Galactagogues are valueless in the ma jority of cases, most of them exerting practically no influence upon the gland. Occasionally a slight stimulating effect may be noted, but this lasts only a short time, and the organ soon lapses into its former torpor.
Beer, ale, porter, and other malt liquors, especially alcoholic beverages, are more hurtful than beneficial, and what improvement may show itself is due mainly to the confidence in the bev erage taken, through the agency of auto suggestion. The quantity of milk may be increased, but its quality is compro mised, especially when poor beer is con sumed by the mother. It encourages the production of fat at the expense of the casein or milk-sugar. Pure malt may be substituted with great advantage.
It is an error to suppose that stout or porter improves milk. Another error is the belief that beef-tea and chicken-broth are good for nursing mothers. Angel Money (Austral. Med. Gaz., Jan. 20, '97).
Sonsatose exercises a specific effect upon the mammary glands of nursing mothers; it produces an ample secretion of the mother's milk, and causes the ail ments occurring during nursing to disap pear quickly. The dose consists of 1 tea spoonful in a cup of warns milk, soup, cocoa, etc., from three to four times a day. Felix Heymann (Deut. med.-Zeit., Nos. 59, 63, '98).
Probably the most satisfactory among the galactagogues is jaborandi. The fluid extract or the tincture may be given in 7.,-drachm doses. The active perspiration and salivation produced are objectionable, however, while the effects of the remedy are not lasting.
Case where the administration of 10 drops of the fluid extract of jaborandi every four hours to a patient whose milk had ceased for a fortnight effected a re establishment of the secretion. The pa tient, however, soon began to suffer from extreme nervous excitement with delu sions. On stopping the jaborandi the nervous and mental symptoms disap peared and also the secretion of milk.
Waugh (Lancet, Dec. 24, '87): Castor-oil leaves have always borne considerable reputation. A decoction is made by boiling well a handful of them in 3 to 4 quarts of pure water. The breasts are bathed with this decoction for fifteen to twenty minutes. Part of the boiled leaves is then thinly spread over the breast and allowed to remain until all moisture has been removed from them by evaporation, and probably, in some measure, by absorption. The pro cedure is repeated at short intervals until the milk flows upon suction by the child, which it usually does in the course of a few hours. (Routh.)
Galega is credited with galactagogue properties, to 1 drachm of the dried leaves being administered daily.
Electricity sometimes proves effective. A mild current (3 to 5 milliamperes) is passed through each breast after care fully wetting the sponges in salt-water and applying them on each side of the gland. By changing the position of the electrodes, every minute or so, to a neighboring spot, all the acini may be traversed by the.current during a sitting of ten minutes. The applications should be made every two or three hours. A strong current is more hurtful than beneficial. Artificial suction with the breast-pump and massage are greatly used. The extract of thyroid gland has recently given very satisfactory results.
Nine cases showing the value of thy roid-gland extract as a galaetagogue, the object being to increase the activity of the metabolic processes. In one of the cases the administration of four tabloids was sufficient to restore the lacteal se cretion, which continued as long as the tabloids were regularly taken. Neglect of the tabloid caused the milk to fail. In six cases the milk-supply returned in three days and became plentiful. In two, no influence on the milk observed, the patients being delicate, nervous, and worn out. R. R. Stawell (Intercolonial Med. Jour., Apr. 20, '97).
As to the diet, it should be as gen erous as the patient can digest. There is little to be gained by the common practice of prescribing two or three extra meals a day. The milk-supply as well as the general health of the woman will depend more upon what she digests and assimilates than upon the amount of food taken into the stomach. Three daily meals with, at most, a single liquid meal at bed-time, will generally be better than five or six. Milk should constitute a portion of the dietary. The difficulty in digesting milk, of which many patients complain, is, for the most part, imagi nary. If taken as a part of the meal and not in addition to it, it will, as a rule, be well borne. Frequently patients who cannot use cold milk can take it hot without difficulty.
The secretion of milk is said to be greatly diminished by fatty food. A vegetable diet reduces the proportion of butter and casein and diminishes the sugar. A meat diet has the opposite effect. Systematic nursing with strict observance of stated intervals is essential for its influence upon both the quantity and quality of the milk-secretion. (Charles Jewett.)