Indications for Weaning. Further, should the monthly courses return or should pregnancy commence, weaning should immediately take place. To persist in nursing under such circumstances would be fraught with danger to the mother, and, probably, productive of permanently feeble health and stunted growth to the infant. Mania, where there is any predisposition to it, is extremely likely to happen when pregnancy or menstruation is allowed to proceed simultaneously with lactation.
83. WEANING The ordinary period for weaning is about the eighth or ninth month: but the time that the child is in good health, and free from the irritation of teething, should be chosen as the most appropriate. Too hot weather, or the pre-valency of any intestinal epidemic, may necessitate the determine of weaning for a short time. If the mother is feeble and sickly, it is generally desirably to wean the infant when it is six months old, or, as state in the previous Section, even at the end of the first or second month, if the mother presents evidence of suffering from lactation. On the other hand, if the child is very feeble, or suffering from any disease, it may be well to nurse it to the tenth or eleventh month if, at the same time, the mother’s health is robust. Beyond that time nursing is nearly always productive of serious consequences, both to the mother and child. When weaning is decided upon, the mother should gradually diminish the allowance of the breast, and increase the supply of suitable kinds of food. The sudden weaning increases the risk of local mischief, and of a general derangement of her health. In some cases it is a good expedient for the mother either to send the child away, or leave him at home and to go away herself for a few days. As soon as the weaning is commenced, the mother should remain quiet for a little time, in order that the swollen breasts may not suffer from the motion of the arms or the pressure of the stays, and that the system may be free from excitement. She should take only light nourishment; refrain from food likely to induce thirst; drink as little as possible, and that of cold water; keep the breasts covered with some light, warm material; and avoid soups and other liquid kinds of food.
MEDICINAL TREATMENT.
Bryonia. Excessive quantities of milk.
Belladonna. Red, painful, and distended breasts.
Calcarea C., Pulsatilla, and Rhus are sometimes required.
ACCESSORY MEANS. In addition to the suggestions offered above, if the flow of milk continues too abundant during the first few days of weaning, nipple-glasses may be kept applied to receive the milk; gentle friction with the hand, lubricated with olive- oil, may also be had recourse to, for softening the skin. When the breasts are large and flabby they should be supported by a board handkerchief or strips of plaster, as recommenced under “Mammary Abscess.” The breasts must not on any account be drawn, as a continued secretion is thus promoted; such a practice also endangers the formation of Mammary Abscesses.
84. GATHERED BREASTS (Mammary Abscess)
This may take place at any time during the nursing period; but it is usually an accompaniment of that great functional change in the glands which marks the commencement of lactation, especially in the first or second month, often as early as the fourth or fifth day after the birth of the child. It is most likely to arise after the birth of the first child.
SYMPTOMS. These vary according to the situation and extent of the inflammation. If it merely affects the subcutaneous cellular tissue covering the gland, it will present only the features common to an abscess in any other situation near the surface. When the inflammation occurs in the tissue behind the gland, and on which it is placed, the pain is severe, throbbing, deep-seated and increased by moving the arm shoulder; the breast becomes swollen, red, and very prominent; being pushed forward by the abscess behind. Sometimes, but less frequently, the gland itself is involved, when the pain becomes very acute and lancinating, the swelling very considerable, and there is much constitutional disturbance, – quick, full pulse, hot skin, thirst headache, sleeplessness, etc. This variety of gathered breast is preceded by rigors (shivering fits), followed by heat, and the case should be immediately placed under the care of a medical man, who may only then be able to arrest the further progress of the disease.
CAUSES. Exposure to cold by not covering the breasts during nursing; sitting up in bed, uncovered, to nurse the child; too small, depressed, or sore nipples, so that the breasts becomes distended with milk, favouring inflammation and suppuration; efforts of the child to suck when there is no milk in the breast; emotions, mechanical injuries; too prolonged nursing, the Abscess in the latter case not appearing until a late period-the tenth to the twelfth month. Too sudden weaning by allowing a large accumulation of milk in the breasts, and deranging the general health by abruptness of the new condition of things, is also an exciting cause. Tight-fitting stays, by compressing the gland, s keep the breasts too hot, and deranging the general health by abruptness of the new condition of thing, s is also an exciting cause.
Tight-fitting stays, by compressing the gland, s keep the breasts too hot, and derange the circulation in them, and act as predisposing causes. But constitutional debility is the great predisposing caust; hence it most frequently happens after a first labour, which is often a protracted one; after giving birth to twins; and after profuse haemorrhage. Debility leading to Abscess may occur as the result of innutritious slop-diet, too often adopted during the first week of confinement. Some patients are so strongly predisposed to Mammary Abscess that without the greatest care they are certain to have one during the nursing period.
MEDICINAL TREATMENT. Aconite, Arsenicum, Belladonna, Bryonia, China, Hepar. S., Phosphorus, Phytolacca, Silicea, Sulphur
INDICATIONS FOR THE PRINCIPAL REMEDIES.
Aconitum. Given at the very commencement, the inflammation may be at once subdued, red suppuration prevented.
Belladonna. This medicine may be required during the inflammatory state if the surface of the breasts have an erysipelatous, glassy redness
Bryonia. Large collection of milk, the breasts being hard, or feeling heavy, hot, and painful. Whenever, after the first coming-in of the milk, from catching cold while nursing, or from abrupt weaning, the breasts become swollen, tender, knotty, and painful, Bryonia will often resolve the inflammation and prevent the formation of abscesses if the remedy be given early.
Hepar S. May be required to expedite the process of suppuration.
Phosphorus. Relieves pain in the breasts and promotes the healing of the abscess.
Phytolacca. This is probably the most useful remedy for inflammatory engorgements of the mammary gland both at the commencement, and when suppuration has already taken place. It may be used internally, and in the form of a lotion. The testimony to the value of this remedy is very strong.
Silicea is of great service in strumous cases where the abscess is slow in healing.
Sulphur. Chronic abscess, profuse suppuration, with chilliness in the forenoon, feverish symptoms, and flushed face in the after-part of the day.
ACCESSORY MEANS. Two or three hours after labour-sooner if there is much haemorrhage-the infant should be applied to the breasts, but only about once in every four hours, until the supply of milk is uniformly secreted. The breasts should be supported by a broad handkerchief, or a net-work supporter, or by strips of adhesive plaster, nicely and uniformly applied, as their weight aggravates the patient;’s sufferings greatly; strips of plaster are also used to effect uniform compression of the glands, and thereby diminish their secretion. A linseed poultice, or a piece of spongio-piline dipped in hot water, should be applied to the part; this will allay the pain, by relieving tension and causing perspiration. The use of Camphorated Oil, followed by dry heat-as of an iron passed close to the breast-and ten enveloping the breast in cotton-wool. Dr. Holcombe has most confidence in a plaster made of equal parts of extract of Belladonna and compound Iodine ointment, into which a few grains of gum camphor have been rubbed. This should be worn continuously and renewed every twelve hours as long as continuously and renewed every twelve hours as long as necessary. A solution of Camphor and Glycerine, applied over the gland by means of flannel compress, is also a useful application. In extensive engorgement and induration an opening is necessary, and should be made in the most dependent situation as soon as fluctuation is discovered. If the matter be not evacuated as soon as it can be felt, it will be difficult in various directions through the breast.
It is important to remember that Mammary Abscess is a symptom which strongly poisons to constitutional feebleness, indicating the necessity for pure air, sunlight, suitable bathing and nourishing diet, lightly dressed eggs, tender lean meat, oatmeal, and brown bread. By eating the latter the patient has the advantage of the Phosphorus which is contained in the covering of the grain, but much of which is lost by the dressings which fine flour undergoes. The mind must be kept from domestic worry and all kinds of care.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."