Advice to a wife and mother in two parts

by Pye Henry Chavasse

680. Cracked and fissured nipples.—Sometimes the nipple is sore from having either cracks or fissures upon it. These cracks or fissures may attack any part of the nipple, but are very apt to form where the nipple joins the breast; and, when very severe, an ignorant nurse, who is always fond of dealing in the marvelous, declares that the child has nearly bitten the nipple off! Treatment.—Now, the best remedy for a cracked and fissured nipple is for the infant, until the cracks and fissures are cured, to suck through the intervention of an india-rubber teat and shield; and every time, directly after the babe has been put to the nipple, to apply to the parts affected either neat brandy or the glycerin and brandy liniment, as I have before recommended. When the child is not at the breast, Dr. Wansbrough’s Nipple Shields should be worn; the dress will keep them in their places.

681. Another cause of a sore nipple is from the mother, after the babe has been sucking, putting up the nipple wet. She, therefore, ought always to dry the nipple—not by rubbing it, but by dabbing it with either a soft cambric or lawn handkerchief, or with a piece of soft linen rag (one or other of which ought always to be at hand), every time directly after the infant has done sucking, and just before applying either of the above powders or liniment to the nipple.

682. When the nipple is very sore, a mother, whenever the child is put to the bosom, suffers intense pain. This being the case, she had better suckle him through the intervention of an india-rubber teat, properly fastened on a shield, as before recommended. See page [276], paragraph 672. But she ought never to use an india-rubber teat unless it be absolutely necessary—that is to say, if the nipple be only slightly sore, she should not, on any account, apply it; but there are cases where the nipple is so very sore that a mother would have to give up nursing if the shield and teat were not used; these, and very small and drawn-in-nipples, are the only cases in which an india-rubber teat and shield is admissible.

683. A nursing mother is sometimes annoyed by the milk flowing constantly away, making her wet and uncomfortable. All she can do under such circumstances is to wear nipple-glasses, and to apply a piece of flannel to the bosom, which will prevent the milk from chilling her, and will thus do away with the danger of her catching cold, etc.

684. The breast.—A mother ought, before applying the infant to the bosom, to carefully ascertain if there be milk. This may readily be done by squeezing the nipple between the finger and the thumb. If there be no milk, she must wait until the milk be secreted, or serious consequences both to her and to him might ensue: to the former, inflammation and gathering of the bosom, and sore nipples; to the latter, thrush, diarrhœa, and eruptions on the skin.[^[123]]

685. If there be a supply of milk in the breast, and if still the child will not suck, the medical man’s attention ought to be drawn to the fact, in order that he may ascertain whether the child be tongue-tied; if he be, the mystery is explained, and a trifling, painless operation will soon make all right.

686. If the bosoms be full and uneasy, they ought, three or four times a day, to be well although tenderly rubbed with olive oil and eau de Cologne (equal parts of each, mixed in a vial). Some nurses rub with their fingers only. Now, such rubbing does harm. The proper way to apply friction is to pour a small quantity of the oil and eau de Cologne—first shaking the bottle—into the palm of the hand, the hand being warm, and then to well rub the breasts, taking care to use the whole of the inside of the hand.

687. After the bosoms have been well rubbed, each ought to be nicely supported with a large, soft, folded silk handkerchief; each handkerchief must pass under each breast and over the shoulders, and should be tied at the back of the neck, thus acting as a sling.

688. If the bosoms be very uncomfortable, young cabbage-leaves (with the “veins” of each leaf cut level to the leaf) ought, after each application of the oil and eau de Cologne, to be applied; or a large warm white-bread-and-milk and olive oil poultice ought to be used, which must be renewed three or four times a day. The way to make the poultice is as follows: A thick round of bread should be cut from a white loaf; the crust should be removed, the crumb ought to be cut into pieces about an inch square, upon which boiling-hot new milk should be poured; it ought to be covered over for ten minutes; then the milk should be drained off, and the olive oil—previously warmed by placing a little in a teacup on the hob—should be beaten up by means of a fork with the moistened bread until it be of the consistence of a soft poultice. It ought to be applied to the bosom as hot as it can comfortably be borne.

689. Gathered breast.—A gathered bosom, or “bad breast” as it is sometimes called, is more likely to occur after a first confinement and during the first month. Great care, therefore, ought to be taken to avoid such a misfortune. A gathered breast is frequently owing to the carelessness of a mother in not covering her bosoms during the time she is suckling. Too much attention cannot be paid to keeping the breasts comfortably warm. This, during the act of nursing, should be done by throwing either a shawl or a square of flannel over the neck, shoulders, and bosoms.