_On Lactation, and the Disorders frequently produced in Women by that
process._
There can be no doubt that, speaking generally, a mother is bound to
suckle her children, and that the performance of this duty is no less
conducive to her own health than to the moral and physical welfare of
her offspring; yet there is not a more unfounded doctrine than that
which presumes every woman who is willing to be also capable of
advantageously discharging the important office of a nurse.
If the mother enjoy good health, and the process be not continued too
long, it is likely to produce beneficial effects both in herself and her
infant; but if she be of a very delicate habit--labour under any
dangerous disease--be subject during the period of lactation to great
affliction, or constant mental inquietude--or should the periodical
appearance return, pregnancy occur, or suckling be continued too long,
it may not only prove highly detrimental to herself, but may be the
means of occasioning serious or fatal consequences to her child.
In cases of extreme delicacy of constitution, lactation will often
produce the worst effects. Many young ladies, on becoming mothers, are
incapable of supporting the constant drain to which the wants of their
infants subject them--they lose their good looks, become gradually
weaker, and as their strength declines, their milk is simultaneously
lessened in quantity, and altered in its other properties.
If the suckling be still continued, their debility daily increases,
distressing pains in the back and loins succeed; the patients become
exceedingly nervous, as it is termed, and are unusually susceptible of
ordinary impressions; pain in the head, often of great violence,
follows, which, in some cases, is succeeded by delirium, in others, by
absolute mania. Nor is this the whole catalogue of ills to which
in such cases the unfortunate mother is subjected: the appetite
fails, distressing languor is experienced by day, while copious
perspirations deluge her by night, and dissipate the last remains of
strength--producing a state which may easily be mistaken for, or
terminate in, true pulmonary consumption;--finally, the sight becomes
progressively weaker, until vision is almost destroyed; the eyelids
exude a glutinous secretion, and ophthalmia itself is occasionally
induced.
These are the symptoms too often caused by lactation in delicate or
debilitated habits, even a few months after delivery; the same also are
observed when suckling has been injudiciously protracted beyond the
period to which it should be confined.
A few only of the foregoing symptoms may be noticed, or nearly the whole
may present themselves, in the same patient; and when this happens,
unless the cause which has given rise to them be at once detected, and
appropriate treatment employed, the most serious consequences may be
apprehended.
In these cases, the first step necessary is to discontinue the suckling
altogether: half measures will never answer. Sometimes it is proposed by
the patient, or her friends (more usually the latter), to compromise the
affair by feeding the child partly on spoon meat, and allowing him still
to take the breast, though less frequently than before.
This plan I uniformly object to, for the following reasons:--
1st. Because the mother will not be likely to recover so long as she
continues to suckle at all.
2nd. Because her milk being necessarily of a bad quality, it cannot be
expected that the child will derive benefit from it; but, on the
contrary, there is every probability that his health will suffer by
using diet of such an improper description.
The obvious dependence of the foregoing symptoms upon debility will, of
course, at once suggest to practitioners the nature of the treatment to
be adopted: which should be such as is calculated to invigorate the
system generally--namely, the administration of tonics, &c.
Bark and its various preparations, especially the sulphate of quinine,
with the occasional use of warm aperients (sedulously avoiding the more
violent purgatives), will be found eminently successful; whereas,
cupping at the nape of the neck (which I have seen prescribed for the
headache), and other depletory measures, have proved as manifestly
injurious.
'Every disease productive of great weakness is increased by the state of
the system which follows child-bearing. Of this description are
consumption, dropsy,' &c. In these cases it is evident that the process
of lactation, by adding to the debility already present, must prove
highly injurious, and consequently should be always avoided.
I have already noticed the effects which are produced upon the milk by
the influence of mental emotions on the part of the mother, as well as
by the recurrence of the periodical appearance; and since these are
chiefly injurious to the child, by depraving its sustenance, their
further consideration will be deferred till the next chapter.
With respect to the remaining topic--namely, the occurrence of
miscarriage from suckling--I am convinced that it is by no means an
unfrequent accident, though its real cause is perhaps rarely suspected,
having only met with one patient who considered the mishap in question
to have arisen from keeping her child too long at the breast. Having
already, I trust satisfactorily, explained the manner in which abortion
is produced by the act of suckling, I shall conclude this part of my
subject with the relation of a case that occurred in private practice,
which so strongly corroborates many of the observations in the preceding
and following pages, that I shall offer no apology for its introduction:
more particularly, since the lady herself to whom it refers has
benevolently expressed a wish for its publication, in order that those
who become acquainted with the facts there detailed may be prevented
from undergoing similar unnecessary sufferings:--
CASE.
Mrs. A----, a lady of delicate constitution, about twenty years of age,
three or four months subsequent to the birth of her first child, began
to find her milk gradually lessen in quantity; it had also much changed
from its previous appearance, resembling at the time just stated, a
yellowish, turbid serum. Her child became emaciated; and diarrh[oe]a
supervening, my professional services were required. My advice was, that
the child should be at once weaned, and a suitable wet-nurse, if
possible, procured--neither of which suggestions, as will shortly
appear, were followed. I urged the necessity of this measure more
particularly, because Mrs. A---- was daily getting thinner and weaker;
she also complained of great pain in the head and back, and of an
increasing dimness of sight, which made her fear she should become
blind; but the mother-in-law of my patient being, unfortunately, of
opinion that pregnancy in the latter would not again occur during the
continuance of lactation, recommended that the child, although chiefly
supported upon spoon-meat, should occasionally be allowed to take the
breast; and this plan, notwithstanding the wish of Mrs. A---- to the
contrary, and my own remonstrances on the subject, was adopted--the
effects of which were to increase the mother's ailments, as well as
those of her infant. Things went on thus for some time longer, when I
once more endeavoured to persuade Mrs. A---- to follow my advice,
observing, that by an opposite line of conduct she was not only injuring
her own health, but that of her child, neither of which, I assured her,
in my opinion, would be re-established till the latter had been weaned.
I expressed also my complete incredulity as to the non-recurrence of
pregnancy in consequence of her infant remaining at the breast; and I
added--'It is my firm conviction that if you be pregnant, or should
happen shortly to become so, you will miscarry.' About a week after
this conversation she was suddenly seized with flooding, and what I had
predicted took place. She now left off suckling, and in about a month,
under suitable treatment, completely got rid of all her former
complaints: the child also immediately began to improve.
The present case clearly proves that the process of lactation will not
_invariably_ prevent the occurrence of pregnancy, since Mrs. A---- became
in this state, notwithstanding she continued to suckle her child: and I
think few will be so hardy as to doubt that it was the cause of her
miscarrying: more particularly when I mention that, at a future period,
the same lady, during my absence abroad, being once more persuaded to
try whether she could not avoid becoming pregnant (which was very much
to be desired, on account of her delicate state of health) by continuing
to perform the duties of a nurse, again suffered all the distressing
symptoms before described, and again miscarried.
This case, finally, affords evidence of the evil consequences often
produced in children by impoverished and unhealthy milk; and of their
speedy disappearance when the exciting cause--namely, deteriorated
milk--is no longer afforded.