The Mother and Her Child

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DIET

There are certain laws which govern the diet at all times; for
instance, the man who digs ditches requires more of a certain element
of food and more food in general, than does the man who digs thoughts
out of his brain. The growing child requires somewhat different
elements of food than does an adult. In other words, "The diet should
suit the times, occasions, occupations, etc."

In the case of the expectant mother it should be remembered that the
child gains nine-tenths of its weight after the fifth month of
pregnancy, and it is, therefore, not necessary that a woman shall
begin "eating for two" until after the fifth month. And since it is
also true that the baby doubles its weight during the last eight weeks
of pregnancy, it follows that then is the time when special attention
must be given to the quantity as well as the quality of "mothers'
food."

During the first five months, if the urine and blood-pressure are
normal, the "lady in waiting" should follow her usual dietetic tastes
and fancies so long as they do not distress or cause indigestion.
Because of the additional work of the elimination of the fetal wastes,
much water, seven or eight glasses a day, should be taken; while one
of the meals--should there be three--may well consist largely of
fruit. All of the vegetables may be enjoyed; salads with simple
dressings and fruits may be eaten liberally. Of the breads, bran,
whole wheat, or graham are far better for the bowels than the finer
grain breads, or the hot breads.

Something fresh--raw--should be taken every day, such as lettuce,
radishes, cabbage salad, and fresh fruits.

If the prospective mother is accustomed to the liberal use of meat,
providing the blood-pressure and urine are normal, she may be able to
indulge in meat once a day. Many physicians believe that the maternal
woman should eat meat rather sparingly--from once a day to once or
twice or three times a week.

Of the desserts, gelatine, junket, ice cream, sponge cake, and fruit
are far better than the rich pastries, which never fail even in health
to encourage indigestion and heart burn. The fruitades are all good.
Candies and other sweets may be eaten in moderation. Alcohol should be
avoided. Tea and coffee should be restricted, and in many cases
abandoned. For many, two meals and a lunch of fruit or broth are
better than three full meals. There is a continual and increased
accumulation of waste matter which must be thrown off by the lungs,
kidneys bowels, and skin; so that clogging of one channel of
elimination makes more work for one or more of the other eliminative
organs.

Sometimes the craving for food is excessive, and the desire to nibble
between meals is quite troublesome. These unusual feelings should be
controlled or ignored. A glass of orangeade will sometimes satisfy
this unnatural craving. Save your appetite for meal time--for a good
appetite means good digestion--all things equal. The woman who
habitually eats between meals is the sluggish, constipated individual
who needs to acquire self-control and learn self-mastery.

WATER DRINKING

Water is the circulating medium of the body, from which the digestive
secretions are formed, and by which the food is assimilated and
distributed to individual cells. And, finally, water is the agent for
dissolving and removing waste products from the body through the
various eliminating organs. We literally live, think, and have our
being, as it were, under water. The tiny cell creatures of our bodies,
from the humble bile workers of the liver to the exalted thinking
cells of the brain, all carry on their work submerged. Accordingly,
the amount of water we drink each day, determines whether the liquids
circulating through our tissues shall be pure, fresh, and life-giving,
or stagnant, stale, and death-dealing.

Thirst is the expression of the nervous system, constituting a call
for water, the same as hunger represents a call for food. Pure water,
free from all foreign substances, is the best liquid with which to
quench this thirst.

It is just as important to supply abundance of water for the proper
bathing and cleansing of the internal parts of the body, as it is to
wash and bathe the external skin frequently. The living tissues are
just as literally soiled and dirtied by their life action and their
poisonous excretions, as is the skin soiled by its excretions of sweat
and poisonous solids. Thus the regular drinking of water is absolutely
necessary to enable the body to enjoy its internal bath, and this
internal cleansing is just as grateful and refreshing to the cells and
tissues, as is the external bath to the nerves which exist in the
skin.

The total amount of water necessary varies according to the nature of
one's work, the amount of sweating from the skin, the moisture of the
atmosphere, the amount of water in the food, etc. We believe the
average person requires about eight glasses of liquid a day; that is,
about two quarts. By the word "glass" we refer to the ordinary glass
or goblet, two of which equal one pint. This amount of water should
be increased, if anything, throughout pregnancy; while, during the
later months, the amount of water taken each day should be at least
doubled.

In the condemnation of so-called artificial beverages, an exception
should be made of the fruit juices. The fresh, unfermented juices of
various fruits come very near being pure, distilled water, as they
consist of only a little fruit sugar and acid, together with small
amounts of flavoring and coloring substances, dissolved in pure water.
None of these substances contained in pure fruit juice needs to be
digested.

Lemonade not too sweet, and taken in moderate quantities, is certainly
a beverage free from objection when used by the average pregnant
woman. Unripe or overripe fruits frequently cause bowel disturbances;
as also do the millions of germs which lurk upon the outside of
fruits, and which find their way into the stomach and bowels when
these fruits are eaten raw without washing or paring. Otherwise, the
juices of fruits and melons are wholesome food beverages when consumed
in moderation.

EXERCISE

It should be the regular practice of every expectant mother to spend a
portion of each day in agreeable, suitable exercise or physical work
of some description. This exercise will be far more beneficial if it
can be taken in the open air. The weather and the strength of the
patient must be taken into consideration and the necessary
modifications of the daily exercise should be made.

An expectant mother living in the city and enjoying the average health
and strength, should engage in such agreeable exercise as the raising
of flowers, the training of vines, with brisk walks in the fresh air.
As much time as possible should be spent in the parks.

The rural "mother in waiting," may do light gardening, raising of
chickens, or pigeons, training of vines, or other outdoor work she may
enjoy.

No matter what kind of weather prevails, a daily brisk walk should be
taken, out of doors, on the porch or in a room with open windows. A
daily sweat, as well as the daily prayer, is good for the well-being
of the expectant mother. All forms of light housework are commendable.
Keep out of crowds. Spend more time in the parks than in the
department stores. An occasional evening at the concert or theater is
diversion and harmless provided the ventilation is good. Such
exercises as horseback riding, bicycling, dancing, driving over rough
roads, lifting and straining of any kind, and all other forms of
fatiguing exercise should be avoided.

REST

Rest and relaxation are quite necessary for men and women even in the
best of health. A kind providence has arranged that we spend a large
portion of our time resting, and sleeping. In addition to unbroken
rest at night it is well for the prospective mother quietly to
withdraw from the family circle, when the first signs of fatigue begin
to appear, and indulge in a little rest, before she gets into a state
of nervousness--where nerves twitch and she becomes irritable.

A mother who has borne six children, who has had little domestic
help, and who yet retains her youthful appearance and energy,
thinks her present condition due to the fact that while carrying
and nursing her babies she never permitted herself to reach that
stage of exhaustion where her nerves twitched, her voice
shrilled, and she became irritable. She made it a practice to
drop her work when these symptoms began to appear, and to seek
the sanctuary of a quiet room apart from her family, if only for
ten or fifteen minutes. And, most important, from the very start
she trained her household to respect her right thus to draw
apart.

I have told many women whose household duties press hard: "Your
husband would rather see a cold lunch on the table, or 'go out' for
dinner, while his wife rested, smiling and happy, than to have a most
sumptuous meal spread before him and the wife tired, and fretful."
Every woman should make it the rule of her life to stop just this side
of the outburst of words, and lie down long enough, breathing deeply,
to calm the spirit.

FRESH AIR

"With all persons plenty of fresh air, night and day, is indispensable
to health, and to none more than the pregnant woman. She should sleep
with the windows open, or out of doors, at all seasons of the year; of
course, making due allowance for the severity of the winters in the
North. It is not only necessary to provide for the adequate
ventilation of sleeping-rooms, but also for that of the living-rooms
of the house.

Many persons, who are quite particular to open wide the windows of the
bedrooms, forget that the other rooms need it quite as much. All the
rooms of the house which are occupied should be thoroughly ventilated
by throwing doors and windows open every morning; at night when the
family is assembled the air must be changed now and then or it will
become unfit for human lungs."

Men and women are outdoor animals. They were made to live in a garden,
not a house. Remember that each person requires one cubic foot of
fresh air every second. Don't allow the temperature of living-rooms,
during the winter season, to go above sixty-eight degrees. If your
home has no system of ventilation, open wide the windows and doors
several times a day and enjoy the blessings of a thorough-going
flushing with fresh air.

Oxygen is the vital fire of life. Our food, however well digested and
assimilated, is just as useless to the body without oxygen, as coal is
to the furnace without air. It is equally important to keep up the
proper degree of moisture in the air of the living-rooms.

BATHING

Bathing is made necessary by the clothes we wear and by our indoor
life. If the skin were daily exposed to sunshine and fresh air, it
would seldom be necessary to bathe. The neglect of regular bathing
results in overworking the liver and kidneys, and debilitates the
skin. Regular bathing--ofttimes sweating baths--is very essential to
the hygiene of pregnancy.

The neutral bath (97 F.) is excellent to quiet the nerves and induce
sleep. Morning bathing is an exceedingly valuable practice. If
properly taken before breakfast or midway between breakfast and lunch,
it is found to be refreshing and tonic in nature. The feet should be
in warm water, the application of cold should be short and vigorous. A
rough mit dipped in cold water, rubbed over the body until the skin is
pink, is a splendid tonic.

Warm cleansing baths should be taken twice a week at night. There is
no good reason for the use of the vaginal douche during pregnancy.

THE TEETH

Because the mother's system is drained of the lime salts which aid in
building up the bones of the child, along with other metabolic changes
which cause the retention of certain acids which ofttimes affect the
teeth, they should be frequently examined and carefully guarded.
Severe dental work should be avoided, but all cavities should receive
temporary fillings while the teeth are kept free from deposits.

As a preventive to this tendency of the teeth to decay, a simple mouth
wash of one of the following may be used after meals:

1. One teaspoon of milk magnesia.
2. One tablespoon of lime water.
3. One-half teaspoon common baking soda.

Any one to be dissolved in a glass of water.

DIRECTIONS FOR SAVING URINE SPECIMENS

Beginning with the second voiding of urine after rising on the morning
of the day you are to save the specimen, save all that is passed
during the following twenty-four hours, including the first voiding on
the second morning. Measure carefully the total quantity passed in the
twenty-four hours. Shake thoroughly so that all the sediment will be
mixed, and immediately after shaking take out eight ounces or
thereabouts for delivery to the physician the same forenoon. The
following items should be noted, and this memoranda should accompany
the specimen:

1. Patient's name.

2. Address.

3. This specimen was taken from a twenty-four hour voiding of urine,
which began at .... A.M. ...., and ended at .... A.M. ....

4. The total quantity voided during this twenty-four hours was ....
pints.

This specimen should reach the laboratory by ten o'clock the same
morning.

It is of utmost importance the specimen should be taken to your
physician every two weeks, and oftener if conditions indicate it. Take
it yourself at the appointed time.

THE BOWELS

Owing to the increasing pressure exerted upon the intestines, most
expectant mothers experience a tendency to sluggish bowels and
constipation. This unpleasant symptom is usually increased during the
later months.

In the first place, a definite time must be selected for bowel action.
It may ofttimes be necessary, and it is far less harmful, to insert a
glycerine suppository into the rectum, than to get into the enema
habit. The injection of a large quantity of water into the lower bowel
will mechanically empty it; but the effects are atonic and depressing
as regards future action.

Before we take up the advisability of taking laxatives let us consider
what foods will aid in combating constipation. The following list of
foods are laxative in their action and will be found helpful in
overcoming the constipation so often associated with pregnancy:

1. All forms of sugar, especially fruit sugar, honey, syrup, and malt.
All the concentrated fruit juices. Sweet fruits, such as figs,
raisins, prunes, fruit jellies, etc.

2. All sour fruits, and fruit acids: Apples, grapes, gooseberries,
grape fruit, currants, plums, and tomatoes.

3. Fruit juices, especially from sour fruits: Grape juice, lemonade,
fruit soup, etc.

4. All foods high in fat: Butter, cream, eggs, eggnog, ripe olives,
olive oil, nuts--especially pecans, brazil nuts, and pine nuts.

5. Buttermilk and koumiss.

6. All foods rich in cellulose: Wheat flakes, asparagus, cauliflower,
spinach, sweet potatoes, green corn and popcorn, graham flour, oatmeal
foods, whole-wheat preparations, bran bread, apples, blackberries,
cherries, cranberries, melons, oranges, peaches, pineapples, plums,
whortleberries, raw cabbage, celery, greens, lettuce, onions,
parsnips, turnips, lima beans, and peanuts.

White bread should be tabooed, and in its place a well-made bran bread
should be used. Two recipes for bran bread follow, one sweetened and
containing fruit, the other unsweetened:

BRAN BREAD RECIPES

1. Two eggs, beaten separately; three-fourths cup of molasses, plus
one round teaspoon of soda; one cup of sour cream; one cup of sultana
seedless raisins; one cup of wheat flour, plus one heaping teaspoon
baking powder; two cups of bran; stir well and bake one hour.

2. One cup of cooking molasses; one teaspoon of soda; one small
teaspoon of salt, one pint of sour milk or buttermilk, one quart of
bran, one pint of flour. Stir well, and bake for one hour in a very
slow oven. It may be baked in loaf, or in gem pans, as preferred. The
bread should be moist and tender, and may be eaten freely, day after
day, and is quite sure to have a salutary effect if used persistently.

The drinking of one-half glass of cold water on rising in the morning
often aids in keeping the bowels active. Of the laxative drugs which
may be used at such a time, cascara sagrada and senna are among the
least harmful. Two recipes of senna preparation follow, and may be
tried in obstinate cases:

1. _Senna Prunes._ Place an ounce of senna leaves in a jar and pour
over them a quart of boiling water. After allowing them to stand for
two hours strain, and to the clear liquid add a pound of well-washed
prunes. Let them soak over night. In the morning cook until tender in
the same water, sweetening with two tablespoons of brown sugar. Both
the fruit and the sirup are laxative. Begin by eating a half-dozen of
the prunes with sirup at night, and increase or decrease the amount as
may be needed.

2. _Senna with prunes and figs._ This recipe does not call for
cooking. Take a pound of dried figs and a pound of dried prunes, wash
well. Remove the stones from the prunes and if very dry soak for an
hour. Then put both fruits through the meat chopper, adding two ounces
of finely powdered senna leaves. Stir into this mixture two
tablespoons of molasses to bind it together, the result being a thick
paste. Begin by eating at bedtime an amount equal to the size of an
egg, and increase or decrease as may be necessary. Keep the paste
tightly covered in a glass jar in a cool place. If the senna is
distasteful a smaller quantity may be used at first.

CARE OF THE BREASTS

The breasts are usually neglected during the months of pregnancy, and
as a result complications occur after the baby comes which cause no
end of discomfort to the mother. If, during the pregnancy, the breasts
are washed daily with liquid soap and cold water, and rubbed
increasingly until all sensitiveness has disappeared, they may be
toughened to the extent that no pain whatsoever is experienced by the
mother when the babe begins to nurse. During the last month of
pregnancy a solution of tannin upon a piece of cotton may be applied
after the usual vigorous bathing. If the nipples are retracted they
should be massaged until visible results are attained.

THE MENTAL STATE

Keep the mind occupied with normal, useful, and healthy thoughts.
Listen to no tales of woe. Stay away from the neighborhood auntie
dolefuls. Keep yourself happy and free from all worry, care, and
anxiety.

"Put no faith in fables of cravings, markings, signs, or
superstitions. They are all unfounded vagaries of ignorant old women
and will not bear investigation."

Don't take drugs for worry and sleeplessness. Take a bath.

The secret of deliverance from worrying is self-control. Minimize your
difficulties. Cultivate faith and trust.

The conditions which favor sound sleep are: Quiet, mental peace, pure
blood, good digestion, fresh air (the colder the better), physical
weariness (but not fatigue), mental weariness (but not worry).

When tempted to borrow trouble, when harassed by fictitious worries,
remember the old man who had passed through many troubles, most of
which never happened. Train the mind to think positive thoughts.
Replace worry-thought with an opposite thought which will occupy the
mind and enthuse the soul. Drive out fear-thought by exercising
faith-thought. Cultivate the art of living with yourself as you are,
and with the world as it is. Learn the art of living easily. Associate
with children and learn how to forget the vexing trifles of everyday
life.

There is something decidedly wrong with one's nerves when everybody is
constantly "getting on them." They are either highly diseased or
abnormally sensitive. Every woman is a slave to every other that
annoys her.

Fear is capable of so disarranging the circulation as to contribute to
the elevation of blood-pressure--which will be more fully considered
in a later chapter.

CHAPTER V

COMPLICATIONS OF PREGNANCY

It is the purpose of this chapter to take up the various complications
which may appear in the course of an otherwise normal pregnancy, and
offer advice appropriate for their management.

MORNING SICKNESS

About one-half of the expectant mothers that come under our care and
observation, experience varying degrees of nausea or "morning
sickness." This troublesome symptom makes its appearance usually about
the fourth week of pregnancy and lasts from six to eight weeks.

On attempting to rise from the bed, there is an uncomfortably warm
feeling in the stomach followed by a welling up into the throat of a
warmish, brackish tasting liquid which causes the patient to hasten to
rid herself of it; or, as she rides on the train, on the street cars,
in a carriage or automobile, she frequently senses the same unpleasant
and nauseating symptoms during the second and third months of
pregnancy. Normally, this uncomfortable symptom quite disappears by
the end of the third month. A number of remedies have been suggested
for it, but that which seems to help one, gives little or no relief to
another; we therefore mention a variety of remedies which may be
tried.

First and most important of all remedies--is to keep the bowels open.
Sluggishness of the intestinal tract greatly increases the tendency to
dizziness and nausea. During the attack, it is advisable not to
attempt to brush the teeth, gargle, or even drink cold water. While
you are yet lying down, the maid or the goodman of the house should
bring to you a piece of dry, buttered toast, a lettuce sandwich with
a bit of lemon juice, or perhaps a cup of hot milk or hot malted milk.
Coffee helps to raise the blood-pressure, and all articles of diet
that tend to raise the blood-pressure are best avoided during
pregnancy. A cup of cocoa may be tried, but, as a rule, women at this
time do not relish anything sweet. Oftentimes a salted pretzel is just
the thing, or a salted wafer will greatly help. Remain in bed from
one-half to one hour and then rise very slowly. There should be plenty
of fresh air in the room, as remaining in overheated places is quite
likely to produce a feeling of sickness at the stomach.

When the attack comes on during a train ride, open the window and
breathe deeply, this, with the aid of a clove or the tasting of a bit
of lemon, will usually give relief. In extreme instances the patient
should lie down flatly on the back, with the eyelids closed. Go to the
rear of the street car, so that you can get off quickly if necessity
demands; breathe deeply of the air; resort to the use of cloves or
lemons; and thus by many and varied methods will the expectant mother
be enabled to continue her journey or finish her shopping errand. We
would suggest that, as far as possible, walking should be substituted
for riding. I have never heard of a woman being troubled with nausea
while walking in the parks, on shady streets, along the country road,
or on the beach.

Of the medicines prescribed for "morning sickness" and the nausea of
pregnancy, cerium oxalate taken three times a day in doses of five
grains each, is probably one of the best.

The persistent or pernicious vomiting which continues on through
pregnancy will be spoken of later.

HEARTBURN

Acid eructations are spoken of as "heartburn," and are occasioned by
the increased activity of the acid making glands of the stomach. Under
certain conditions this acid content of the stomach is regurgitated
back into the throat and even belched up into the mouth. In this
condition it is well to avoid most acid fruits. Ice cream and other
frozen desserts are beneficial. The lowered temperature of cold foods
depresses the activity of the acid glands, as also does the fats of
the cream, while protein food substances such as white of egg, cheese,
and lean meat, help by combining with the excess of acid present in
the stomach. Buttermilk or the prepared lactic acid milk, if taken
very cold, is often helpful, notwithstanding it is an acid substance,
in connection with the dietetic management of heartburn. If the acid
eructations be troublesome between the meals, the taking of calcined
magnesia (one round teaspoon in a glass of cold water), or, one-half
teaspoon of common baking soda in a glass of water, will afford
immediate and temporary relief. Simply nibbling a little from a block
of magnesia will often give instant relief. These alkalines
effectively neutralize the mischievous acids which cause the so-called
"heartburn."

IRRITABILITY OF THE BLADDER

The flexing or bending forward of the gravid uterus, by making
pressure on the bladder, sets up more or less irritation and
consequent disturbance of the urinary function. The capacity of the
bladder is actually diminished, and this produces frequent urination.
There is usually no pain connected with this annoying symptom--the
chief discomfort is the frequent getting up at night. This
inconvenience may be lessened by drinking less water after six P.M.
These bladder disturbances are most marked in the earlier months, and
gradually disappear as the uterus raises higher up into the abdomen;
although this symptom may reappear in the last two weeks, as the head
descends downward on its outward journey.

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