movement, will often quiet an incipient storm.  The longer he cries, the more trouble it is to soothe him.  Sleep provokes sleep, so that often we find restlessness and sound sleep alternating in a sort of cycle, a good week perhaps following a bad one.  The nurse who is quick to cut short a storm of crying and to soothe the child again to sleep is helping him to form habits of sleep.  The nurse who leaves him to cry, believing that in time he will of his own accord recognise the futility of his behaviour, is making him form habits of crying.  A rigid routine in sleep is a good thing, but the routine belongs to the baby, not to the nurse.  The child must be educated to sleep, not taught to cry.  A baby has but little power of altering his position when it becomes strained or uncomfortable.  He cannot turn over and nestle down into a new posture.  If we watch him wake, the first stirring may be very gradual, and in a moment he may fall again to sleep.  A few minutes later he stirs again more strongly, and is wider awake and for longer.  It may only be after a third waking, by a summation of stimuli, that he is finally roused and breaks into loud crying.  The nurse who is on the watch, who, sleeping beside him, wakes at the slightest sound and is quick to turn him over and settle him into a new position of rest, will probably report in the morning that the baby has had a good night.  The nurse who lets the child grow wide awake and start crying loudly, will spend perhaps many hours before quiet is again restored.  Of the voluntary, purposive crying of infants a little older I am not here speaking.  Infants in the second six months are quite capable of establishing a “Tyranny of Tears” and feeling their power.  Fortunately it requires no great experience to distinguish one from the other, and to adopt for each the appropriate treatment.

Again, in elementary teaching upon the management of infants stress is laid, rightly enough, upon the importance of regularity in the times of feeding, and on the observance in this respect also of a very strict routine.  But in the case of the very nervous infant a certain latitude should be allowed to an experienced nurse or mother.  We may wreck everything by a blind adhesion to a too rigid scheme, which may demand that we leave the child to scream for an hour before his meal, or that, when at length he has fallen into a sound sleep after hours of wakefulness, we should proceed to wake him.

Symptoms of dyspepsia which are due to continued nervous excitement demand treatment which is very different from that which would be appropriate to dyspepsia which is due to other causes, such as overfeeding or unsuitable feeding.  The temporary restriction of food, which is commonly ordered in dyspepsia from these causes, is very badly supported by the nervous infant.  Hunger invariably increases the unrest, and the unrest increases the dyspepsia.

The difficulties of managing a nervous infant are very real, and call for the most exemplary patience on the part of the mother and the clearest insight into the nature of the disturbance.