The first step is to convince the young mother of what it means to her baby and her obligation to try to nurse him, since, excepting under very rare and unusual conditions, she can nurse him if she wants to enough to make the necessary effort and sacrifice.
The important contra-indications for attempting breast-feeding are retracted nipples, tuberculosis, eclampsia, severe heart or kidney disease and certain acute infectious diseases such as typhoid fever.
It seldom happens that the mother who has had average prenatal care, followed by good care during and after delivery, is unable to nurse her baby if she orders her life in the way that is known to be necessary to promote and maintain lactation. The first essential is her real desire to nurse her baby; next, her appreciation of the continuous care of herself that is necessary and third, her whole-hearted willingness to take this care for her baby’s sake.
It is safe to say that if the doctor and the nurse and the patient all want the baby to nurse at the breast, and all do everything in their power to make this possible, they will almost invariably succeed. This assertion can scarcely be made too positively, and the nurse should never lose sight of the fact that if the baby is not breast-fed he is being defrauded, and in the vast majority of cases, because of insufficient effort on the part of the doctor, nurse or patient, or all three.
A favorable frame of mind and state of good nutrition in the mother are the two indispensable factors in establishing breast-feeding and in maintaining the secretion of an adequate supply of breast-milk. These conditions, in turn, are both affected by her general mode of living, as long as the baby nurses.
Women with happy, cheerful dispositions usually nurse their babies satisfactorily, while those who worry and fret are likely to have an insufficient supply of milk, or milk of a poor quality. And in addition to this sustained influence, the temporary effect of a fit of temper; of fright; grief; anxiety or any marked emotional disturbance is frequently injurious to the quality of milk that previously has been satisfactory. Actual poisons are created by such emotions and may affect the baby so unfavorably as to make it advisable to give him artificial food, for the time being, and empty the breasts by stripping or pumping, before he resumes breast feeding.
A mother’s lack of faith in her ability to nurse is so detrimental in its effect that she must be assured over and over, that she can nurse her baby if she will persevere. If the nursing does not go well at first she must not give up, but must continue to put the baby to the breasts regularly, as this is the best means of stimulating them to activity. His feeding should be supplemented with modified cow’s milk, if the breast milk is inadequate, either in amount or quality.
Method of Nursing. The baby should be put to the breast for the first time between eight and twelve hours after he is born. This gives the tired mother an opportunity to rest and sleep, and the baby, too, is benefited by being kept warm and quiet during this interval. His need for food is not great as yet, nor is there much if any nourishment available for him.
In preparing to nurse her baby, the mother should turn slightly to one side, and hold the baby in the curve of her arm so that he may easily grasp the nipple on that side. She should hold her breast from the baby’s face with her free hand by placing the thumb above and fingers below the nipple, thus leaving his nose uncovered, to permit his breathing freely. (Fig. [138].) The mother and baby should lie in such positions that both will be comfortable and relaxed, and the baby will be able to take into his mouth, not only the nipple but the areola as well, so as to compress the base of the nipple with his jaws as he extracts the milk by suction.
