subject to infection, and 179 the same aseptic precaution must be taken and ob- served in dressing and handling it as any other sur- gical case. Many infants die from infection which usually results in tetanus. In many cases it is the re- sult of negligence in not observing surgical cleanli- ness in handling and dressing it. Should a fetid odor develop, notify the physician. Never put vas- eline or any kind of grease or oil on the umbilicus cord. The cord must dry up, and if we put grease on it, it will decompose and may cause serious trouble. Watch the cord carefully for several hours after birth to see that there is no bleeding. There have been cases where babies have become very weak from loss of blood before this condition has been dis- covered. Should hemorrhage occur, apply a paii of artery forceps, or have some one squeeze the cord tightlv outside the dressings. But under no circum- stances touch the cord with the ringers. Disinfect vour hands and tie the cord again with a piece of sterile tape. Tie just above the first ligature. Xow wash the cord and adjacent parts with a one in two thousands bichloride solution, put on a fresh piece of sterilized absorbent cotton saturated with a one in two thousand- bichloride solution, and over this vour sterile gauze. Then dust freely, as before. with boric acid powder and apply the binder.<Callout type="important" title="Important">Do not use grease or oil on the umbilical cord to prevent decomposition.</Callout> If umbilicus hernia should occur, it is usually caused by partial failure in the development of the abdominal wall in early fetal life, or to crying or stress against, this defective wall. Should it occur, a compress must be used. Cover a twenty-five cent piece, after it has been sterilized by boiling, or a thin piece of cork- about the same size and thickness, with several layers of old clean linen or gauze, place it against the cord.<Callout type="tip" title="Tip">Use a sterilized compress to correct umbilical hernia.</Callout> 180 a thin layer of aseptic cotton between; now apply surgical adhesive plaster across it in small strips,, interlacing and crossing each other. This often cor- rects this condition. Care must be taken to keep the umbilicus clean. The compress should be removed every three or four days and the cord cleaned with cotton and bichloride solution, then dust a little boric acid powder around the cord and reapply your com- press.<Callout type="warning" title="Warning">Avoid using grease on the umbilical cord to prevent serious complications.</Callout> In applying the adhesive plaster, try and apply the strips in different places so as not to cause an irritation of the skin. This is often all the treatment that is necessary. Care of the Genitals. — Perfect cleanliness is abso- lutely essential. Xo secretions should be allowed to accumulate. The parts should be washed daily, usually at the time of the bath. These parts should receive special attention at birth. Male babies, the prepuce or foreskin should be pushed well back and with a little sterile olive oil and cotton all secretion should be wiped from the gland. The penis is then wiped off with a saturated solution of boric acid or a mild bichloride solution in the strength of one in ten thousands, and the prepuce gently smoothed back in place over the penis.<Callout type="beginner" title="Beginner">Gently clean male babies' foreskins to prevent irritation.</Callout> Little girl babies are by far the most difficult to wash. The mucus membrane of the labia is so delicate that the greatest care must be exercised not to irritate it. and as a rule the labia, vulva and adjacent parts are covered very thickly with vernix caseosa. The free use of sterile olive oil aids greatly in its removal, allowing it to remain on for some time before removing it. Then with cotton remove it very gently. Sometimes it requires seA'eral applications before it is clean.<Callout type="risk" title="Risk">Irritating a baby's delicate genitals can cause long-term damage.</Callout> Never rub or use force. Great care must be used not to injure the 181 delicate external genitals in the removing- of the secretion which sometimes accumulates in the little labia folds. To anything abnormal the physician's attention should be called at once.<Callout type="gear" title="Gear">Use sterile olive oil and cotton for cleaning a baby's genitals.</Callout> Care of the Nails. — The nails of a baby are best cleaned with a toothpick. A small piece of absorbent cotton is wrapped around the point so as not to in- jure the delicate, tender skin. Cut the finger nails round and the toe nails square, to prevent ingrowing toe nails.<Callout type="tip" title="Tip">Use a toothpick and sterile cotton for cleaning baby's nails.</Callout> The Clothing.— In winter the body should be covered by a soft flannel shirt, and in summer a thin gauze flannel or silk shirt is worn. The abdomen and umbilicus is supported and protected by a flannel band which should fit snug, but not too tight, but be firm enough to give support to the abdominal wall. In the contraction of the limbs in temper a great deal of force is sent to the abdominal wall. If the binder is on properly there is little danger of umbilicus hernia.<Callout type="important" title="Important">Ensure the flannel band fits snugly but not too tight.</Callout> The abdominal binder or belly band of a baby should go once and a half around the body ; it should fit snugly, but not too tight, as it would inter- fere with the free movement of the chest in breathing, and sometimes, if too tight, it presses on the stomach and causes the infant to vomit its food. If too loose, it will slip up and thus fail in the use or purpose for which it was intended, namely, to keep the vital organs warm, to keep in place the umbilicus dressing, and the most important, to support the abdominal wall.<Callout type="risk" title="Risk">A poorly fitting band can cause discomfort and vomiting.</Callout> The band should be discarded when the child is about three months old and replaced or succeeded by the flannel knit ribbed abdominal binder with shoulder straps. This style should be worn summer and winter until the child is eight years old. Espe- 182 cially is it recommended for little boys. There are two grades, winter and summer weight. They are a great protection, especially for delicate children.<Callout type="gear" title="Gear">Use a flannel knit ribbed abdominal binder with shoulder straps.</Callout> Keep the baby's feet warm, but avoid wrapping it in shawls until it is covered with perspiration. The room should be kept the proper temperature and wraps will not be needed.
Key Takeaways
- Keep the umbilical cord clean to prevent infection.
- Use aseptic techniques when handling and dressing the umbilical cord.
- Clean male and female babies' genitals gently to avoid irritation.
- Ensure the abdominal binder fits properly to support the baby's abdomen.
Practical Tips
- Use sterile olive oil for cleaning a baby's genitals to prevent irritation.
- Ensure the flannel band is snug but not too tight to avoid discomfort or vomiting.
- Keep the umbilical cord dry and clean by using bichloride solution and boric acid powder.
Warnings & Risks
- Do not use grease on the umbilical cord as it can cause decomposition and serious trouble.
- Avoid rubbing or forcing when cleaning a baby's genitals to prevent long-term damage.
- Report any abnormalities in the baby's condition immediately to the physician.
Modern Application
While many of the techniques described in this chapter are rooted in historical practices, the emphasis on cleanliness, proper handling, and monitoring for signs of infection remain crucial. Modern parents can apply these principles by ensuring they maintain a sterile environment, use appropriate cleaning methods, and seek medical advice promptly if any issues arise.
Frequently Asked Questions
Q: What should I do if my baby's umbilical cord has a fetid odor?
If you notice a fetid odor from your baby’s umbilical cord, notify the physician immediately. This could indicate an infection that requires medical attention.
Q: How often should I clean my baby's genitals?
Genitals should be washed daily as part of regular hygiene routines. Use a saturated solution of boric acid or a mild bichloride solution for males, and gently remove vernix caseosa from females with sterile olive oil.
Q: What is the best way to clean my baby's nails?
Use a toothpick wrapped in sterile cotton to clean your baby’s nails. Cut the finger nails round and toe nails square to prevent ingrowing toenails.