These Inconveniences induced the Physicians of that Hospital to alter the Method, which for some Time past has been as follows. The Child is put to the Breast commonly within twenty-four Hours after Delivery: and tho’ at first it sucks little, and that only a thin Serum, (which however is of singular Service to the Infant by discharging the Meconium that fills the large Intestines) yet the Advantage to the Mother is, that by this means the Milk comes gradually and kindly; and before the usual Time of the Breasts hardening in the other Method, the Difficulty is conquered in this; the Milk flows freely, the Breasts are soft and easy, and the Heat of the Body continues temperate: insomuch that Dr. Hunter farther assures me, that there has been much less of Inflammations of the Breasts and Milk fevers, and but one Milk Sore among upwards of fourteen hundred Women that have been deliver’d there since this Method has been pursued.[2]
Here, tho’ it is a Digression from my Subject, I cannot help reflecting with Pleasure on the Benefit arising to many industrious virtuous People from the Institution of this Hospital. Every Charitable Foundation, every Contribution to relieve the Needy, does Honour not only to those who give, but to the Nation where it is given; for when Individuals are known to be humane and benevolent, Strangers will conclude it as a national Virtue. It is certain that all public Receptacles for the Comfort and Support of the Distressed Indigent argue a compassionate Heart in those who support them, and a just Sense of others Woe; but the Lying-in-Hospital has a Delicacy in it peculiar to itself. The Ladies who contribute to it’s Support, prove, in Terms far more expressive than Words, their Sympathy with the Sufferings of their Sex; and particularly with those whom Fortune has placed the farthest from them. The Gentlemen who encourage it, and labour for it’s Promotion, shew a Tenderness which can only dwell in manly Hearts: for he certainly comes nearest to the Dignity of a Man, who has the tenderest Sense of the Sufferings of the opposite Sex; and particularly of those, which his own Existence is the necessary Cause of. But farther, most other Public Charities seem in their Nature limited; seem to extend no farther than the immediate Relief of those under their Care; whereas this is far more extensive: the Mother is comforted, and with tenderest Care brought thro’ her Child-bed; the Child (as far as Skill can reach) is safely entered on the Stage of Life; and thus is Mankind not only preserved, but perpetuated; and thus too is Society enlarged, and improved, to a boundless Degree. Thus much have I said to do justice to an Undertaking in itself highly laudable, and infallibly productive of the greatest Good. But there is another Effect, perhaps hitherto unthought of, which will necessarily attend this Hospital, and is no less than a general Concern; that of the Improvement of Midwifry: the several Gentlemen who attend it in that Capacity, cannot but have the best Foundation in their Art, that which is extended and strengthened by the frequent Occurrence of the more nice and uncommon Cases among such Variety: and the Women whom they educate to Midwifry in that Hospital, must from their many Opportunities become valuable Practitioners for such of their Sex as are inclined to employ them rather than a Man.
But to return to the Matter in hand. This Method of putting Children to the Breast much sooner than usual, corresponds with the Opinion of Dr. Cadogan, who in a small Pamphlet on the Management of Children, has said a great many sensible useful Things; and among the rest, he proposes, that a Child be put to the Breast in seven or eight Hours after it is born; whereby, says he, “It would not only provide for itself the best of Nourishment, but by opening a free Passage for it, take off the Mother’s Load as it increased, before it could oppress or hurt her; and therefore effectually prevent the Fever; which is caus’d only by the painful Distention of the lacteal Vessels of the Breasts, when the Milk is injudiciously suffer’d to accumulate.” To this I have two Things to add; First, to recommend to Parents that the Advice here given be reduced to Practice, unless some extraordinary Circumstances intervene; in which Case, their own Judgment must direct them to seek an Opinion suitable to the Exigence. Secondly, that all Precautions be taken to prevent the Mother’s catching Cold, or being too much fatigued in the first Days after Delivery. It is here meant, besides the Child’s having it’s most proper Nourishment, the Breast, as soon as possible; that the Mother be secured not only from the Danger of sore Breasts, but even from Inflammations and Fevers so common to the Sex in Child-bed. But while we are guarding against Mischief one way, it is no less our Duty to prevent it, if possible, every way; therefore do I again caution that the utmost Care be taken to prevent the Mother’s catching Cold, or sitting up in Bed too long for her Strength in the first Attempts to suckle her Child. It is common for a Child, when first put to the Breast, to be unapt; the Mother, especially if a young one, is often awkward; and if the Nurse be unhandy or careless, the Consequences may be fatal; and indeed frequently are so: the Reason is plain. The Perspiration which usually follows Delivery is necessary; and where Nature is defective, Art is employ’d to keep it up: if then these Sweats are salutary, whatever obstructs or checks them must be dangerous; and nothing sooner or more certainly effects this than the being injudiciously uncover’d. But besides catching Cold, there is great Danger to be apprehended from Fatigue. That too much Fatigue in these early Days after Delivery may be very pernicious, every body knows who is experienced. Nothing so common as a Woman’s having had a good Labour, and being so extremely well, that on the second, third, or fourth Day she indulges herself with the Conversation of a Friend, or sits up in Bed for some time for Refreshment; in Consequence of which she grows hot, has a restless Night, and before Morning is in a raging Fever; perhaps delirious.
The precise Time of a Child’s sucking is a Point much controverted, particularly among Ladies, but nothing ascertain’d. The present Fashion ’tis true, is to let Children suck only three or four Months; but surely this is too important an affair for Fashion to take place of Reason. From my Acquaintance with the Learned on this Head, I gather, that generally speaking a Child should not suck less than six Months, nor more than twelve; but that the Medium, that is, nine Months, is for the most part the best. Still there may be Reasons for varying these stated Times; if so, Reason in that as well as in other things should be our Guide. And farther, there may be Circumstances which impede the Mother’s suckling her Child at all; the want of Health is a principal one; but then it should be a real want of Health, not an imaginary one. Where then a Doubt arises, I advise Parents not rashly and hastily to resolve for themselves, but to consult proper Judges, and always, where it is in their Power, be determined by their Physician.
But here, as an Encouragement to Mothers to suckle their Children, I must observe, that it is the Opinion of Physicians that many Women would mend their Health by it; and very few, if any, hurt a good Constitution, unless thro’ Imprudence or Ignorance: now to obviate these, let Mothers be careful to set out right, and then they have very little to fear.
Hunger, Fatigue, and Fretting, are the three most obvious things that impair a Mother’s Health in Nursing. I say nothing of gross Intemperance, violent Passions, and the like, for they are always to be banish’d; nay we are not once to suppose they exist in the Sex. Hunger is carefully to be avoided: while the Mother gives suck, she should never let the Keenness of her Appetite go off by waiting long for her Meals; for that often repeated will sink the Spirits, fill her with Wind, impair her Strength, and consequently not only hurt herself, but prejudice her Milk also.
I confess it is my Opinion that a very nice regard to a Nurse’s Diet is not so generally necessary as is imagined. Temperance is universally to be held as a Rule; but under the appearance of avoiding one Error, they run into a greater; they often eat of very rich Dishes, and shun the use of Vegetables: whereas to People who are young and healthy, nothing is more wholsome than Vegetables blended with Meat: and the only Caution that is material to be given, is, that they guard them with Pepper; whereby they will keep under the Effect they sometimes have, of producing Wind. But should Garden Stuff, after all this, disagree, Prudence will certainly direct the Mother to disuse it; tho’ at the same time it must be own’d, that where this is the Case, her Digestion is not what it ought to be to constitute perfect Health. To this Head I will add, that where a Woman has been accustom’d to drink a glass or two of Wine or Ale at Meals, she should not debar herself from it now; as her waste of Strength and Spirits certainly demand at least her usual way of Life; tho’ it does not seem needful for her to go far beyond it.
By Fatigue I mean so much Exercise as manifestly impairs the Strength, or brings on various Pains, so as to render a Mother incapable of executing what she has begun; or at least makes the Office extremely slavish to her. Exercise is good, but Fatigue is bad. There are so many different Conditions in this great Family of the World, and so many different Circumstances in each Station, that it is impossible to lay down Rules for every Individual, or prescribe an universal one for all; in general I recommend on this occasion the joint Attention of both Father and Mother. If a Man reflects that while his Wife is suckling her Child, she is labouring to compleat the principal Work for which they came together, he cannot surely suffer her to endure Fatigue beyond her Power to bear; nor can he feel for her that Tenderness he ought, if he imposes any Hardship on her that can be dispens’d with. On the other hand, the Mother is to remember, that besides being chearful and keeping her Mind at rest, she must keep her Limbs at rest too; that is, she must often forego other Exercise, that she may be enabled to bestow a larger Portion of Kindness on her Child.
But there are several ways a Woman may be fatigued with Nursing without the least necessity. The first thing a Mother has to do, is, to use her Child to such Positions in suckling as she likes best, and is most convenient to herself. When up, the Mother should by all means sit upright, and the Child be rais’d to the Breast: the Child should yield to the Mother, and not the Mother to the Child. That distorted Posture so commonly seen in suckling gives great Pain to the Back, and cramps all the Limbs; and this without any other effect on the Child than indulging a manifest Wilfulness. When in Bed, the Child should take the Breast as it lyes; and not incommode the Mother by making her sit up in Bed by the Hour, purely to humour it, as is too common: for this too, without any Benefit to the Child, greatly increases the Mother’s Fatigue, by robbing her of her Sleep, and by exposing her to catch Cold from the various Seasons it happens in. But these Inconveniences may farther be obviated, by letting the Child lye in a Cradle without the Breast the Night thro’, or with a Maid in another Room; for it is certain, that neither Breast, Drink, nor Feeding are so absolutely necessary in the Night as is commonly imagin’d. Some of my fair Readers will, I doubt, reject my Counsel in this particular; but I urge it on the double Motive of Benefit to the Child, and Ease to the Mother. Yet not to be too rigorous in this Point, not to affect too sensibly a Mother’s Tenderness, suppose a Child be sometimes allow’d the Breast in the Night, it certainly should be only sometimes; for the Practice of letting it drag at it the Night thro’ is a grievous Error: it hurts both Child and Mother; the Child by this Means is continually wrangling, fretting, and dissatisfy’d, and the Mother is often so sensibly affected by it, as even to be thrown into Hysteric Fits.