Where the mother does not intend to nurse her child, a different plan of
treatment must be adopted: the shoulders should be lightly covered, cold
evaporating lotions applied to the breasts, and the bowels freely opened
by saline laxatives, her diet must be abstemious until the fulness of the
breasts subsides, and she ought not to take much fluid: where there is a
disposition to febrile action, an antimonial may be advantageously
combined with the salines. In most instances the milk is thus checked
without any inconvenience, but every now and then much illness and
suffering is produced before this can be effected. Wherever, therefore, it
is possible for the patient to suckle, the practitioner should urge the
importance of it in the strongest terms.
"A very serious evil from a woman neglecting this imperious duty is the
probability of her becoming more frequently pregnant than the constitution
of most females can sustain without permanent injury. A woman who suckles
her children has generally an interval of a year and a half or two years
between each confinement; but she who without an adequate cause for the
omission does not nurse, must expect to bear a child every twelve months,
and must reconcile her mind to a shattered constitution and early old
age." (Conquest's _Outlines_.)
_Management of the lochia._ The management of the lochia constitutes also
an important part of the treatment of a natural labour, for the patient's
health will be materially affected by any alteration either in its
quantity or quality. The lochia usually continues to be a sanguineous
discharge for about three days, becoming paler, thin, watery, and of a
brownish hue, and gradually disappears: a free lochial discharge for the
first forty-eight hours, at least, is one of the greatest safeguards
against the different forms of puerperal fever and inflammation which are
so justly dreaded by the practitioner, and nothing tends to ensure this
desirable object so much as the early application of the child to the
breast. It may seem paradoxical to assert, that what prevents hæmorrhage
after labour should promote the lochial discharge: we do not attempt to
explain why such is the case, but merely mention it as a fact repeatedly
observed. As the lochia is secreted from the internal surface of the
uterus, it will continue to accumulate in this cavity and that of the
vagina so long as the patient remains in the horizontal posture, the
direction of the vagina preventing its spontaneous escape: it will,
therefore, be desirable to favour its discharge by occasionally altering
the position of the patient, and thus prevent its becoming offensive,
which it would readily do from the temperature at which it is kept by the
surrounding parts, from being in contact with the external air, and from
its muco-sanguineous character. In the same way it frequently happens that
small coagula of blood lodge in the uterus and rapidly grow putrid. In
Public-domain text, read in full here on John Shaqi.
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