The Care and Feeding of Children | Page 8

of sleep,
household cares, social dissipation etc., have more than anything else to
do with the failure of the modern mother as a nurse. Uncontrolled
emotions, grief, excitement, fright, passion, may cause milk to disagree
with the child; at times they may excite acute illness, and at other times
they may cause a sudden and complete disappearance of the milk.
Does menstruation affect the milk?
In nearly all cases the quantity of milk is lessened so that the infant is
not satisfied and may gain less in weight or not at all. In many cases the
quality of the milk is also affected to such a degree as to cause slight
disturbances of digestion, such as restlessness, colic, and perhaps some
derangement of the bowels. In a few, attacks of acute indigestion are
excited.
Is regular menstruation a reason for stopping nursing?

Not invariably; as a rule both functions do not go on together. But if the
child is gaining regularly in weight between the periods, nursing may
be continued indefinitely, although it may be well to feed the infant
wholly or in part during the first day or two that the mother is unwell.
What symptoms indicate that a nursing infant is well nourished?
The child has a good colour, sleeps for two or three hours after nursing,
or, if awake, is quiet, good-natured, and apparently comfortable. It has
normal movements of the bowels and gains steadily in weight.
_What symptoms indicate that a child who is nursing is not properly
nourished?_
It does not gain and may even lose in weight. It no longer exhibits its
usual energy and playfulness, but is either listless and indifferent or
cross, fretful and irritable, and is apt to sleep poorly. It grows pale and
anæmic and its tissues become soft and flabby. When the milk is scanty
it will often nurse a long time at the breasts, sometimes three quarters
of an hour, before stopping. At other times it may take the breast for a
moment only, and then turn away in apparent disgust.
What should be done when such symptoms appear?
This depends upon the severity of the symptoms and how long they
have lasted. If the child has made no gain for three or four weeks, or is
losing weight, immediate weaning will probably be necessary; in any
case, other food in addition to the breast milk should be given at once.
One may begin by alternating the nursing and the bottle-feeding and
increase the number of bottle-feedings as may be indicated by the
results.
Is there any objection to a baby being partly nursed and partly fed?
None whatever; it is often better from the outset to feed the baby during
the night, in order not to disturb the mother's rest.
_What symptoms indicate that the mother's milk disagrees with the

child?_
The child suffers from almost constant discomfort sleeps; little and then
restlessly, cries a great deal, belches gas from the stomach, and passes
much by the bowels, or if not passed, the gas accumulates and causes
abdominal distention and colicky pain. There may be vomiting, but
more often the trouble is intestinal. Sometimes the bowels are
constipated, but usually the movements are frequent, loose, green,
contain mucus and are passed with much gas.
What should be done under these circumstances?
If the symptoms have persisted for two or three weeks and the child is
not gaining in weight, there is little chance of improvement, and the
child should be taken from the breast at once. If there is some gain in
weight, one may try for a little longer, endeavouring to improve the
mother's milk by rest, fresh air, careful diet, etc. However, one should
always realize that the trouble is with the milk, not with the child.
What changes should be made if a nursing infant habitually vomits?
If this occurs soon after nursing, the infant has usually taken too much
and the time of nursing should be shortened, or one breast may be
given instead of two; the nursing should also be interrupted by
occasional rests, so that the milk is not taken too fast.
If the vomiting occurs some time after nursing and is repeated, it is a
sign of indigestion; often because the milk is too rich in fat. The
intervals between nursings should then be lengthened; the breast milk
may be diluted by giving one or two tablespoonfuls of plain boiled
water, lime-water, or barley-water, five or ten minutes before nursing;
the mother should eat less hearty food, especially less meat.
What should be done if the infant has frequent or habitual colic?
This is usually because the milk is too rich in proteids; the mother
should take more out-of-door exercise, eat less meat, and seek to
control her emotions; all causes of