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Case of a Child Born Betwixt the
End of the Sixth and Middle of the
Seventh Month and Brought Up

R. Annan

Med. Times 18:109, 1848

Mrs. R. aged thirty-eight... of Kimoss-shire [Scotland] isthe mother of six children, the youngest being under two years.

On the 5th of April 1848 [26 weeks of gestation] the painsof labour came on rather unexpectedly, and in less than two hours sheg ave birth to a female child, which, on my arrival, I found verycarefully wrapped up and placed so as to receive the gentle warmth of a fire. Unloosening the cloths to enable me properly to tie the cord,which had been hastily cut through and tied about six inches from the naval, I found a tiny infant, the proportions of which I did not think it proper then to take time to ascertain. As it was not expected to survive long it was placed on a cushion in an easy chair, so as to be sheltered from draughts of air, and at the same time so as to receive benefit from the fire, being previously wrapped up in folds of cotton wool and covered over with flannel. An earthenware bottle, filled with warm water, which has been pretty constantly continued, was placed behind the cushion. To attempt otherwise to dress the infant was never once thought of. This was about 10 A.M. As the infant showed more signs of vitality, the lips and mouth were gently moistened with a mixture of one part of cream, three parts of warm water, and sweetened with sugar. At first it was not observed toswallow, but in the evening, when I returned, there could be little doubt that this had been the case from the minute quantities of the mixture, given from time to time, not having been rejected. On the following day, to this mixture from three to four drops of sherry wine were added, and continued to be used as yesterday. On the third day the deglutition was very perceptible. Of this advantage wastaken, and under the eye of a most careful female relative from three to four drops of wine were given every six hours, in as much of the mixture as the infant was found able to swallow.

On the seventh day the child was weighed and found, including a small flannel roller, to be twenty-four ounces. The roller was under one ounce in weight. At this period the length of the child wasnot taken, but was supposed to be from twelve to thirteen inches. As the feelings of the mother were most acute, and as, indeed she was considered to be in a dying state, and as it was not expected that the infant could suck, an occasional wetnurse was not got till the ninth day; the other nourishment being supplemented nearly as above. At first the nurse merely milked a proportion into the mouth, but inless than eight days it was found that the child could draw a little, which gradually improved. Occasionally a small portion of magnesiausta or castor oil was given, so as to ensure regularity in the bowels. About the end of the third week very fine oatmeal gruel,sweetened with sugar, was alternated with the cream and water, the quantity of wine being gradually increased; and latterly the quantity given during twenty-four hours has been from one to one and a halfteaspoonful.

When six weeks and one day old, the weight was accurately ascertained to be thirty-nine ounces; the length, as nearly as a tape applied to the child would enable, showed sixteen and a half inches; and on the 30th of May the weight wasforty-three ounces, having gained four ounces since last weighing. At the last period the circumference, by the forehead andocciput, was barely eleven and a half inches.

During the last four weeks the child has been regularly bathed in water, at first tepid, but latterly of the temperature of from 65° to 70° of Fahrenheit; and occasionally, according to the testimony of the very careful female relative, who has hitherto so creditably and successfully super-intended the nursing, sometimes considerably lower; and the infant is described as uniformly enlivened and strengthened after the bath. The stomach, it is remarkable, has never once given way; and this must be solely attributed to the extreme care observed in regulating the proportions of nourishment, whether by the breast or by the spoon; and it has been remarked that the little creature seems uncommonly happy after her doses of wine and gruel. When lifted for necessary purposes, she does not fail to testify by her crying the sense she entertains of the annoyance.

Of the benefits to be derived, in such cases, from the judicious use of wine, there can be but little doubt; and, without wine, it seems almost certain the other nourishment would have been of little avail; and the same may be said of the proper regulation of the temperature -- in this case hitherto exclusively artificial, except during the short periods when applied to the nurse's breast. At present all looks well, but the mother being dead, and the family arrangements requiring, at no distant period, the removal of theinfant to the abode of the wetnurse, half a mile distant, the change is not to be viewed without suspicion as to its effects.


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