Nature, indeed, has saved mothers the necessity of oppressing their stomachs by way of providing for the wants of their young, and has enabled them to give suck without either suffering from exhaustion or having recourse to a more stimulating diet. This is accomplished simply by the suppression of that periodical evacuation to which all healthy women are subject during the greater portion of life except when pregnant or nursing; and as, in every situation, it is certainly more advantageous for all parties to follow out the intentions of Nature, than to substitute any contrivance of their own to effect a given end, so, in the present instance, more will be gained by the observance of the ordinary laws of health on the part of the nurse, than by any foolish deviation founded on ignorance and caprice. It often happens, for example, that, from the waste caused by a great flow of milk, the appetite becomes keener, and digestion more vigorous than usual. In such cases, it is obviously allowable to increase to a moderate extent the amount of food, because the demand for it is natural and healthy. But it is a total perversion to say, that, because the appetite and digestion are vigorous, the diet ought therefore to be made rich and stimulating. And it is not less absurd to infer, that because a healthy nurse enjoys a keen appetite, and derives benefit from a moderate increase of her usual food, a sickly or delicate nurse will therefore be benefited by also eating more whether she has a natural appetite for it or not. The two cases, although generally confounded, are so widely different, that, while the increase of food promotes the flow of milk in the one, it is almost sure to diminish or put an entire stop to it in the other.
The length of time during which an infant ought to be fed at the breast is subject to some variation. In this country, the end of the ninth month is usually considered a proper time for weaning; but much depends on the condition of the mother, and also on that of the child. If both are in vigorous health, if the infant has cut several of its teeth and been already accustomed to be fed, and if the season be favourable, weaning ought to be then gradually accomplished. But if the nursling is feeble in constitution, the teeth late in appearing, and the nurse has a sufficient supply of good milk, especially if it be the winter season, it will be far better to prolong the nursing for a few months. In such a case, the single fact of the non-appearance of the teeth, would suffice to indicate an unfitness of the system for any other than the natural food from the maternal breast. In general, weaning takes place too early, at least in Scotland.
Where a healthy and well-constituted nurse has been provided, on account of the existence of a hereditary taint, such as active scrofula or cancer, in the parent, it is generally advantageous to defer the weaning beyond the usual time. But we must, in this case, be watchful not to delay it, if either the nurse or the child begins to suffer from its continuance.
It would carry me too far from the main object of this work to discuss all the contingencies against which it is occasionally necessary to provide in the management of the young. This, however, is scarcely required, seeing that medical advice is generally resorted to at the time of their occurrence; and the exposition of principles already given will enable most reflecting readers to decide for themselves, how far they may safely trust to their own lights, without delaying to seek advice from others till the evil is done.
After the child has been weaned, panada, gruel, thin arrow-root, tapioca, sago, rusk, or crust of bread, may be allowed along with the fresh milk and water and sugar, which ought still to constitute the principal part of the food; and one or other ought to be preferred according to its effects. When these are given in moderate quantity, and not too frequently, they generally agree well; but in some delicate children they cause acidity, flatulence, and griping. In this case, a proportion of weak chicken-broth, or beef-tea freed from fat, and thickened with rusk, soft boiled rice or arrow-root, may be added.
The same kind of food ought to be continued till after the appearance of the canine or dog-teeth. When these have fairly protruded, a portion of soft-boiled egg may be given as an introduction to the use of a more completely animal diet. In general, solid animal food ought not to be allowed in any quantity till all the teeth have appeared, and the digestive powers be fully adequate to its assimilation.
In this respect, there are two errors which ought equally to be avoided. If animal food be given too early, or in too great quantity, the system becomes excited, and diseases of irritation are apt to be produced, which impede nutrition, and lead ultimately to the production of scrofula and other organic changes in the glands and bowels, and not unfrequently also in the brain and lungs. In these instances, the child generally eats heartily, but nevertheless continues thin, and is subject to frequent flushing and irregularity of the bowels, head-ach, and restlessness. His mind partakes of the general irritability of the system, and peevish impatience takes the place of the placid good-humour natural to healthy childhood. In this state the ordinary diseases of infancy,—measles, scarlet fever, and whooping cough—are often attended with an unusual and dangerous degree of constitutional disturbance; and when inflammation takes place, the necessary depletion is borne with difficulty, and the system does not easily rally.
The consequences now enumerated, and the error from which they spring, are most frequently met with in the middle and higher classes of society. Aware that animal substances contain the largest proportion of nutriment in a given bulk, but ignorant of the relation subsisting between particular kinds of food and particular states of the system, and which in practice can never be safely overlooked, the fond parent naturally imagines that the more nutritious the food, and the larger the quantity administered, the stronger and healthier will the child become. No suspicion is entertained that strong diet may overpower weak organs, and thus induce the very evils which it is sought to avoid; whereas, by adapting the quality and quantity of the food to the condition of the system, the assimilating powers may be gradually invigorated, and healthy nutrition be completely ensured.
Among the wealthier classes, imperfect nutrition most generally arises from excess in quantity, or a too stimulating quality, of food; but among the lower classes from deficiency in quantity or quality, added to scantiness of clothing, want of cleanliness, and imperfect ventilation. And hence Dr Clark, in treating of the prevention of scrofula and consumption in early life, lays great stress on the proper regulation of diet, and shews that, even in families free from all hereditary taint, a morbid condition of the system extremely favourable to the production of both diseases, is speedily brought about by continued mismanagement of diet; and both the public and the profession are deeply indebted to him for drawing attention to the extensive influence of dyspeptic ailments in paving the way for the future inroads of a deadlier disease. It is true that it has long been the fashion to ascribe all bodily and mental disorders to bile, indigestion, or the state of the bowels; but the rationale of the result has seldom been perceived, or turned to any good account in improving preventive or remedial treatment. Dr Clark’s treatise, however, presents a remarkable exception, and may be referred to as a most instructive specimen of cautious and discriminating medical inquiry.
When we reflect that the object of digestion is to furnish materials for the growth of the body, and to supply the waste which the system is constantly undergoing, it must appear self-evident, that, if the digestive powers be impaired by disease, by improper quantity or quality of food, or by any other cause, the result must necessarily be the formation of an imperfect chyle, and consequently of imperfect blood. The elements of the blood are derived from the chyle, and if it be vitiated, the blood also must suffer; if the blood be impoverished, so must necessarily be all the organs which it supplies; and if the body be thus debilitated, can any wonder be felt that it should no longer be able to resist the action of offending causes which full health alone can withstand? No matter whether the imperfect chyle springs from deficiency or excess, from too weak or too strong food, from constitutional debility or the inroad of disease,—imperfect nutrition is its invariable consequence, and that cannot happen without exposing the system to morbid influences in a greater or less degree, according to the nature of the constitution and other concomitant circumstances.