Midwifery and the diseases of women

by Joel Shew

I am willing, however, to admit that it is probably the better rule for the child to be nursed somewhat late at night; for example, when you retire to rest; after that it should not be allowed nourishment till morning.

At what time to cease Nursing.—This, too, is a question which deserves a careful consideration—one on which the health of both parent and offspring very much depends.

It is probably true that women in the civilized and refined parts of the world do not, as a general fact, nurse their children for as long a period as is the case among the savage nations.

The Indian women of our own country, it would appear, are in the habit of continuing to suckle their children two years or more before weaning them. Nor do they at all allow of cohabitation during this period—a practice which might well be imitated by the more enlightened portions of the human race. “I shall not undertake to determine,” says Dr. Rush, “how far the wholesome quality of the mother’s milk is increased by her (the Indian woman’s) refusing the embraces of her husband during the time of giving suck.” If, then, the mother’s milk is to be deteriorated by the practice referred to, her health, also, must suffer in a corresponding ratio.

It would appear, also, that in Bible times the period of nourishing children at the breast was prolonged to a much greater period than is common in these latter times, for we read of the giving of suck three years.

Reappearance of the Menses.—Some have supposed that the period of nursing should be graduated according to the reappearance of the catamenial discharge, because, as they have supposed, the milk is deteriorated by that circumstance.

Let us inquire, in the first place, at what time after a woman has given birth to a child, does the menstrual function ordinarily commence?

Some authors tell us that this does not happen for nine or ten months, usually. Dr. Meigs tells us that he expects his patients “to become unwell at the seventh month of lactation.” “But more frequently than is generally believed,” says Dr. Tilt, “the periodical flow coincides with the secretion of milk as early as the second or third month of lactation, and this in perfectly healthy women; and I am in a great measure able to confirm the assertion of certain authors, that menstruation often continues regularly from the beginning of lactation.” These, however, are exceptional cases, the rule being that a number of months, ranging probably from seven or eight to fifteen, elapses before the menses reappear.

But it is by no means proved that lactation should be made to cease as soon as the woman has her monthly discharge. I have myself known numbers of cases in which nursing was continued for some months after, and apparently with good results to both mother and child. How is it in those cases where the menses do not cease at all, or, at farthest, come on at a much earlier period than it would be advisable to wean the child? Must we be obliged to wean the child in these cases? I think not.

Dr. Hassall, of London, we are informed, examined with a microscope the milk of a lady taken from her on the second day of menstruation, which had come on for the first time at the ninth month of lactation, and he reported that the milk was perfectly normal in quality.