R J 61 U71 1916 DOCS 1 UC-NRLF B ^ ES"] 7ST DEPARTMENT OF THE INTERIOR OFFICE OF INDL\N AFFAIRS INDIAN BABIES Q^^c HOW TO KEEP THEM WELL WASHINGTON GOVERNMENT PRINTING OFFICE 1916 FOREWORD. Mt Friends : Do you know that one Indian baby out of every three dies before it is 3 years old because it does not have the right kind of care? The reports which I receive from superintendents, doctors, field matrons, and others show this to be true. Do you know that a great many of these deaths can be prevented? It is not natural for a baby to be sick. Health is its normal condi- tion. It is a pity, therefore, that so many Indian baby lives have been lost because the'rr mothers did not know how to keep them well. Almost every sickness your baby has had could have been prevented. You are very much interested in the welfare of Indian babies, and I am, too. I hope you will read this pamphlet and faithfully follow the suggestions it contains. Possibly you will find that some of these differ from what you have supposed to be the best rules for taking care of your baby. It is because so man}' Indian mothers follow Avrong ideas in caring for their children that so many of them die. I am sure, therefore, that if you will endeavor to care for your little ones as suggested in this pamphlet you will be rewarded with the best and most wonderful possession any of us may ever hope to attain — healthy and happy children. At the close of this pamphlet you will find my " Save the Babies " letter of January 10, 1016. Tell your friends about this pamphlet and explain it to those who can not read. If you desire more copies the superintendent, doctor, field matron, or any other Indian Service employee will be glad to obtain them for you. Sincerelv, vour friend. C omniissioner. ~i'~ya c ^ c S. (J7i INDIAN BABIES: HOW TO KEEP THEM WELL. BEFORE THE BABY ARRIVES. Motherhood should cause you no fear or trouble. As soon as you know a baby is coming, tell your physician and field matron about it. They will tell you what you must do to keep well. If you have had one miscarriage another may be prevented by proper treatment. These accidents are often caused by lifting heavy things and by sudden jolts, etc. They are more dangerous than normal births. If you are going to have a baby you must have plenty of sleep. Do not stay up late and dance all night. Keep the windows open while you sleep or, better still, sleep out of doors when the weather will permit. Take frequent baths. It is better for you and will be better for the baby. Keep your breasts clean and soften them with a little vaseline each day. If you do this they will not be so apt to get sore. Drink plenty of water and keep the bowels moving every day. Eat clean, well-cooked food. The baby must not be starved before it is born. Remember, however, that overeating is bad both for you and the baby. Do not drink beer or other alcoholic drinks or patent medicines. AFTER THE BABY IS BORN. Have the baby's birth reported. For many reasons it is important that the birth of your child be legally recorded. Such a record may help you to prove some day that- it is an American citizen. It will prove how old it is, and establish the right to vote, to marry, to make contracts, to establish claims to inheritance, etc. They all depend upon the filing of a correct birth record. The superintendent, phy- sician, or field matron will attend to this for you, if you ask them. If you love your baby, nurse it for the first 1*2 months. Ten babies nursed on the bottle among white people die to one nursed on the breast. The mother's milk is nature's food and is better for the baby than any other. It is always ready and is never sour. It does not have to be prepared or measured. It will make your baby strong, as it is free from o-erms and dirt. 6 INDIAX BABIES: HOW TO KEEP THEM WELL. Do not wean the baby until it has nursed 10 months or a year, as long as it is gaining weight: but if you are very ill or think you can not nurse, or the baby is losing weight, consult the doctor and ask liim how to feed your baby from the bottle. Some Indian mothers, however, nurse their babies two or three years. This is a bad prac- tice, both for mother and baby. The baby may be put to the breast as soon as it is washed, dressed, and ready for the mother, if she is not too tired. If so. let her rest a ^■L'KSK YOL'K OWN BABY. few hours. During the first -24: hours the baby should not nurse more than four or five times, but at both breasts each time. If it cries much it can have cool boiled water. Do not feed it tea, cofee, melons, candy, or any solid food. A new baby Avill thrive better if the intervals between feedings is fairly long. During the first two days three nursings a day and one at night are enough. From the third day to the fourth month, there should be seven nursings in the 24 hours, three hours apart, one of them being at night. Xight feeding (after the 10 o'clock INDIAN BABIES : HOW TO KEEP THEM WELL. BABY BEING AVEIGHED. IXDIAX BABIES: HOW TO KEEP TIIEM WELL. (.1\E UAUV I'LK.MV Ul CUUl., IJUU.KD WATEIl INDIAN BABIES : HOW TO KEEP THEM WELL. 9 nursing) may be omitted when the child is 4 months old. The fol- lowing table shows the nursing interval and the number of feedings in 24: hours when the three-hour interval is used. Period. First and second days Thii'd day to four months Four to seven months Seven to twelve months. . Nursings Interval in 24 hours. by day. Hours. 4 6 7 3 G 3 4 Night nursings (10 p. m. to 6 a. m.). ]\Iothers must not offer the breast everj' time the baby cries. Cxive the breast by the clock. At other times give pure water. Babies, as well as adults, need water. If you follow this rule there will be fewer dead babies. Do not give the baby solid food until the teeth are Avell-developed, and then only simple, well-cooked food, such as bread and butter, baked potato, cereal, rice, broths, soft-boiled eggs, or a little fruit. All fruits, however, should be well cooked. After the baby is a year old plenty of cow's milk is very good food. If you can not get this, you may be able to get condensed milk, which is a good substitute and many Indian babies thrive on it. Feed the baby regularly. 50572°— IG 2 10 INDIAN BABIES : HOW TO KEEP THEM WELL. BOTTLE FEEDING. If the baby must be fed from the bottle, absolute cleanliness is essential in everything used, and the milk must be modified or diluted as the doctor directs. BABY VSIXG NL'KSING BOTTLE. Do not use patent foods sometimes found in traders' stores unless the doctor recommends them. Be sure, if 3'ou are using cow's milk, that the cow is not dirty when milked, that the stable is not dirty, that the milk is not dirty. The milk must be clean and free from germs. Many babies' deaths during the summer are due to feeding impure milk or milk which has not been kept cool. To prevent milk from INDIAN BABIES : HOW TO KEEP THEM WELL. 11 making the baby sick, during the hot weather, scaki the milk without letting it boil. To do this set a covered bottle of milk in a saucer and place this in a shallow pail. Pour water in the pail until the water level is about 4 inches from the top of the bottle. Set on the stove, and as soon as the water comes to a boil remove the bottle of milk and allow it to cool. It is better to prepare in this way a day's feedings at one time, if you have some way in which to keep the milk cool afterwards. Be sure to keep it covered. Never keep the feeding bottle warm all night, as germs will grow in it and the milk will get sour. A double boiler, as illustrated, is a useful device for the purpose of scalding milk. HOW TO KILL GEKMS IN MILK. If you can not afford to consult a physician or there is no agency or school phj^sician, read the following instructions in regard to feeding your baby. The simplest plan is to use whole milk (taken before the cream has been allowed to rise), and dilute it according to the child's age and digestion. Beginning on the third day, the average baby should be given 3 ounces of milk daily, diluted with 7 ounces of water. To this should be added 1 tablespoonful of lime water and 2 even teaspoonfuls of sugar. This should be given in seven feedings. One ounce is about two level tablespoon fuls. At one week the average child requires 5 ounces of milk daily, which should be diluted with 10 ounces of water. To this should be added li even tablespoonfuls of sugar and 1 ounce of lime water. This should be given in seven feedings. The milk should be increased half an ounce about every four days. And the water should be increased half an ounce about every eight days. 12 INDIAN BABIES : HOW TO KEEP THEM WELL. At 3 months the average child requires 16 ounces of milk daily, which should be diluted with IG ounces of water. To this should be added 3 even tablespoonfuls of sugar and '2 ounces of lime water. This should be given in six feedings. In mixing the milk and water after the third month, the milk should be increased half an ounce about every six days, and the water should be reduced half an ounce about every two weeks. At 6 months the average child requires 24 ounces of milk daily, which should be diluted with 12 ounces of water. To this should be DRESSING THE BABY. added 2 ounces of lime water aiul 3 even tablespoonfuls of sugar. This should be given in five feedings. The amount of milk should now be increased half an ounce every week. The milk should be increased if the child is hungry and is digesting his food well. It should not be increased unless he is hungry, or if he is suffering from indigestion even though he seems hungry. At nine months the average child requires 30 ounces of milk daily, which should be diluted with 10 ounces of water. To this should be INDIAN BABIES : HOW TO KEEP THEM WELL. 13 added 2 even tablespoonfuLs of sugar and 2 ounces of lime water. This siiould be given in five feedings. The sugar added may be milk sugar, or, if this can not be obtained, cane sugar (granuhited sugar) or maltose (malt sugai') may be used. At first plain water should be used to dilute milk. Barley water: After three months a weak barley water may be used in place of the plain water; it is made by adding one-half level tablespoonful of barley flour to IG ounces of water and cooking for 20 minutes. SLEEPING BABY. At six months the barley flour may be increased to 1^ even table- spoonfuls cooked in 12 ounces of water. At nine months the barley flour may be increased to 3 level table- spoonfuls cooked in 8 ounces of water. A very large baby ma}^ require a little more milk and a small or delicate baby will require less than the milk allowed in these direc- tions. - The following table shows amount of food required at the different ages and the proper intervals between feedings. 14 INDIAN BABIES : HOW TO KEEP THEM WELL. Schedule for feeding healthy infants during the first year. Age. Interval Night between feedings me^lsby (10 p.m. day. to 7 a.m.). Number of feed- ings in 24 hours. Quantity fori feeding. Quantity for 24 hours. Second to seventh day Second and tliird weeks Hours. 3 3 1 1 1 1 7 7 7 7 6 5 Ounces. 2 '-4 Ounces. 10-17 14-28 Fourth to ninth week 3 3 -4i 21-31 Tenth week to fifth month Fifth to seventh month Seventh to twelfth month 3 3 4 3^5 44-6^ f)i-9 24-35 27-39 33^5 Give the baby plenty of cool boiled water between feedings. Use nursino; bottles like this : EIGHT KIND OF BOTTLE. Do not use a bottle with a long tube like this. clean and forms a good hiding place for germs: It is too hard to WKONG KIND OF BOTTLK. INDIAN BABIES : HOW TO KEEP THEM WELL. 15 Many Indian babies when ^xry young are strapped by theii- mothers to boards and cradles. A NAVA.TO CKADLE. This is not good for the baby as it restricts the baby's movements. How would you like to have your arms and legs tied up so you could not move them? It is natural for a baby to want to work its arms and legs, and we must not stop him from doing so. 16 INDIAN BABIES: HOW TO KEEP THEM WELL. CLOTHING THE BABY. Fresh air. — When Indian Ijabies are very young it is wv.i uncom- mon to see the Indian mothers cover the cradles entirely with a blanket. This shuts off the fresh air from the babv and does it NOmiAL BABY PKOPEULY DKESSED. harm. It renders the baby more likely to catch cold and makes it uncomfortably hot. Later on when the baby learns to walk he is often allowed to run about naked. This is not good either. Babies must not be either smothered or frozen. INDIAN BABIES : HOW TO KEEP THEM WELL. 17 The baby is very sensitive to heat and cold. In hot weather mothers shoiikl not put too many clothes on the baby. When he f LEK. .ILLINOIS STATE- BOARDof HEALTH PUBLIC HEALThhCARTOON SERIES.NV TRACHOMA (SORE EYES). Watch Yonr baby's eyes, especially if any of the family have trachoma. You have seen many Indians with "sore eyes'* and know how much pain they suffer and how many of them lose their sight, some of them becoming totally blind. The matter from these " sore eyes" is very contagious, and will surely give your baby trachoma if any of it gets into the baby's eyes. Therefore do not allow anyone to use the towels or wash cloths that belong to the baby. Do not wipe the baby's eyes with anything dirty. Trachoma spreads very rap- idly in dirty homes. Keep your homes clean and your towels, hand- kerchiefs, bedding, clothing, and bodies clean. Have the baby's eyes examined by the doctor from time to time to see whether he may have trachoma. This disease can be cured and the eyesight saved if treatment is given early. T'nless the treatment is kept up for many months the disease will not be cured. If you have sore eyes, go to the doctor at once. Indians having trachoma should have their toAvels. handkerchiefs, wash cloths, and washbasins separate from those used by well persons. INDIAN BABIES : HOW TO KEEP THEM WELL. 25 HOSPITALS. On some of the reservations hospitals have been erected where the sick grown-ups and the Indian babies as well may receive treatment. Many diseases can be handled better in a hospital than at home. This is true of tuberculosis (consumption), trachoma (sore eyes), pneumonia, any serious lung trouble, and many other diseases. Mothers should go to hospitals when their babies are about to be born, especially those women mIio have had trouble before. The AN INDIAN SERVICE HOSPITAL. mothers can then have good treatment and the babies will get a good start in life. AMien the superintendent or physician tells you you ought to go to a hospital, you should go at once. Of course, all Indians treated in hospitals do not get Avell, but almost all of them do. You are much more likely to get well if treated in a hospital than if treated any other Avay. 26 INDIAX BABIES : HOW TO KEEP THEM WELL. SAVE THE BABIES. January 10, lOlfi. To superintendents and other employees of the United States Indian Service: In au address before the Congress on Indian Progress held at San Francisco in August of last year I said : It is our cliief duty to protect the Indian's health and to save him from premature death. Before we educate him, l)efore we conserve his property, we should save his life. If he is to be perpetuated, we must care for the children. We must stop the tendency of the Indian to diminish in number, and restore a condition that will insure his increase. Every Indian hospital bed not necessarily occupied with those suffering from disease or injury should be available for the mother in childbirth. It is of first importance that we begin" by reestablishing the health and constitution of Indian children. Education and protection of property are highly important, but everything is secondary to the basic condition which makes for the perpetuation of the race. That thought has deepened its hold upon my convictions. We must guarantee to the Indian the first of inalienable rights — the right to live. No race was ever created for utter extinction. The chief concern of all ethics and all science and all philosophies is life. The Indian has demonstrated his humanity and his capacity for intellectual and moral progress amid conditions not always propitious, and I am eager to participate with all the favoring forces that contribute to his racial triumph, believing as I do that when he comes to himself as a factor in the modern world his achievements will enrich and brighten the civilization of his native land. I should like to get the feeling I have upon this question into the conscience and aspirations of every Indian Service employee until there shall prevail a sort of righteous passion to see that every Indian child has a fair chance to live. There is something fundamental here. We can not solve the Indian problem without Indians. 'We can not educate their children unless they are kept alive. All our Indian schools, reservations, individual allotments, and accumulated incomes tend pathetically toward a wasted altruism if maintained and conserved for a withering, decadent people. If we have an Indian policy worthy of the name, its goal must be an enduring and sturdy race, true to the noblest of its original instincts and virtues and loyally sympa- thetic with our social and national life ; a body of efficient citizens blending their unique poise and powers with the keen and sleepless vigor of the white man. We must, therefore, renew daily our warfare against the arch foe of efficiency — disease. We must begin at the right place — not only with the infant at its mother's breast but with the unborn generation. The new campaign for health in which I would enlist you is first of all to save the babies ! Statistics startle us with the fact that approximately three-fifths of the Indian infants die before the age of 5 years. Of what use to this mournful mortality are our splendidly equipped schools? I earnestly call upon every Indian Bureau employee to help reduce this frightful percentage I Superintendents, teachers, physicians, matrons, nurses, everyone can do something by instruction or example, the physician with his science, the nurse with her trained skill, the matron with her motherly solicitude, all of us by personal hygiene, cleanliness, and sobriety. With this idea uppermost, all employees whose duties bring them in touch with Indian families must work in closest harmony for surrounding the expectant Indian mother with favorable health conditions before and after childbirth. The sanitation of the homes of such women should have special attention, and no baby allowed to be born into an environment germinating disease if prevention is available. The simplest rules of motherhood applied under intelligent and friendly direction would save most of the Indian babies who annually fill untimely graves. 27 28 INDIAN babies: how to keep them well. I want to send this safety, as far as possible, into every home of an Indian mother, whether that home l)e a tepee, a tent, a log house with dirt floors, or a more com- fortable abode. This means work, hard work, but the reward will be living souls. I shall expect each superintendent to acquaint himself with the home conditions of every Indian family on the reservation and to adopt practical and effective means for quick and certain improvement. Superintendents must organize such a system of cooperative information through their employees as will enable them to do this, exercising, of course, great care and discretion in gathering the requisite information. I shall consider, on the superintendent's recommendation, a reasonable use of indi- vidual Indian moneys for the improvement of insanitary homes, where the family has such funds. In the absence of such moneys, every effort must be made to seciire clean and wholesome conditions through the efforts of the adult members of the family. If there are no members physically able to labor, expenditure may be recommended from the funds " Relieving distress and prevention, etc., of disease among Indians." The crux of the matter is this : We must, if possible, get rid of the intolerable conditions that infest some of the Indian homes on the reservation, creating an atmos- phere of death instead of life. It will be the duty of the field matron to learn of conditions existing in Indian homes and of cases requiring medical attention and report them to the superintendent.- It will be her duty to see that the prospective mother knows what equipment is necessary for the proper care of her new-born babe, and the importance of the provision wftich the husband should make for the health and comfort of the mother and child should be early and urgently impressed upon him. Physicians must be promptly advised of all cases of prospective motherhood and they must see that proper attention Is given before and after that event, arranging, if practicable, for hospital facilities where the :Bbme surroundings are unfavorable. Spe- cial effort should be made to see that the mother has nourishing food before and following childbirth. I am advised that the death rate among Indian babies is most excessive after the nursing period when, through ignorance or carelessness, they are given improper food, such as green fruits, melons, or corn, made further harmful, perhaps, by the presence of flies, and from the use of which intestinal disorders are almost sure to follow. There should be vigilant and unrelenting effort to impress upon parents the great importance of supplying food which will furnish proper nourishment for the growing child. There should be constant endeavor to educate parents to an understanding of the value of a sufficient supply of cow's or goat's milk, or condensed milk, pure water, and suitable solid food, and to the necessity of maintaining cleanliness of person, cook- ing utensils, and other articles of domestic use. It would be worth while, it would be great, if we could lift the Indian out of his uninformed condition and induce him to see that the natural and beautiful love he has for his children will not keep them alive and well and joyous unless supplemented by a rational use of food, clothing, fresh air, and pure water. If Government aid is necessary to bring health out of disease and squalor, it should not be withheld, but good results if obtained will scarcely continue unless the Indian parents exchange indolence for industry and are awakened to the use and beauty of personal and environing cleanliness. This campaign for better babies, for the rescue of a race, calls for rodouliled energy and zeal throughout the service, for it means p(>rsonal work and tireless patience. It is a well-nigh stupendous task, but will be a glorious one if we can make successful headway. I believe that the high aspirations and missionary spirit generally prevailing among our field employees are a guaranty of substantial and lasting achievements, and I hope and believe we shall have the quickened cooperation of all denominational agencies, re- ligious missionaries, and mission schools having special interest in the Indian's spiritual Avelfare and whose priceless labors, luminant with self-sacrifice and religious fervor, have done so much for the red man. We shall all, I am sure, exert an irresistible union of effort. The educational itropaganda against disease must, of course, be steadily increased and strengthened. Our Indian schools, where so nmny of the rising generations are assembled, are well organized and should be a mighty instrumentality for health and higher ideals of life. In their education of girls I hope to see added emphasis given to such subjects as home nursing, child welfare and motherhood, the sanitation, arrange- ment, and management of the home, and that nothing reasonable shall be spared to fit every Indian girl for intelligent housekeeping and for attractive home making. INDIAN BABIES : HOW TO KEEP THEM WELL. 29 There is amonj; the Indians a marked and tender affection for their children, but too often the wife, the mother, is regarded and treated as the burden bearer. I wish we might see this habit overcome, for it is distinctly barbaric. I want to see developed and prevalent in every Indian school from the least to the largest that modern and truly chivalrous spirit that recognizes and respects the sacredness of womanhood. I should like to have every Indian boy leave school with this lofty and just sentiment fused into his character, as the picture in the porcelain, liecause of the deep and ex- quisite power it will have to bless his future home with health and happiness. While, therefore, this appeal aims primarily at the safety and health of the child and is intended to enforce the thought that the future of the Indian race may depend vitally upon what we shall be able to accomplish for its new generation, it is also a message of reinforcement to every utterance and every effort expressed or put forth within the Indian Service in behalf of the adult against tuberculosis, trachoma, and every other disease ; against the liquor curse and the use of any kind of enervating drug or dope. I look to the schools chiefly to safeguard the boys and girls enrolled there against these deadly scourges, and there must be no abatement but rather re- newed and continuing energies in this direction. In closing, I ask every employee to do his or her part in widening our work against disease until our Indian reservations become the home of healthy, happy, bright-eyed children with a fair start in life, and our schools become impregnable defenses against every enemy to healthy and high-minded boys and girls. . . Sincerely, yours, Cato Sells, Commi.