Breastfeeding

“ Feeding the baby whenever he cries produces indigestion, colic, irritability, self-indulgence.
Ten to fifteen minutes is the usual duration of a feeding. The first milk is thinner, the latter part of the nursing richer. Generally one breast is taken at a feeding, the other breast at the succeeding feeding; if the quantity in one is insufficient, both may be used at one feeding. Neither the mother nor the baby should go to sleep during the nursing. If the baby dawdles, the food may be taken away until the next time. He should stop a minute at the end of each five minutes, to rest and breathe. ”

“ A favorable frame of mind and state of good nutrition in the mother are the two indispensable factors in establishing breast-feeding and in maintaining the secretion of an adequate supply of breast-milk. These conditions, in turn, are both affected by her general mode of living, as long as the baby nurses.
Women with happy, cheerful dispositions usually nurse their babies satisfactorily, while those who worry and fret are likely to have an insufficient supply of milk, or milk of a poor quality. ”

“ But no such regularity should be insisted upon where both baby and mother suffer during the interval when nursing is denied; the former, hungry and crying lustily, and the mother under a nervous strain that is harmful to both. Let there be no hard-and-fast rules. Babies who feed as often as they feel like it (being allowed proper, though not necessarily long, intervals for digestion) generally suffer no ill effects and are healthy and strong. Mother’s milk, the natural feeding, should always be given, rather than any artificial food, when the supply is sufficient and good. ”

“ It may be necessary to supplement the breast feeding with suitably modified cows’ milk during menstruation, but the baby should be put to the breast regularly, just the same, for if the stimulation of the baby’s suckling is discontinued, the temporary reduction in the amount of the milk secreted will probably become permanent.
The state of pregnancy, however, is different, for though some women nurse a baby satisfactorily for some months after becoming pregnant, it is not considered advisable to subject any woman to the combined strain of pregnancy and nursing. ”

“ WEANING TOO EARLY.—The substitution of artificial food for the breast- milk of the mother, at a period when the digestive organs of the infant are too delicate for this change, is a frequent source of the affections now under consideration.
The attempt to wean a delicate child, for instance, when only six months old, will inevitably be followed by disorder of the stomach and bowels. Unless, therefore, a mother is obliged to resort to this measure, from becoming pregnant, or any other unavoidable cause, if she consult the welfare of her child, she will not give up nursing at this early period. ”

“ A good many doctors think that for the sake of giving the nursing mother an opportunity to go out, mingle with her friends, take in some music or a play, it is often a good plan to replace one breast feeding, sometime in the course of each day, with a bottle feeding. The freedom which this long interval between two nursings gives the mother for diversion and amusement, will often affect her general condition so favorably that the quality of her milk is definitely better than it otherwise would be and the baby is benefited as a result. ”

“ If the mother cannot supply it, a wet-nurse should be procured, and, if the infant has not the strength to suckle, the milk should be drawn from the breast and fed with a medicine-dropper or a spoon.
In addition to providing proper food and maintaining an even body- temperature, care must also be taken to protect these infants from various harmful influences such as too much handling, strong light, and loud noises. Although every precaution be observed, frequently all counts for nothing; but if the child does thrive, there is no reason for worry about its ultimate development. ”

“ The breast, before the infant is applied, should be sponged with tepid water and dried, and this should be again done when the child has finished suckling. The child's mouth should also be wiped out with a clean linen rag moistened with water or boracic lotion. Those who ought not to suckle are women who are consumptive, women who are very nervous and excitable, and those whose nipples are so depressed that they are obliged to give up all attempts at nursing. The diet of the nursing mother should be wholesome and nourishing, while at the same time easy of digestion. ”

“ HYGIENE OF THE MOTHER.—Since the mammary glands manufacture their product from the constituents of the mother's blood and their activity is controlled by her nerves, it is clear that her physical condition and her state of mind will influence the secretion of milk. Intelligent women who understand this desire to know how they should live that they may best insure an ample supply of good milk. Fortunately the first important step toward success has been taken when a mother wishes to nurse her baby ”

“ If the mother’s milk is satisfactory and the baby is doing well, it is often considered wiser not to discontinue the breast feeding entirely, during the hot summer months, even though the weaning falls due at this time. ”

“ We have learned how to modify cow's milk so that in chemical constituents, at least, it is a very close imitation of human milk; but human milk possesses, in addition to its chemical properties, other desirable qualities which cannot be instilled into an artificial food. We must agree, therefore, that attempts to disseminate a wider knowledge of the correct principles of bottle-feeding do not have the highest aim. Our real need is a vastly greater proportion of women who nurse their children.
THE BREASTS.—For success in nursing the first essential is healthful breasts. ”

“ Believing that many more mothers than do so should nurse their babies, we have carefully tabulated a number of aids to the milk supply, which we hope will be most earnestly tried before the baby is taken from the breast—for so many, many more bottle-fed babies die during the first year than the breast fed. The dangers of infection, the worry of the food preparation, the uncertainty of results, all call for a most untiring effort on the part of every doctor, nurse, and mother, in their endeavors to secure maternal nursing. ”

“ Artificial Feeding. There is no entirely adequate substitute for satisfactory maternal nursing, and any other food that is given to the young baby is at best a makeshift. Considering the baby’s delicacy, therefore, and his urgent needs, no pains should be spared to make any artificial food which is given to him as satisfactory as possible. In preparing and giving artificial food it must be borne in mind that normal breast milk:
1.490 Is exactly right in quantity, quality and proportion. 2. Is fresh, clean and sweet. 3. Is free from bacteria. 4. Tends to protect the baby from infection. ”

“ The important contra-indications for attempting breast-feeding are retracted nipples, tuberculosis, eclampsia, severe heart or kidney disease and certain acute infectious diseases such as typhoid fever.
It seldom happens that the mother who has had average prenatal care, followed by good care during and after delivery, is unable to nurse her baby if she orders her life in the way that is known to be necessary to promote and maintain lactation. The first essential is her real desire to nurse her baby ”

“ Under ideal circumstances the mother does not menstruate while she nurses her infant; whereas, if the breasts are not in use, the menstrual function returns six to eight weeks after delivery. Other pertinent clinical facts also lend weight to the opinion that the activity of the breasts, more technically called lactation, should not only prevent menstruation but also hinder the ripening of egg-cells in the ovary. Thus, the nursing infant has a potent influence upon the reproductive function of its mother, enabling it to preserve its food supply ”

“ The care of the MOTHER’S BREASTS is important. Before the milk is abundantly secreted, she should not be fretted by very frequent ineffectual attempts at nursing, though it may be necessary to draw out the nipple by means of a breast pump. The milk should be drawn out when the breasts become full and distended, and they should not be allowed to remain hard and sore. Apply fomentations; cabbage leaves, wilted in hot vinegar and 48water, or warm solution of carbolic acid, one part to eighty. ”

“ If the suggestion regarding the daily substitution of one bottle for the mother's milk has been adopted, there will be no difficulty in discontinuing breast-feeding whenever it is desirable; otherwise an infant may raise strong objection to the change. The mother, on the other hand, will not be seriously inconvenienced by the weaning, provided she leaves her breasts alone. ”

“ Her milk will be totally unfit for its nourishment: at one time it will be deficient in quantity, at another, so depraved in its quality, that serious disturbance to the infant's health, will ensue. The young and inexperienced mother, who is a parent for the first time, and altogether ignorant of the duties of her office, and at the same time most anxious to fulfil them faithfully, is but too frequently an instance in point; although at a future period she will generally make a good nurse. ”

“ After the first month the breast should not be given more frequently than once every two and a half or three hours during the day, and during the night once every three or four hours. As the child grows older, the time which is allowed to intervene between each meal should be increased,
Till the appearance of the first or milk teeth, the child should be fed exclusively on the breast milk; after that, which is Nature's indication that the stomach has become fit to digest other substances, the child may be given rusks, Mellin's food, Robb's biscuits, or Robinson's groats. ”

“ The busy house-mother who is nursing her baby is particularly warned against nursing the child when greatly exhausted. It is far better to keep the baby waiting a few minutes, while the mother sits down and rests or sips a glass of milk. Nursing a baby when overtired or overheated, or extremely nervous and angry, is positively injurious and unjust to the child.
Of the utmost importance in regulating the condition of the baby’s health through breast milk is the condition of the mother’s bowels. These should move once daily and, if possible, the movement should be natural. ”

“ In feeding premature babies, breast milk is ordinarily the most desirable food. If the baby is too feeble to nurse, as frequently occurs, the milk may be expressed from the breast of his mother or a wet nurse, by stripping or pumping, into a sterile receptacle, and if not used immediately it should be covered and placed in the refrigerator. Breast milk is sometimes used whole and sometimes diluted with water, and is given by gavage if the baby is very feeble ”

“ The production of milk is definitely stimulated by the baby’s suckling and will not continue for more than a few days without this stimulation, a fact to be remembered if, for any reason, it is desirable to dry up the breasts. The end earnestly to be desired is for the breasts to produce a quantity and quality of milk which will adequately nourish the baby during the first eight or ten months of his life, and with proper care and effort this ideal can nearly always be realized. ”

“ The baby should have maternal nursing if possible, during the summer, for breast-fed babies fall victim to summer complaint much less frequently than de bottle babies. Quite evidently, then, you should regulate your own life with even more care than usual—for the baby’s sake. He should be fed with absolute regularity, and as a rule, no matter what the nature of his food, it should be reduced one quarter to one third in amount when the days are very hot, and he should have an increased amount of cool, boiled water to drink. ”

“ To ascertain whether or not such a baby is getting enough milk it is customary to weigh him, without undressing him, before and after each nursing. Each fluid ounce of food will increase his weight one ounce. If the baby is not getting a normal amount of milk at each nursing he is often given enough modified milk after each meal to supply the deficit, but at the same time an effort is made to increase the supply of breast milk by improving the mother’s personal hygiene. ”

“ With infants it is always best, when it is possible, to give breast milk. As this is the natural food it requires less effort on the part of the digestive apparatus to become available. It has been proved that even during the time when the baby is nursing the milk is projected in spurts into the duodenum without waiting to be attacked by digestive enzymes in the stomach, and [Pg 244g] for this reason the breast-fed infant is more apt to be efficiently nourished than the artificially fed baby, who loses his dinner by vomiting before absorption has had a chance to occur. ”

“ Breast feeding is the most urgent single need of the baby, for whose coming we are making preparations, and practically every mother, excepting those with definite physical disability, can supply this need of her baby’s if she gives herself proper care both before and after his birth. You will be glad to know in this connection that everything that promotes your general health helps to prepare you to nurse your baby, but there is need also for care of the breasts and nipples themselves, to make the nursing satisfactory, and to prevent sore nipples and possibly even breast abscesses. ”