PURPOSE AND PLAN OF RESEARCH. 41 



CARE OF THE NEW-BORN INFANT. 



The general routine followed at the Boston Lying-in Hospital for 

 the care of infants during and after delivery is as follows : 



The infant is delivered in the "case room" of the hospital. This 

 room is kept at a temperature of 80 to 84 F. Ordinarily, after the 

 baby is delivered, it is held up by the feet in order to drain the mucus 

 from its mouth and throat. About one out of five babies is patted on 

 the back to make it cry and in this way to expand the lungs. The cord 

 is then cut, tied with two ligatures, and sterile dressings applied. 

 These dressings consist of two sterile sponges, one of which is put 

 around the cord and the other over the cord. The dressings are 

 held in place by a gauze band placed over them. The infant is laid 

 in a crib on its right side, with a blanket so folded about it as to cover 

 the entire body, and with the feet slightly elevated, so that the mucus 

 may continue to drain from the mouth. A tin heater, with a tempera- 

 ture of about 100 F. and covered with Canton flannel, is then put at 

 the baby's back at such distance that a hand can be placed between the 

 heater and the body of the infant. The baby is left in the crib for 1^ 

 to 2 hours after birth, while the nurse is caring for the mother. As 

 soon as the nurse is free, the baby is bathed in cotton-seed oil. The 

 temperature of the oil is not known, but the nurse says that it is "kept 

 warm" and is probably the same temperature as that of the room 

 (80 to 84 F.) or a little warmer. After the oil-bath, the infant is 

 powdered with castile soap and washed in sterile water, the temperature 

 of the bath being about 100 F. The exposure to the air is in all about 

 15 minutes, this including the oiling, bathing, and weighing. 



The infant is next taken to the "wardroom," which has a tempera- 

 ture of 68 to 74 F., and put in its crib, where it remains until it is 

 nursed. It is first put to the breast 8 hours after birth and subsequently 

 every 6 hours during the first 24 hours, the nursing period being 3 to 

 4 minutes. Some babies take hold of the nipple and nurse immedi- 

 ately, while others are lazy and have to be urged by the attendant. 

 During the second day the baby is put to the breast every 4 hours and 

 is left there 3 to 4 minutes. In the third 24 hours, the baby is nursed 

 every 2 hours during the day and every 4 hours during the night, 

 thus making, in all, 10 feedings. When the milk secretion is once 

 established, i. e., when "the milk comes in," the baby is left at the 

 breast 10 minutes at each feeding. 



This routine was varied somewhat when the infants were taken to 

 the respiration apparatus within an hour of birth. An extra nurse 

 took the baby after delivery and oiled, bathed, and dressed it as pre- 

 viously described. It was then wrapped in two or three blankets, 

 the number varying with the weather. The blankets were drawn up so 

 as to form a hood almost entirely covering the infant's head and the 

 baby was then carried in the nurse's arms from the Lying-in Hospital to 



