Occasionally an infant will not pass any urine for many hours after its birth. This most frequently arises from the fact of none being secreted. In the last case of this kind that I was called to, three days had elapsed since birth, and no urine had been passed; it proved that none had been secreted. Sometimes, however, it is the effect of another cause, which the use of the warm bath will be found to remove, which should always therefore be employed four and twenty hours after the birth of the infant, if it has not by that time passed any water.
It now and then happens, but fortunately very rarely, that some physical obstruction exists. It is always important, therefore, for the nurse to pay attention to the above point; and it is her duty to direct the attention of the medical man to the subject, if anything unusual or unnatural be present. The same observation applies to the bowel also; and if twelve hours pass without any motion, the parts should be examined.
SWELLING OF THE BREASTS.
At birth, or two or three days subsequently, the breasts of the infant will frequently be found swollen, hard, and painful, containing a fluid much resembling milk. Nurses generally endeavour to squeeze this out, and thus do great mischief; for by this means inflammation is excited in the part, and sometimes abscess is the result.
If the breasts are simply slightly enlarged, it is unnecessary to do any thing more than rub them occasionally and very gently with warm almond oil, and a little time will restore them to their proper size.
If, however, they are inflamed, hot, painful, with a red surface, and unusually large, a bread and water poultice must be applied every three or four hours, which will generally prevent either the formation of matter, or any other unpleasant consequence. In a few days, under this treatment, they will usually subside, and be quite well.
INFLAMMATION OF THE EYES.
ITS IMPORTANCE.—About the second or third day after the child's birth, an inflammation sometimes attacks the eye, which is of considerable consequence. The more so, from its commencing in a way not calculated to excite the attention, or alarm the fears, of the mother or nurse. The child cannot express its sensations, and the swelling of the eye conceals the progress of the disease, so that serious mischief is frequently done before the medical man sees the patient. In the first place, the inflammation is not immediately noticed; and, in the second, the measures employed are frequently insufficient to check its progress: hence it causes more blindness (I refer to the lower classes of society more particularly) than any other inflammatory disorder that happens to the eye; and the number of children is very considerable, whose sight is partially or completely destroyed by it. The parent or nurse is apt to suppose, when this inflammation first appears, that it is merely a cold in the eye, which will go off; and the consequences which I have just mentioned take place, in many cases, before they are aware of the danger, and before the medical man is resorted to for assistance.
I only desire, in mentioning this complaint, to inform the attendants of the lying-in-room of its great importance, that it may not be trifled with, that upon its first approach the physician may be informed of it, and that the treatment he directs for its cure may be sedulously and rigidly followed.
SYMPTOMS.—The inflammation commonly comes on about three days after birth, but it may take place at a later period. It may be known by its commencing thus:—When the child wakes from sleep, the eyelids will be observed to stick together a little; their edges will be redder than natural, and especially at the corners; the child experiences pain from the access of light, and therefore shuts the eye against it. A little white matter will also be observed lying on the inside of the lower lid. After a short time, the lids swell, become red on their external surface, and a large quantity of matter is secreted, and constantly poured from the eye; the quantity of discharge increasing until it becomes very great.