WHEN THE MILK IS EXCESSIVELY RICH, AND THE QUANTITY ABUNDANT, a reduction in the amount of meat, and the abstention from malted or alcoholic drinks, with active out-door exercise, will usually reduce the ingredients to the standard. This condition of the milk frequently obtains with wet-nurses.
To conclude, if the milk is very rich, the proportions can usually be reduced, by careful observation of the measures recommended, to a point where the in fant is able to digest it. If the milk is poor and scanty there is less probability of success. In either case, if, after two or three weeks' trial, the milk has not im proved, and the child continues to suffer from indigestion, it is better to wean at once, or secure another nurse, rather than persist longer in the attempt.
Wet-nursing.
In the majority of cases artificial feed ing is to be preferred to wet-nursing, but in some cases the latter is a necessity. To secure a good wet-nurse is difficult, and there is no certainty that her milk will agree with the foster-child. The ideal wet-nurse is a healthy, young, un married primipara that lost her infant shortly after birth; she should be phleg matic in temperament, and of sufficient intelligence to nurse the baby regularly. The actual wet-nurse in this country is usually a buxom married multipara whose baby and home-cares keep her constantly dissatisfied with her tempo rary occupation. One may approximate the ideal by selecting a healthy woman between twenty and thirty, not neces sarily a primipara, who has a thriving infant. Women with syphilis, tubercu losis, chorea, or epilepsy should be ex cluded, both hy their history and by examination of the hair, throat, skin, lymph-nodes, and chest. The breasts should be well-developed glands that become hard with milk within three hours after a nursing; the nipples should be of good size, well formed, and free from fissures.
The wet-nurse's child should, of course, be carefully examined. In re gard to the age of the child, it need not correspond very closely to that of the foster-child. In general, the milk should not be more than six weeks old for a child of one to three weeks: if the foster dub? ort-r s x eks, the milk may be ft+ ',Le to four months old.
Lniportant caution is to see that rp.-rte is not overfed., and that she taaes rti.tular active out-of-door exercise; Mot the milk is apt to become too i- the lie-t infant-food. i• artificial food -houlil be trusted un -- it « main- the essential elements • f l•riasst mill, • namely, fat, proteid, and _..r. The-ti elements are to be found *1 IN in milk. and CONS,' 11111k is the only aNailable for general use. Cows' 1.•111, inu-t be modified in order to bring the ptreentaivk of the three elements to •irri-pond ith tho_se found in human E. T. Abrams (Medical .News, Nov. 29. nio2).
Weaning and Mixed Feeding.
With few women among the better classes. can nursing be continued beyond the ninth, and generally not beyond the sIxth or seventh month, without ex hausting the mother or partially starv ing the child.
WHEN bHOULD -WEANING BE BEGUN? When bHOULD -WEANING BE BEGUN? —Stationary weight or actual loss, the child being otherwise well, means in food. After the sixth or -epenth month this indicates weaning. th.fore the sixth month the attempt may I e made to improve the milk by the mt,ans already suggested, using in the n.eantime supplemental bottle-feedings tsto Gr three times a day. If the milk dties nrt become normal in amount, may still satisfy the infant at three frur nursings daily, the bottle being :.:;ven in place of the other nursings.
method of "mixed feeding'' mav Irofitably continued as long as the child thrives: it is much better for the claild than complete weaning. If the nurse cannot satisfy the baby at least twice a day, the child had best be weaned. Speaking. generally, weaning -..hould be begun at the ninth or tenth month; but even then the weekly weigh ing is the safest guide.
it is a great mistake quickly to abandon breast-feeding for artificial feeding on the ground that the mother's milk is not of proper composition and does not agree. Far too many instances observed of tbe damage which has come from the too hasty recommendation to wean which has been given by the fam ily physician. Caution against the use of patent commercial foods, which con tain, as a rule, a large amount of unal tered starch. J. P. Crozer Griffith (Amer. Medicine, May 3, 1902).