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37
I.—The Health of the Mother before the Birth.
Many women regard suffering during pregnancy as a natural accompaniment
of this state. The condition of pregnancy should not, however,
be regarded as pathological, but attention should rather be devoted to
the prevention, and, if necessary, treatment of such ailments or minor
departures from the normal which occur all too frequently among
pregnant women.
In a small percentage of cases pathological conditions must be
expected to supervene, but the total sum of physical or mental disturbance
or suffering in this numerous and important class of the
community could undoubtedly be in great degree eliminated were due
attention given to the adoption of suitable hygienic measures.
The feeding of the expectant mother is clearly a point of considerable
importance. She should be encouraged to provide nourishing food for
herself, and directions as to the avoidance of unsuitable substances
should be given; in this latter category such things as alcohol in any
form, vinegar, pickles, &c., will be included.
The clothing of the mother is frequently of unsuitable type. The
health visitor should bear in mind that no part of the body should be
constricted by clothing, more especially in cases where there is any
tendency to varicosity of veins or to oedema of the feet and ankles.
Constriction above or below the knee should be avoided.
The presence of a septic focus or foci in any part of the mother's
organism will be a source of danger to the infant. Decayed teeth or
pyorrhoea alveolaris even in a mild degree will be liable to affect the
child detrimentally. The habit of excessive kissing of infants is to be
deprecated, but it is hardly probable that it will be eliminated. Dummy
teats, which at the present time are regrettably prevalent, and the teats
of the feeding bottles of artificially-fed children, are unfortunately not
infrequently moistened in the mother's mouth before being put into that
of the child. The danger to the infant from this revolting practice,
especially if carious teeth or other septic focus be present, need hardly
be emphasised.
The care and condition of the breasts should be inquired into. The
importance of cleanliness of the breasts is perhaps not sufficiently
realised. The common practice of "hardening" the nipples with
alcohol before the confinement is not desirable, and cracked nipples may
best be avoided by strict attention to cleanliness and the application of
some emollient or of friar's balsam. The difficulty attending breastfeeding
consequent on the condition of depressed nipples may be aided
by pulling them outwards during the later months of pregnancy.