Deficiency of milk may exist 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:

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.

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, during 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.

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From the first moment the infant is applied to the breast, it must be nursed upon a certain plan. This is necessary to the well-doing of the child, and will contribute essentially to preserve the health of the parent, who will thus be rendered a good nurse, and her duty at the same time will become a pleasure.

This implies, however, a careful attention on the part of the mother to her own health; for that of her child is essentially dependent upon it. Healthy, nourishing, and digestible milk can be procured only from a healthy parent; and it is against common sense to expect that, if a mother impairs her health and digestion by improper diet, neglect of exercise, and impure air, she can, nevertheless, provide as wholesome and uncontaminated a fluid for her child, as if she were diligently attentive to these important points. Every instance of indisposition in the nurse is liable to affect the infant.

And this leads me to observe, that it is a common mistake to suppose that, because a woman is nursing, she ought therefore to live very fully, and to add an allowance of wine, porter, or other fermented liquor, to her usual diet. The only result of this plan is, to cause an unnatural degree of fulness in the system, which places the nurse on the brink of disease, and which of itself frequently puts a stop to the secretion of the milk, instead of increasing it. The right plan of proceeding is plain enough; only let attention be paid to the ordinary laws of health, and the mother, if she have a sound constitution, will make a better nurse than by any foolish deviation founded on ignorance and caprice.

The following case proves the correctness of this statement:

A young lady, confined with her first child, left the lying-in room at the expiration of the third week, a good nurse, and in perfect health. She had had some slight trouble with her nipples, but this was soon overcome.

The porter system was now commenced, and from a pint to a pint and a half of this beverage was taken in the four and twenty hours. This was resorted to, not because there was any deficiency in the supply of milk, for it was ample, and the infant thriving upon it; but because, having become a nurse, she was told that it was usual and necessary, and that without it her milk and strength would ere long fail.

After this plan had been followed for a few days, the mother became drowsy and disposed to sleep in the daytime; and headach, thirst, a hot skin, in fact, fever supervened; the milk diminished in quantity, and, for the first time, the stomach and bowels of the infant became disordered. The porter was ordered to be left off; remedial measures were prescribed; and all symptoms, both in parent and child, were after a while removed, and health restored.

Having been accustomed, prior to becoming a mother, to take a glass or two of wine, and occasionally a tumbler of table beer, she was advised to follow precisely her former dietetic plan, but with the addition of half a pint of barley-milk morning and night. Both parent and child continued in excellent health during the remaining period of suckling, and the latter did not taste artificial food until the ninth month, the parent’s milk being all-sufficient for its wants.

No one can doubt that the porter was in this case the source of the mischief. The patient had gone into the lying-in-room in full health, had had a good time, and came out from her chamber (comparatively) as strong as she entered it. Her constitution had not been previously worn down by repeated child-bearing and nursing, she had an ample supply of milk, and was fully capable, therefore, of performing the duties which now devolved upon her, without resorting to any unusual stimulant or support. Her previous habits were totally at variance with the plan which was adopted; her system became too full, disease was produced, and the result experienced was nothing more than what might be expected.

The plan to be followed for the first six months. Until the breast- milk is fully established, which may not be until the second or third day subsequent to delivery (almost invariably so in a first confinement), the infant must be fed upon a little thin gruel, or upon one third water and two thirds milk, sweetened with loaf sugar.

After this time it must obtain its nourishment from the breast alone, and for a week or ten days the appetite of the infant must be the mother’s guide, as to the frequency in offering the breast. The stomach at birth is feeble, and as yet unaccustomed to food; its wants, therefore, are easily satisfied, but they are frequently renewed. An interval, however, sufficient for digesting the little swallowed, is obtained before the appetite again revives, and a fresh supply is demanded.

At the expiration of a week or so it is essentially necessary, and with some children this may be done with safety from the first day of suckling, to nurse the infant at regular intervals of three or four hours, day and night. This allows sufficient time for each meal to be digested, and tends to keep the bowels of the child in order. Such regularity, moreover, will do much to obviate fretfulness, and that constant cry, which seems as if it could be allayed only by constantly putting the child to the breast. A young mother very frequently runs into a serious error in this particular, considering every expression of uneasiness as an indication of appetite, and whenever the infant cries offering it the breast, although ten minutes may not have elapsed since its last meal. This is an injurious and even dangerous practice, for, by overloading the stomach, the food remains undigested, the child’s bowels are always out of order, it soon becomes restless and feverish, and is, perhaps, eventually lost; when, by simply attending to the above rules of nursing, the infant might have become healthy and vigorous.

For the same reason, the infant that sleeps with its parent must not be allowed to have the nipple remaining in its mouth all night. If nursed as suggested, it will be found to awaken, as the hour for its meal approaches, with great regularity. In reference to night-nursing, I would suggest suckling the babe as late as ten o’clock p. m., and not putting it to the breast again until five o’clock the next morning. Many mothers have adopted this hint, with great advantage to their own health, and without the slightest detriment to that of the child. With the latter it soon becomes a habit; to induce it, however, it must be taught early.

The foregoing plan, and without variation, must be pursued to the sixth month.

After the sixth month to the time of weaning, if the parent has a large supply of good and nourishing milk, and her child is healthy and evidently flourishing upon it, no change in its diet ought to be made. If otherwise, however, (and this will but too frequently be the case, even before the sixth month) the child may be fed twice in the course of the day, and that kind of food chosen which, after a little trial, is found to agree best.

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