed, and a nice fur rug laid over it. Sent out in this way the risk of cold is minimized. In cold weather young infants should have veils over their faces and mouths. The best thing for this purpose is lace, which, however, must not be too thin; the old-fashioned Brussels lace veils, perhaps doubled, are extremely good. Woollen veils should not be used, as the particles of the wool get breathed in, and are apt to irritate the throat and nasal passages. For the same reason the fur rug should always be well shaken out before use, so that there shall be no loose hairs. Bearskin is one of the best furs for this purpose, and white bear looks lovely with the rosy face of baby peeping out over the edge of it.
Children after the first few weeks of life, and unless they are delicate, should not be kept at home merely because the weather is cold, but should have on warm out-door garments.
Young children of both sexes should always wear hoods out of doors. It is commonly noted by doctors that baby-boys suffer greatly from earache and catarrhal diseases of the ear; whereas little girls rarely suffer in that way. The cause is not far to seek, for girl-babies generally wear hoods out of doors, while infant-boys, by some cruel freak of fashion, are condemned to wear uncomfortable, stiff, and unprotecting hats. The ear-pieces which are sometimes put on boy's hats either slip out of place and are useless, or have to be fastened with elastic or silk strings so tightly under the chin that the pressure is injurious. Hoods made of white cashmere, and lined with the same material, are both healthy and comfortable, or they may be crocheted out of Berlin wool and lined with soft white cashmere or llama. Of whatever colour the outside may be, the lining should always be white for reasons I am going to explain later on.
In putting on the hood care should be taken that the ears lie in their natural position, flat, underneath it. If the hood is carelessly put on, the ears may easily be doubled forward by it, and become permanently deformed by a continuance of this practice. Here I may also observe that children's ears are frequently disfigured by hats which are pressed down too low upon the head, or by the elastic or strings of the hat, which, being carelessly fastened under the chin, push the ears forwards and outwards. It is wonderful how careless mothers and nurses are in this respect, considering what a great disadvantage it is in after-life to have ugly ears. Infants should not be allowed to lie asleep with their ears doubled forward by the position of the head.
Warm woollen overdresses should be worn by infants instead of the long heavy cloaks with capes generally adopted; and, indeed, very pretty and cheap outdoor garments for children of any age up till five or six may be made of some thick white woollen stuff, or knitted or crocheted out of wool. For infants these should reach two or three inches below the robes; after the child can walk, it may be made to the ankles. Both this and the summer cloak should have sleeves, so as not to impede the movements of the arms, as capes do, and should fasten down to the bottom.
Capes are very undesirable, as their weight is unevenly distributed, hanging entirely from the neck and shoulders; they also open, leaving the chest exposed, and allowing the cold air to attack it and the armpits. About the most charming winter jacket for a child of any age from ten months to seven years is an ermine one, with or without the little black tails, and lined with white or pale blue satin, a little frill of which finishes off the neck. Squirrel-back is also very pretty, lined with grey satin to match. The advantage of fur jackets is their great warmth and extreme lightness; they should be ventilated and made long enough to nearly reach the ankle, and should fasten with hooks and eyes down to the very bottom. Sealskin is not to be recommended for children's wear, as it is too heavy. Pretty little muffs may be made of the same fur as the jackets, and the muffs should be fastened round children's necks, so that they may not be lost. They should not, however, be hung on by a cord, which drags the neck down by the weight of the muff attached, but should have a broadish ribbon to match the lining passed through them and over the child's head; this must be prevented from pressing on the neck by being fastened to the back of the jacket about two inches below the collar.
Fur hoods are not to be recommended unless they are ventilated, as the ordinary fur hood keeps the head too warm, and does not permit the perspiration to evaporate. As I said before, I now insist again, that boys as well as girls should wear hoods. That his sex is not publicly advertised should not be a very serious grievance to a gentleman under five years old. The hoods may be made of satin to match the lining and frill of the jacket, but should be lined with fine white cashmere.
Children able to walk should have woollen or fur gaiters over their legs when they go out. Children should never be kept at home simply because the weather is cold; if they are properly dressed, the cold will do them no harm, unless they are already out of health. Even drizzling rain is not to be feared, and the children may be taken out in frosty weather, or slight sleet, and even when the snow is thick on the ground, provided their boots are waterproof, and that the nurse can be trusted to see that they do not get severe falls. Fog, however, should be avoided like poison, which in very truth it is.
The little ones should be out in the air as much as possible. In the winter they should go out in the morning from 10.30 till 12.30, and in the afternoon from 1.45 till 3 o'clock. In the summer they should be out from 8.30 till 10.45 in the morning, and from 4.30 till 7 o'clock in the afternoon; their meals must be managed so as to leave these hours free. In winter they should have dinner a quarter of an hour after returning from their morning airing, and should sleep in the afternoon from 3.30 till 5 o'clock, when they should have another meal. In the summer they should have a very light meal on returning from their morning walk, and be put to sleep at about 11.30, dine at 3 o'clock, and have supper at 7.15. Of course young infants require to be fed more often than this, and cannot be kept out continuously for so long; but they can be taken in for a few minutes, fed, and then brought out in the perambulator again.
Open-air exercise is one of the most important conditions for the preservation and obtaining of health, and though exercise for the young infant must be passive, for the child who can walk and run, it may, and should be very active indeed; and children, instead of being commanded to walk steadily for fear of spoiling their clothes, should be encouraged to play in the open air as much as possible. They should be given, toy sets of harness, so that they may play horses. They should skip and roll hoops, and, above all, play ball. Ball is the oldest of all games, and the one most in favour with the ancient Greeks, the nation of all others the most remarkable for its muscular symmetry. The ordinary india-rubber ball, about three or three and a half inches in diameter, is so light that, while it can be thrown about in every way, and give exercise to every muscle in the body, at the same time strengthening the lungs by the increased rapidity of respiration, if it strikes any part of the body it can do no harm, and does not even produce as much as a bruise. Of gymnastics I propose to write at some future time; but no amount of gymnastics can have that healthful, physical, and mental influence which belongs to a good game thoroughly enjoyed.
The old prejudice against young children being allowed to sleep in the open air probably arose from the fact that in the old-fashioned perambu lator the child's head was apt to hang in bad positions during sleep, and I have often seen a poor baby sleeping with its head hanging over one side of the machine, and observed the nurse or mother shake it with the remark, "Stay awake, can't you ?" But the more hours a day a baby sleeps the better, and the more it is in the open air the better also, and so it is well, if possible, to combine the two.
Unless the temperature of the air is damp and chilly—as at night, for example—good rather than harm will result from the little one's sleeping out of doors, if it is lying in a comfortable position and is properly clothed. It is necessary to clothe the child more warmly during sleep than when awake, for the temperature of the body falls during sleep.
If there is a garden or square to which access can be obtained in warm summer weather, it is a good plan to carry out a plain wicker bassinet with a blanket folded in the bottom, and let the baby lie in that instead of in the nurse's arms; or it may be laid on a rug on the grass, and allowed to kick to its heart's delight, which will do it a very great deal of good. The same thing may be done if there is a safe balcony or leads attached to the house. The hood of the bassinet will keep the sun off the child, and if a rug is used, an umbrella or a towel over two chairs should be carefully fixed up to serve the same purpose. A child can lie thus for hours on a warm day, drinking in the air and sunshine, and gaining a store of health for its future life.
It is irksome for the nurse, and injurious to the infant for it always to be in arms, and people are far too afraid to let babies lie about and exercise their limbs freely by stretching them in all directions. They will do this if left to themselves, but they cannot do it when cramped by the nurse's body and arms, or even by the walls of the cradle. The children of a learned professor, a friend of mine, when infants, were accustomed to lie all day on rugs on the floor, or on the grass, and as soon as they could crawl, they were put to sleep also on mattresses on the floor, which effectually prevented any danger of their falling out of bed. Care was taken that these children should be out of harm's way; but they were always allowed perfect freedom of movement, and not constantly watched and restrained, The result has been all that could possibly be desired; they have grown up perfectly developed in every limb, strong both in body and mind, and completely devoid of fear. There is such a thing as watching and guarding children too closely, and so making them from the first too dependent on others. It must not be forgotten that education, in the true sense of the word, begins from the very first moment of life.
The baby moving its limbs, and rolling about on the floor or grass, which it can do with perfect freedom in the short clothes I advocate, but not in the long ones generally worn, gains power in its muscles, and will soon begin to tumble about and crawl. If external sources of danger are removed, it cannot easily hurt itself, and it will crawl until the bones are firm enough to bear the weight of its body, and the muscles powerful enough to move them. An old writer says of the children of the Caribs, "although the little creatures are left to roll about on the ground in a state of nudity,[1] they, nevertheless, grow marvellously well, and most of them become so robust as to be able to walk without support at six months old."[2] The word, nevertheless, which I italicize is an expression of naïve surprise, for the author had been accustomed to the swaddling and restraint system, and naturally thought no other could be successful. That the system here advocated is that which best serves the purpose of development is shown by the above quotation. By means of natural and proper exercise the muscles get strength and tone, and the bones acquire firmness. I do not think any one can cite the case of even one baby brought up carefully in arms which could walk, if only a few steps, when six months old. It is important that all the muscles should be rendered strong and firm, for they command the bones, and if one set of muscles is weak, opposing sets drag out of position the bones they should keep in their proper places. It is especially necessary that the muscles of the back should be strong; for if they are not, the greater weight of the body being towards the front, the spine will bend forwards, and the proper expansion of the chest be interfered with. The bones of the chest are: the spine at the back; the ribs at the sides attached to the bones of the spine; and the breast-bone, or sternum, to which the ribs are attached in front. The ribs incline downwards with the spine, so that when we bend forward the capacity of the chest is diminished, and breathing hampered; from this come pallor, general debility, and diseases of the chest. The muscles of the back counteract the action of those of the chest in maintaining the erect position of the body, to preserve which no less than five layers of powerful muscles along the spine only are engaged. The spine is a highly flexible column, made up of a number of bones called vertebræ, united by cartilages and ligaments, and movable in all directions by the action of the overlying muscles. In childhood the spine is most liable to yield and become weak or deformed at the neck and loins, for the neck has to support the weight of the head, and the loins that of the internal organs of the body. In early infancy the muscles of these parts have not attained the strength necessary for the performance of these duties. The new-born infant's head falls forward, or from side to side, and requires to be carefully supported, lest the neck should be dislocated. Even quite tiny babies are unfortunately often carried in a sitting position, when they of course stoop forward, the head drooping, and the arms hanging forward beyond the centre of gravity; these drag on the shoulders, which are further rounded, while the strain on the muscles of the back is increased; and if the practice is persisted in, a permanent deformity results from it. Further, when the head falls forward, and the spine becomes bent, the cushion-like cartilages between the vertebræ become thinned on the inner side, and the angle at which the ribs stand out from the spine is diminished; the ends of the ribs are thus brought nearer together, the breast-bone drawn inwards, and the cavity of the chest diminished. The ribs in inclining downwards push down the organs of the chest, so that they press on to the abdominal organs, and prevent them from acting properly. The same evil results in an increased degree in tight lacing, as I shall point out when discussing that subject.
Children should not be allowed to sit up until they have been seen to do so on their own account, which they will, as soon as they are strong enough, if left to themselves. This leads me to remark that the high chairs used for young children are injurious. A bar is placed across the front of the chair to prevent the little one from falling out, and the little one leans forward against it to get at the playthings on the table in front. The chest is thus pressed inwards against the bar, the shoulders are rounded with the scapulæ projecting, the head falls forward, and the muscles of the back are elongated and weakened. The legs, too, resting on the board placed underneath to support them, are cramped, and the child is actually forced into a bad and unhealthy position.
A rug on the floor is the best place for a small child to play, and it should be allowed to roll about as much as it likes. As it grows bigger, a low chair and table suited to its size can be provided; if it falls off that chair, no harm will be done; but to fasten a child in one position may produce serious evil.
When by crawling about the child has acquired sufficient strength, it will not only sit up, but it will catch hold of tables and chairs, stand up, and try to walk by catching at one object after another. Before this takes place any attempts to teach it to walk are highly injurious, and both parents and nurses should take this thoroughly to heart; for both, either for their own amusement or from vanity, are very fond of encouraging the little one to walk "like a man," and show off this too precocious accomplishment.
Among the poor, children are put on their feet too young, because the mother is too lazy or too busy to carry them, and also from motives of vanity, and this is the chief cause of the appalling number of bow legs, flat feet, and other deformities which we see in our walks abroad. Without any attempts to teach it, the child would walk when it reaches the proper stage of development, because it has inherited the capacity to do so, and because it is urged to do so in imitation of others.
Cases in which this has taken place are rare, because the vast majority of people, educated or not, are imbued with the erroneous notion that it is necessary to hurry up Nature in this respect; but a distinguished physician informed Dr. Bastian that up to the age of two years his daughter had never walked a step, nor even tried to walk, when one day he put her in a standing position, and to the great surprise of those present, she walked from one side of the room to the other.
In the first attempts to walk the child has to acquire the power of maintaining its equilibrium; if it is held up by one arm the attitude is unfavourable to this, and trunk and spine are twisted to one side; if by both, the position is also unnatural, and in either case there is a risk of dislocation at the shoulder if a stumble occurs, while the lower limbs are apt to yield, and the little one becomes careless of its own exertions, which is alike bad for its body and mind. All baby-jumpers, baby-walkers, and inventions of that kind are to be avoided. Leading-strings give support at the risk of compressing and deforming the chest; but there is no objection, when the child has gained strength to stand, to placing one hand on each side of the chest, so as to give the slightest possible support, while being ready to give more if the balance is lost. By this plan, natural efforts are assisted without being forced, and the child becomes able to walk, not only sooner, but more safely and gracefully than is possible when any artificial method is adopted.
In lifting young children, care should be taken never to take hold of them by the arms, as the sockets of the joints are so shallow, and the connections of the bones so feeble, that dislocation may easily take place. For the same reason the practice of raising children in the air by alternate arms and legs "to see if they are all right" is most dangerous. The hands should be placed on each side of the chest below the armpits to lift the little ones.
When they are just able to walk, the manner in which children are dragged along in the street by one arm is extremely reprehensible. As the grown person walking with the child is so much taller than it, even if no force is put on the arm, it is fatiguing to keep it held up; and if one arm is always held, that shoulder may become higher than the other, and lateral curvature of the spine take place. Hence every now and then the hand should be changed, which will be a relief, not only to the child, but also to the nurse or mother. A better plan still is to have a set of toy harness, and hold the child by the reins, as the arms are not then dragged upon, but it is kept from running away and getting into mischief or danger.
Children are sometimes so roughly dragged across a crowded road that the arm is dislocated at the shoulder; they should be carried across, if too young to walk properly.
When they are able to walk and run, they should be allowed to do so, and should rather be encouraged to talk and laugh and shout during exercise, than scolded for it, for their lungs, as well as their muscles, will benefit by being freely brought into action.
Parents and nurses are too apt to applaud and encourage what they consider a decorous gait in their children. They like to see them walking quietly along, holding each other by the hand, and hardly looking either to the right or to the left. This is, however, a most unnatural state of affairs, and as such is to be condemned. Upon all who are responsible for the lives and well-being of children I would urge the maxim which Thompson formulates in the following lines :—
- " Health is the vital principle of bliss,
- And exercise of health."
- " Health is the vital principle of bliss,
All unnatural positions, such as stooping, poking the head forward, standing on one leg, leaning towards one side, or holding the head on one side, should be discouraged, as they are likely to produce deformity. When, as is usually the case, the positions are adopted owing to local weakness, which renders them more comfortable than others, the little sufferer should be persuaded to lie on its back for several hours in the day, until it has grown stronger and the tendency has been overcome. Cases of deformity arise commonly in this way in ricketty children; but in strong children bad positions are often adopted from a mere trick, perhaps acquired by imitation, which has been overlooked by parents and nurse, and may equally lead to deformity. Those who have the charge of children should be constantly on the watch for the first symptoms of bad habits, and, when discovered, they should at once set about to combat them; for it is easy to prevent the acquirement of bad habits, but very difficult to cure them when they have gained a footing.
If one limb or organ is weaker than the others, it should be strengthened by suitable exercises; and here I would allude to a practice which pervades the civilized world. The left side of the body in the majority is the weaker, and this is increased by the constant use of the right in preference to it. Thus spinal curvature generally takes place towards the right side, and the cause of this is the early and constant use of the right hand and arm in the preference to the left. Mr. Charles Reade, although ridiculed at the time, was perfectly wise in maintaining that the left hand should be trained to be equally useful with the right. The right side of the brain governs the left side of the body, and vice versâ; the parts of each hemisphere corresponding in their structure and functions to those of the other. Moreover, those parts which govern the action of certain muscles are developed by exercise of these muscles. The constant use of the right hand stimulates the hyper-development of the left side of the brain; whereas, if the left hand were more used, the right side of the brain would increase in development, and such terrible loss of power as now takes place during injury to or disease of the left hemisphere would not be experienced.
Under the present régime the right foot is used in sympathy with the right hand, and when people stand long, the weight of the body is rested upon it, by which the length of the limb is diminished, as also the arch of the foot. To produce equilibrium of body and brain, the muscles of both sides should be equally exercised, and little children should be taught from the first to use both hands indiscriminately, instead of being scolded for using the left. I have more than once seen children at table with their left hands tied behind them, so as to prevent the possibility of their using them. The sight was shocking to me, as an illustration of the folly that may be perpetrated in the name of precedent. The mothers themselves having been taught to use the right hand in preference to the left, continue to teach that doctrine, though it is a wholly unreasoning one.