The amount of milk furnished every day by a healthy woman has been estimated at from a quart to three pints. An infant one or two months of age takes about two wine-glassfuls, or three ounces, every meal; that is, as it sucks every two hours, excepting when asleep, about five half-pints during the twenty-four hours. When it attains the age of three months, it thrives well on five meals a day, the quantity taken at each meal then, the stomach being more capacious, amounting to about half a pint. A child above three months of age ordinarily requires three pints daily.
A healthy mother is fully capable of furnishing this quantity of milk per day, and of affording the child all the nourishment it needs until four or six months after birth.
The quantity of the mother's milk varies according to many circumstances. It is most abundant and also most nutritious in nursing women between the ages of fifteen and thirty; least so, in those from thirty-five to forty. There is likewise a great difference in different women in this respect; and in the same woman varying conditions of health influence the amount of milk secreted.
THE QUALITIES OF A GOOD NURSING MOTHER
are well described by Professor J. Lewis Smith. 'The best wet-nurses are usually robust, without being corpulent. Their appetite is good, and their breasts are distended, from the number and large size of the blood-vessels and milk-ducts. There is but a moderate amount of fat around the gland, and tortuous veins are observed passing over it. Such nurses do not experience a feeling of exhaustion, and do not suffer from lactation. The nutriment which they consume is equally expended on their own sustenance and the supply of milk. There are other good wet-nurses who have the physical condition described, but whose breasts are small. Still the infant continues to suck till it is satisfied, and it thrives. The milk is of good quality, and it appears to be secreted mainly during the time of suckling. Other mothers evidently decline in health during the time of nursing. They furnish milk of good quality and in abundance, and their infants thrive; but it is at their own expense. They themselves say, and with truth, that what they eat goes to milk. They become thinner and paler, are perhaps troubled with palpitation, and are easily exhausted. They often find it necessary to wean before the end of the usual period of lactation. There is another class whose health is habitually poor, but who furnish the usual quantity of milk without the exhaustion experienced by the class just described. The milk of these women is of poor quality. It is abundant, but watery. Their infants are pallid having soft and flabby fibre.'
OVER-ABUNDANCE OF MILK.
An excessive amount of milk often distends the breasts of those women who are prone to have long and profuse monthly sickness. It is also apt to occur in those subject to bleeding piles. It may be produced by any excitement of the womb or ovaries, and by over-nursing. In these cases there is usually a constant oozing away and consequent loss of milk. The mother is troubled by this over-flow, because it keeps her clothing wet; and the child suffers because of the unnutritious, watery character of the milk under such circumstances.
This over-abundant supply may be moderated and the quality improved by diminishing the quantity of drink, and by the use of preparations of iron. Fifteen drops of the muriatic tincture of iron, taken three times a day in a little sweetened water, through a glass tube, will be useful. It will lessen the amount of the milk, and make it richer. So soon as these objects are accomplished, the medicine should be discontinued; as, if taken too long, it may so much diminish the milk as to necessitate weaning. The application of a cloth, wrung out in cold water, around the nipples is also of value. It is to be removed so soon as it becomes warm, and reapplied. In those cases in which the trouble seems to be not so much an over-supply as an inability to retain the milk, the administration of tonics addressed to the nervous system, and the local use of astringents and of collodion around the nipples, will overcome the difficulty; but these remedies can only be employed successfully by the physician. And to him alone should be entrusted the use of those medicines which directly diminish the amount of milk secreted within the breasts. The expedients we have mentioned are the only ones which can be safely employed by the mother herself in this annoying affection.
SCANTINESS OF MILK.
Some mothers have habitually an insufficiency of milk. They are most numerous in large cities, and among working women whose daily occupations require a separation from the infant. Indigestion, and the want of a proper amount of nourishing food, cause a diminution in the quantity of milk. So also do over-feeding and gormandizing. Age lessens the secretion of milk, as has been already mentioned. Those who first bear children late in life, have less milk for them than they who begin earlier. In some cases want of milk in the breasts seems to be due to its reabsorption. In such instances it may make its appearance at distant parts. Thus, a case has been recorded of the coughing up of milk following sudden arrest of the secretion, and others in which it presented itself as an exudation in the groins.