46 CHAPTER II. OF WET-NURSES. Sect. 1.-Choice of a Wet-nurse. ILL HEALTH and many other circumstances may prevent a parent from suckling her child, and render a wet-nurse necessary. Now, although she will do wisely to leave the choice of one to her medical attendant, still, as some difficulty may attend this, and as most certainly the mother herself ought to be acquainted with the principal things to be attended to in the selection of a good nurse, it will be well to point out in what they consist. The first thing to which a medical man looks is the general health of the woman: next the condition of her breast—the quality of her milk-its age and her own; whether she is ever unwell while nursing; and, last of all, the condition and health of the child. Is the woman in good health? Her general appearance ought to betoken a robust constitution, free from all suspicion of a strumous character or any hereditary taint of syphilis, consumption, cancer, and the like; her tongue should be clean and firm, her digestion good; her teeth and gums sound and perfect, and her skin free from eruptions; her breath sweet. Inquire as to the condition of her health during her pregnancy. Avoid a wet-nurse who has any tendency to miscarriages. If possible, see her husband also, and be sure that he is and has been a steady, well-conducted man. What is the condition of her breast?-A good breast should be firm and well-formed; its size not dependent upon a large quantity of fat, which will generally take away from its firmness, giving it a flabby appearance, but upon its glandular structure, which conveys to the touch a knotted, irregular, and hard feel; and the nipple must be perfect, of moderate size, but well developed. What is the quality of the milk?—It should be thin, and of a bluish-white colour; sweet to the taste; and when allowed to stand, should throw up a considerable quantity of cream. Dropped in water, it should form a light cloudy appearance, and not sink at once to the bottom in thick drops. What is its age?—If the lying-in month of the patient has scarcely expired, the wet-nurse to be hired ought certainly not to have reached her second month. At this time, the nearer the birth of the child, and the delivery of its foster-parent, the better. The reason for which is, that during the first few weeks the milk is thinner and more watery than it afterwards becomes. If, consequently, a newly-born infant be provided with a nurse who has been delivered three or four months, the natural relation between its stomach and the quality of the milk is destroyed, and the infant suffers from the oppression of food too heavy for its digestive power. In fact, it has been observed to be very injurious. On the other hand, if you are seeking a wetnurse for an infant of four or five months old, it would be very prejudicial to transfer the child to a woman recently delivered; the milk would be too watery for its support, and its health in consequence would give way. The nurse herself should not be too old.-A vigorous young woman from twenty-one to thirty admits of no question. And the woman who has had one or two children before is always to be preferred, as she will be likely to have more milk, and may also be supposed to have acquired some experience in the management of infants. Inquire whether she is ever unwell while nursing? If so, reject her at once. You will have no difficulty in ascertaining this point; for this class of persons have an idea that their milk is renewed, as they term it, by this circumstance, monthly; and, therefore, that it is a recommendation, rendering their milk fitter for younger children than it would otherwise have been. It produces, however, quite a contrary effect; it much impairs the milk, which will be found to disagree with the newly-born child, rendering it fretful from the first. After a time it is vomited up, and produces frequent watery dark-green motions. Last of all, what is the condition of the child?We would particularly advise that a medical man should examine the proposed wet-nurse's baby: for the appearance of health does not suffice. Particularly reject the mother of any child with skin eruptions, or a tendency to cold in the head (called snuffles). It ought to have a sprightly appearance-to bear the marks of being well-nourished, its flesh firm and clear. It should be examined in this respect particularly about the head, neck, and buttocks-also its mouth and gums. If a medical man finds that both mother and child answer to the above description, he has no hesitation in recommending the former as likely to prove a good wet-nurse. The principal points which the parent must investigate for herself (independently of the medical attendant's inquiries) have reference to the moral qualifications of the applicant; and if there is found to be any defect here, however healthy or otherwise desirable, her services ought to be declined. Temperance, cleanliness, a character for good conduct, fondness for children, and aptness in their management, are among the most important requisites. An amiable disposition and cheerful temper are also very desirable; for of course the remarks made in the preceding chapter on the injurious influence of mental disturbance on the breast-milk of the parent apply with equal force to that of the wet nurse. It is unnecessary to allude to other qualities which a woman who is sought as a wet-nurse should possess ; they will naturally suggest themselves to any thoughtful mind. Sect. 2.-Diet of a Wet-nurse. The diet should not differ much from that to which the individual has been accustomed; and any change which it may be necessary to make in it should be gradual. It is erroneous to suppose that women, when nursing, require to be much more highly fed than at other times a good nurse does not need this, and a bad one will not be the better for it. The quantity which many nurses eat and drink, and the indolent life which they too often are allowed to lead, have the effect of deranging their digestive organs, and frequently induce a state of febrile excitement, which E always diminishes, and even sometimes altogether disperses, the milk. It will be always necessary for the mother to be watchful lest the wet-nurse overload her stomach with a mass of indigestible food and drink. She should have a wholesome mixed animal and vegetable diet, and a moderate quantity of malt liquor, provided it be found necessary. As I have before said, a very prevailing notion exists that porter tends to produce a great flow of milk. In consequence of this prejudice, the wet-nurse is often allowed as much as she likes; a large quantity is in this way taken, and after a short time so much febrile action excited in the system, that, instead of increasing the flow of milk, it diminishes it greatly. Sometimes without diminishing the quantity, it imperceptibly but seriously deteriorates its quality. For instance a wet-nurse became necessary for an infant of two months old, and a healthy young woman was obtained. At first the nurse's milk seemed to suit the child, and everything went on well for three weeks. At this time I was sent for, the infant having had diarrhoea for three or four days, with green motions and occasional vomiting. I looked for the cause, and, amongst other inquiries, to the health of the nurse. was told that she was in perfect health; but perceiving that she looked ruddier and more full in the face than heretofore, I inquired about the quantity of beverage allowed, and found it exceeded two pints of porter daily. I then prescribed-for the infant, no medicine; for the nurse, one pint of porter only. As the patient lived some little distance from town, I did not see the child for three days: it was then somewhat better, but still not well. I directed the malt liquor to be discontinued altogether, and the nurse to have the shower I |