THE MOTHER’S CARE OF HERSELF—FOR THE BABY’S SAKE
Now that you actually have your baby in your arms, soft and warm and
lovely, you find yourself looking into those wide, wondering eyes of his
and wanting nothing so much as to give him your protection.
If he could talk, as he looks back at you, I fancy your baby would tell
you how much your care of him, during the months before he was born, has
meant, and then he would beg you to stand by, very closely, for a few
months more, until he is a little more used to being a separate person
living outside your body.
“You have given me a wonderful start,” he seems to tell you, “and now I
want to go on and develop the best possible mind and body. I shall be
able to do this if you will help me, for what you can give me now is of
more importance than what all the rest of the people in the world can
give. You can give me through your milk exactly the materials that
Nature intends me to use to develop and build this partly finished body
of mine, and to protect it from disease. Just tide me over this most
difficult period of my life, and I’ll be a credit to us both, not only
as a baby but as a growing child and later as a robust man or woman,
helping to do my share of the world’s work. I’ll have fine straight
limbs to bear me on my way, a good brain to help me take a creditable
place among people who count, and steady nerves I’ll have, that will
always be dependable. I’ll put into reality the dreams that you and I
are dreaming, and when I do, I’ll look back to these early weeks and
months and realize that I could not have done it but for you.”
And so you look into the eyes of this baby of yours and pledge yourself
to stand by and do for him all that lies in your power, realizing
already that the keeping of that pledge is going to bring you, along
with its demands, an endless and satisfying happiness; a consciousness
that you are doing something indispensable to your baby’s welfare that
no one else in the world can do.
You know, now, that your baby’s greatest single need for the next few
months is satisfactory nursing at your breast, but you will be able to
give him this only if your diet and general mode of living are favorable
to the production of good milk.
Quite evidently, then, your big service to your baby, for a while, is
largely a matter of caring for yourself.
It seldom happens that the mother who has had good prenatal care,
followed by good care during and after labor, is unable to nurse her
baby if she orders her own life in the way that is known to be necessary
to promote and maintain the production of breast milk. The first
essential is her real desire to nurse her baby, next, her appreciation
of the continuous care of herself that is necessary to this end, and
third her whole-hearted willingness to take such care, for her baby’s
sake.
It is safe to say that if the doctor and the nurse and the baby’s mother
all want him to nurse at the breast, and all do everything in their
power to make this possible, they will almost invariably succeed. This
assertion can scarcely be made too positively and we should never lose
sight of the fact that if the baby is not breast-fed he is being
defrauded, and in the vast majority of cases, because of insufficient
effort on the part of those who are caring for him.
Practically the only conditions which doctors in general now recognize
as sufficient reason for the mother’s not nursing her baby are retracted
nipples, tuberculosis, convulsions, severe heart or kidney trouble,
certain acute infectious diseases such as typhoid fever, and the state
of pregnancy.
When none of these conditions exist, a favorable frame of mind and a
state of good nutrition are the two indispensable factors in
establishing breast feeding and maintaining the production of a
satisfactory quantity and quality of breast milk. These factors in turn
are both affected by the mother’s general mode of living.
Women with happy, cheerful dispositions usually nurse their babies
satisfactorily, while those who worry and fret are likely to have an
insufficient supply of milk or milk of a poor quality. In addition to
this sustained influence exerted by the nursing mother’s state of mind
it is well to remember that the quality of milk that has been entirely
satisfactory may be seriously injured, for the time being, by a fit of
temper, fright, grief, anxiety or any marked emotional disturbance.
Actual poisons seem to be created as a result of these emotions and they
may affect the baby so unfavorably as to make it necessary to give him
artificial food, temporarily, and empty the breasts by pumping or
stripping before he begins to nurse again.
I realize that it is not easy entirely to reorganize your life and
assume new and exacting duties, while recovering from an experience
resembling an illness in some of its effects, and still remain calm,
undiscouraged and perpetually cheerful. But each tiny victory that you
accomplish in your attempt to achieve this end will bring such
satisfaction that you will not count the cost. And the incomparable,
always deepening happiness of watching your very own baby grow lovelier
and sturdier, day by day, because of the things that you, and no one
else, are doing, will make you deny, even to yourself, that anything you
do is hard. Particularly will this be true if you repeatedly remind
yourself that the satisfactorily breast-fed baby is much more likely to
live through the difficult first year than is the bottle-fed baby, and
also is much less susceptible to disease and infection.
We shall consider, for a moment, the more important details of the
routine care that you should give yourself, for the baby’s sake, and
then we shall be ready for the pleasantest task of all—the actual care
of the baby himself.
In general you should try to live just a normal, tranquil, unhurried
kind of life that is unfailingly regular in its daily routine.
=Diet.= As was the case during pregnancy, the question of your diet is
an important one. Throughout the entire nursing period your food should
be such that it will nourish you and also aid in producing milk of a
character that will meet the baby’s needs, the needs of a growing,
developing body. The best producer of such milk is a diet consisting
largely of milk, eggs, “leafy” vegetables and fresh fruit, all taken
with an appetite made keen by constant fresh air. Bear this in mind and
it will keep you from putting your faith in so-called milk-producing
foods and nostrums.
Your meals may well be made up from the groups of foods that are
suitable for the expectant mother, as given in Chapter V. At this time,
as during pregnancy, you should avoid all food that may produce any form
of indigestion, but for the baby’s sake now, as well as your own. While
it is not generally believed by doctors of to-day, that there are many,
if any, articles of diet which may in themselves injure the mother’s
milk, it is generally accepted that if her digestion is upset this may
be, and usually is, bad for her milk and therefore bad for the baby.
Certain drugs are excreted through the milk and may affect the baby just
as they would if administered to him directly, as for example alcohol
and opium, from which morphine, heroin, codein, laudanum and paregoric
are derived.
Although the old belief no longer holds sway, that certain substances
from such highly flavored vegetables as onions, cabbages, turnips and
garlic were excreted through the milk and upset the baby, it is
definitely known that certain substances in certain foods are excreted
through the milk to the baby’s great advantage. It is necessary to the
baby’s well-being, therefore, that the nursing mother’s diet shall
include, regularly, those articles of food which contain these
substances. These foods are milk, egg-yolk, glandular organs such as
sweetbreads, kidneys and liver; the green salads such as lettuce,
romaine, endive, and cress and the citrous fruits which are oranges,
lemons, grapefruit and limes.
These are called “protective foods” because they protect the body
against certain diseases which will be described in the chapter on
Nutrition. It is possible for a baby who nurses at the breast of a woman
whose diet is poor in protective foods, to be so incompletely nourished
as to be on the border line of one of these diseases, or even to develop
the disease itself.
It becomes apparent, therefore, that although you did not have to “eat
for two” before the baby came, you have to do so now in certain very
important respects. For this reason it may be advisable for you to
increase the nourishment provided by your three regular meals by taking
a glass of milk, cocoa, or some beverage made of milk, during the
morning and afternoon and before retiring.
The morning and afternoon lunches would better be taken about an hour
and a half after breakfast and luncheon, respectively, in order not to
spoil your appetite for the meals which follow. It is of considerable
importance that you take your meals with clock-like regularity and enjoy
them, as enjoyment promotes digestion; but at the same time you should
guard against overeating for fear of causing indigestion, as this, you
know, is almost sure to upset the baby. Rich and highly seasoned foods,
in fact any articles of food or drink which might upset you, should be
avoided for the same reason. Drink water freely but do not take alcohol
nor strong tea or coffee without your doctor’s permission.
Summing up the matter of your diet, we find that you should have light,
nourishing, easily digestible food, consisting chiefly of cereals,
creamed dishes, creamed soups, eggs, meat in moderation, salads and the
fresh fruits and vegetables that ordinarily agree with you. Many doctors
advise at least a quart of milk daily, in addition to that which is used
in preparing the meals and an abundance of water to drink.
=Bowels.= Your bowels should move freely and regularly every day, but
you should not take cathartics, or even enemata without your doctor’s
order. You probably will be able to establish the habit of a daily
movement by taking exercise, eating bulky fruit and vegetables, drinking
an abundance of water and regularly attempting to empty your bowels at
the same time every day, preferably immediately after breakfast.
=Rest and Exercise.= You will not be likely to thrive, nor will the
baby, unless you have adequate rest and sleep and take daily at least a
moderate amount of exercise in the open air. You need eight hours sleep,
out of twenty-four, in a room with the windows open, and as fatigue is
bad for your milk it may be a good plan for you to lie down for a while
every afternoon. Your exercise will, of course, have to be adjusted to
your tastes, habits, circumstances and physical endurance, for it must
always be stopped before you are tired. Walking is often the best form
of exercise that the nursing mother can take and though as a rule she
may engage in any mild sports that she enjoys, violent exercise is
inadvisable because of the exhaustion that may follow.
=Recreation.= Part of the value of exercise lies in the pleasure and
diversion which it offers, for as we have seen, a happy, contented frame
of mind is practically indispensable to the production of good milk. In
addition to some regular and enjoyable exercise, therefore, you need a
certain amount of recreation and change of thought and environment. If
life is monotonous and colorless, the average woman is almost sure to
become irritable and depressed; to lose her poise and perspective; to
worry and fret, and then, no matter what she eats nor how much she
sleeps, her digestion will suffer, her milk will be affected and the
baby will pay. This, of course, goes back to the question of the young
mother’s mental state and the condition of her nerves as determining
factors in her ability to nurse the baby successfully.
Just here it is important to say a word of caution about this very
question of your attitude of mind, particularly as it relates to your
care of yourself.
It may be that one of the most difficult tasks you will have will be
that of getting out of the habit of accepting the position that borders
on being an invalid—of being a protected person who is thought about,
cared for and considered at every turn. This has been your position for
several months and the most natural result of it all is a tendency to
cling, perhaps ever so little and even unconsciously, to this very
pleasant state. It is not possible for anyone to reduce so broad and
intangible a subject to a few definite words of advice. But think it
over for yourself and try to strike that happiest of happy mediums that
lies somewhere between the equally harmful courses of coddling yourself
and of overdoing.
A good many doctors think that for the sake of giving the nursing mother
an opportunity to go out, mingle with her friends, take in some music or
a play, it is often a good plan to replace one breast feeding, sometime
in the course of each day, with a bottle feeding. The freedom which this
long interval between two nursings gives the mother for diversion and
amusement, will often affect her general condition so favorably that the
quality of her milk is definitely better than it otherwise would be and
the baby is benefited as a result. This single supplementary feeding
cannot be regarded lightly, however, for it must be prepared with the
same cleanliness and accuracy as an entirely artificial diet, which will
be described in the next chapter.
=Weaning.= One advantage in giving the baby a supplementary bottle once
a day, is that it paves the way for weaning, when the time comes to make
this change. Under ordinary conditions, the mother begins to wean her
baby about the eighth or tenth month. Having started by replacing one
breast feeding, daily, with a bottle feeding, she gradually increases
the number of bottles given daily until the breast feedings are
discontinued by the time the baby is eleven or twelve months old. There
are exceptions to this general rule, of course, and under any conditions
the weaning should always be directed by a doctor, for the baby may
suffer seriously unless the change in food is skillfully made. If the
mother’s milk is satisfactory and the baby is doing well, it is often
considered wise not to discontinue the breast feeding entirely, during
the hot summer months even though the weaning falls due at this time.
It was formerly deemed advisable to wean the baby for any one of several
reasons, but at present the only indications for this step which seem to
be generally accepted by the medical profession, are: pulmonary
tuberculosis, acute infectious diseases in the mother and pregnancy.
Menstruation was long regarded as incompatible with satisfactory
nursing, but it is now known that if the mother is taking proper care of
herself and is in generally good condition, the impoverishing effect of
menstruation upon the milk is usually for the duration of the periods
only. It may be necessary to supplement the breast feeding with suitably
modified cows’ milk during menstruation, but the baby should be put to
the breast regularly, just the same, for if the stimulation of the
baby’s suckling is discontinued, the temporary reduction in the amount
of the milk secreted will probably become permanent.
The state of pregnancy, however, is different, for though some women
nurse a baby satisfactorily for some months after becoming pregnant, it
is not considered advisable to subject any woman to the combined strain
of pregnancy and nursing. Moreover, the mother’s milk is usually so
impoverished during pregnancy that the nursing baby suffers in
consequence.
=Drying up the breasts= used to be a great bugbear. Lotions, ointments
and binders were employed and often a breast pump as well. Various drugs
were given by mouth and the mother was more or less rigidly dieted. It
is true that some of these measures are still employed and are followed
by a disappearance of the milk. But at the same time, the breasts dry up
quite as satisfactorily when none of these things are done, provided the
baby does not nurse. It is not known what starts the secretion of milk
in the mother’s breasts, but certain it is that absence of the baby’s
suckling stops it.
If it is left to you to dry up your breasts, your safest course will be
to do nothing beyond applying a supporting bandage, if your breasts are
heavy enough to be uncomfortable, and keeping your nipples scrupulously
clean. You may rely absolutely upon the fact that the baby’s suckling is
the most important stimulation in promoting the activity of the breasts
and if this stimulation is not given, or is removed, the secretion of
milk will invariably subside in the course of a few days. This is true
whether the reason for drying up the breasts is that the baby is
stillborn or has died, or a live baby’s nursing is discontinued. It is
true that the breasts may be swollen and very uncomfortable for a day or
two, and in addition to a supporting bandage the doctor may order
sedatives, but the discomfort subsides as the milk disappears.
Quite naturally you will not drink an extra amount of milk if you are
drying up your breasts, but it probably will not be necessary to place
any other restrictions upon your diet.
In thinking over the nursing period as a whole, we find that after all
it is a fairly simple matter so to order one’s life as to promote and
maintain a satisfactory supply of milk. The milk thus produced is the
ideal baby food and _there is no entirely adequate substitute_. Never
forget that. It gives the baby enormously increased chances of living
past babyhood and protects him from many diseases.
Quite evidently breast feeding is every baby’s birthright and his mother
is the only one who can deprive him of it.