Treatment of Cracked Nipples.—In addition to washing the nipples, drying them thoroughly, and placing a pad of dry gauze over them after each feeding, they should be painted with an 8 per cent. solution of nitrate of silver twice daily. Before the next feeding, after the silver has been used, they should be washed with cooled boiled water. If the cracks are very bad it may be necessary to use a nipple-shield over them while nursing for a few days.
Tender Nipples.—Many women complain of the pain caused by the baby when it is first put to the breast. These nipples are not cracked, they are simple hypersensitive. They should be thoroughly cleansed and dried as above and painted with the compound tincture of benzoin. They should be washed off with the boracic acid solution before each feeding. After a few days under this treatment the tenderness will leave them.
Mastitis in Nursing Mothers.—When inflammation of
the breast takes place in a nursing mother it is the result of exposure to cold, or it may result from injury. If infection occurs and an abscess develops, it results from the entrance, through the nipples, or cracks, or fissures in the nipple, of bacteria into the breast. There is fever, with chills and prostration, and very soon it is impossible to nurse the child because of the pain. Nursing should be immediately discontinued, the breast supported by a bandage and the milk drawn, with a breast pump, at the regular nursing intervals. An ice-bag should be constantly applied to the painful area and the bowels kept freely open with a saline laxative. When the fever and the pain subside nursing may be resumed.
If the gland suppurates in spite of treatment it must be freely opened and freely drained.
WEANING
When to Wean the Baby.—Medically there is no exact time at which the baby should be weaned. Certain conditions indicate when it should be undertaken. It is desirable to wean the baby between the tenth and twelfth months. A month or two one way or another will not make much difference if the mother and child are in good condition. It should be weaned between the periods of dentition rather than when it is actively teething. The time of year is important. It would be better to wean it before the hot weather if it is strong and has been accustomed to taking other food than the breast milk. On the other hand it would be decidedly better to defer the weaning until the fall, rather than risk weaning at the tenth or twelfth months if these fall during the height of the hot weather.
Methods of Weaning.—The best way to wean is to do it gradually. It is not desirable to take the mother's milk away suddenly unless there is a very good reason for it. The child should be fed small portions of suitable other food at the beginning of the tenth month. By the end of the tenth month he should be taking a feeding two or three times a day of food other than the breast milk. This feeding may be given in a bottle. In some cases
the mother may be able to feed the child with a spoon instead of the bottle. The substitute feedings allowable at this age are given in another chapter.
Times When Rapid Weaning is Necessary.—There are times when the child must be weaned suddenly, as, for example, at the death of the mother, serious sickness of the mother, or in cases where for any cause the mother suddenly loses her milk. In these cases it is best to wean at once. If an infant refuses to take the bottle under such circumstances, the best plan to adopt, and the wisest one in the long run, is to starve the child into submission. If he gets absolutely nothing but the bottle he will shortly take it without protest. If a meddling individual attempts to feed the child some other food and tries to coax it to take the bottle in the meantime, much harm may result; it is safe only to fight it out for a day or two and win than to half starve the child and lose in the end.