5. _Reflex Causes._ Wakefulness is sometimes due to reflex nervous causes such as the need for circumcision, or the presence of adenoids, enlarged tonsils or worms. Does baby have to breathe through his mouth? Then you may suspect adenoids or other conditions which should be removed. 6. _Chronic Disorders._ The presence of scurvy or syphilis causes the child to cry out sharply as if in acute pain, while in older children tuberculosis of the spine or hip is attended by a sharp, painful crying out during sleep. Malnutrition or anemia are also conditions which greatly disturb sleep. 7. _Soothing Syrups._ Untold trouble, both physical and nervous, is bound to follow the giving of soothing syrups. These medicines soothe by knocking the nerves senseless and never by removing the cause. They contain morphin, opium, cocain, heroin, and other drugs which deaden pain, and are most dangerous to give baby. DAILY NAPS The morning nap from the sixth month on should be from two to three hours long, out on the porch, well protected; while the afternoon nap may be from one to one and a half hours long with an interval of two or three hours before bedtime. The child should be wakened at regular intervals for feedings during the day--every three hours until he is six months old, and then every four hours. These naps should be taken in a cool place--on the porch, on the roof, in the yard, under a tree, or on the protected fire escape. If the nap is to be taken indoors, then lower the windows from the top and darken the room. All children should take daily naps until they are five or six years old. CHAPTER XXIII BABY HYGIENE Possibly if all our babies could grow up in a mild, warm climate, out of doors, where they were cared for by mothers who had nothing else to do but enjoy nature in a garden, their babies unhampered by clothes and other conventionalities inflicted upon us by our present standards of living--well, if that were our environment, probably this chapter on baby hygiene would not need to be written. But realizing that variable climatic conditions, the indoor life, and the necessary bundling up with clothes, all tend to increase the ever-present danger of infection from thickly settled peoples and their domestic pets--these facts, together with the further fact that modern social conditions make it necessary for some mothers to toil long hours--all these influences, I say, considered separately or combined, make it imperative for us to give thoroughgoing consideration to the essentials of baby hygiene. The subjects of fresh air, sleep, bathing, etc., have been duly discussed in previous chapters. WATER DRINKING