Fig. 138.—Position of mother and baby for nursing in bed.
The nurse may have to resort to a number of expedients in persuading the baby to begin to nurse, for he does not always take the breast eagerly at first. He must be kept awake and sometimes suckling will be encouraged by patting or stroking his cheek. Or if his head is drawn away from the breast, a little, he will sometimes take a firmer hold and begin to nurse. Moistening the nipple by expressing a few drops of colostrum or with sweetened water may stimulate the baby’s appetite and thus prompt him to nurse.
The young mother must be prepared to find very discouraging the early attempts to induce the baby to nurse, but if the nurse will help her to persevere in making regular attempts she will almost certainly succeed.
During the first two or three days the baby obtains only colostrum, while nursing, but the regular suckling is extremely important, not alone for the sake of getting him into the habit of nursing but for the sake of stimulating the breasts to secrete milk.
Moreover, the irritation of the nipples so definitely promotes involution of the uterus that this process goes on more rapidly in women who nurse their babies than in those who do not. If the nipples are not sufficiently prominent for the baby to grasp them, a shield will have to be used while they are being brought out. But the shield should be discarded as soon as possible for it is the baby’s suckling that produces the physiological effects. If a shield is used, it should be washed and boiled after each use and kept, between nursings, in a sterile jar or a solution of boracic acid.
The length of the nursing periods and the intervals between them have to be adjusted to the needs and condition of each baby; his weight, vigor, the rapidity with which he nurses, the character of his stools and his general condition, all of which will be considered in connection with the care of the baby. The intervals between nursings are measured from the beginning of one feeding to the beginning of the next, and are fairly uniform for babies of the same age and weight. The length of the nursing period itself is usually from ten to twenty minutes.
Fig. 139.—The Nursing Mother. (By permission from a pastel by Gari Melchers.)
The average baby nurses about every six hours during the first two days, or four times in twenty-four hours. According to one schedule he will nurse every three hours during the day for about three months, beginning with the third day, and at 10 p.m. and 2 a.m., or seven times in twenty four hours. From the third to the sixth month he nurses every three hours during the day and at ten o’clock at night, or six times in twenty-four hours, and from that time until he is weaned he should nurse at four hour intervals during the day and at ten o’clock at night, or five times daily, as follows:
| Day | Night | ||||||
|---|---|---|---|---|---|---|---|
| First and second days | 6 | 12 | 6 | 12 | |||
| First three months | 6 | 9 | 12 | 3 | 6 | 10 | 2 a. m. |
| Third to sixth month | 6 | 9 | 12 | 3 | 6 | 10 | |
| After the sixth month | 6 | 10 | 2 | 6 | 10 | ||