RESEARCH ARTICLES
Newborn care: hygiene and clothing, in the nineteenth century
Mercedes NetoI; Pedro Ruiz NassarII; Thalita Martins FreitasIII; Fernando PortoIV
INurse, PhD Student Graduate Studies in Nursing and Biosciences, at Alfredo Pinto Nursing School, State of Rio de Janeiro, Federal University, Member of the Laboratory Research Groups of Nursing History Research and Laboratory of Scientific approaches in the History of Nursing, Professor, Department of Public Health Nursing, State University of Rio de Janeiro, Responsible for the Epidemiological Surveillance Service and Healthcare Indicators of the Maternity Maria Amélia Buarque de Hollanda - Municipal Health Secretary of Rio de Janeiro, Rio de Janeiro, Brazil, Email: mercedesneto@yahoo.com.br
IINurse, Master's Degree Student in the Graduate Program - Master's degree in Nursing, the Alfredo Pinto School of Nursing, State of Rio de Janeiro.Federal University, Member of the Laboratory Research Groups of Nursing History Research and Laboratory of Scientific approaches in the History of Nursing, Grant holder of the Coordination for Improvement of Higher Education Personnel, Rio de Janeiro, Brazil, Email: pedrornassar@gmail.com
IIINurse, Master's Degree Student in the Graduate Program - Master's degree in Nursing, the Alfredo Pinto School of Nursing, State of Rio de Janeiro.Federal University, Member of the Laboratory Research Groups of Nursing History Research and Laboratory of Scientific approaches in the History of Nursing, Rio de Janeiro, Brazil, Email: thalitamartins@hotmail.com
IVPhD in Nursing with Post Doctorates Degree, School of Nursing, University of São Paulo, Assistant Professor, Alfredo Pinto School of Nursing, and Graduate Program - Master in Nursing and a PhD in Nursing and Biosciences, Federal University of the State of Rio de Janeiro. Rio de Janeiro, Brazil, E-mail: ramosporto@openlink.com.br
ABSTRACT: This study aims to examine newborn body care and clothing, in the nineteenth century. The documents used for analysis were the theses of the Faculty of Medicine of Rio de Janeiro that addressed the issue. The proposed analysis followed the approach of microanalysis. The result of the medical documents showed towards internalize the practice of care change in the culture of hygiene practices by gossips, grandparents, wet-nurses and others aimed to institutionalize its own rules and guidelines for disciplining mothers about care for reference.
Keywords: Nursing; infant care; newborn; historiography.
INTRODUCTION
The nineteenth century was marked by the discovery of humanistic needs and specificities of childhood, seen until then as a transitional period, without meaning to human development1.
For the eighteenth century mindset childhood was delimited by the absence of speech or imperfect speech , involving the period that goes from birth to three years of age, and would be closely related to the physical attributes, speech, teething, secondary characters; male and female gender, size, among other1.
The family and the child begin to be seen as political agents, such as promises of the future of the nation and the mother is considered the most important and vital agent for the protective measures were effective because they were directly responsible for the good and bad of the children2.
In Brazil, during the colonial period a certain devaluation of the child was reflected, especially those of origin of black mothers, by being treated as a commodity and if an orphan, they were delivered to a Doorstep and led to early and exploitative labor. In short, the colonial family ignored and underestimating of the children, being the latest fragile image of childhood3.
With the arrival and establishment of the Royal Family in Rio de Janeiro, there was the emergence of devices that were aimed at adapting the city to European standards. The primary device was the work of doctor hygienists in the direction approaching the city from the way of civilized European life adjusting the hygiene behaviors to be adopted by the population3.
In this context, doctors relied on their scientific studies and gradually drew the precepts of hygiene for the society, despite the predominance of traditional family knowledge, which allowed reduction of child mortality, given the recommendations on hygiene.
The tropical climate in Brazil, at a time when it didn't have global warming, fans or air conditioning, but heat by means of the sun also shining and warming the imperial lands, in Rio de Janeiro. In this climate, the newborns perspired and required bathing and clothing for everyday use.
Stated another way, the hygiene was necessary, but; What is the temperature of the water more suitable for the newborn? What is the best type of fabric to make the clothes for the newborn?
Given the above, the objective of this research was to analyze bodily hygiene care and clothing, for the newborn in the nineteenth century. The justification for undertaking the study is meant that the intended contribution of another study4, for the construction of the history of nursing. , for the construction of the history of healthcare. This care deserves attention in being revisited by traces left in the past, which many times, still, founded the nursing practice in the twenty-first century, being, however, care of the nineteenth century.
METHODOLOGICAL THEORETIC REFERENTIAL
From the theoretical referential of history and the methodological proposal of this research is the approach of the microanalysis. This is understood in the sense of seeing the historical phenomenon through a magnifying glass, and is considered one of the basic tasks of micro-history5.
Therefore, the search of documents in microanalysis occurred in the Library of the National Academy of Medicine, located in Rio de Janeiro, concerning the theses of students of the Medical School from the nineteenth century.
The criteria used for selection of analysis of this study were the theses on the topic of caring for newborns, defined in the bodily hygiene and newborn clothing.
The result of this search totaled four dissertations produced by medical students in the nineteenth century. The documentation found was reproduced by camera, considering the state of fresh documents to be read on the screen of the computer monitor, in zoom up to 100%, or printed.
As criteria temporal delimitation of the period from 1840 to 1882 was established , justified in its own documentary selection, that the approach of the microanalysis, not if it is to delimit the scope of the research within which we must lead the analysis separately, because it is a possibility, if necessary, to generalize the conclusions to which it must reach the study6.
RESULTS AND DISCUSSION
Bath for the Newborn Infant
In 1840, Leitão affirms that bathing was essential for the preservation of health in all ages of life being the childhood that most needed it, therefore guarantee the integrity and the functionalism of the skin surface and the action focus and soothing on the body, by means of the temperature, which years later - 1882 - it would be better exploited7.
Florence Nightingale, in 1860, remembered the British nurses and indirectly those women who cared for children's bodily hygiene. The child's body should be clean, i.e. , "never leaving a single pore of their delicate skin blocked by dirt or by perspiration is the only way to make them happy and healthy"8:174.
In France in the nineteenth century, the family doctor became a new ally of the mother of newborns in calming the maternal anxieties on some recommendations, among them, bodily hygiene. Thus, the daily bathing of newborns was daily practice subject to the temperature of the bath water. It was recommended to start the bath with cold water, gradually, until the child was clean, in the summer and winter. This would establish the hygiene habit for the possibility of a strong and healthy adult, despite the differences of temperatures for bathing, the bath was consensus in the literature9.
The newborn hygiene was, probably, one of the ways to combat other inappropriate hygiene habits based on popular beliefs in the religious sense of protection to ward off diseases. An example of this was the smoking and the baths of protection of newborns with the purpose of blessing and protecting them.
The explanation for this fact is due to the religious conditions of each locality as fads to take care of newborns10.
To combat these practices, hygiene was recommended in the theses of the medicine. The care of the ears should be made thoroughly to remove excess cerumen accumulated inside the ear, because it could produce inflammation, resulting in serious consequences, being done through injections of warm water or ether in the ear11.
For the removal of the vernix , called verniz caseoso, blood and other secretions from the delivery, the body would be covered with oil, fresh butter and without salt or egg yolk, diluted in a little water, to remove the greasy substances of the skin11.
After removal of the vernix, the skin should be cleaned with a sponge and then the child, would be immersed in water at room temperature around 28 0 C to 30 0 C, because it corresponded to the temperature of intrauterine life11.
Another important precaution regarding the first intestinal elimination, known as meconium, which after being eliminated, it was the mother or who was responsible for taking care of the newborn promoting their hygiene.
In this perspective, bathing the newborn, the care should be to avoid the cooling of the body, with the recommendation that at the end, it should be wrapped in dry and heated towel. The bath as one of hygiene care in childhood in the course of the nineteenth century should be administered without leaving the newborn dizzy. This is due to the argument put forward in two works entitled Beliefs: hygiene and maternal care, for the first age by Ernance Dufaux of lla Jonclere and the book Treaty of physical education for boys, for use by
Portuguese Parents authored by Francisco de Melo Franco, in 179012.
The medical literature indicates that the bath in particular was a separate chapter on the practice of body hygiene, for example, the cold bath was recommended since the child's first year of life12.
Temperature of the newborn bath water
The cold baths increased the power of the organs, by consolidating the tissues and preventing the losses caused by perspiration, being that Locke one of the first physicians to adopt the use of cold baths as a fortified formula for children, followed by Floyer and Rousseau, but the exaggerated use led to disadvantages, namely:
When Lycurgo barbarously dunked a newborn in a river the , and by this means intended to educate citizens strong, able men, by their physical development, to sustain the Republic; for those who do not steal life? How many unfortunate were not victims of such a cruel test? Only those escaped,
whose constitution presented strong resistance, and if opposed a cruel blow. Barbaric Practice, and unfaithful!!!7:7.
In addition, the thesis says that if it were necessary a cold bath should be done, but quickly, i.e. if you start with water in hot temperatures, passing the warm and, gradually, reaching the cold, which would be confirmed the indication in 1882, in another thesis.
In 1864, it was possible to find reports of experiences of Milne Edward, that prove the low resistance of the newborn the low temperatures and the comparative statistics of mortality of children in cold climates and hot in the winter and summer seasons13.
Years later, 1882, it was reported that, in spite of baths being given at a low temperature, during early childhood in England, they should be avoided in the first two months of life. This was due, because they produced some depression of heart rate and respiratory movements that seldom return to the normal physiological state.
It is noteworthy that the classification of the water temperatures of the baths of the newborn, was as follows: cold (0-25°), indifferent (25-30°) and warm (30-40°)11 .
Moreover, it was discussed that the hot baths should not be performed on newborns, since they stimulate the nervous system by promoting abundant sweating, causing weakness, being even fatal. Thus, they used the argument that the children had disadvantages the high temperatures of the water for the baths, because it was suddenly the skin temperature, having as a consequence increase of pulmonary and cutaneous exhalation, and when extended, elicited by: onset of congestive phenomena for various organs and; increase
of the nervous excitability, exercising at the same time debilitating actions11.
The indication of the ideal temperature of water for the baths of newborns was lukewarm water, because it softened the skin, softening the irritability, to produce good general condition and by promoting sleep and keep the health11, in spite of a previous study, in 1864, recommend for newborns hot baths or warm, the temperature between 25 to 35 Celsius, and should be bathed at least once in every 24 hours and, still, perform whenever necessary, especially after the umbilical cord section13.
It is clear from the discussion that the baths indifferent to be lukewarm or tepid, were convenient children during the first days of life, mainly with the purpose of calming the nervous system.
Clothing for the newborn
The concern with the dowry for the newborn was not only on the part of the pregnant women, the nineteenth-century medicine also presented evidence of this concern, in order to meet the best way the needs of the garment of the newborn.