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A child’s sleep patterns will vary according to a number of intrinsic and extrinsic factors, including his temperament. There is no doubt that some babies with a ‘difficult temperament’ profile — that is intense, active, babies who have difficulty getting into a rhythm — are much more likely to have erratic, difficult-to-manage sleep patterns. It is equally true that whether or not a child has significant sleep problems is very much a consequence of the transactions between the child and his parents. This then becomes a very important factor in planning intervention and treatment programs, which focus on changing parental reaction to the child’s sleep patterns.

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Do not allow twisting or bending of the spine to happen in ANY direction. It requires three people to move the person and a fourth to steady the head.

Fractured ribs may result from a fall or a direct blow. There will usually be pain while breathing, and tenderness over the broken ribs.

A firm bandage wrapped around the whole chest, or in the case of a woman, a “long-line” bra may be used, firmly done up.

This will help to immobilise the chest and will make movement easier.

A flail-chest may occur particularly following a motor car accident, where the chest is struck by the steering column. Here the ribs are broken on both sides of the breastbone, so that the chest tends to flap in and out on breathing. This can seriously hamper the respiration. The application of a firm, wide bandage, or a folded sheet, fixed around the chest, may be life-saving in this case.

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This may arise as a complication of another eye disorder but most are due to unknown causes.

Primary glaucoma usually arises after the age of 40, being most common in the fifties and sixties.

Acute glaucoma comes on suddenly. It is associated with severe pain in the eye and may radiate to the temple, down the nose or even further around the head and face. Vomiting is common , and this combination of severe headache, vomiting and disturbed vision may be mistaken for migraine.

Vision rapidly deteriorates and haloes may be seen on looking at lights. This is due to swelling or oedema of the cornea, the clear window at the front of the eye.

The eye is reddened and there is watering from an excess production of tears. The cornea looks steamy and loses sensation.

Acute glaucoma is a medical emergency and requires immediate treatment or vision may be permanently lost.

Drops to help the drainage of fluid, drugs by mouth to remove fluid and lower the pressure and, sometimes, operation may be required.

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The number of hairs we have on our bodies is determined before we are born. The hair follicles form early in foetal life and all areas of the body, except the colored portion of the lips, the palms and soles are covered with fine vellus hairs. We each have about five million.

The scalp, eyebrows, under the arms, the pubic areas, and the adult male face have coarser, more pigmented hair called terminal hair.

The hair on our head goes through a cyclical growth pattern over a period which may vary from a few months to three years. It then enters a resting phase while a new hair is developing in the follicle below.

This resting hair may be dislodged by minor trauma, such as brushing or combing, pushed out by the growing hair underneath.

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If breast-fed, the baby sucks away at the nipple, often swallowing a lot of air as well as milk. In bottle-fed babies, the same thing happens. Often if the nipple (teat) is too small, the baby will suck valiantly and unconsciously swallow a lot of air. Alternatively, if the milk flow is too fast, in the process of gulping it down the baby may also swallow too much air.

Air in the stomach and bowel creates distension, and this is uncomfortable. So baby cries. The more the baby cries, inhaling quickly at the end of each wail, the more air tends to be swallowed. So the evil cycle goes on. More crying, more air, more bowel distension, more unhappiness, more emotional tension—a worried frantic mother whose tension is quickly felt by the baby. A cycle can quickly develop. The wind-colic syndrome can easily become established on a regular basis.

On the other hand, some babies are simply overfed, sometimes by anxious mothers who fear they are not getting enough food; so overdistension of the bowel will also give pain. Of course, a hungry baby is an unhappy one and will often start crying as an alarm that it’s time for tucker. Never overlook this fact. Most parents soon come to understand their babies and the various signals that they give.

Emotional factors are a common cause of colic. Many babies are active and tense, and they are then more likely to develop this symptom. Family tensions and parental anxieties are readily picked up by sensitive infants; and this can reflect on their nervous systems and tummy system which rapidly senses when all is not well in the environment.

Some infants are allergic to cow’s milk, and colic is then much more likely. There may be a family history of milk allergy; other infants in the family may have had similar experiences, which is worth remembering.

Treatment

What to do? It is worth trying the simple measures first, for they often work. They are usually easy and don’t cost anything but a bit of time and effort.

Burp the baby. Remove the air from the stomach by lying the baby partially over your shoulder, patting the baby’s back and gently pressing on the baby’s abdomen. Air tends to rise, and in this simple manner it will find its way to the exit through the small valve at the lower end of the food pipe, the oesophagus. Baby will give a few lovely loud burps, and often will settle down and be happy and quiet thereafter.

After this, if the baby is still unhappy, try simple repetitive movements such as gently rocking to and fro, in the position in which the baby appears most comfortable. Speak soothing, comforting soft words, and coo the infant into a sedated state.

Most mothers are unaware of it, but they are the world’s best hypnotists—for this, in truth, is a simple form of medical hypnotherapy. Soothing words spoken in a soft monotone, especially in association with comfortable warmth and gentle movement, can work wonders. Every mother can do it and many become experts. Ideally, freedom from loud noises is advisable. Many babies will slip off to sleep. Some parents of very sensitive infants find that placing their baby near a dull, repetitive noise is helpful—near running water, a humming vacuum cleaner, or a radio softly playing.

Sometimes, placing warmth over the abdomen may help (but be careful you do not burn the baby’s sensitive skin). A warm water bottle wrapped in blanket may help. Occasionally, if baby has not had a recent bowel action, an infant bowel suppository may assist in stimulating a bowel action and, at the same time, help the trapped air to move on through the bowel.

Preventing recurrences is a good idea. Check for possible hindrances in feeding methods. Check bottle nipples to make certain the fluid flows at an even and satisfactory rate, not too meagre but without flooding. This may be readily adjusted. If breast-feeding, if the flow is excessive try feeding baby whilst you are lying down, with baby lying on top. In this way the baby must suck uphill, and this may reduce the oversupply and the gulping and air swallowing. Make certain baby is getting adequate food, and is not yelling simply because of hunger. A little experimenting will soon give you the answers, and you can then gauge feeding times more suitably.

Try simple remedies

It may be necessary to re-evaluate the food the baby is being given. If allergy appears to be the fault, a switch to some other product may be necessary. There are other, non-cow’s milk products now readily available, and these are often beneficial in certain cases of milk allergy. Lessening the milk’s fat content may be necessary. Often this may be done with the assistance of a baby health centre sister or after the doctor has checked the baby to eliminate any serious underlying cause of the symptoms.

Many other simple measures may be checked. The surroundings should be examined for possible aggravating factors. Excitement is always a big bogey and is not for babies; this may readily over-stimulate their sensitive nervous systems, and produce or aggravate symptoms. Always keep excitement to a minimum when the baby is around. Anxieties and tensions are often relayed to babies through their sensitive receptor mechanism; we don’t know how this works but it certainly is highly sensitive and very efficient. A calm approach at all times is the ideal, even if you have some inner stresses.

lake all measures to prevent-, overheating the baby, or alternatively letting the baby get cold.

Enlist the help of your doctor if the simple measures fail to work. Sometimes there may be underlying reasons. In any event, it is often difficult to tell if the baby simply has wind and colic, or if there is pain for some other reason such as an underlying disorder. Pain is a common problem, and there are many causes—some serious—as other sections in this chapter will indicate. Never be fearful or embarrassed about asking your doctor. The doctor will not consider it a waste of time, and neither should you. The sooner you develop a good rapport with your family doctor the better.

Occasionally, medication may be prescribed. Mixtures containing so-called antispasomodics, once popular, have declined a bit, but are still often used with reasonable efficacy. These are usually given in a pleasant liquid form. At other times mild sedatives may be prescribed. But never give medication unless specifically prescribed by your doctor. Try the simple measures first every time.

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Baby tends to turn his head readily; he can lift his lower limbs high and stretch them out. He can now turn and twist in any direction and roll around when lying flat on his tummy. He becomes more and more mobile, getting up on his hands and knees, making forward movements. Or he may creep along, using his limbs to assist in his movements. He can now stand erect, but support is still usually necessary.

He is learning how to balance more readily, and may still need a little support. He can bend his trunk, bounce and dangle objects. He can sit alone for short periods only, and may be able to stay in the one spot for half an hour but may slump forwards on to his hands in an effort to balance himself.

His movements are improving and increasing. He can hold his bottle by now, and can manipulate many objects. He tends to reach for items with one arm rather than both at the same time.

Talk

This is gradually becoming more adult-like, with more consonants interspersed with the vowel sounds he has been making for some time. The vocal pitch and volume tends to vary and normalize. He shows more control over the noises he is making.

His baby babblings continue, and often these increase when he is excited. He tends to respond to female noises by more babblings.

If happy or unhappy, he gives vent to this vocally. He tends to growl, complain, grunt, coo and gurgle, depending on the mood of the moment.

Mind

His range of movements increases. He will often coo or cease crying when he hears music or certain voices. He will likewise react to different volumes of noise.

He is now alert most of the hours of daylight, and he is also aware of what is happening for up to two hours at a time.

If he sees an object he wants, he reaches for it directly and more concisely, without so much of the inaccurate jerking movements of previous months. Movements are becoming more definite. He keeps looking at the object he reaches for but may even close his eyes whilst reaching. He can now pick up toys expertly and without the tentative inaccuracies of the past.

He often looks at things upside down, and purposely alters the viewing angle.

He shows increasing interest in certain objects—he will tend to pick up a cup by the handle, lifts inverted objects, etc. If he drops a toy, he will often deliberately reach out to grasp for it and retrieve it.

He will look at writing or scribbling done by somebody else.

He realizes that his hands and the things they move are related.

He is gaining greater control over his hand movements. For example, he may hold one block, reach for another, and then look at a third block, being capable of this increased range of mental and physical activity.

Relationships

He still smiles at his reflection in the mirror, and he can tell his real self from the reflected image. He now recognizes his name and will turn in answer to it. He often tries to mimic the facial expressions of others. If holding an object in his mouth, he will tend to touch it with each hand alternately.

Strangers tend to disturb his mental equanimity. He can tell adults from children, and he tends to react favourably to children, whether he knows them or not. He will call his parents if he needs help

He likes playing with people, especially games in which he and another are mutually involved, such as ‘peek-a-boo’. He enjoys the interpersonal relationships of others.

He likes to feed himself with his fingers. His appreciation for taste develops and he soon develops strong preferences. He likes to manipulate his bottle without outside interference and may commence to use a cup.

At long last, he may sleep through the night, and he tends to sleep about half of the normal 24-hour day/night period. In short, baby is really starting to ‘grow up’.

AN IMPORTANT NOTE

Enormous normal variations occur in individual babies. The above scheduling is only a guide; and do not be too worried if your baby does not conform exactly to it. Each baby is a human personality in the making and will differ. However, if there are obvious marked variations, or an exceptional slowness, it is important to have the baby checked by your paediatrician or family doctor.

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