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involution had set in. A few day's systematic training and the yield of
milk steadily improves in the disused gland, and increases also in the
previously over-worked and partially exhausted breast.
A woman complains that her child is not satisfied with the breastmilk,
cries all day, and is vomiting profusely. She thinks the milk is
failing. Weighing the child before and after a series of meals shows the
"dissatisfaction" and vomiting to be due to the pain of over-feeding.
The milk supply is over abundant, and the average yield is between 6
and 7 ozs. per feed. Inspection of the glands often gives no information
which could lead one to expect a surplus of milk. By curtailing the feeds
the infant's behaviour rapidly alters, and in a few days it is thriving
and sleeping quietly. Again, an infant whose weight had been stationary
for several weeks was recommended for daily observation. Profuse
nasal catarrh was suspected as being responsible. The mother's statement
that her child turned from the breast was confirmed, and the amount
of milk taken at each feed was small. The effort to suckle with nasal
breathing completely obstructed produced rapid exhaustion in the child.
It was brought early in the morning and left until evening in a cot in the
garden, where a simple toilet of the nose was carried out. The condition
yielded in a few days and a rapid gain in weight followed, coinciding
with a great increase in the amount of milk taken.
A common type of case which we have treated here with conspicuous
success, but which is particularly resistant to any other means, is the
irritable nervous type of infant—very frequently a first-born—whose
exacting behaviour troubles and fatigues the parents. Here we get
almost uniformly a report from the nurse that the mother has no appreciation
of the need of quiet handling, punctual routine, and strict discipline.
Indeed, so worn out are the mothers of these screaming infants
that we not uncommonly take charge of the babies from morning to
night for several days, stop all attemps at breast-feeding for the time,
and send the women home to rest and make up their shortage of sleep.
The child is meanwhile hand fed and kept in the open air. After
two or three days breast-nursing is restarted and the mother trained
very carefully to avoid stimulating the child by jogging and jolting;
often her methods of handling a newborn are of the crudest. Most
make apt pupils; a few require weeks before they can nurse their
babies without provoking a storm of nervous crying. The improvements
which follow both in the yield of milk and in the infants' behaviour
and nutrition are most satisfactory. Moreover, the experience is
invaluable for any subsequent baby the woman may bear.