HARE-LIP.

This is a blemish too well known to require a formal description.  The questions most interesting to a mother in relation to it, are,—­How is her child to be nourished, that is born with it? and when ought an operation to be performed for its removal?

The mode of feeding the infant.—­If the defect is but trifling, the infant will be able to suck, provided the mother’s nipple is large, and the milk flows freely from it.  If this is not the case, the difficulty may be obviated by using the cork nipple shield.[FN#29] I have known this to answer the purpose admirably, when the mother had previously despaired of nursing her infant, the nipple being too small for it to grasp.

[FN#29] See p. 41.

If, however, the defect exists in a still greater degree, feeding by means of the spoon must be resorted to; the greatest care being necessary as to the quantity, quality, and preparation of the food.[FN#30]

[FN#30] See “Artificial Feeding,” p. 34.

Caution in reference to the operation.—­With regard to the operation for the removal of this deformity, I would strongly warn parents against desiring its too early performance.  Various considerations contribute to make the distressed parents anxious for this.  But very seldom indeed—­except the deformity be very great, and implicating other parts beside the lip—­will the operation be required, or ought it to be resorted to, before the second year and a half of the infant’s life; and for this very cogent reasons exist.  For instance, convulsions may thus be induced, which often terminate fatally.

The most proper age for removing this deformity by operation, is from that of two years and a half to four years.

BLEEDING FROM THE NAVEL-STRING.

Bleeding from the navel-string will sometime take place hours after it has been supposed to be carefully secured.  This will arise, either from the cord being carelessly tied, or from its being unusually large at birth, and in a few hours shrinking so much that the ligature no longer sufficiently presses on the vessels.  In either case, it is of importance that the attendants in the lying-in-room should understand how to manage this accident when it occurs, that it may not prove injurious or fatal to the child.

The mode of arresting the bleeding.—­The clothes of the child and the flannel roller must be taken off;—­the whole cord without delay must be unwrapped, and then a second ligature be applied below the original one, (viz. nearer to the body of the infant,) taking great care that it shall not cut through the cord when drawn very tight, but at the same time drawing it sufficiently tight to compress the vessels.

The ligature should be composed of fine linen threads, three or four thicknesses, and not of tape or bobbin, or any substance of this nature, as it cannot be relied on for this purpose.