SUCKLING.
THE DUTIES OF A NURSING MOTHER
613. A mother ought not, unless she intend to devote herself to her
baby, to undertake to suckle him. She must make up her mind to forego
the so-called pleasures of fashionable life. There ought, in a case of
this kind, to be no half-and-half measures; she should either give up
her helpless babe to the tender mercies of a wet-nurse, or she must
devote her whole time and energy to his welfare—to the greatest treasure
that God hath given her.
614. If a mother be blessed with health and strength, it is most
unnatural and very cruel for her not to suckle her child—
“Connubial fair! whom no fond transport warms
To lull your infant in maternal arms;
Who, blessed in vain with tumid bosoms, hear
His tender wailings with unfeeling ear;
The soothing kiss and milky rill deny
To the sweet pouting lip and glistening eye!
Ah! what avails the cradle’s damask roof,
The eider bolster, and embroidered woof!
Oft hears the gilded couch unpitied plains,
And many a tear the tasseled cushion stains!
No voice so sweet attunes his cares to rest,
So soft no pillow as his mother’s breast!—
Thus charmed to sweet repose, when twilight hours
Shed their soft influence on celestial bowers,
The cherub Innocence, with smile divine,
Shuts his white wings, and sleeps on beauty’s shrine.”[111]
615. Oh, if a mother did but know the joy that suckling her infant
imparts, she would never for one moment contemplate having a wet-nurse
to rob her of that joy—
“The starting beverage meets the thirsty lip;
’Tis joy to yield it, and ’tis joy to sip.”[112]
616. Lamentable, indeed, must it be, if any unavoidable obstacle should
prevent a mother from nursing her own child!
THE BREAST.
617. As soon as the patient has recovered from the fatigue of the
labor—that is to say, in about four or six hours—attention ought to be
paid, more especially in a _first_ confinement, to the bosoms.
618. In a _first_ confinement, there is, until the third day, but very
little milk; although there is usually on that day, and for two or three
days afterward, a great deal of swelling, of hardness, of distention,
and of uneasiness of the breasts, in consequence of which, in a _first_
confinement, both care and attention are needed.
619. If there be milk in the breast, which may be readily ascertained by
squeezing the nipple between the finger and the thumb, the infant
should, at _first_, be applied—not _frequently_, as some do, but at
considerable intervals, say until the milk be properly secreted—every
four hours; when the milk flows, the child ought to be applied more
frequently, but still at stated times.
620. To wash away any viscid mucus from the nipple, or any stale
perspiration from the bosom, let the breasts and the nipples, before
applying the baby, be first sponged with a little warm water, and then
be dried with a warm, dry, soft napkin; for some infants are so
particular that unless the breasts and the nipples be perfectly free
from mucus and from perspiration, they will not suck. If after the above
cleansing process there be any difficulty in making him take the bosom,
smear a little cream on the nipple, and then immediately apply him to
it.
621. If the breasts be full, hard, knotty, and painful, which they
generally are two or three days after a _first_ confinement, let them be
well but tenderly rubbed every four hours, either with the best olive
oil (a little of which should, before using it, be previously warmed, by
putting a little of the oil in a teacup on the hob by the fire) or with
equal parts of olive oil and of _eau de Cologne_, which should be well
shaken up in a bottle every time before it be used.
622. On the third day, more especially after a _first_ confinement, the
breasts are apt to become very much swollen, painful, and distended. If
such be the case, it might be necessary, for a few days, to have them
drawn, once or twice daily, by a woman who makes it her business, and
who is usually called either a breast-drawer, or, in vulgar parlance, a
suck-pap. A clean, sober, healthy, respectable woman ought to be
selected. There is, in nearly every large town, one generally to be
found who is at the head of her profession. Such a one should be chosen.
623. If the bosoms be more than usually large and painful, in addition
to assiduously using the above liniment, apply to the breasts, in the
intervals, young cabbage-leaves, which should be renewed after each
rubbing. Before applying them, the “veins” of the leaves, with a sharp
knife, must be cut smooth, level with the leaf. It will require several,
as the whole of the breast ought to be covered. The cabbage-leaves will
be found both cooling and comfortable. Each bosom should then be nicely
supported with a soft folded silk handkerchief, going under each breast
and suspending it; each handkerchief should then be tied at the back of
the neck, thus acting as a kind of sling.
624. The patient ought not, while the breasts are full and
uncomfortable, to drink _much_ fluid, as it would only encourage a
larger secretion of milk.
625. When the milk is at “its height,” as it is called, she ought every
morning, for a couple of mornings, to take a little cooling medicine—a
Seidlitz powder—and, every four hours, the following effervescing
mixture:
Take of—Bicarbonate of Potash, one drachm and a half;
Distilled Water, eight ounces:
To make a mixture. Two tablespoonfuls to be taken, with two
tablespoonfuls of the Acid Mixture, every four hours, while
effervescing.
Take of—Citric Acid, three drachms;
Distilled Water, eight ounces:
Mix.—The Acid Mixture.
The best way of taking the above effervescing medicine is to put two
tablespoonfuls of the first mixture into a tumbler, and two
tablespoonfuls of the acid mixture into a wineglass, then to add the
latter to the former, and it will bubble up like soda-water; she should
_instantly_ drink it off while effervescing.
626. In two or three days, under the above management, the size of the
bosoms will decrease, all pain will cease, and the infant will take the
breast with ease and comfort.
627. _Second and succeeding confinements._—If the breasts are tolerably
comfortable (which in the second and in succeeding confinements they
probably will be), let nothing be done to them except, as soon as the
milk comes, at regular intervals applying the child alternately to each
of them. Many a bosom has been made uncomfortable, irritable, swollen,
and even sometimes gathered, by the nurse’s interference and meddling.
Meddlesome midwifery is bad, and I am quite sure that meddlesome
breast-tending is equally so. A nurse, in her wisdom, fancies that by
rubbing, by pressing, by squeezing, by fingering, by liniment, and by
drawing, she does great good, while in reality, in the majority of
cases, by such interference she does great harm.
628. The child will, in _second_ and in _succeeding_ confinements, as a
rule, be the best and the only doctor the bosoms require. I am quite
convinced that, in a general way, nurses interfere too much, and that
the bosoms in consequence suffer. It is, of course, the doctor’s and not
the nurse’s province in such matters, to direct the treatment; while it
is the nurse’s duty to fully carry out the doctor’s instructions.
629. There is nothing, in my opinion, that so truly tells whether a
nurse be a _good_ one or otherwise, as the way she manages the breasts;
a _good_ nurse is judicious, and obeys the medical man’s orders to the
very letter; while, on the other hand, a _bad_ nurse acts on her own
judgment, and is always quacking, interfering, and fussing with the
breasts, and doing on the sly what she dare not do openly: such
conceited, meddlesome nurses are to be studiously avoided; they often
cause, from their meddlesome ways, the breasts to gather.
630. Let the above advice be borne in mind, and much trouble, misery,
and annoyance might be averted. Nature, in the majority of cases,
manages these things much better than any nurse possibly can do, and
does not, as a rule, require helping. The breasts are sadly too much
interfered and messed with by nurses, and by nurses who are, in other
respects, tolerably good ones.
STATED TIMES FOR SUCKLING.
631. A mother ought to suckle her baby at stated times. It is a bad
habit to give him the bosom every time he cries, regardless of the
cause; for be it what it may—over-feeding, griping, “wind,” or
acidity—she is apt to consider the breast a panacea for all his
sufferings. “A mother generally suckles her infant too often—having him
almost constantly at the bosom. This practice is injurious both to
parent and to child. For the first month he should be suckled about
every hour and a half; for the second month, every two hours; gradually,
as he becomes older, increasing the distance of time between, until at
length he has the breast about every four hours. If he were suckled at
stated periods he would only look for it at those times, and be
satisfied.”[113]
632. A mother frequently allows her babe to be at the bosom a great part
of every night. Now, this plan is hurtful both to her and to him; it
weakens her, and thus enfeebles him; it robs them both of their sleep;
and generates bad habits, which it will be difficult to break through;
it often gives the mother a sore nipple and the child a sore mouth.
633. It is surprising how soon an infant, at a very early age, may, by
judicious management, be brought into good habits; it only requires, at
first, a little determination and perseverance: therefore a nursing
mother ought at once to commence by giving the child the breast at
stated periods, and she should rigidly adhere to the times above
recommended.
634. A mother should not, _directly_ after taking a long walk, and while
her skin is in a state of _violent_ perspiration, give her baby the
bosom; the milk being at that time in a heated state, will disorder the
child’s bowels, or it may originate in him some skin disease, and one
which it might be difficult to cure. She ought, therefore, before she
gives him the breast, to wait until the surface of her body be
_moderately_ cool. Let her be careful the while not to sit in draughts.
CLOTHING.
635. A nursing mother ought to have her dress, more especially her
stays, made loose and comfortable.
636. A gathered breast sometimes arises from the bones of the stays
pressing into the bosom; I should, therefore, recommend her to have the
bones removed.
637. If a lady be not in the habit of wearing a flannel waistcoat, she
ought at least to have her bosoms covered with flannel, taking care that
there be a piece of soft linen over the nipples.
638. I should advise a nursing mother to provide herself with a
waterproof nursing apron, which may be procured either at any baby-linen
establishment or at an india-rubber warehouse.
DIETARY.
639. A nursing mother ought to live plainly; her diet should be both
light and nourishing. It is a mistaken notion that at these times she
requires _extra_ good living. She ought never to be forced to eat more
than her appetite demands; if she be, either indigestion, or heartburn,
or sickness, or costiveness, or a bowel complaint will ensue. It is a
folly at any time to force the appetite. If she be not hungry,
compelling her to eat will do her more harm than good. A medical man, in
such a case, ought to be consulted.
640. The best meats are mutton and beef; veal and pork may, for a
change, be eaten. _Salted_ meats are hard of digestion; if boiled beef,
therefore, be eaten, it ought to be only _slightly_ salted. It is
better, in winter, to have the boiled beef _unsalted_; it is then,
especially if it be the rump, deliciously tender. Salt, of course, must
be eaten with the _unsalted_ meat. High-seasoned dishes are injurious;
they inflame the blood, and thus they disorder the milk.
641. Some persons consider that there is no care required in the
selection of the food, and that a nursing mother may eat anything, be it
ever so gross and unwholesome; but, if we appeal to reason and to facts,
we shall be borne out in saying that great care is required. It is well
known that cow’s milk very much partakes of the properties of the food
on which the animal lives. Thus, if a cow feed on swedes, the milk and
the butter will have a turnipy flavor. This, beyond a doubt, decides
that the milk does partake of the qualities of the food on which she
feeds. The same reasoning holds good in the human species, and proves
the absurdity of a nursing mother being allowed to eat anything, be it
ever so gross, indigestible, or unwholesome. Again, either a dose of
purgative medicine given to her, or greens taken by her at dinner, will
sometimes purge the baby as violently, or even more so, than it will
herself.
642. Even the milk of a healthy wet-nurse acts differently, and less
beneficially, upon the child than the mother’s _own_ milk. The ages of
the mother and of the wet-nurse, the ages of her own and the latter’s
infant, the constitutions of the one and of the other, the adaptability
of a mother’s milk for her _own_ particular child—all tend to make a
foster-mother not so desirable a nurse as the mother herself. Again, a
mother cannot at all times get to the antecedents of a wet-nurse; and,
if she can, they will not always bear investigation.
643. With regard to the ages of the mother and of the wet-nurse—for
instance, as a wet-nurse’s milk is generally a few weeks older than the
mother’s own milk, the wet-nurse’s milk may, and frequently does,
produce costiveness of the bowels of her foster-child; while, on the
other hand, the mother’s own milk, being in age just adapted to her
babe’s, may and generally does keep her own infant’s bowels regular. The
milk, according to the age of the child, alters in properties and
qualities to suit the age, constitution, and acquirements of her
baby—adapting itself, so to speak, to his progressive development. Hence
the importance of a mother, if possible, suckling her own child.
644. A babe who is suckled by a mother who lives grossly is more prone
to disease, particularly to skin and to inflammatory complaints, and to
disease which is more difficult to subdue.
645. Do not let me be misunderstood: I am not advocating that a mother
should be fussily particular—by no means. Let her take a variety of
food, both animal and vegetable; let her from day to day vary her diet;
let her ring the changes on boiled and stewed, on grilled and roast
meats; on mutton and lamb and beef; on chicken and game and fish; on
vegetables, potatoes, and turnips; on broccoli and cauliflower, on
asparagus and peas (provided they are young and well boiled), and French
beans. “The maxim of the greatest importance in reference to the
materials of human food is, mixture and variety—a maxim founded, as has
been stated, upon man’s omnivorous nature. Animal and vegetable
substances, soups and solid meat, fish, flesh, and fowl, in combination
or succession, ought, if due advantage is to be taken of the
health-sustaining element in food, to form the dietary of every
household.”[114]
646. But what I object to a nursing mother taking are—gross meats, such
as goose and duck; highly-salted beef; shell-fish, such as lobster and
crab; rich dishes; _highly-seasoned_ soup; pastry, unless it be plain;
and cabbages and greens and pickles, if found to disagree with the baby;
and any other article of food which is either rich, or gross, or
indigestible, and which, from experience, she has found to disagree
either with herself or with her child. It will be seen, therefore, from
the above catalogue, that my restrictions as to diet are limited, and
are, I hope, founded both on reason and on common sense.
647. A moderate quantity—say a tumblerful—either of fresh _mild_ ale or
of porter will generally be found the best beverage both for dinner and
for supper. There is much more nourishment in either ale—home-brewed—or
in porter, than in wine; therefore, for a nursing mother, either ale or
porter is far preferable to wine. Wine, if taken at all, ought to be
used very sparingly, and then not at the same meal with the porter or
ale. In the higher ranks of life, where a lady is in the habit of
drinking wine, it is necessary to continue it, although the quantity
should not be increased, and ought never to exceed a couple of
glasses—dry sherry being the best wine for the purpose.
648. A nursing mother is subject to thirst. When such be the case, she
ought not to fly either to beer or to wine to quench it; this will only
add fuel to the fire. The best beverages will be either toast and water,
milk and water, barley-water, barley-water and new milk (in equal
proportions), or black tea, either hot or cold. Cold black tea is a good
quencher of thirst.
649. A lady who is nursing is at times liable to fits of depression. Let
me strongly urge the importance of her abstaining from wine and from all
other stimulants as a remedy; they would only raise for a time her
spirits, and then would depress them in an increased ratio. Either a
drive in the country, or a short walk, or a cup of tea, or a chat with a
friend, would be the best medicine. The diet should be good and
nourishing; plenty of bread and plenty of meat should be her staple
food, in addition to which Du Barry’s _Arabica Revalenta_, made either
with fresh milk or with cream and water, is, in these cases, most useful
and sustaining. The best time for taking it is either for luncheon or
for supper. A lady subject to depression should bear in mind that she
requires nourishment, not stimulants,—that much wine and spirits might
cheer her for the moment, but will assuredly depress her afterward.
Depression always follows overstimulation; wine and spirits therefore,
in such a case, if taken largely, are false and hollow friends. It is
necessary to bear the above facts in mind, as there are many advocates
who strongly recommend, in a case of this kind, a large consumption of
wine and brandy. Such men are, at the present moment, doing an immense
deal of mischief; they are, in point of fact, inducing and encouraging
drunkenness.
650. Spirits—brandy, rum, gin, and whisky—are, during suckling,
injurious; I may even say that they are insidious poisons to the parent,
and, indirectly, to the child.
651. When an infant is laboring under an inflammatory complaint, a
nursing mother ought not to take stimulants, such as either ale or wine.
In a case of this kind, toast and water will, for her dinner, be the
best beverage, gruel for her supper, and black tea—not coffee, as it
would be too stimulating—both for her breakfast and tea.
FRESH AIR AND EXERCISE.
652. Out-door exercise during suckling cannot be too strongly insisted
upon; it is the finest medicine both for babe and mother. Whenever the
weather will admit, it must be taken. It is utterly impossible for a
nursing mother to make good milk, unless she do take an abundance of
exercise and breathe plenty of fresh air.
653. Whatever improves the health of the mother, of course at the same
time benefits the child: there is nothing more conducive to health than
an abundance of out-door exercise. It often happens that a mother who is
nursing seldom leaves her house; she is a regular fixture; the
consequence is, both she and her babe are usually delicate and prone to
sickness.
654. A mother ought not, _immediately_ after taking exercise, to nurse
her infant, but wait for half an hour. Nor should she take _violent_
exercise, as it would be likely to disorder the milk.
655. Carriage exercise, if the weather be hot and sultry, is preferable
to walking; if that be not practicable, she ought to have the windows
thrown wide open, and should walk about the hall, the landings, and the
rooms, as she would by such means avoid the intense heat of the sun.
Although carriage exercise during intensely hot weather is preferable to
walking exercise, yet, notwithstanding, walking must, during some
portion of the day, be practiced. There is no substitute, as far as
health is concerned, for walking. Many ailments that ladies now labor
under could be walked away; and really it would be a pleasant physic—far
more agreeable than pills and potions!
THE POSITION OF A MOTHER DURING SUCKLING.
656. Good habits are as easily formed as bad ones. A mother, when in
bed, ought always to suckle her child while she is lying down. The
sitting up in bed, during such times, is a fruitful source of
inflammation and of gathering of the breasts. Of course, during the day
the sitting-up position is the best. Let me caution her not to nurse her
baby in a half-sitting and half-lying posture; it will spoil her figure,
disturb her repose, and weaken her back.
THE TEMPER.
657. Passion is injurious to the mother’s milk, and consequently to the
child. Sudden joy and grief frequently disorder the infant’s bowels,
producing griping, looseness, etc.; hence, a mother who has a mild,
placid temper generally makes an excellent nurse, on which account it is
a fortunate circumstance that she is frequently better-tempered during
suckling than at any other period of her life; indeed, she usually, at
such times, experiences great joy and gladness.
658. The happiest period of a woman’s existence is, as a rule, when she
first becomes a mother. “The pleasure of the young mother in her babe is
said to be more exquisite than any other earthly bliss.”[115]
659. It is an old and, I believe, a true saying, that the child inherits
the temper of his mother or of his wet-nurse. This may be owing to the
following reasons: If the mother or the wet-nurse be good-tempered, the
milk will be more likely to be wholesome, which will, of course, make
him more healthy, and consequently better-tempered.
660. While, on the other hand, if the mother or the nurse be of an
irritable, cross temper, the milk will suffer, and will thus cause
disarrangement to his system; and hence ill health and ill temper will
be likely to ensue. We all know the influence that good or bad health
has on the temper.
661. An important reason, then, why a nursing mother is often
better-tempered than she is at other times is, she is in better health,
her stomach is in a healthier state:
“A good digestion turneth all to health.”[116]
There is an old and a true saying, “that it is the stomach that makes
the man,” and if the man, the woman:
“Your stomach makes your fabric roll,
Just as the bias rules the bowl.”[117]
662. Hear what Shakspeare says of the functions of the stomach. The
stomach is supposed to speak (and does it not frequently speak, and in
very unmistakable language, if we will but only listen to its voice?):
“True is it, my incorporate friends, quoth he,
That I receive the general food at first
Which you do live upon: and fit it is;
Because I am the store-house and the shop
Of the whole body: But if you do remember,
I send it through the rivers of your blood,
Even to the court, the heart,—to the seat o’ the brain;
And, through the cranks and offices of man,
The strongest nerves, and small inferior veins,
From me receive that natural competency
Whereby they live: And though that all at once,
You, my good friends, though all at once cannot
See what I do deliver out to each;
Yet I can make my audit up, that all
From me do back receive the flour of all,
And leave me but the bran.”
_Coriolanus_, act i. sc. 1.
OCCUPATION.
663. I strongly recommend a nursing mother to attend to her household
duties. She is never so happy, nor so well, as when her mind is
moderately occupied at something useful. She never looks so charming as
when she is attending to her household duties—
“For nothing lovelier can be found
In woman, than to study household good.”[118]
664. I do not mean by occupation the frequenting of balls, of routs, or
of parties: a nursing mother has no business to be at such places; she
ought to devote herself to her infant and to her household, and she will
then experience the greatest happiness this world can afford.
665. One reason why the poor make so much better nursing mothers than
the rich is the former having so much occupation; while the latter,
having no real work to do, the health becomes injured, and in
consequence the functions of the breasts suffer; indeed, many a
fashionable lady has no milk at all, and is therefore compelled to
delegate to a wet-nurse one of her greatest privileges and enjoyments.
666. What would not some rich mother give for the splendid supply of
milk—of healthy, nourishing, life-giving milk—of the poor woman who has
to labor for her daily bread!
667. What is the reason that wealthy ladies so frequently require
wet-nurses? The want of occupation! And from whom do they obtain the
supply of wet-nurses? From the poor women who have no lack of
occupation, as they have to labor for their daily food, and have in
consequence the riches of health, though poor in this world’s goods—
“For health is riches to the poor.”[119]
Bear this in mind, ye wealthy, and indolent, and pampered ladies, and
alter your plans of life, or take the consequences, and still let the
poor women have the healthy, the chubby, the rosy, the laughing
children; and you, ye rich ones, have the unhealthy, the skinny, the
sallow, the dismal little old men and women who are constantly under the
doctor’s care, and who have to struggle for their very existence!
“Employment, which Galen calls ‘nature’s physician,’ is so essential to
human happiness, that Indolence is justly considered as the mother of
Misery.”[120]
668. Occupation, then—bustling occupation, real downright work, either
in the form of out-door exercise, or of attending to her household
duties—a lady, if she desire to have a good breast of milk, ought to
take; if, in point of fact, she wishes to have healthy children. For the
Almighty is no respecter of persons. And he has ordained that work shall
be the lot of man and of woman too! It is a blessed thing to be obliged
to work. If we do not work, we have all to pay a heavy penalty, in the
form of loss of both health and happiness. “For work is the grand cure
of all the maladies and miseries that ever beset mankind—honest work,
which you intend getting done.”[121]
669. A mother who is listless and idle, lolling either the greater part
of every day in an easy-chair, or reclining on a sofa in a room where a
breath of air is not allowed to enter, usually makes a miserable and a
wretched nurse. She is nervous, dyspeptic, and emaciated; having but
little milk, and that little of a bad quality, her baby is puny, pallid,
and unhealthy, and frequently drops into an untimely grave. Occupation,
then, with fresh air and exercise, is indispensable to a mother who is
suckling.
AILMENTS, Etc.
670. _The Nipple._—A _good_ nipple is important both to the comfort of
the mother and to the well-doing of the child.
671. One, among many, of the ill effects of stays and of corsets is the
_pushing-in of the nipples_; sore nipples, and consequent suffering, are
the result. Moreover, a mother thus circumstanced may be quite unable to
suckle her infant; and then she will be severely punished for her
ignorance and folly; she will be compelled to forego the pleasure of
nursing her own children, and she will be obliged to delegate to
hirelings her greatest privilege! Ladies who never wear stays have much
better nipples, and more fully-developed bosoms; hence such mothers are
more likely to make better nurses to their babies. There is no doubt
that the pressure of the stays on the bosom tends both to waste away the
gland of the breast (where the milk is secreted), and to cause the
nipple either to dwindle or to be pushed in, and thus to sadly interfere
with its functions. I should strongly advise every mother who has
daughters old enough to profit by it, to bear this fact in mind, and
thus to prevent mischief when mischief might be prevented, by not
allowing them, when young, to wear stays.
672. _Treatment of very small and drawn-in nipples._—The baby ought to
suck through the intervention of an india-rubber teat fastened on a
boxwood shield, or through an india-rubber teat and shield, made
entirely of india-rubber.[122] The india-rubber teat must, before it is
used, be softened by dipping it in warm but not in hot water. I have
known many mothers able to suckle their children with this contrivance
who otherwise would have been obliged either to have weaned them, or to
have procured the assistance of a wet-nurse. The above aid, in the
generality of instances, will enable the infant to suck with ease. After
this has for a time been used, the nipples will be so improved as to
render the continuance of it unnecessary. Of course I do not advise the
use of an india-rubber teat until a fair trial has been given by
applying the babe at _once_ to the nipple; but if he cannot draw out the
nipple, then, rather than wean him, or than employ a wet-nurse, let the
teat be tried.
673. Remember, as soon as the nipple be sufficiently drawn out, which in
all probability it will in a few days, the teat ought to be dispensed
with. In such a case, when the infant is not at the breast, Dr.
Wansbrough’s Metallic Nipple Shields should be worn. Small and bad
nipples have, by the wearing of these shields, frequently been drawn out
and made good ones; the dress will suffice to keep them in their places.
674. _Sore nipples._—If a lady, during the latter few months of her
pregnancy, were to adopt the plan recommended at page 162, paragraph
353, sore nipples, during the period of suckling, would not be so
prevalent as they now are.
675. A sore nipple is frequently produced by the injudicious custom of
allowing the child to have the nipple almost constantly in his mouth.
Stated periods for suckling, as recommended at paragraph 631, ought to
be strictly adopted. Another frequent cause of a sore nipple is from the
babe having the thrush. It is a folly to attempt to cure the nipple
without at the same time curing the mouth of the infant.
676. _Treatment._—One of the best remedies for a sore nipple is the
following powder:
Take of—Biborate of Soda, one drachm;
Powdered Starch, seven drachms:
Mix,—A pinch of the powder to be frequently applied to the nipple.
677. Dr. A. Todd Thomson’s—my old preceptor—remedy for sore nipple is a
very good one; it is as follows:
Take of—Finely-powdered Gum Arabic, half an ounce;
Powdered Alum, five grains:
To be well mixed together in a mortar to make a powder, of which a
pinch should either be sprinkled over the nipple, or it may be
applied to the part by means of a camel’s-hair brush every time
directly after the child has done sucking. Let the brush, covered
with the dry powder, gently sweep over the sore nipple.
As there is nothing in either of the above powders injurious to the
infant, the powder, before applying him to the breast, ought not to be
wiped off; indeed, either the one or the other of the powders (the
former one especially, as it contains borax) is likely to be of service
in preventing or in curing the sore mouth of the child.
678. If the above powders should not have the desired effect
(efficacious though they usually are), “a liniment composed of equal
parts of glycerin and of brandy” (say a vial containing two drachms of
each) ought to be tried, which must be shaken up just before using. It
should, by means of a camel’s-hair brush, every time directly after the
baby has been suckled, be painted on the nipple. A piece of either old
soft cambric or lawn, about the size of the palm of the hand, snipped
around to make it fit, ought then to be moistened in the glycerin and
the brandy, and should be applied to each of the sore nipples, and worn
(until they are cured) whenever the child is not at the breast. These
applications will be found of much service and of great comfort, and
will act as nipple shields, protecting and healing the nipples. A soft
sponge of warm water may be gently applied to the nipple just before
putting the child to the bosom.
679. If the above remedies should not succeed in curing the sore
nipple, then she ought to try Dr. Wansbrough’s Metallic Nipple Shield
(as recommended previously for small and drawn-in nipples), and
should, whenever the babe is not sucking, constantly wear it on the
nipple. It is very cooling and healing, and keeps off all pressure
from the clothes. It will frequently cure a sore nipple when other
remedies have failed. The shield may be procured of any respectable
surgical-instrument-maker.
680. _Cracked and fissured nipples._—Sometimes the nipple is sore from
having either cracks or fissures upon it. These cracks or fissures may
attack any part of the nipple, but are very apt to form where the nipple
joins the breast; and, when very severe, an ignorant nurse, who is
always fond of dealing in the marvelous, declares that the child has
nearly bitten the nipple off! _Treatment._—Now, the best remedy for a
_cracked_ and _fissured_ nipple is for the infant, until the cracks and
fissures are cured, to suck through the intervention of an india-rubber
teat and shield; and every time, directly after the babe has been put to
the nipple, to apply to the parts affected either neat brandy or the
glycerin and brandy liniment, as I have before recommended. When the
child is not at the breast, Dr. Wansbrough’s Nipple Shields should be
worn; the dress will keep them in their places.
681. Another cause of a sore nipple is from the mother, after the babe
has been sucking, putting up the nipple wet. She, therefore, _ought
always to dry the nipple_—not by rubbing it, but by dabbing it with
either a soft cambric or lawn handkerchief, or with a piece of soft
linen rag (one or other of which ought always to be at hand), every time
directly after the infant has done sucking, and just before applying
either of the above powders or liniment to the nipple.
682. When the nipple is very sore, a mother, whenever the child is put
to the bosom, suffers intense pain. This being the case, she had better
suckle him through the intervention of an india-rubber teat, properly
fastened on a shield, as before recommended. See page 276, paragraph
672. But she ought never to use an india-rubber teat unless it be
absolutely necessary—that is to say, if the nipple be only _slightly_
sore, she should not, on any account, apply it; but there are cases
where the nipple is so _very_ sore that a mother would have to give up
nursing if the shield and teat were not used; these, and very small and
drawn-in-nipples, are the only cases in which an india-rubber teat and
shield is admissible.
683. A nursing mother is sometimes annoyed by the milk _flowing
constantly away_, making her wet and uncomfortable. All she can do under
such circumstances is to wear nipple-glasses, and to apply a piece of
flannel to the bosom, which will prevent the milk from chilling her, and
will thus do away with the danger of her catching cold, etc.
684. _The breast._—A mother ought, before applying the infant to the
bosom, to carefully ascertain if there be milk. This may readily be done
by squeezing the nipple between the finger and the thumb. If there be
_no_ milk, she must wait until the milk be secreted, or serious
consequences both to her and to him might ensue: to the former,
inflammation and gathering of the bosom, and sore nipples; to the
latter, thrush, diarrhœa, and eruptions on the skin.[123]
685. If there be a supply of milk in the breast, and if still the child
will not suck, the medical man’s attention ought to be drawn to the
fact, in order that he may ascertain whether the child be tongue-tied;
if he be, the mystery is explained, and a trifling, painless operation
will soon make all right.
686. If the _bosoms be full and uneasy_, they ought, three or four times
a day, to be well although tenderly rubbed with olive oil and _eau de
Cologne_ (equal parts of each, mixed in a vial). Some nurses rub with
their fingers only. Now, such rubbing does harm. The proper way to apply
friction is to pour a small quantity of the oil and _eau de
Cologne_—first shaking the bottle—into the palm of the hand, the hand
being warm, and then to well rub the breasts, taking care to use the
whole of the inside of the hand.
687. After the bosoms have been well rubbed, each ought to be nicely
supported with a large, soft, folded silk handkerchief; each
handkerchief must pass _under_ each breast and _over_ the shoulders, and
should be tied at the back of the neck, thus acting as a sling.
688. If the bosoms be very uncomfortable, young cabbage-leaves (with the
“veins” of each leaf cut level to the leaf) ought, after each
application of the oil and _eau de Cologne_, to be applied; or a large
warm white-bread-and-milk and olive oil poultice ought to be used, which
must be renewed three or four times a day. The way to make the poultice
is as follows: A thick round of bread should be cut from a white loaf;
the crust should be removed, the crumb ought to be cut into pieces about
an inch square, upon which boiling-hot new milk should be poured; it
ought to be covered over for ten minutes; then the milk should be
drained off, and the olive oil—previously warmed by placing a little in
a teacup on the hob—should be beaten up by means of a fork with the
moistened bread until it be of the consistence of a soft poultice. It
ought to be applied to the bosom as hot as it can comfortably be borne.
689. _Gathered breast._—A gathered bosom, or “bad breast” as it is
sometimes called, is more likely to occur after a _first_ confinement
and during the _first_ month. Great care, therefore, ought to be taken
to avoid such a misfortune. A gathered breast is frequently owing to the
carelessness of a mother in not covering her bosoms during the time she
is suckling. Too much attention cannot be paid to keeping the breasts
_comfortably_ warm. This, during the act of nursing, should be done by
throwing either a shawl or a square of flannel over the neck, shoulders,
and bosoms.
690. Another cause of a gathered breast arises from a mother sitting up
in bed to suckle her baby. An infant ought to be accustomed to take the
bosom while he is lying down; if this habit be not at first instituted,
it will be difficult to adopt it afterward. Good habits may be taught a
child from the very earliest period of his existence.
691. A sore nipple is another fruitful cause of a gathered breast. A
mother, in consequence of the suffering it produces, dreads putting the
baby to it; she therefore keeps him almost entirely to the other bosom.
The result is, the breast with the sore nipple becomes distended with
milk, which, being unrelieved, ends in inflammation, and subsequently in
gathering.
692. The _fruitless_ attempt of an infant, to procure milk when there is
very little or none secreted is another and a frequent cause of a
gathered bosom. Dr. Ballard, in his valuable little work before quoted,
considers this to be the _principal_ cause of a gathered breast; and, as
the subject is of immense importance, I cannot do better than give it in
his own words, more especially as he has the merit of originating and of
bringing the subject prominently before his professional brethren. He
says: “This (mammary abscess or gathered breast) is another form of
disease entirely referable to the cause under consideration [fruitless
sucking]. In the case last related, the formation of mammary abscess
[gathered breast] was only just prevented by arresting any further
irritation of the breast by suckling; and since I have kept careful
notes of my cases, I have observed that in all instances of abscess
there has been abundant evidence of a demand being made upon the gland
for a supply of milk beyond that which it had the power of secreting. If
the child _only_ has been kept to the breast, then _it_ has suffered
with disordered bowels; but in the majority of cases an additional
irritation has been applied; the commonly-received doctrine that a
turgid breast is necessarily overloaded with milk, leads mothers and
nurses to the use of breast-pumps, exhausted bottles, or even the
application of the powerful sucking powers of the nurse herself, to
relieve the breasts of their supposed excess; and it is this
extraordinary irritation which, in the majority of cases, determines the
formation of an abscess [gathering]. Sometimes these measures are
adopted to remove the milk when a woman is not going to suckle, and then
an abscess not unfrequently is established. I have previously alluded to
the mistake into which mothers and nurses are led by the appearance of a
swollen breast; it is not evidence that the gland can secrete freely,
and it is in this turgid state that the excessive irritation tells most
severely. This hyperæmic [plethoric] condition seems to be a step toward
inflammation, and the irritation supplies that which is wanting to
complete the process. If a woman will only remove the child from the
breast directly the act of sucking produces pain, she may be pretty sure
to avoid abscess. So long as the milk can be obtained there is no pain.”
The above most valuable advice deserves great attention, and ought to be
strictly followed.
693. _How is a patient to know that she is about to have a gathered
bosom?_—There are two forms of gathered breast; one being of vast and
the other of trifling importance. The first, the serious one, consists
of gathering of the _structure of the gland_ of the breast itself; the
latter, merely of the _superficial part_ of the bosom, and ought to be
treated in the same manner as any other _external_ gathering, with warm
poultices.
694. In the _mild_ or superficial kind of gathered bosom, the mother may
still persevere in suckling her child, as the secreting portion of the
breast is not at all implicated in the gathering; but in the _severe_
form, she ought not, on any account whatever, to be allowed to do so,
but should instantly wean her child from the affected side. The
_healthy_ breast she may still continue to nurse from.
695. The _important_ form of a gathered breast I will now describe: A
severe gathered bosom is always ushered in with a shivering fit. Let
this fact be impressed deeply upon my reader’s mind. This shivering is
either accompanied or followed by sharp lancinating pains of the bosom.
The breast now greatly enlarges, becomes hot, and _is very painful_. The
milk in the affected bosom either lessens or entirely disappears. If the
child be applied to the breast (which he ought not to be), it gives the
mother _intense_ pain. She is now feverish and ill; she loses her
strength and appetite, and is very thirsty.
696. A medical man must, at the very _onset_ of the shivering fit, be
sent for; and he will, in the generality of instances, be able to
prevent such a painful and distressing occurrence as a gathered breast.
If twelve hours be allowed to elapse after the shivering has taken
place, the chances are that the gathering cannot altogether be
prevented; although even then it may, by judicious treatment, be
materially lessened and ameliorated.
697. We sometimes hear of a poor woman suffering dreadfully for months,
and of her having a dozen or twenty holes in her bosom! This is
generally owing to the doctor not having been sent for _immediately_
after the shivering; I therefore cannot too strongly insist, under such
circumstances, upon a mother obtaining _prompt_ assistance, not only to
obviate present suffering, but, at the same time, to prevent the
function of the breast from being injured, which it inevitably, more or
less, will be, if the _important_ form of gathering be allowed to take
place.
698. When a nursing mother _feels faint_, she ought _immediately_ to lie
down and to take a little nourishment; either a crust of bread and a
draught of ale or of porter, or a glass of wine, or a cup of tea with
the yelk of an egg beaten up in it, either of which will answer the
purpose extremely well. Brandy, or any other spirit, I would not
recommend, as it will only cause, as soon as the _immediate_ effects of
the brandy are gone off, a greater depression to ensue; not only so, but
the _frequent_ taking of brandy might become a habit—a necessity which
would be a calamity deeply to be deplored!
699. A mother is sometimes faint from suckling her child too often, she
having him almost constantly at the bosom. So long, of course, as she
continues this foolish practice, she must expect to suffer from
faintness.
700. _Aperients, etc. during suckling._—Strong purgatives, during this
period, are highly improper, as they are apt to give pain to the infant
as well as to injure the mother. If it be absolutely necessary to give
an aperient, the mildest, such as a dose of castor oil, should be
chosen.
701. If she cannot take oil, then she should apply it _externally_ to
the bowels as a liniment, as recommended at page 144.
702. An enema, either of warm water, or of gruel, oil, and table
salt,[124] applied by means of a good self-injecting enema apparatus, is
in such a case an excellent—indeed, the very best—method of opening the
bowels, as it neither interferes with the digestion of the mother nor of
the child.
703. The less opening medicine, whatever be the kind, a mother who is
suckling takes, the better will it be both for herself and for her babe.
Even castor oil, the least objectionable, during suckling, of aperients,
if she once begin to take it _regularly_, the bowels will not act
without it, and a wretched state of things is established. No, if the
bowels will not act, an enema is by far the best remedy; you can never
do any harm, either to the mother or to the babe, by the administration
of an enema; it will neither induce future constipation, nor will it
interfere with the digestion of the mother, nor with the bowels, nor
with the health of the infant.
704. When a lady who is nursing is habitually costive, she ought to eat
brown instead of white-bread. This will, in the majority of cases,
enable her to do without an aperient. The brown bread may be made by
mixing one part of bran and three parts of fine wheaten flour together,
and then making it in the usual way into bread. Treacle instead of
butter on the brown bread increases its efficacy as an aperient.
705. Either stewed prunes or stewed French plums are an excellent remedy
to prevent constipation. The patient ought to eat, every morning, a
dozen or fifteen of them. The best way to stew either prunes or French
plums is the following: Put a pound, either of prunes or of French
plums, and two tablespoonfuls of _raw_ sugar, into a brown jar; cover
them with water, put them into a slow oven, and stew them for three or
four hours. Both stewed rhubarb and stewed pears often act as mild or
gentle aperients. Muscatel raisins, eaten at dessert, will oftentimes,
without medicine, relieve the bowels.
706. A Bee-master in _The Times_, or, as he is usually called, _The
Times_ Bee-master, has satisfactorily proved that honey—pure honey—is
most wholesome and beneficial to the human economy. He recommends it to
be occasionally eaten in lieu of butter for breakfast. Butter, in some
localities, and in some seasons of the year, is far from good and
wholesome.
707. The Germans are in the habit of eating for breakfast and for tea a
variety of fruit jams instead of butter with their bread. Now, if the
bowels be costive, jam is an excellent substitute for butter. The
Scotch, too, scarcely ever sit down either to breakfast or tea without
there being a pot of marmalade on the tables. English ladies, in this
matter, may well take a leaf out of the books of the Germans and of the
Scotch.
708. A basinful of gruel, made either with Robinson’s Patent Groats,
or with the Derbyshire oatmeal, sweetened with _brown_ sugar, every
night for supper will often supersede the necessity of giving opening
medicine. A tumblerful of cold spring water—cold from the pump—taken
_early_ every morning, sometimes effectually relieves the bowels.
Coffee ought to be substituted for tea for breakfast, as coffee
frequently acts as an aperient, more especially if the coffee be
sweetened with brown sugar. A glass of sherry should be taken every
day _during_ dinner, as, if the bowels be sluggish, it sometimes
stimulates them to action. I should strongly recommend a patient, in
such a case, to eat a great variety of food, and to let the
_vegetable_ element predominate. _Much_ meat encourages constipation.
Fruit—Muscatel raisins especially—farinaceous food, coffee, and a
variety of vegetables, each and all incite the bowels to do their
duty.
709. Although a nursing mother ought, more especially if she be costive,
to take a variety of _well-cooked_ vegetables—such as potatoes,
asparagus, broccoli, cauliflower, French beans, stewed celery, and
turnips; she should avoid eating greens, cabbages, and pickles, as they
would be likely to affect the baby, and might cause him to suffer from
gripings, pain, and “looseness” of the bowels.
710. The “wet compress” is another excellent method of opening the
bowels. The way of applying it is as follows: Fold a large napkin a few
thicknesses until it is about half a foot square; then dip it in _cold_
water and place it over the bowels; over which apply either oilskin or
gutta-percha skin, which should be, in order to exclude the air,
considerably larger than the folded napkin. It should be kept in its
place by means of either a bolster-case or a broad bandage, and must be
applied at bedtime, and ought to remain on for three or four hours, or
until the bowels be opened.
711. Let me again—for it cannot be too urgently insisted upon—strongly
advise a nursing mother to use every means in the way of diet, etc., to
supersede the necessity of the taking of opening medicine, as the
repetition of aperients injures, and that severely, both mother and
child. Moreover, the more opening medicine a person swallows, the more
she requires; so that if she once get into the habit of regularly taking
aperients, the bowels will not act without them. What a miserable
existence, to be always swallowing physic!
712. If a lady, then, during the period of suckling, were to take
systematic exercise in the open air; to bustle about the house and to
attend to her household duties; if she were to drink, the moment she
awakes in the morning, a tumbler of _cold_ water, and every day _during_
dinner a glass of sherry; if she were to substitute _brown_ bread for
_white_ bread, and _coffee_ for _tea_ at breakfast, and _brown_ for
_white_ sugar; if she were to vary her food, both animal and vegetable,
and partake plentifully of sound ripe fruit; if she were to use an
abundance of _cold_ water to her skin; if she were, occasionally, at
bedtime, to apply a “wet compress” to her bowels, and to visit the
water-closet daily at one hour; if she were—even if the bowels were not
opened for four or five days—_not_ to take an aperient of any kind
whatever, and avoid quacking herself with physic; in short, if she would
adopt the above safe and simple remedies, which are in the reach of all,
she would not suffer so much from costiveness, which is frequently the
bane, the misery, and the curse of her existence! But then, to get the
bowels into a proper and healthy state, it would take both time and
trouble; and how readily can a couple of pills be swallowed, and how
quickly they act, and how soon they have to be repeated; until at length
the bowels will not act at all unless goaded into action, and the pills
become a necessity! Oh, the folly and the mischief of such a system!
WEANING.
713. There is an old saying, “that a woman should carry her child nine
months, and should suckle him nine months.” It is well known that the
first part of the old adage is correct, and experience has proved the
latter to be equally so. If a babe be weaned _before_ he be nine months,
he loses that muscular strength which the breast-milk alone can give; if
he be suckled _after_ he be nine months, he becomes flabby, weak, and
delicate. “It is generally recognized that the healthiest children are
those weaned at nine months complete. Prolonged nursing hurts both child
and mother; in the child, causing a tendency to brain disease, probably
through disordered digestion and nutrition; in the mother, causing a
strong tendency to deafness and blindness. It is a very singular fact,
to which it is desirable that attention were paid, that in those
districts of Scotland—viz., the Highland and insular—where the mothers
suckle their infants from fourteen to eighteen months, deaf-dumbness and
blindness prevail to a very much larger extent among the people than in
districts where nine or ten months is the usual limit of the nursing
period.”[125]
714. _The time, then, when an infant ought to be weaned._—“This, of
course, must depend upon the strength of the child, and upon the health
of the mother: nine months on an average is the proper time. If she be
delicate, it may be found necessary to wean him at six months; or if he
be weak, or laboring under any disease, it may be well to continue
suckling him for twelve months; but after that time the breast will do
him more harm than good, and will, moreover, injure the mother’s
health.”[126]
715. If he be suckled after he be twelve months old, he is generally
pale, flabby, unhealthy, and rickety; and the mother is usually nervous,
emaciated, and hysterical. A child who is suckled beyond the proper
time, more especially if there be any predisposition, sometimes dies
either of water on the brain, or of consumption of the lungs, or of
mesenteric disease.
716. _The manner in which a mother ought to act when she weans her
child._—“She must, as the word signifies, do it gradually—that is to
say, she should by degrees give him less and less of the breast, and
more and more of artificial food; she ought, at length, only to suckle
him at night; and lastly, it would be well for the mother either to send
him away, or to leave him at home, and for a few days to go away
herself.”[127]
717. “A good plan is for the nurse to have in the bed a half-pint bottle
of new milk, which, to prevent it from turning sour, has been previously
boiled, so as to give a little to the child in lieu of the breast. The
warmth of the body will keep the milk of a proper temperature; and will
supersede the use of lamps, of candle-frames, and other troublesome
contrivances.”[128]
718. If the mother be not able to leave home herself, or to send her
child _from_ home, she ought then to let the child sleep in another
room, with some _responsible_ person—I say _responsible_ person, for a
baby must not be left to the tender mercies of a giggling, thoughtless
young girl.
719. If the mother, during the daytime, cannot resist having her child
in the room with her, then I should advise her to make a paste of
aloes—that is to say, let her mix a little powdered aloes with a few
drops of water, until it be of the consistence of paste—and let her
smear it on the nipple every time just before putting him to the breast;
this will be _quite_ enough for him; and one or two aloe applications to
the nipple will make him take a disgust to the bosom, and thus the
weaning will be accomplished. A mother need not be afraid that the aloes
will injure her baby; the _minute_ quantity he will swallow will do no
harm; for the moment he tastes it, the aloes being extremely bitter, he
will splutter it out of his mouth.
720. Another application for the nipple, to effect weaning, is wormwood.
There are two ways of applying it, either (1) by sprinkling a very small
pinch of powdered wormwood on the nipple; or (2) by bathing the nipple
with a small quantity of wormwood tea just before applying the babe to
it—either the one or the other of these plans will make him take a
dislike to the breast, and thus the weaning will be accomplished.
Wormwood is excessively bitter and disagreeable, and a slight quantity
of it on the nipple will cause an infant to turn away from it with
loathing and disgust—the wormwood, the minute quantity he will taste,
will not at all injure him. Wormwood was in Shakspeare’s time used for
the purpose of weaning:
“And she was wean’d,—I never shall forget it—
Of all the days of the year upon that day:
For I had then laid wormwood to my dug [breast],
Sitting in the sun under the dove-house wall,
My lord and you were then at Mantua:
Nay, I do bear a brain: but, as I said,
When it did taste the wormwood on the nipple
Of my dug, and felt it bitter, pretty fool!
To see it tetchy, and fall out with the dug.”[129]
721. The best way of “_drying up the milk_” is to apply to each breast
soap plaster (_emplastrum saponis_), spread on soft pieces of
wash-leather, the shape and size of the top of a hat, with a round hole
the size of a shilling in the middle of each to admit the nipple, and
with a slit from the center to the circumference of each plaster to make
a better fit. These plasters ought to be spread by a chemist.
722. When the child is once weaned, the breasts ought _not_ to be drawn,
as the drawing of them would cause them to secrete larger quantities of
milk; if, therefore, the bosoms be ever so full or uncomfortable, a
mother ought to leave them alone; she should wait patiently, and the
milk will gradually diminish, and will at length disappear.
723. The drawing of the bosoms, during weaning, either by means of a
breast-pump, or by the mouth, or by other like contrivances, has
frequently caused gathered breasts. If not drawn, they scarcely, if
ever, gather.
724. The foregoing plan of “drying up the milk” will generally in five
or six days assuage the milk away; but if, at the end of three days, the
bosoms still continue full and uncomfortable, the plasters should be
removed, and the breasts ought, every four hours, to be well but
tenderly rubbed with equal parts of olive oil and of _eau de Cologne_;
the nurse supporting the bosom, during such friction, with her other
hand.
725. Let me impress the above important advice on a nursing mother’s
mind; it might save a great deal of after-suffering and misery.
726. It might be well to state that, after the child has been weaned,
the milk does _not_ always _entirely_ leave the breast, not even for
weeks, and, in some cases, not even for months; it is not of the
slightest consequence, and requires no treatment to get rid of it.
727. A mother ought, during the period of weaning, to live abstemiously,
and should drink as little as possible. In many cases, it is necessary
to give, every morning, for two or three mornings, a few doses of mild
aperient medicine, such as either a Seidlitz powder, or a teaspoonful of
Henry’s magnesia and a teaspoonful of Epsom salts in half a tumbler of
warm water.
728. _Symptoms denoting the necessity of weaning._—A mother sometimes
cannot suckle her child; the attempt bringing on a train of symptoms
somewhat similar to the following: singing in the ears; dimness of
sight; aching of the eyeballs; throbbing in the head; nervousness;
hysterics; tremblings; faintness; loss of appetite and of flesh;
fluttering and palpitation of the heart; feelings of great exhaustion;
indigestion; costiveness; sinking sensations of the stomach; pains in
the _left_ side; great weakness and dragging pains of the loins, which
are usually increased whenever the infant is put to the bosom; pallor of
the countenance; shortness of breath; swelling of the ankles.
729. Of course, every mother who is suffering from suckling does not
have the _whole_ of the above long catalogue of symptoms! But if she has
three or four of the more serious of them, she ought not to disobey the
warnings, but should discontinue nursing; although it may be necessary,
if the babe himself be not old enough to wean, to obtain a healthy
wet-nurse to take her place.
730. Remember, then, that if the above warning symptoms be disregarded,
dangerous consequences, both to parent and child, might be the result.
It might either throw the mother into a consumption, or it might bring
on heart disease; and, in consequence of his not being able to obtain
sufficient or proper nourishment, it might cause the infant to dwindle
and pine away, and, eventually, to die of water on the brain.
731. Soon after nine months’ nursing, “the monthly courses” generally
return. This is another warning that the babe ought _immediately_ to be
weaned, as the milk will lessen both in quantity and in nourishment, and
the child in consequence will become delicate and puny, and every day he
is suckled will lose, instead of gain, ground. I have known many
children, from protracted suckling, smaller at twelve months than they
were at nine months; and well they might be, as, after nine months, the
mother’s milk usually does them harm instead of doing them good, and
thus causes them to dwindle away.
732. At another time, although the above train of symptoms does not
occur, and notwithstanding she may be in perfect health, a mother may
not be able to suckle her baby. Such a one usually has very small
breasts, and but little milk in them, and if she endeavor to nurse her
infant, it produces a _violent aching_ of the bosom. Should she
disregard these warnings, and should still persevere, it might produce
inflammation of the breast, which will probably end in a gathering.
733. _An obstinate sore nipple is sometimes a symptom denoting the
necessity of weaning._—When the nipples are, and, notwithstanding
judicious treatment, persistently for some time continue, very sore, it
is often an indication that a lady ought to wean her baby.
Long-continued, obstinate sore nipples frequently occur in a delicate
woman, and speak, in language unmistakable, that the child, as far as
the mother herself is concerned, must be weaned. Of course, if the
infant be not old enough to wean, when practicable a wet-nurse ought to
take the mother’s place. If the above advice were more frequently
followed than it is, gathered breasts, much suffering, and broken health
would not so frequently prevail as they now do.
734. If a mother be predisposed to consumption; if she has had spitting
of blood; if she be subject to violent palpitation of the heart; if she
be laboring under great debility and extreme delicacy of constitution;
if she has any of the above complaints or symptoms, she ought not on any
account to suckle her child, but should by all means procure a healthy
wet-nurse.
735. Occasionally a mother suckles her infant when she is pregnant. This
is highly improper, as it not only injures her own health, and may bring
on a miscarriage, but it is also prejudicial to the baby, and may
produce a delicacy of constitution from which he might never recover.
* * * * *
In conclusion, I fervently hope that this little book will, through
God’s blessing, be to my fair reader, during the whole period of her
wifehood, a friend in her need, a guide in her difficulties, and a
silent but trusty counselor in all things pertaining to her health. I
sincerely trust that it will give her as much pleasure in the reading of
these pages as it has given me in the writing of them.
INDEX.
Ablution after labor, 245.
among the poor, 41.
manner of young wife performing, 42.
morning, 41.
in pregnancy, 124.
thorough, 41.
Abortion, 174.
the procuring of, 120.
Accoucheur, the duties of, 206.
Advice to a monthly nurse, 196.
After birth should never be brought away by nurse, 233.
After pains, 212.
Age at which menstruation commences, 105.
Age, best, to marry, 104.
Ages of mother and wet-nurse, 265.
Ailments of pregnancy, 140.
during suckling, 236.
Air, cold, the value of, 37.
pure in bedroom, 34.
Air and exercise in pregnancy, 125.
during suckling, 268.
and occupation, 126.
Ale and porter, sour, 253.
more nourishing than wine, 266.
Alcohol a deadly poison, 57.
in brandy and in wine, 57.
Aloe paste in weaning, 295.
Amusements of a young wife, 20.
Aperient pills after confinement, 241.
Aperients in pregnancy, 140.
the abuse of, 244.
before labor, 155.
_immediately_ after, improper, 241.
during suckling, 287.
on frequent, 99.
Appetite, bad, 51.
and leanness, 54.
Applications for hair, 47.
Armstrong on ablution, 49.
Articles wanted at labor, 216.
Artificial respiration, 232.
Assisting nature, on, 209.
Bad breast, 282.
Bandage after confinement, 236.
Barley-water and new milk, 251.
Barren wives, 14.
diet of, 38.
number of, 14.
Barrenness and fashion, 68.
in higher ranks, 60.
Bathing feet, 45.
shoulders and back, 42.
whole body, 42.
Bay salt, 45.
Bearing down pains, 202.
of womb, 247.
Beauty-sleep, 72.
Bed, “the guarding of,” 218.
Bed-pan, the best kind of, 244.
Bedroom for pregnant female, 137.
ventilation of, 73.
Bedstead, a four-post, in labor, 216.
Beef-tea, how to make (_note_), 249.
“Being out in reckoning,” 187.
Beverage after labor, 251.
the best for young wife, 55.
for mother whose child is ill, 268.
Bidet should be regularly used, 124.
Bladder, irritability of, 164, 199.
importance of attending to, 233.
in pregnancy, 164.
sluggishness of, 164.
state of, after confinement, 239.
“Blue-stocking,” as a wife, 93.
Bosom after labor, 259.
Bowels to be opened before labor, 155.
if regular, _no_ aperient required, 145.
Bowel complaints of pregnancy, 145.
Bowels, state of, after labor, 241.
Boy or girl?, 188.
Brandy to be in the lying-in room, 222.
on the use of, during labor, 222, 235.
Bran-bread as an aperient, 289.
Breakfast for young wife, 50.
a meager, 50.
Breast-drawer, 258.
during suckling, 260, 282.
Breast, full and uneasy, 282.
in second and in succeeding confinements, 259.
painful during pregnancy, 162.
gathered, 282.
causes of, 283.
importance of early treatment, 286.
shivering fit in, 286.
symptoms of, 286.
two forms of, 285.
Breast-pump, ill effects of, 296.
Bringing up of girls, 96.
Bugs and fleas, 97.
Business of a wife, 90.
Calomel dangerous in pregnancy, 140.
Carbonic acid gas in crowded rooms, 33, 86.
Carpet for bath-room, 47.
Carriage exercise, on the abuse of, 29.
Castor oil, the dose and manner of administering, 141.
external use of, 144.
Caudle should be banished lying-in room, 236.
“Caul,” a child’s (_note_), 230.
Cause, one, of small families, 60.
“Ceasing to be unwell,” 117.
to menstruate, 115.
Champagne-cup, 63.
Change of air for delicate wife, 96.
“Change of life,” 115.
“Change of life,” great importance of _not_ neglecting, 115.
of room after labor, 253.
Cheerful wife, 87.
Cheerfulness during labor, 220.
and occupation, 87, 93.
Child born before arrival of medical man, 228.
should be gradually weaned, 294.
Childless house, 14.
Chimney, on stopping, 35.
Chloroform in hard and lingering labor, 225.
Chlorosis and hysteria, 113.
Circulation, languid, 30, 55.
Cleanliness of body, 41.
“Cleansings,” 245.
Clever wife a fortune, 90.
Clothing in pregnancy, 123.
after labor, 234.
during suckling, 262.
Clysters, 242, 288.
Coffee as an aperient, 142, 290.
Complexion, a fine, 25, 27.
Contentment, 87.
Cook, an idiot of a, 90.
Cookery, good and careful, 89.
Costiveness during pregnancy, 140.
a cause of _hard_ labor, 143.
“Count,” 185.
the German method of making, 187.
a good plan to make the, 186.
Country, on living in the, 36, 137.
Cramp of the bowels, 168.
Cramps of the legs and thighs in pregnancy, 168, 203.
Creasote in toothache, 156.
“Croakers,” during labor, 190, 219.
Croquet, best of games, 85.
Crying out, when in pain, 214.
Curates’ wives, 38.
Dancing, danger of young wife, 86.
Dangers of wine-drinking, 56.
of early marriages, 104.
Daylight, importance of, 79.
Depression of spirits during suckling, 267.
Derbyshire oatmeal gruel, 143.
Dews of morning and evening, 26, 70.
Diarrhœa in pregnancy, 145.
Dietary of a young wife, 49.
pregnant female, 134.
after labor, 249.
Diet during suckling, 263.
of lying-in women, 249
of young wife, 49.
Digestion, a good, 271.
Dirt in wrong place, 132.
Difficulty of lying down in pregnancy, 138.
of making water, 223.
Dinners and tempers, 92.
Disinfectant, 129.
Dissipation and barrenness, 14.
Domette bandages, 153.
Dozing, ill effects of, 67.
Drainage, 132.
Dress for labor, 217.
for young wife, 82.
“Drying up the milk,” 296.
Duration of menstruation, 105.
Duties of a nursing mother, 255.
of a wife, 92.
Early Maturity, 106.
riser needs refreshment, 68.
rising and early to bed, 71.
a cosmetic, 70.
a duty, 71.
good effects of, 70.
Early rising rejuvenizes, 70.
Economy, domestic, 87.
Employment “nature’s doctor,” 274.
_Enceinte_, the origin of the word (_note_), 113.
Enema apparatus, 100, 197.
for costiveness, 100.
for lying-in patient, 242.
Enemata of tepid water, 152.
Ewers and basins, Liliputian, 41.
Exercise for a young wife, 23.
a necessity, 24.
before breakfast, 47.
best aperient, 144.
for the delicate, 25.
immense importance of, 23.
in close carriages, 29.
in pregnancy, 125.
during suckling, 268
fresh air and occupation during pregnancy, 126.
in open air after labor, 254.
promotes sleep, 78.
False labor pains, 183.
Fainting in pregnancy, 165.
Faintness during suckling, 287.
“Falling of the womb,” 247.
Falling off of hair, 47.
Fashion and barrenness, 38.
Fashionable system of spending married life, 18.
Fat and pregnancy, how to distinguish between, 121.
Feet, cold, exercise the remedy for, 30.
and legs, bathing, 45.
Females who have sick pregnancies, 161.
“Female slipper,” 239.
Fire-guard on lying-in room grate, 237.
Fire, ill effects of sitting near, 27.
Flannel, 218.
next skin, 83.
Flatulence and “quickening,” 121.
Fleas and bugs, 97.
Fœtal circulation (_note_), 122.
Folly of shutting out light, 79.
Food, variety of, necessary, 265.
French bed-pan, 244.
cookery, 91.
plums, stewed, 289.
Friend, the choice of, during labor, 219.
Fruit useful in pregnancy, 136.
Fruitful women, 60.
Fruit tree, a simile, 15.
Fruitless suckling, 283.
Fumigations, 129.
Garters, ill effects of, in pregnancy, 123.
Gathered breasts, 282.
causes of, 283.
importance of early treatment, 286.
German breakfast, 289.
Gestation, period of, 185.
Ginger plaster, 157.
Girl or boy?, 188.
Greens, cabbages, and pickles, 290.
“Guarding of the bed,” 218.
Hair, on washing, 46.
Health, a beautifier, 23.
importance of, 101.
of wives, 13.
worth trying for, 17.
Heart, palpitation of, during pregnancy, 167.
Heartburn in pregnancy, 147.
Hints to attendants, 228.
to mother when infant is ill, 268.
Home known only in England, 86.
Honey, on the wholesomeness of, 289.
Hot-water bag, 147, 168.
House, a healthy, 36.
Household duties, 86.
good, 272.
Hysteria, 113.
Husband in lying-in room, 210.
Idle ladies, 78.
people, 25.
Idleness brings misery, 127.
effects of, 17.
India-rubber teat and shield for drawn-in nipple, 276.
for sore nipple, 280.
Indolence, the ill effects of, in pregnancy, 126.
Infant born apparently dead, 230.
the period of suckling an, 293.
the cry of an, 230.
Introductory Chapter, 13.
Irish women, poor, 38.
Irritation and itching, 172.
Jam as an aperient, 89.
Jeremy Taylor’s description of a wife, 13.
Labor, 199.
the easy and the hard, 94.
rapid, directions concerning, 228.
symptoms of, 199–215.
treatment of, 216–254.
Lavements in pregnancy, 144.
Leather cheaper than physic, 24.
Legs, the swollen, of pregnancy, 152.
Length of time of first labor, 210.
of an after labor, 210.
Life is to be well, 18.
Light, effects of, 79.
is life, 79.
Little ablution—much clothing, 84.
Lively women and easy labors, 127.
Luxurious idle wife, 77.
Luxury, an age of, 28.
ill effects of, 38.
Lying-in room, 237.
temperature of, 237.
Maid-servants and the “ologies,” 92.
Marmalade as an aperient, 290.
Marshmallow and chamomile fomentation (_note_), 245.
Martin Luther on work, 89.
Mastication, thorough, 54.
Materials of food should be mixed and varied, 265.
Means to strengthen, 16.
Meddlesome breast-tending, 260.
midwifery reprobated, 205.
Medical men, 209.
Medicines in pregnancy, 140–173.
opening, danger of, 99.
Menstrual fluid, 111.
Menstruation, 103.
accompanied with “the whites,” 112.
before marriage, 111.
during 30 years, 102.
painful, 111.
dangers of, 111.
profuse, 112.
sparing, 112.
too pale or too dark, 111.
when not properly performed, 111.
Milk at its “height,” 259.
the best way of “drying up” the, 296.
flowing away constantly, 280.
very fattening, 54.
Miscarriage, 174.
care required after, 178.
causes of, 175.
consequences of a neglected, 178.
flooding in, 177.
prevention of, 179.
symptoms of a threatened, 176.
treatment of, 179.
usual time of taking place, 177.
Misconception and prejudice, 238.
Mission, the glorious, 101.
Monthly nurse, 189–198.
Morning sickness, 117, 158.
Mothers predisposed to consumption, 300.
who cannot suckle, 299.
unnatural, 255.
Mountain-air, 97.
Mufflers and sore throats, 84.
Mutton-chops, folly of living entirely on, 52.
Nature in early morning, 68.
Navel, pouting of, as a sign of pregnancy, 122.
Navel-string, the manner of tying, 233.
not to be tied until the child breathes, 232.
Nipple, cracked and fissured, 279.
during suckling, 257.
means to harden, 162.
great importance of hardening, 162.
retraction of, 275.
shields, 276.
sore, 277.
an obstinate, 299.
washing of, and breast, 257.
wet, 280.
shields, Wansbrough’s, 279.
Nose, a sentinel, 129.
Nurse, monthly, 189–198.
importance of choosing a good, 189.
on wearing crinoline, 197.
on wearing slippers instead of shoes, 198.
Nursery-basin, 43.
Nursing, prolonged, danger of, 293.
apron, 263.
Oatmeal, Derbyshire, 143.
gruel as a fomentation, 245.
Occupation, 87, 272.
fresh air, and exercise, 272.
Offspring of very young and very old, 104.
Olive oil as an aperient, 142.
Opening medicine, 99.
Pains, “bearing down,” 203.
_before_ and _during_ menstruation, 111.
“grinding,” 200.
at night in pregnancy, 139.
Painless parturition, 212.
Palpitation of the heart in pregnancy, 167.
Passion, the ill effects of, during suckling, 270.
Pendulous belly of pregnancy, 154.
Pepper plaster, 157.
Period of gestation, 185.
of taking exercise, 254.
Pessaries, 248.
Physic, a substitute for exercise, 31.
best, is exercise, 25.
Piles in pregnancy, 148.
Pleasure and health, 85.
Plethoric pregnant females, 136.
Poisoned by one’s own breath, 35.
Porter and ale for a nursing mother, 266.
Position after delivery, 237.
of a mother during suckling, 270.
of patient after labor, 237.
“Pottering” nurse, 190.
Poultice, a bread and milk and sweet oil, 282.
Precursory symptoms of labor, 199.
Pregnancy, 117.
duration of, 185.
a natural process, 127.
period of, 185.
signs of, 117.
Preliminary observations, 13.
Preparation for health, 47.
for labor, 216.
Profession of a wife, 90.
Prolific mothers (_note_), 105.
Proper time for a patient to sit up after labor, 246.
to send for medical man, 200, 203.
to send for the nurse, 200.
Protrusion of the bowels, 149.
Prunes, stewed, 289.
Puberty, period of (_note_), 105.
Pump-water, contamination, 132.
on boiling, 133.
on purity of, 132.
“Quickening,” 120.
flatulence mistaken for, 121.
Quiet after confinement, 246.
Rain and wind, exercise in, 24.
Rats in drains and sewers, 130.
“Reckoning,” to make the, 186.
Refreshment after labor, 235.
Remedies to prevent costiveness, 291.
Respiration, artificial, 232.
Rest after delivery, 234.
in pregnancy, 133.
and quietude after labor, 246.
Restlessness at night, 138.
remedies for, 138.
Rich ladies, 38.
Rising of the sun on seeing the, 71.
Rock-salt, 45.
Rules for a female prone to miscarry, 180.
for barren wife, 14.
of health, 99.
Sea-bathing, in pregnancy, 125.
Sea water good for hair, 46.
Servants taught the “ologies,” 92.
Shivering during labor, 201.
“Show,” a sure sign of labor, 200.
Shower-bath in pregnancy, 125.
Sick pregnancies, 161.
Sickness during labor, 201.
Signs of the fœtal circulation (_note_) 123.
of pregnancy, 117.
Sitting over fire, 27.
with back to fire, 27.
Sitz-bath, the value of, 44, 124, 172.
Skin of the abdomen cracked, 154.
Skylight the best ventilator, 128.
Sleep in pregnancy, 137.
the choicest gift, 77.
the value of, immediately after labor, 238.
for young wife, 78.
Sleepiness of pregnant females, 138.
Sleeplessness of pregnant females, 138.
Slipper bed-pan, 239, 244.
Sluggard’s dwelling, 71.
“Smoking dunghill,” a, 131.
Sore nipples, 277.
Spirits during suckling, 268.
Spurious labor pains, 183.
Stages of labor, 213.
Stays should not be worn during labor, 218.
Stocking, elastic, 153.
Stomach, functions of, 271.
Subsidence of the womb before labor, 199.
“Suck-pap,” 258.
Suckling, 255.
when female is pregnant, 300.
Suppers, hearty meal, 52.
Support to bowels after confinement, 236.
Swedish ladies, 91.
Swollen legs in pregnancy, 152.
Symptoms of labor, 199.
denoting necessity of weaning, 298.
Table of duration of pregnancy, 185.
Taking, the frequent, of physic, 31.
Teat, india-rubber, and shield, 276.
Teeth frequently decay in pregnancy, 156.
and gums, 55.
Temperature of a lying-in room, 237.
“The top of the morning,” 72.
Things which will be wanted at a labor, 216.
Tic-douloureux, 157.
Tight lacing injurious to a young wife, 81.
ill effects of, in pregnancy, 123.
Time when a child should be weaned, 293.
Toothache in pregnancy, 155.
remedies for, 156.
Tooth extraction, the danger of, in pregnancy, 155.
“Trap to catch sunbeam,” 81.
True labor pains, 202.
“Trying of a pain,” 221.
“Turn of years,” 115.
Unladylike, on being, 96.
Urine, retention of, 240.
Vaginal syringe, 196.
Veal-and-milk broth, 251.
Veins, enlarged, of the leg, 152.
Ventilation, importance of, 33, 128.
manner of performing, 34.
of lying-in room, 254.
thorough, 36.
Visitors in a lying-in room, 238.
Walk before breakfast, 47.
in frosty weather, 28.
Walking glorious exercise, 23.
Warm ablutions after labor, 245.
baths for infants apparently still-born, 231.
Water poisoned by drains, 132.
Waters, “the breaking of the,” 202.
Weaning, 292.
Weaning an infant, the method of, 294.
Wellington, the Duke of, 67.
Westmoreland and Cumberland poor women, 229.
Wet-nurses’ and mother’s milk, 265.
Whining and repining, 95.
“Whites” during pregnancy, 169.
cause miscarriage, 112.
when not pregnant, 112.
Wife, a domestic, 90.
educated to be useful, 90.
instructing servants, 92.
the mission of a, 22.
the profession of a, 90.
young, 13.
Wine, abuse of, 57.
bibbing causes barrenness, 57.
drinking of, 55.
in France, 61.
on children taking, 61.
much injures complexion, 64.
during suckling, 267.
Womb, bearing down of, 247.
Work, a cure for many ailments, 93.
Wormwood on nipples in weaning, 296.
ADVICE TO A MOTHER
ON THE
MANAGEMENT OF HER CHILDREN,
AND ON THE
TREATMENT ON THE MOMENT
OF
SOME OF THEIR MORE PRESSING ILLNESSES AND ACCIDENTS.
BY
PYE HENRY CHAVASSE,
FELLOW OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND; FELLOW OF THE
OBSTETRICAL SOCIETY OF LONDON; FORMERLY PRESIDENT OF QUEEN’S COLLEGE
MEDICO-CHIRURGICAL SOCIETY, BIRMINGHAM; AUTHOR OF “ADVICE TO A WIFE ON
THE MANAGEMENT OF HER OWN HEALTH.”
“Lo, children and the fruit of the womb are an heritage and cometh of
the Lord.”
SEVENTEENTH EDITION.
PHILADELPHIA
J. B. LIPPINCOTT & CO.
1881.
TO
SIR CHARLES LOCOCK, BART., F.R.S.,
FIRST PHYSICIAN-ACCOUCHEUR TO HER MAJESTY THE QUEEN.
DEAR SIR CHARLES:
Your kind and flattering approval of this little Book, and your valuable
suggestions for its improvement, demand my warmest gratitude and
acknowledgments, and have stimulated me to renewed exertions to make it
still more complete and useful, and thus more worthy of your
approbation.
You have greatly added to my obligation, by allowing me to indicate
those passages of the work that you considered required correction,
addition, and improvement. On reference to these pages, it will be at
once perceived how greatly I am indebted to you, and how much I have
profited by your valuable advice.
I have the honor to remain,
Dear Sir Charles,
Your faithful and obliged servant,
PYE HENRY CHAVASSE.
PRIORY HOUSE, OLD SQUARE,
BIRMINGHAM.
PREFACE.
The sale of this book is enormous; where hundreds were formerly disposed
of, thousands are now sold; and the sale still increases with increasing
velocity.
The book has been a great success: I had the good fortune, some thirty
years ago, to turn up new ground—to hit upon a mine, which I have, ever
since, even until now, worked with my best energy and ability. One cause
of the immense success this work has achieved is, that it treats of some
subjects which, although they be subjects of vital importance to the
well-being of children, all other works of a kindred nature do not even
touch upon.
I have, during the last thirty years, been constantly on the watch to
give a mother additional and useful advice on the management of her
children; so that, in point of fact, this present edition consists of
more than treble the quantity of information contained in the earlier
editions. The quantity is not only increased, but the quality is, I
trust, greatly improved.
The last edition, comprising five thousand copies, has been rapidly
exhausted: to supply the increased and increasing demand, seven thousand
copies of this—the NINTH EDITION—are now published. The enormous, and,
for a medical work, unusually large sale, is most gratifying to me as
well as to my worthy publishers.
I have taken great pains to improve the present edition: much new matter
has been introduced; several paragraphs have been abridged; some
portions have been rewritten—as my extended experience has enabled me to
enter on many of the subjects more fully, and, I trust, more usefully;
and the book has been throughout thoroughly revised.
Lord Chesterfield, in writing to his son, once said: “If I had had
longer time, I would have written you a shorter letter.” Now, I have
found time both to curtail some of the passages of this work, and to
remove many, indeed, a large majority of the quotations from the text. I
have, consequently, been able to fill up the various spaces with much
original, and, I trust, useful matter; and thus, without materially
increasing the bulk of the book, to keep it within reasonable bounds.
The _notes_ and _annotations_ of Sir CHARLES LOCOCK are, however,
perfectly intact—they are too valuable either to be omitted, or to be,
in the slightest degree, curtailed.
The writing, revising, improving, and enlarging of this, and of my other
work—_Advice to a Wife_—have, for upwards of a quarter of a century,
been my absorbing occupation—my engrossing study. I have loved, and
cherished, and tended the two books as though they were my children; and
have, in each successive edition, always striven to bring them, as
nearly as my abilities would allow, to a state of completeness—to make
them, in fact, a perfect _Vade-mecum_ for Wives and Mothers. I might
truly say, that the occupation has ever been to me a source of pure and
unalloyed enjoyment. The correction of the pages has often cheered me
when I have been in grief or in trouble, and has soothed me when, in my
profession, I have been either harassed or vexed: truly, I have had my
reward! My fervent desire is, that some portion of the pleasure and
comfort I have derived from the writing of these books may be
experienced by my readers. If it be only a tithe of what I myself have
felt, I shall be more than amply rewarded for my pains.
P. H. C.
CONTENTS.
PART I.—INFANCY.
PAGE
PRELIMINARY CONVERSATION 1013
ABLUTION 1016
MANAGEMENT OF THE NAVEL 1024
CLOTHING 1028
DIET 1032
VACCINATION 1056
DENTITION 1062
EXERCISE 1075
SLEEP 1077
THE BLADDER AND THE BOWELS 1084
AILMENTS, DISEASE, ETC. 1085
CONCLUDING REMARKS ON INFANCY 1119
PART II.—CHILDHOOD.
ABLUTION 1120
CLOTHING 1123
DIET 1132
THE NURSERY 1150
EXERCISE 1172
AMUSEMENTS 1177
EDUCATION 1183
SLEEP 1188
SECOND DENTITION 1194
DISEASE, ETC. 1195
WARM BATHS 1294
WARM EXTERNAL APPLICATIONS 1295
ACCIDENTS 1297
PART III.—BOYHOOD AND GIRLHOOD.
ABLUTION, ETC. 1318
CLOTHING 1327
DIET 1332
AIR AND EXERCISE 1337
AMUSEMENTS 1341
EDUCATION 1347
HOUSEHOLD WORK FOR GIRLS 1355
CHOICE OF PROFESSION OR TRADE 1355
SLEEP 1359
ON THE TEETH AND THE GUMS 1364
PREVENTION OF DISEASE, ETC. 1366
INDEX 1403
ADVICE TO A MOTHER.
PART I.—INFANCY.
_I hardly know so melancholy a reflection, as that Parents are
necessarily the sole directors of the management of Children; whether
they have, or have not judgment, penetration, or taste, to perform the
task._—GREVILLE.
_Man’s breathing Miniature!_—COLERIDGE.
PRELIMINARY CONVERSATION.
1. _I wish to consult you on many subjects appertaining to the
management and the care of children,—will you favor me with your advice
and counsel?_
I shall be happy to accede to your request, and to give you the fruits
of my experience in the clearest manner I am able, and in the simplest
language I can command—freed from all technicalities. I will endeavor to
guide you in the management of the health of your offspring;—I will
describe to you the _symptoms_ of the diseases of children;—I will warn
you of approaching danger, in order that you may promptly apply for
medical assistance before disease has gained too firm a footing;—I will
give you the _treatment_ on the moment of some of their more pressing
illnesses—when medical aid cannot quickly be procured, and where delay
may be death;—I will instruct you, in case of accidents, on the
_immediate_ employment of remedies—where procrastination may be
dangerous;—I will tell you how a sick child should be nursed, and how a
sick room ought to be managed;—I will use my best energy to banish
injurious practices from the nursery;—I will treat of the means to
prevent disease where it be possible;—I will show you the way to
preserve the health of the healthy,—and how to strengthen the
delicate;—and will strive to make a medical man’s task more agreeable to
himself,—and more beneficial to his patient,—by dispelling errors and
prejudices, and by proving the importance of your _strictly_ adhering to
his rules. If I can accomplish any of these objects, I shall be amply
repaid by the pleasing satisfaction that I have been of some little
service to the rising generation.
2. _Then you consider it important that I should be made acquainted
with, and be well informed upon, the subjects you have just named?_
Certainly. I deem it to be your imperative duty to _study_ the subjects
well. The proper management of children is a vital question,—a mother’s
question,—and the most important that can be brought under the
consideration of a parent; and, strange to say, it is one that has been
more neglected than any other. How many mothers undertake the
responsible management of children without previous instruction, or
without forethought; they undertake it as though it may be learned
either by intuition or by instinct or by affection! The consequence is,
that frequently they are in a sea of trouble and uncertainty, tossing
about without either rule or compass; until, too often, their hopes and
treasures are shipwrecked and lost!
The care and management, and consequently the health and future
well-doing of the child, principally devolve upon the mother; “for it is
the mother after all that has most to do with the making or the marring
of the man.”[130] Dr. Guthrie justly remarks that—“Moses might never
have been the man he was unless he had been nursed by his own mother.
How many celebrated men have owed their greatness and their goodness to
a mother’s training!” Napoleon owed much to his mother. “‘The fate of a
child,’ said Napoleon, ‘is always the work of his mother;’ and this
extraordinary man took pleasure in repeating, that to his mother he owed
his elevation. All history confirms this opinion.... The character of
the mother influences the children more than that of the father, because
it is more exposed to their daily, hourly observation.”[131]
I am not overstating the importance of the subject in hand when I say
that a child is the most valuable treasure in the world, that “he is the
precious gift of God,” that he is the source of a mother’s greatest and
purest enjoyment, that he is the strongest bond of affection between her
and her husband, and that
“A babe in a house is a well-spring of pleasure,
A messenger of peace and love.”[132]
In the writing of the following pages I have had one object constantly
in view—namely, health—
“That salt of life, which does to all a relish give;
Its standing pleasure, and intrinsic wealth,
The body’s virtue, and the soul’s good fortune—health.”
ABLUTION.
3. _Is a new-born infant, for the first time, to be washed in warm or in
cold water?_
It is not an uncommon plan to use _cold_ water from the first, under the
impression of its strengthening the child. This appears to be a cruel
and barbarous practice, and is likely to have a contrary tendency.
Moreover, it frequently produces either inflammation of the eyes, or
stuffing of the nose, or inflammation of the lungs, or looseness of the
bowels. Although I do not approve of _cold_ water, we ought not to run
into an opposite extreme, as _hot_ water would weaken and enervate the
babe, and thus would predispose him to disease. Lukewarm _rain_ water
will be the best to wash him with. This, if it be summer, should have
its temperature gradually lowered, until it be quite cold; if it be
winter, a _dash_ of warm water ought still to be added, to take off the
chill.
It will be necessary to use soap—Castile soap being the best for the
purpose—it being less irritating to the skin than the ordinary soap.
Care should be taken that it does not get into the eyes, as it may
produce either inflammation or smarting of those organs.
If the skin be delicate, or if there be any excoriation or
“breaking-out” on the skin, then Glycerin soap, instead of the Castile
soap, ought to be used.
4. _At what age do you recommend a mother to commence washing her infant
in the tub or in the nursery-basin?_[133]
As soon as the navel-string comes away.[134] Do not be afraid of
water,—and that in plenty,—as it is one of the best strengtheners to a
child’s constitution. How many infants suffer, for the want of water,
from excoriation!
5. _Which do you prefer—flannel or sponge—to wash a child with?_
For the first part of the washing a piece of flannel is very useful—that
is to say, to use with the soap, and to loosen the dirt and the
perspiration; but for the finishing-up process, a sponge—a large
sponge—is superior to flannel, to wash all away, and to complete the
bathing. A sponge cleanses and gets into all the nooks, corners, and
crevices of the skin. Besides, sponge, to finish up with, is softer and
more agreeable to the tender skin of a child than flannel. Moreover, a
sponge holds more water than flannel, and thus enables you to stream the
water more effectually over him. A large sponge will act like a
miniature shower-bath, and will thus brace and strengthen him.
6. _To prevent a new-born babe from catching cold, is it necessary to
wash his head with brandy?_
It is _not_ necessary. The idea that it will prevent cold is erroneous,
as the rapid evaporation of heat which the brandy causes is more likely
to give than to prevent cold?
7. _Ought that tenacious, paste-like substance, adhering to the skin of
a new-born babe, to be washed off at the first dressing?_
It should, provided it be done with a soft sponge and with care. If
there be any difficulty in removing the substance, gently rub it, by
means of a flannel,[135] either with a little lard, or fresh butter, or
sweet oil. After the parts have been well smeared and gently rubbed with
the lard, or oil, or butter, let all be washed off together, and be
thoroughly cleansed away, by means of a sponge and soap and warm water,
and then, to complete the process, gently put him for a minute or two in
his tub. If this paste-like substance be allowed to remain on the skin,
it might produce either an excoriation or a “breaking-out.” Besides, it
is impossible, if that tenacious substance be allowed to remain on it,
for the skin to perform its proper functions.
8. _Have you any general observations to make on the washing of a
new-born infant?_
A babe ought, every morning of his life, to be thoroughly washed from
head to foot; and this can only be properly done by putting him bodily
either into a tub, or into a bath, or into a large nursery-basin half
filled with water. The head, before placing him in the bath, should be
first wetted (but not dried); then immediately put him into the water,
and, with a piece of flannel well soaked, cleanse his whole body,
particularly his armpits, between his thighs, his groins, and his hams;
then take a large sponge in hand, and allow the water from it, well
filled, to stream all over his body, particularly over his back and
loins. Let this advice be well observed, and you will find the plan most
strengthening to your child. The skin must, after every bath, be
thoroughly but quickly dried with warm, dry, soft towels, first
enveloping the child in one, and then gently absorbing the moisture with
the towel, not roughly scrubbing and rubbing his tender skin as though a
horse were being rubbed down.
The ears must after each ablution be carefully and well dried with a
soft dry napkin; inattention to this advice has sometimes caused a
gathering in the ear—a painful and distressing complaint; and at other
times it has produced deafness.
Directly after the infant is dried, all the parts that are at all likely
to be chafed ought to be well powdered. After he is well dried and
powdered, the chest, the back, the bowels, and the limbs should be
gently rubbed, taking care not to expose him unnecessarily during such
friction.
He ought to be partially washed every evening; indeed it may be
necessary to use a sponge and a little warm water frequently during the
day, namely, each time after the bowels have been relieved. _Cleanliness
is one of the grand incentives to health_, and therefore cannot be too
strongly insisted upon. If more attention were paid to this subject,
children would be more exempt from chafings, “breakings-out,” and
consequent suffering, than they at present are. After the second month,
if the babe be delicate, the addition of two handfuls of table salt to
the water he is washed with in the morning will tend to brace and
strengthen him.
With regard to the best powder to dust an infant with, there is nothing
better for general use than starch—the old-fashioned starch _made of
wheaten flour_—reduced by means of a pestle and mortar to a fine powder;
or Violet Powder, which is nothing more than finely-powdered starch
scented, and which may be procured of any respectable chemist. Some
mothers are in the habit of using white lead; but as this is a poison,
it ought _on no account_ to be resorted to.[136]
9. _If the parts about the groin and fundament be excoriated, what is
then the best application?_
After sponging the parts with tepid _rain_ water, holding him over his
tub, and allowing the water from a well-filled sponge to stream over the
parts, and then drying them with a soft napkin (not rubbing, but gently
dabbing with the napkin), there is nothing better than dusting the parts
frequently with finely-powdered Native Carbonate of Zinc. The best way
of using this powder is, tying up a little of it in a piece of muslin,
and then gently dabbing the parts with it.
Remember excoriations are generally owing to the want of water—to the
want of an abundance of water. An infant who is every morning well
soused and well swilled with water, seldom suffers either from
excoriations or from any other of the numerous skin diseases.
Cleanliness, then, is the grand preventive of, and the best remedy for,
excoriations. Naaman the Syrian was ordered “to wash and be clean,” and
he was healed, “and his flesh came again like unto the flesh of a little
child, and he was clean.”[137] This was, of course, a miracle; but how
often does water, without any special intervention, act miraculously
both in preventing and in curing skin diseases!
An infant’s clothes, napkins especially, ought never to be washed with
soda; the washing of napkins with soda is apt to produce excoriations
and breakings-out. “As washerwomen often deny that they use soda, it can
be easily detected by simply soaking a clean napkin in fresh water and
then tasting the water; if it be brackish and salt, soda has been
employed.”[138]
10. _Who is the proper person to wash and dress the babe?_
The monthly nurse, as long as she is in attendance; but afterward the
mother, unless she should happen to have an experienced, sensible,
thoughtful nurse, which, unfortunately, is seldom the case.[139]
11. _What is the best kind of apron for a mother, or for a nurse to
wear, while washing the infant?_
Flannel—a good, thick, soft flannel, usually called bath-coating—apron,
made long and full, and which of course ought to be well dried every
time before it is used.
12. _Perhaps you will kindly recapitulate, and give me further advice on
the subject of the ablution of my babe?_
Let him by all means, then, as soon as the navel-string has separated
from the body, be bathed either _in_ his tub, or _in_ his bath, or _in_
his large nursery-basin; for if he is to be strong and hearty, _in_ the
water every morning he must go. The water ought to be slightly warmer
than new milk. It is dangerous for him to remain for a long period in
his bath; this, of course, holds good in a tenfold degree if the child
has either a cold, or a pain in his bowels. Take care that, immediately
after he comes out of his tub, he is well dried with warm towels. It is
well to let him have his bath the first thing in the morning, and before
he has been put to the breast; let him be washed before he has his
breakfast; it will refresh him and give him an appetite. Besides, he
ought to have his morning ablution on an empty stomach, or it may
interfere with digestion, and might produce sickness and pain. In
putting him in his tub, let his head be the first part washed. We all
know, that in bathing in the sea, how much better we can bear the water
if we first wet our head; if we do not do so, we feel shivering and
starved and miserable. Let there be no dawdling in the washing; let it
be quickly over. When he is thoroughly dried with warm _dry_ towels, let
him be well rubbed with the warm hand of the mother or of the nurse. As
I previously recommended, while drying him and while rubbing him, let
him repose and kick and stretch either on the warm flannel apron, or
else on a small blanket placed on the lap. One bathing in the tub, and
that in the morning, is sufficient, and better than night and morning.
During the day, as I before observed, he may, after the action either of
his bowels or of his bladder, require several spongings of lukewarm
water, _for cleanliness is a grand incentive to health and comeliness_.
Remember it is absolutely necessary to every child from his earliest
babyhood to have a bath, to be immersed every morning of his life in the
water. This advice, unless in cases of severe illness, admits of no
exception. Water to the body—to the whole body—is a necessity of life,
of health, and of happiness; it wards off disease, it braces the nerves,
it hardens the frame, it is the finest tonic in the world. Oh, if every
mother would follow to the very letter this advice, how much misery, how
much ill health, might then be averted!
MANAGEMENT OF THE NAVEL.
13. _Should the navel-string be wrapped in_ SINGED _rag?_
There is nothing better than a piece of fine old linen rag, _unsinged_;
when singed, it frequently irritates the infant’s skin.
14. _How ought the navel-string to be wrapped in the rag?_
Take a piece of soft linen rag, about three inches wide and four inches
long, and wrap it neatly round the navel-string, in the same manner you
would around a cut finger, and then, to keep on the rag, tie it with a
few rounds of whity-brown thread. The navel-string thus covered should,
pointing upward, be placed on the belly of the child, and must be
secured in its place by means of a flannel belly-band.
15. _If, after the navel-string has been secured, bleeding should (in
the absence of the medical man) occur, how must it be restrained?_
The nurse or the attendant ought immediately to take off the rag, and
tightly, with a ligature composed of four or five whity-brown threads,
retie the navel-string; and to make assurance doubly sure, after once
tying it, she should pass the threads a second time around the
navel-string and tie it again; and after carefully ascertaining that it
no longer bleeds, fasten it up in the rag as before. Bleeding of the
navel-string rarely occurs, yet, if it should do so—the medical man not
being at hand—the child’s after-health, or even his life, may, if the
above directions be not adopted, be endangered.
16. _When does the navel-string separate from the child?_
From five days to a week after birth; in some cases not until ten days
or a fortnight, or even, in rare cases, not until three weeks.
17. _If the navel-string does not at the end of a week come away, ought
any means to be used to cause the separation?_
Certainly not; it ought always to be allowed to drop off, which, when in
a fit state, it will readily do. Meddling with the navel-string has
frequently cost the babe a great deal of suffering, and in some cases
even his life.
18. _The navel is sometimes a little sore after the navel-string comes
away; what ought then to be done?_
A little simple cerate should be spread on lint, and be applied every
morning to the part affected; and a white-bread poultice, every night,
until it be quite healed.
19. _What are the causes of a rupture of the navel? What ought to be
done? Can it be cured?_
(1.) A rupture of the navel is sometimes occasioned by a meddlesome
nurse. She is very anxious to cause the navel-string to separate from
the infant’s body, more especially when it is longer in coming away than
usual. She, therefore, before it is in a fit state to drop off, forces
it away. (2.) The rupture, at another time, is occasioned by the child
incessantly crying. A mother, then, should always bear in mind that a
rupture of the navel is often caused by much crying, and that it
occasions much crying; indeed, it is a frequent cause of incessant
crying. A child, therefore, who, without any assignable cause, is
constantly crying, should have his navel carefully examined.
A rupture of the navel ought always to be treated early—the earlier the
better. Ruptures of the navel can only be _cured_ in infancy and in
childhood. If it be allowed to run on until adult age, a _cure_ is
impossible. Palliative means can then only be adopted.
The best treatment is a Burgundy pitch plaster, spread on a soft piece
of wash-leather about the size of the top of a tumbler, with a properly
adjusted pad (made from the plaster) fastened on the center of the
plaster, which will effectually keep up the rupture, and in a few weeks
will cure it. It will be necessary, from time to time, to renew the
plaster until the cure be effected. These plasters will be found both
more efficacious and pleasant than either a truss or an elastic bandage;
which latter appliances sometimes gall, and do more harm than they do
good.
20. _If a child has a groin rupture (an inguinal rupture), can that also
be cured?_