A syphilitic woman may nurse her own child, provided her condition is good and the child also is syphilitic.
Theoretically, the return of menstruation in no way affects the nursing child, unless the blood is lost to the point of anæmia. Yet cases do occur in which the child has indigestion, colic and bad stools, as well as loses weight, when the mother is menstruating.
The quality of the milk is sometimes altered, but only for a day or so, and the child should continue at the breast unless some definite indication for removal arises.
Weaning ordinarily is completed by the ninth month, but the child should never be carried beyond the twelfth month on account of changes in the character of the milk.
When a child is weaned, the substitution of an artificial food may be made gradually,—a bottle a day, two bottles a day, etc., until, in a couple of weeks, the breasts are at rest.
The excessive prolongation of lactation is shown upon the mother by impairment of the health. The patient is pale, weak, anæmic, fretful, and thin. Headaches, dizziness, loss of appetite, and constant fatigue will be complained of.
The treatment is to remove the child at once and put the mother on stimulating drugs and foods. A change of air and scenery, if possible, will be highly beneficial.
The wet nurse is always a tribulation, which must be endured until the child can be put on artificial food. She should have a Wassermann test before entering upon her duties. Syphilis, tuberculosis, and gonorrhœa must be guarded against. She must be kept like the family cow, in a placid frame of mind, fed on nutritious food that is not too rich, and exercised enough to keep the blood circulating.
Light housework and duties that take her out of doors part of the time are advisable. Her moral character can only be assured through those who have known her. If she brings her own child with her, she will need watching to provide for an equable distribution of the milk. The first few days is never a criterion of a wet nurse’s effectiveness. Change of food and surroundings may interfere with her usefulness.
Gas may complicate the puerperium after Cæsarean section, and even after normal labor. A rectal tube of soft rubber may be passed as high as possible into the bowel and left for some time, or enemas of S. S., turpentine, asafœtida, or milk and molasses may be given. By mouth calomel or mag. cit. is valuable.