DEFICIENCY OF MILK

If this deficiency exist from the earliest weeks after delivery, and
it is not quickly remedied by the means presently to be pointed out, a
wet-nurse must be obtained. It will be of no avail partially to nurse,
and partially to feed the infant at this period and under such
circumstances, for if it is not soon lost, it will only live for a few
months, or a year at most, and be an object of the greatest anxiety and
grief to its parent. This condition arises from the unwholesomeness of
the mother's milk, united with the artificial food; for when the milk
is deficient from the first, and continues so notwithstanding the means
used for its increase, it is invariably unhealthy in its quality.
This deficiency, however, may exist, and even at a very early period
after delivery, and yet be removed. This, however, is not to be
accomplished by the means too frequently resorted to; for it is the
custom with many, two or three weeks after their confinement, if the
supply of nourishment for the infant is scanty, to partake largely of
malt liquor for its increase. Sooner or later this will be found
injurious to the constitution of the mother: but how, then, is this
deficiency to be obviated? Let the nurse keep but in good health, and
this point gained, the milk, both as to quantity and quality, will be
as ample, nutritious, and good, as can be produced by the individual.
I would recommend a plain, generous, and nutritious diet; not one
description of food exclusively, but, as is natural, a wholesome,
mixed, animal, and vegetable diet, with or without wine or malt liquor,
according to former habit; and, occasionally, where malt liquor has
never been previously taken, a pint of good sound ale may be taken
daily with advantage, if it agree with the stomach. Regular exercise in
the open air is of the greatest importance, as it has an extraordinary
influence in promoting the secretion of healthy milk. Early after
leaving the lying-in room, carriage exercise, where it can be
obtained, is to be preferred, to be exchanged, in a week or so, for
horse exercise, or the daily walk. The tepid, or cold salt-water shower
bath, should be used every morning; but if it cannot be borne, sponging
the body withsalt-water must be substituted.
By adopting with perseverance the foregoing plan, a breast of milk
will be obtained as ample in quantity, and good in quality, as the
constitution of the parent can produce, as the following case proves:
On the 17th September, 1839, I attended a lady twenty-four years of
age, a delicate, but healthy woman, in her first confinement. The
labour was good. Every thing went on well for the first week, except
that, although the breasts became enlarged, and promised a good supply
of nourishment for the infant, at its close there was merely a little
oozing from the nipple. During the next fortnight a slight, but very
gradual increase in quantity took place, so that a dessert spoonful
only was obtained about the middle of this period, and perhaps double
this quantity at its expiration. In the mean time the child was
necessarily fed upon an artificial diet, and as a consequence its
bowels became deranged, and a severe diarrhoea followed. A wet-nurse
was advised for the child as the only means of saving its life, and
change of air for the mother as the most likely expedient (in
connection with the general treatment pointed out above) for obtaining
a good breast of milk. Accordingly, on the 5th October, the patient,
taking with her the infant and a wet-nurse, went a few miles from town.
For three or four days it was a question whether the little one would
live, for so greatly had it been reduced by the looseness of the bowels
that it had not strength to grasp the nipple of its nurse; the milk,
therefore, was obliged to be drawn, and the child fed with it from a
spoon. After the lapse of a few days, however, it could obtain the
breast-milk for itself; and, to make short of the case, on the 25th of
the same month, the mother and child returned home, the former having a
very fair proportion of healthy milk in her bosom, and the child
perfectly recovered and evidently thriving fast upon it.
Where, however, there has been an early deficiency in the supply of
nourishment, it will most frequently happen that, before the sixth or
seventh month, the infant's demands will be greater than the mother can
meet. The deficiency must be made up by artificial food, which must be
of a kind generally employed before the sixth month, and given through
the bottle. If, however, this plan of dieting should disagree, the
child must, even at this period, have a wet-nurse.
Women who marry comparatively late in life, and bear children,
generally have a deficiency of milk after the second or third month:
artificial feeding must in part be here resorted to.