Nursing of Twins.—Should a mother undertake herself to suckle her own children, when both live, in twin cases? If she has strength enough, and a sufficiency of milk, it is better that she do so. No one else can be expected to feel that interest in a child which a mother naturally does. Inasmuch, then, as the period of nursing—if every thing be properly managed—is that in which woman enjoys probably better health and a greater immunity from disease than at any other time of her life, let her, I say, if it be at all within the range of consistency, nurse her own child; and if there is need of aid from any source, it is better, as a general thing, to depend upon pure cow’s milk, with the addition, perhaps, of a very little pure, soft water, but of no other substance whatever, not even sugar, which is so frequently resorted to. By this simple means, in connection with prudent management throughout, the child may be nourished; wholly, if the mother is not able to give it suck, or in part, if it need more nutriment than she is able to afford it.
LETTER XXXII.
TREATMENT OF AFTER-PAINS.
The Nature of After-Pains—The different Kinds—Their Causes—Treatment—The great Value of Water-Cure.
Usually after delivery, the woman experiences more or less pain in or about the abdomen, generally in the womb or the back, constituting what is termed “after-pains;” these are called after-pains, because they occur after delivery.
It is an important fact, one well worth considering, that as a rule, no after-pains worth mentioning are experienced during the first confinement. Do women become weakened necessarily by giving birth to children? Are their cares and duties too many as they become mothers, in the present state of society? Are the plans of medical treatment, such as are usually adopted in childbirth, calculated more and more to undermine the constitution? Are people almost universally in the habit of debilitating themselves by connubial excesses in the married state? These are questions of vital importance to all who expect to be mothers.
After-pains proceed from the contraction of the uterus, caused by the presence of bloody clots, the blood having oozed from the orifices of the torn vessels, and becoming coagulated in its cavity. The pains come on usually very soon after the expulsion of the after-birth, and may last a few hours, or for a number of days, according to the nature of the case and the treatment employed. Each severe pain usually expels a clot; they are often increased when the child attempts to suck, a fact showing the great sympathy existing between the uterus and the mammary glands.
After-pains may also be caused by costiveness, or, rather, by the presence of hardened fecal matter in the colon. They may also proceed from flatulency.
Dr. Dewees mentions one kind of after-pains of very distressing character, which he had not seen noticed by other writers. He met with a few cases, and I have myself seen one or two instances of the same kind. It is a most severe and constant pain at the very extremity of the sacrum and coccyx (the extreme lower portion of the spinal column). It begins, Dr. Dewees says, the instant the child is born, and continues, with the most agonizing severity, until overcome by the rapid and liberal use of camphor and opium. The sedative effect of cold water is, I hold, altogether better than these so-called remedies. This pain, it is declared by the patient, is vastly more insupportable than the pains of labor, for it is as intense in character, and holds on almost without intermission, which the pains of labor do not.
After-pains are, no doubt, sometimes rendered much worse than they otherwise would be, by improper management at the time of confinement; if the labor is hurried in an unnatural way, the probability of more severe pains is evidently increased; especially if the after-birth is hurried away before the uterus has sufficient time to contract itself they are rendered more protracted and severe; the better the womb contracts, the less the blood will flow into its cavity.
We should be careful always to distinguish these pains from inflammation of the uterus, peritoneum, or other parts within the abdomen. After-pains are remittent; the abdomen is not particularly painful to the touch; the lochial discharge is not obstructed; the patient has no shivering; milk is secreted in due time; there is no general feverishness worth mentioning; and the pulse is not affected. But in case of inflammation, the opposite of these symptoms obtains. There may be, it is true, and sometimes is, more or less increase of heat when there is simply after-pain, but this heat does not at all amount to inflammation.