ing, as
well as the child's toys, hands, etc., must be kept scrupulously
clean.

CONSTIPATION

In the chapter, "The Feeding Problem," constipation in bottle-fed
babies was discussed. The bowels should move at least once in
twenty-four hours. The passages are frequently very hard and leave the
body only after a very great effort of straining. This constipation,
often continuing until late childhood, should be corrected in the
following manner:

In early infancy--as early as the fourth month--prune juice may be
given as directed elsewhere, while in later months prune pulp or fig
pulp, which has been carefully rubbed through a fine-mesh colander,
may be given at meal time. By the time the baby is eleven or twelve
months old, strained apple sauce may be given.

We deplore the use of the water enema as a regular daily procedure; in
its place we suggest the use of the enema of oil or the introduction
into the rectum of a gluten suppository or in obstinate cases a
glycerine suppository. Abdominal massage should be daily administered.
With a well-oiled hand, begin on the right abdomen and proceed upward
to the lower border of the right ribs and across to the left side and
down. This should be repeated many times at a regular hour each day.
The mother should select an hour for the bowels to move, preferably
after the forenoon feeding, and if the child is too small to sit upon
the toilet chair, a gluten suppository may be placed into the rectum
before the forenoon feed and some time during the middle of the day
the bowel movement will be found in the napkin.

For the older child, before a certain meal each day, a well-vaselined
piece of cotton may be inserted in the rectum; this often produces a
bowel movement immediately after the meal. Laxative foods, such as
bran, stewed figs, stewed prunes, or a raw apple, should be used
faithfully--as repeated medication never corrects the difficulty, but
usually prolongs it.

To immediately flush out the bowel, a soapsuds enema or a plain water
enema may be allowed to flow into the lower colon, or a glycerine
suppository inserted into the rectum will quickly bring a bowel
movement. These methods are only of temporary value; a regular habit
should be formed, if possible, to bring about a natural, normal bowel
movement. When necessary to resort to drugs--such remedies as cascara
sagrada, milk of magnesia, or syrup of rhubarb, are satisfactory, as
well as our old stand-by--castor oi