The Maternal Management of Children, in Health and Disease. Thomas Bull
this leads me to observe, that it is a common mistake to suppose that, because a woman is nursing, she ought therefore to live very fully, and to add an allowance of wine, porter, or other fermented liquor, to her usual diet. The only result of this plan is, to cause an unnatural degree of fulness in the system, which places the nurse on the brink of disease, and which of itself frequently puts a stop to the secretion of the milk, instead of increasing it. The right plan of proceeding is plain enough; only let attention be paid to the ordinary laws of health, and the mother, if she have a sound constitution, will make a better nurse than by any foolish deviation founded on ignorance and caprice.
The following case proves the correctness of this statement:—
A young married lady, confined with her first child, left the lying-in- room at the expiration of the third week, a good nurse, and in perfect health. She had had some slight trouble with her nipples, but this was soon overcome.
The porter system was now commenced, and from a pint to a pint and a half of this beverage was taken in the four and twenty hours. This was resorted to, not because there was any deficiency in the supply of milk, for it was ample, and the infant thriving upon it; but because, having become a nurse, she was told that it was usual and necessary, and that without it her milk and strength would ere long fail.
After this plan had been followed for a few days, the mother became drowsy and disposed to sleep in the daytime; and headach, thirst, a hot skin, in fact, fever supervened; the milk diminished in quantity, and, for the first time, the stomach and bowels of the infant became disordered. The porter was ordered to be left off; remedial measures were prescribed; and all symptoms, both in parent and child, were after a while removed, and health restored.
Having been accustomed, prior to becoming a mother, to take a glass or two of wine, and occasionally a tumbler of table beer, she was advised to follow precisely her former dietetic plan, but with the addition of half a pint of barley-milk morning and night. Both parent and child continued in excellent health during the remaining period of suckling, and the latter did not taste artificial food until the ninth month, the parent's milk being all-sufficient for its wants.
No one can doubt that the porter was in this case the source of the mischief. The patient had gone into the lying-in-room in full health, had had a good time, and came out from her chamber (comparatively) as strong as she entered it. Her constitution had not been previously worn down by repeated child-bearing and nursing, she had an ample supply of milk, and was fully capable, therefore, of performing the duties which now devolved upon her, without resorting to any unusual stimulant or support. Her previous habits were totally at variance with the plan which was adopted; her system became too full, disease was produced, and the result experienced was nothing more than what might be expected.
The plan to be followed for the first six months.-Until the breast- milk is fully established, which may not be until the second or third day subsequent to delivery (almost invariably so in a first confinement), the infant must be fed upon a little thin gruel, or upon one third water and two thirds milk, sweetened with loaf sugar.
After this time it must obtain its nourishment from the breast alone, and for a week or ten days the appetite of the infant must be the mother's guide, as to the frequency in offering the breast. The stomach at birth is feeble, and as yet unaccustomed to food; its wants, therefore, are easily satisfied, but they are frequently renewed. An interval, however, sufficient for digesting the little swallowed, is obtained before the appetite again revives, and a fresh supply is demanded.
At the expiration of a week or so it is essentially necessary, and with some children this may be done with safety from the first day of suckling, to nurse the infant at regular intervals of three or four hours, day and night. This allows sufficient time for each meal to be digested, and tends to keep the bowels of the child in order. Such regularity, moreover, will do much to obviate fretfulness, and that constant cry, which seems as if it could be allayed only by constantly putting the child to the breast. A young mother very frequently runs into a serious error in this particular, considering every expression of uneasiness as an indication of appetite, and whenever the infant cries offering it the breast, although ten minutes may not have elapsed since its last meal. This is an injurious and even dangerous practice, for, by overloading the stomach, the food remains undigested, the child's bowels are always out of order, it soon becomes restless and feverish, and is, perhaps, eventually lost; when, by simply attending to the above rules of nursing, the infant might have become healthy and vigorous.
For the same reason, the infant that sleeps with its parent must not be allowed to have the nipple remaining in its mouth all night. If nursed as suggested, it will be found to awaken, as the hour for its meal approaches, with great regularity. In reference to night-nursing, I would suggest suckling the babe as late as ten o'clock p. m., and not putting it to the breast again until five o'clock the next morning. Many mothers have adopted this hint, with great advantage to their own health, and without the slightest detriment to that of the child. With the latter it soon becomes a habit; to induce it, however, it must be taught early.
The foregoing plan, and without variation, must be pursued to the sixth month.
AFTER THE SIXTH MONTH TO THE TIME OF WEANING.—If the parent has a large supply of good and nourishing milk, and her child is healthy and evidently flourishing upon it, no change in its diet ought to be made. If otherwise, however, (and this will but too frequently be the case, even before the sixth month[FN#1],) the child may be fed twice in the course of the day, and that kind of food chosen which, after a little trial, is found to agree best.
[FN#1] See Deficiency of Milk, p. 11.
Leman's tops and bottoms, steeped in hot water, with the addition of a little fresh milk, and sweetened or not with loaf sugar, is one of the best description.
If the stomach reject this, farinaceous food boiled in water, and mixed with a small quantity of milk, may be employed. Or weak mutton or veal broth, or beef tea, clear and free from fat, and mixed with an equal quantity of farinaceous food.
If this artificial diet is used before the sixth month, it must be given through the sucking-bottle; after this period with a spoon: in either case it must be previously passed through a sieve.
When the large or grinding teeth have appeared, the same food is still to be continued, but need not any longer be expressed through the sieve.
Such is the plan of nursing to be followed by the mother until she wean her infant altogether from the breast. The period when this ought to take place, as also the manner of accomplishing it, are detailed in the section on "Weaning."[FN#2]
[FN#2] See page 51.
The diet from weaning to the termination of infancy is pointed out under "Artificial Feeding."[FN#3]
[FN#3] See page 34.
DEFICIENCY OF MILK.
If this deficiency exist from the earliest weeks after delivery, and it is not quickly remedied by the means presently to be pointed out, a wet-nurse must be obtained. It will be of no avail partially to nurse, and partially to feed the infant at this period and under such circumstances, for if it is not soon lost, it will only live for a few months, or a year at most, and be an object of the greatest anxiety and grief to its parent. This condition arises from the unwholesomeness of the mother's milk, united with the artificial food; for when the milk is deficient from the first, and continues so notwithstanding the means used for its increase, it is invariably unhealthy in its quality.
This deficiency, however, may exist, and even at a very early period after delivery, and yet be removed. This, however, is not to be accomplished by the means too frequently resorted to; for it is the custom with many, two or three weeks after their confinement, if the supply of nourishment for the infant is scanty, to partake largely of malt liquor for its increase. Sooner or later this will be found injurious to the constitution of the mother: but how, then, is this deficiency to be obviated? Let the nurse keep but in good