The quality of the milk is affected by another circumstance. As a rule, so long as the mother continues nursing, her monthly illness does not return, and also as a rule she does not become again pregnant. But the rule has numerous exceptions. It is very seldom that the monthly illness of a nursing mother returns soon after delivery, but not so uncommon for it to return about the sixth or seventh month. During the period of the illness the milk is impaired in quality, and the child is likely to be fretful and its digestion to be disturbed. If this happens while the infant is still quite young it may necessitate the mother giving up nursing, but if the child is already six or seven months old it need not cause any inconvenience. The child is probably already having some artificial feeding, and during the period of the illness the breast may be withheld more than usual. It rarely happens that pregnancy occurs during nursing except towards the end of the nursing period. If it do occur, nursing must be •given up.
To repeat: Up to the age of four or six months the child is to be fed entirely by its mother's milk; it should be put to the breast at regular intervals of about three hours at first, nothing, neither the child's sleep nor the mother's, being allowed to interfere with this arrangement, which is carried out by night as well as by day; after ten days or a fortnight, the child being healthy and vigorous, the interval may be slightly lengthened through the day, and lengthened to four hours during the night.
After a month or five weeks it will often, by judicious management, be possible for the mother to arrange to have a moderately long night's rest, uninterrupted. If the child is suckled about 10 or 11 at night, it may bs allowed to sleep on till 4 or 5 in the morning, without a further supply of food. If the child is ordinarily strong, the mother will be able, by the exercise of a little patience and perseverance, to gradually train the child to this habit; and its value for herself is very plain. But she will only succeed by herself being strictly regular in suckling the child at the proper times.
Should there be, as there often is, any suffi cient reason for a mother not suckling her child, there are two methods of rearing the infant. The one, by many deemed the more preferable method, is to secure the services of a wet-nurse. In many families the expense is a fatal objection to this method. The second
method is to rear the child with artificial food, to rear it "by hand," or to "bring it up on the bottle," as people say.
The Choice of a should be made with care. She should be in evident good health, but should also be carefully examined to be sure that she is free from any communicable disease, like consumption and syphilis. For this purpose her teeth, gums, throat, skin and hair, and glands of the neck should be inspected. It is well also to learn the character of her husband, and his state of health. Her breasts should be firm, and should have the knotty irregular feeling of glandular structure, not fat and flabby. The nipples should be well formed, and free from fissures. In order that her milk should be suitable, as regards age, to the child, she should have been herself confined about the same time as the mother of the child she is about to nurse, and rather later than earlier. Her milk should be examined. It should be bluish-white, sweetish, and should yield on standing a considerable quantity of cream. The best test of the excellence of the nurse is the appearance of her own child. If it present any skin eruption, cracks or fissures of the month or nostrils, or blotches about the buttocks, she should be rejected.
The wet-nurse should follow the same rules as to frequency of suckling the child as have been laid down for the nursing mother, and her own habits of life must be carefully regulated. Her food should be plain, nourishing, and at regular intervals. She ought not to need stimu lants of any kind, neither porter nor beer. She ought to be cleanly in habit, ought to go early to bed, and rise early. She should have stated daily exercise. Next to the quality of her milk, the quality of her temper is of the most impor tance. A bad temper ought to be a fault not possible of being overlooked. It is a strong objection to continuing a wet-nurse if her monthly illnesses return. It ought to be un necessary to add that the wet-nurse should be carefully and constantly superintended, no matter how trustworthy she may be.
The writer does not agree with the generally accepted view that a wet-nurse is to be pre ferred to artificial feeding. There are no diffi culties nowadays in the artificial feeding of infants that a little patience and intelligence cannot overcome, while there are risks asso ciated with a wet-nurse that can seldom be entirely discounted.