The habit of nursing a child while sitting up in bed or half reclining upon a lounge is a wrong one. Such a position is injurious to the b.r.e.a.s.t.s, hurtful to the woman"s figure, and apt to cause backache. When in bed, the mother ought always to be rec.u.mbent while the child is at the breast, held upon the arm of the side upon which she lies. When out of bed, she should sit upright while nursing.
QUANt.i.tY OF MILK REQUIRED BY THE INFANT.
The amount of milk furnished every day by a healthy woman has been estimated at from a quart to three pints. An infant one or two months of age takes about two wine-gla.s.sfuls, or three ounces, every meal; that is, as it sucks every two hours, excepting when asleep, about five half-pints during the twenty-four hours. When it attains the age of three months, it thrives well on five meals a day, the quant.i.ty taken at each meal then, the stomach being more capacious, amounting to about half a pint. A child above three months of age ordinarily requires three pints daily.
A healthy mother is fully capable of furnishing this quant.i.ty of milk per day, and of affording the child all the nourishment it needs until four or six months after birth.
The quant.i.ty of the mother"s milk varies according to many circ.u.mstances. It is most abundant and also most nutritious in nursing women between the ages of fifteen and thirty; least so, in those from thirty-five to forty. There is likewise a great difference in different women in this respect; and in the same woman varying conditions of health influence the amount of milk secreted.
THE QUALITIES OF A GOOD NURSING MOTHER
are well described by Professor J. Lewis Smith. "The best wet-nurses are usually robust, without being corpulent. Their appet.i.te is good, and their b.r.e.a.s.t.s are distended, from the number and large size of the blood-vessels and milk-ducts. There is but a moderate amount of fat around the gland, and tortuous veins are observed pa.s.sing over it. Such nurses do not experience a feeling of exhaustion, and do not suffer from lactation. The nutriment which they consume is equally expended on their own sustenance and the supply of milk. There are other good wet-nurses who have the physical condition described, but whose b.r.e.a.s.t.s are small.
Still the infant continues to suck till it is satisfied, and it thrives.
The milk is of good quality, and it appears to be secreted mainly during the time of suckling. Other mothers evidently decline in health during the time of nursing. They furnish milk of good quality and in abundance, and their infants thrive; but it is at their own expense. They themselves say, and with truth, that what they eat goes to milk. They become thinner and paler, are perhaps troubled with palpitation, and are easily exhausted. They often find it necessary to wean before the end of the usual period of lactation. There is another cla.s.s whose health is habitually poor, but who furnish the usual quant.i.ty of milk without the exhaustion experienced by the cla.s.s just described. The milk of these women is of poor quality. It is abundant, but watery. Their infants are pallid having soft and flabby fibre."
OVER-ABUNDANCE OF MILK.
An excessive amount of milk often distends the b.r.e.a.s.t.s of those women who are p.r.o.ne to have long and profuse monthly sickness. It is also apt to occur in those subject to bleeding piles. It may be produced by any excitement of the womb or ovaries, and by over-nursing. In these cases there is usually a constant oozing away and consequent loss of milk. The mother is troubled by this over-flow, because it keeps her clothing wet; and the child suffers because of the unnutritious, watery character of the milk under such circ.u.mstances.
This over-abundant supply may be moderated and the quality improved by diminishing the quant.i.ty of drink, and by the use of preparations of iron. Fifteen drops of the muriatic tincture of iron, taken three times a day in a little sweetened water, through a gla.s.s tube, will be useful.
It will lessen the amount of the milk, and make it richer. So soon as these objects are accomplished, the medicine should be discontinued; as, if taken too long, it may so much diminish the milk as to necessitate weaning. The application of a cloth, wrung out in cold water, around the nipples is also of value. It is to be removed so soon as it becomes warm, and reapplied. In those cases in which the trouble seems to be not so much an over-supply as an inability to retain the milk, the administration of tonics addressed to the nervous system, and the local use of astringents and of collodion around the nipples, will overcome the difficulty; but these remedies can only be employed successfully by the physician. And to him alone should be entrusted the use of those medicines which directly diminish the amount of milk secreted within the b.r.e.a.s.t.s. The expedients we have mentioned are the only ones which can be safely employed by the mother herself in this annoying affection.
SCANTINESS OF MILK.
Some mothers have habitually an insufficiency of milk. They are most numerous in large cities, and among working women whose daily occupations require a separation from the infant. Indigestion, and the want of a proper amount of nourishing food, cause a diminution in the quant.i.ty of milk. So also do over-feeding and gormandizing. Age lessens the secretion of milk, as has been already mentioned. Those who first bear children late in life, have less milk for them than they who begin earlier. In some cases want of milk in the b.r.e.a.s.t.s seems to be due to its reabsorption. In such instances it may make its appearance at distant parts. Thus, a case has been recorded of the coughing up of milk following sudden arrest of the secretion, and others in which it presented itself as an exudation in the groins.
In the treatment of a scanty formation of milk, one of the best measures which can be resorted to is the frequent application of the child to the breast. In addition, the flow may be increased by milking the b.r.e.a.s.t.s by means of the thumb and finger, suction through a tobacco-pipe, or the breast-pump, or by the use of another infant. Friction of the b.r.e.a.s.t.s, and forcible drawing upon the nipples, will make them sore, and so irritate them as to defeat the object in view. A change of scene, fresh air, and outdoor exercise, attention to personal cleanliness, and the improvement of the general health, all increase the quant.i.ty, and produce a favourable effect upon the quality, of the milk. A sojourn at the sea-side often promotes an abundant secretion of milk. The diet should be regulated by the condition of the const.i.tution. By those who are weak and pale, a large proportion of meat is required. On the contrary, those who are full-blooded and corpulent should restrict the amount of their animal food, and take more exercise in the open air.
Oatmeal gruel enjoys a reputation for increasing the flow of milk. A basin of it sometimes produces an immediate effect. The same is true of cow"s milk. Porter or ale once or twice a day, in those with reduced systems and impaired digestion and appet.i.te, will be found useful.
Anise, fennel, and caraway-seeds, given in soup, act sometimes as stimulants upon the secretion of milk. The application of a poultice made from the pulverized leaves of the castor-oil plant is a most efficient remedy when milk fails to make its appearance in the breast in sufficient quant.i.ty after confinement.
WET-NURSING BY VIRGINS, AGED WOMEN, AND MEN.
As a rule, the secretion of milk is limited to one s.e.x, and in that is confined to a short period after childbirth. But there are many cases on record of the flowing of milk in women not recently mothers, in girls before the age of p.u.b.erty, in aged women, and even in individuals of the male s.e.x. In such instances, the secretion is induced by the combined influence, acting through the nervous system, of a strong desire for its occurrence, of a fixed attention towards the mammary glands, and of suction from the nipples.
Travellers among savage nations report many examples of such unnatural nursing. Dr. Livingstone says he has frequently seen in Africa a grandchild suckled by a grandmother. Dr. Wm. A. Gillespie, of Virginia records, in the _Boston Medical and Surgical Journal_, the case of a widow, aged about sixty, whose daughter having died, leaving a child two months old, took the child and tried to raise it by feeding. The child"s bowels became deranged, and being unable to procure a nurse, and her b.r.e.a.s.t.s being large and full, he advised her to apply the child, in hopes milk would come. She followed his advice perseveringly, and, to her astonishment, a plentiful secretion of milk was the result, with which she nourished the child, which afterwards became strong and healthy. A similar instance, still more remarkable, is recorded of a woman at seventy years, who twenty years wet-nursed a grandchild after her last confinement.
Cases of nursing in the opposite extreme of life are also well authenticated. The distinguished French physician Baudelocque has related that of a deaf and dumb girl, eight years old, who, by the repeated application to her breast of a young infant, which her mother was suckling, had sufficient milk to nourish the child for a month, while the mother was unable to nurse it on account of sore nipples. The little girl was shown to the Royal Academy of Surgery on the 16th of February, 1783. The quant.i.ty of milk was such, that by simply pressing the breast it was made to flow out in the presence of the Academy, and on the same day, at the house of Baudelocque, before a large cla.s.s of pupils. Again, an interesting case is known of a young woman, who, in consequence of the habit of applying the infant of her mistress to her breast in order to quiet it, caused a free secretion of milk. In the Cape de Verde Islands, it is stated that virgins, old women, and even men, are frequently employed as wet-nurses. Humboldt speaks of a man, thirty-two years old, who gave the breast to his child for five months.
Captain Franklin saw a similar case in the Arctic regions. Professor Hall presented to his cla.s.s in Baltimore a negro, fifty-five years old, who had been the wet-nurse of all the children of his mistress.
Instances of powers of _prolonged nursing_ in mothers are not uncommon.
Indeed it is the habit among some nations to suckle children until they are three or four years of age, even though another pregnancy may intervene, so that immediately one child is succeeded at the breast by another. In those who have thus unnaturally excited the mammary glands, an irrepressible flow sometimes continues after the demand for it has ceased. Dr. Green published, some years ago, in the _New York Journal of Medicine and Surgery_, the case of a woman, aged forty-seven, the mother of five children, who had had an abundant supply of milk for _twenty-seven years_ consecutively. A period of exactly four years and a half occurred between each birth, and the children were permitted to take the breast until they were running about at play. At the time when Dr. G. wrote, she had been nine years a widow, and was obliged to have her b.r.e.a.s.t.s drawn daily, the secretion of milk being so copious. When, therefore, it is desirable, on account of the feebleness of the child, to protract the period of nursing, a wet-nurse should relieve the mother at the end of twelve or fifteen months.
RULES FOR CARE OF HEALTH WHILE NURSING.
From what we have previously said of the influence of the nervous system over the quant.i.ty and quality of the milk, and the instances we have adduced of the danger to the infant of all violent pa.s.sions--such as anger, terror, anxiety, and grief--on the part of the mother, it will be apparent that it is of the greatest moment, during the whole course of nursing, to maintain a tranquil state of mind. Pleasing and peaceful emotions favor the normal secretion of milk, and go far towards securing the health of the child. When strongly affected by any powerful feelings, mothers should not give the breast, but should wait until they have calmed down to their usual tenor of temper. A case is related of a woman who was always excited by a highly electrical state of the atmosphere, and particularly during stormy weather. If when thus influenced she nursed her child he was sure to fall into convulsions; while, if she delayed doing so until this nervous excitement had pa.s.sed, no unpleasant symptoms occurred. But we have already dwelt at length upon this subject in speaking of the influence of the mind of the mother over the child at her breast, and need not therefore recur to it. The _food_ while nursing must be nutritious and varied, though simple and unstimulating; and should consist both of meat and vegetables, soups, fish, flesh, and fowl, either in combination or succession. When the digestion requires stimulation and aid, a gla.s.s of mild ale twice a day will be useful. Wines, brandy, and whisky should not be taken without the advice of a physician. Moderate exercise in the open air and regular habits are necessary. A defective or excessive diet, fatigue, loss of rest at night, and irregularities and excesses of all kinds are unfavorable to mother and child. The proper methods of combating a tendency to over-abundance or to scantiness of milk have been alluded to. Medicines, unless prescribed by the medical attendant, should rarely or never be taken during this period, as many of them enter the milk and may thus affect the child.
RELATIONS OF HUSBAND AND WIFE DURING NURSING.
After a natural and healthful confinement, the nurse usually remains with the mother for a period of four weeks. During the whole of this time the husband should occupy a separate apartment, and, according to some physicians, this separation should be protracted during the entire period of nursing. But this is unusual, and in most cases unnecessary.
Only those women who are warned by the recurrence of their monthly illness that they are liable to another pregnancy immediately, should insist on such an ascetic rule as this.
Unquestionably the quality of the milk is much deteriorated by a conception; and therefore, both in the interest of the mother and child, the husband should renounce his usual privileges at such times.
Most women do not have their periodical illness, and consequently are not liable to a second pregnancy, before seven months have elapsed after childbirth. There are, however, numerous exceptions to this rule, and it is impossible to foretell who will and who will not be the exception.
Moreover, as any excitement of the pa.s.sions alters to some extent the secretion of the b.r.e.a.s.t.s, often to the injury of the child, it is every way advisable that great temperance be exercised in all cases in the marital relations at these epochs.
SIGNS OF OVER-NURSING.
The symptoms of over-nursing may be enumerated as follows:--Aching pain in the back; often, pain across the shoulders, and on the top of the head or forehead; marked paleness of the face; inability to sleep; frightful dreams when sleep does come; great debility; extreme depression of the spirits; disorders of the sight, and mental disturbances, which take on the form of melancholia, the delusions relating mostly to subjects of a religious character, to the effect that the unpardonable sin has been committed, and the like. The headache is situated on the top of the head, and this spot may be noticed to be perceptibly hotter to the touch than other parts of the head. These symptoms indicate that the process of nursing is making too great a drain upon the system.
A woman in ordinary health will generally be able to suckle her child for twelve months without experiencing any bad effects. When the child is kept at the breast much beyond this time, most mothers render themselves liable to the injurious consequences we have mentioned. Some, indeed, cannot furnish the child all the nourishment it needs longer than three or four months, without detriment to themselves. In such cases, by feeding the child two or three times a day, the mother may be relieved of the burden of its entire support, and may thus be enabled to continue nursing. The proper food for infants, under these circ.u.mstances, will be shortly mentioned. The prostrating effects of nursing upon the body and mind of the mother are in some, though comparatively rare, instances so marked, as to render it altogether improper from the commencement.
The treatment of the condition of system described as resulting from over-nursing is, if it cannot be remedied by partially feeding the infant and the use of tonics, to remove the child from the breast altogether, and either procure a wet-nurse for it, or wean it. The wet-nurse is greatly to be preferred; and the preference is the stronger, the younger the child. We have already alluded to the great difficulty of rearing children from birth by the hand. But after the infant has attained the age of several months, the danger of artificial feeding is much lessened, provided that the weaning does not take place during hot weather. This brings us to the consideration of the regimen of the mother who cannot nurse her own child, of the rules for the selection of a wet-nurse, of the directions for bringing up by hand, and of the proper method of weaning. These subjects we will now take up in the order mentioned.
DIRECTIONS FOR MOTHERS WHO CANNOT NURSE THEIR OWN CHILDREN.
There are many reasons why a mother should, if possible, nurse her own child. "One of the princ.i.p.al is," says the distinguished Dr. Tilt, "that as nursing, generally speaking, prevents conception up to the tenth month, so it prevents the ruin of the mother"s const.i.tution by the too rapid bringing forth of children, and, we might even add, prevents a deterioration of the race, by the imperfect bringing up of this too-fast-got family."
The same author appropriately adds: "But while advocating maternal nursing, we must not forget that woman is not now the Eve of a primeval world; that human nature, wherever it is now met, in barbarous tribes or in civilised communities, is frequently so deteriorated, so diseased or p.r.o.ne to disease, that, by nursing, a mother may sometimes undermine her own frail const.i.tution for the sake of giving an imperfect sustenance, and perhaps a poisonous heritage, to her babe."
Some mothers, however anxiously they may wish to do so, cannot nurse their children. They are shut out from this charming and tender experience in the life of a woman. The milk that comes is not sufficient, and quickly disappears. Because of the influence of the mind of the mother over the child at her breast, to which we have before called attention, women who are very hysterical and nervous, subject to violent perturbations of the mind, should not, particularly if there be any family tendency to insanity, expose the child to the mischievous effects latent in their milk. So, also, the presence of certain diseases forbids wet-nursing. Thus it is ordinarily prohibited by consumption, scrofula, skin affections of long standing, and cancer. In consumption, all efforts to suckle are frequently equally fatal to the mother and child. Even a strong hereditary predisposition to this disease may render it advisable, in the opinion of the family physician,--who should always be consulted in such a case,--to counteract the family taint by giving the milk of the healthiest nurse that can be procured. The condition of the nipples and of the breast may not permit of nursing. We have pointed out how best to guard against such an occurrence, in treating of the care of the nipples during pregnancy.
She who is to be debarred from nursing her own child should take care that it is not allowed to approach her b.r.e.a.s.t.s, as sometimes the mental and physical excitement caused by such an approach is of an injurious and lasting character.
Ordinarily, if this direction be followed out, the mother will have little trouble in regard to herself. Under such circ.u.mstances, the chief danger is to the child. Hence the importance of knowing
HOW TO SELECT A WET-NURSE.
The choosing of a wet-nurse is a matter of great moment and responsibility. She should not be over thirty years of age, and should, if possible, be one who has previously suckled and had charge of children. Her own infant should be under the age of six months, for when above that age the milk sometimes disagrees with her new-born charge.
One who has had several children should be preferred, because her milk is richer than after the first confinement.
The doctor should always examine carefully into the condition of the nurse"s health, and into the quality and quant.i.ty of her milk. Various diseases and taints of the system are so hidden, while yet communicable to the child, that the knowledge and skill of a professional expert are required for their detection, and the protection of the nursling. In testing the quality of the milk, the experienced physician allows a little to rest on his finger nail, and by its examination readily decides as to its richness and fitness to nourish the little applicant for food. It is not necessary that the b.r.e.a.s.t.s should be large, as those of moderate size often furnish a sufficient amount of milk. But it is important that the nipples should be well developed. Those wet-nurses should be preferred in whom large blood-vessels are seen prominently pa.s.sing in blue lines over the surface of the b.r.e.a.s.t.s. The possession of a vigorous, healthful infant is a good recommendation for a nurse, but care should be taken to ascertain that it is her _own_, as nurses have been known to borrow for such an occasion and so obtain credit not justly their due.
The moral and mental as well as physical characteristics should be considered. Temperance and cleanliness are indispensable in a wet-nurse, and the want of either should be an imperative reason for rejection.
Equanimity of temper, cheerfulness, and an open, frank, affectionate disposition, are of course greatly to be desired.
If the nurse becomes "unwell," shall the child be taken from her? Should the monthly sickness reappear early, and both nurse and child be in good health, suckling may be continued. But when the return happens about the ninth or tenth month, the child should be weaned or the nurse changed.
There is no physiological reason for preventing the nurse from living matrimonially; but if pregnancy occurs, the child should be taken from her.