The child should be weaned if it is not gaining in weight. This may indicate a deficient quality of the mother's milk, or it may indicate a lack of proportion between the child and mother. If a robust child is depending upon the nourishment furnished by a mother who is not in good physical condition the milk may not be adequate in quality and quantity. The child will not therefore develop normally and it may be necessary to wean it.
If the mother becomes pregnant it will be necessary to wean, because pregnancy invariably affects the quality of the milk. It is a very good habit to accustom the child to take its daily supply of water from a bottle from a very early age. This procedure will make it easier to wean at any time.
Menstruation is not an indication for weaning as has been explained. If, however, the return of menstruation affects the milk so that it disagrees with, or fails to satisfactorily nourish the child, it may be necessary to wean, but not unless.
The best reason for weaning a child at the twelfth month is that a mother's milk after that time is not adequate in quality for a child of that age. A child at one year of age has grown beyond the capability of its
mother to nurse it: nature demands a stronger and a more substantial food than any mother can supply. A mother who nurses her child beyond that period is not only injuring herself, but she is cheating her child. The exception to this rule is, as has been explained, the second summer.
The child will evidence its dissatisfaction with the breast supply if it is not enough; it will not gain in weight, it will be irritable and fretful, it will tug long and tenaciously at the nipple, it will be unwilling to cease nursing after it should have finished, and it will drop the nipple frequently with a dissatisfied cry. These are all signs of insufficient nourishment, and to the observant mother they will at once indicate that the child must be weaned and fed upon a mixed diet.
Care of Breasts While Weaning Child.—The process of weaning should cause little or no discomfort. If the weaning is gradual it is necessary to press out enough milk to relieve the tension from time to time. It usually takes three or four days.
If it is necessary to wean abruptly, as it is occasionally, there may be considerable distress. In these cases it is necessary to massage the breasts completely,—until all the milk is out, or as much as it is possible to get out,—then rub the breasts with warm camphorated oil, and bind them firmly. When the breasts are massaged for any reason, the rubbing should be toward the nipple and it should be done gently. If there are any hard lumps, or caked milk, in the breasts, they must be massaged until soft, and the binding renewed. It may be necessary to repeat this process for a number of days. In binding the breasts use a large wad of absorbent cotton at the sides, under the arms, to support the breasts, and another wad between the breasts. This renders the binding more effective; permits the binder to be put on tighter; and prevents it from cutting into the skin. When weaning has to be done quickly the patient should absolutely abstain from all liquids. A large dose of any saline, Pluto, Apenta, or Hunyadi Water, or Rochelle salts, or Magnesium Citrate, should be given every morning for four or five days.
If the weaning is gradually undertaken the child should be allowed to nurse less frequently. One less nursing every second day until two nursings daily are given. Keep the two daily nursings up for one week and then discontinue them, after which the above measures may be adopted. To dry the milk up, the breasts may be anointed with the following mixture: Ext. Belladonna, 2 drams; Glycerine, 2 ounces; Oil of Wintergreen, 10 drops.