Delay in applying the child to the breast is a common cause of trouble. After it has been fed for several days with the spoon or bottle, it will often refuse to suck. When nursing is deferred, the nipple also becomes tender. For these reasons, as well as the others detailed in our directions for the care of the new-born infant, the child should always, in say from two to three hours after labor, be placed at the breast.
Ulcerated and fissured nipples should be treated by the doctor in attendance. As it is highly desirable, and nearly always possible, to avoid them, we would again call attention to the manner of doing so, indicated in a previous article. Fissured nipples sometimes do harm to the infant, by causing it to swallow blood, disturbing in this way the digestion. But all these local interferences with nursing can generally be obviated in the course of a few weeks, and rarely entirely prevent the exercise of this maternal pleasure and duty.
But there are certain physical conditions which necessitate the employment of a hired wet-nurse, or weaning. If the mother belongs to a consumptive family, and is herself pale, emaciated, harassed by a cough, and exhausted by suckling, wet-nursing is eminently improper. A temporary loss of strength under other circumstances should not induce a mother at once to wean her child; for it is often possible, by the judicious use of tonics, nourishing food, and stimulants, to entirely restore the health with the child at the breast. It should always be recollected, however, that the milk of those in decidedly infirm health is incapable of properly nourishing the child. Professor J. Lewis Smith of New York quotes, in his recent work on Diseases of Children, several instructive cases which show the danger sometimes attending suckling, and which may imperatively demand its discontinuance. 'A very light-complexioned young mother, in very good health, and of a good constitution, though somewhat delicate, was nursing for the third time, and, as regarded the child, successfully. All at once this young woman experienced a feeling of exhaustion. Her skin became constantly hot; there were cough, oppression, night-sweats; her strength visibly declined, and in less than a fortnight she presented the ordinary symptoms of consumption. The nursing was immediately abandoned, and from the moment the secretion of milk had ceased, all the troubles disappeared.' Again: 'A woman of forty years of age having lost, one after another, several children, all of which she had put out to nurse, determined to nurse the last one herself. This woman being vigorous and well built, was eager for the work, and, filled with devotion and spirit, she gave herself up to the nursing of her child with a sort of fury. At nine months she still nursed him from fifteen to twenty times a day. Having become extremely emaciated, she fell all at once into a state of weakness, from which nothing could raise her, and two days after the poor woman died of exhaustion.'
It does not always follow, that because the mother is sick the child should be taken from the breast. It is only necessary in those affections in which there is great depression of the vital powers, or in which there is danger of communicating the disease to the child. In the city, where artificially-fed infants run great risks, extreme caution should be exercised in early weaning.
Inflammation of either of the breasts necessitates the removal of the infant from the affected side, and its restriction to the other. As the inflammation gets well and the milk reappears, the first of it should always be rejected, as it is apt to be thick and stringy, after which nursing may be resumed.
RULES FOR NURSING.
The new-born child should be nursed about every second hour during the day, and not more than once or twice at night. Too much ardor may be displayed by the young mother in the performance of her duties. Not knowing the fact that an infant quite as frequently cries from being overfed as from want of nourishment, she is apt to give it the breast at every cry, day and night. In this manner her health is broken down, and she is compelled perhaps to wean her child, which, with more prudence and knowledge, she might have continued to nurse without detriment to herself. It is particularly important that the child shall acquire the habit of not requiring the breast more than once or twice at night. This, with a little perseverance, can readily be accomplished, so that the hours for rest at night, so much needed by the mother, may not be interfered with. Indeed, if the mother does not enjoy good health, it is better for her not to nurse at all at night, but to have the child fed once or twice with a little cow's milk. For this purpose, take the upper third of the milk which has stood for several hours and dilute it with water, in the proportion of one part of milk to two of water.
In those cases in which the milk of the mother habitually disagrees with the infant, the attention of the doctor should at once be called to the circumstance. A microscopic examination will reveal to the intelligent practitioner the cause of the difficulty, and suggest the remedy.
It may be well here to mention—as, judging from the practice of many nurses and mothers, it seems to be a fact not generally known or attended to—that human milk contains all that is required for the growth and repair of the various parts of the child's body. It should therefore be the sole food in early infancy.