=Lactation.= About the third or fourth day after delivery, when milk replaces colostrum, the breasts become swollen, engorged and often very painful, and not infrequently, a hard, sensitive lump or “cake” may be felt. The growing tendency, now, is merely to support these heavy breasts by means of a binder which has straps passing over the shoulders, in order to hold them up without making pressure (Fig. 122) and to apply ice caps or hot compresses to the painful areas. It used to be customary to massage and pump caked breasts, to apply pressure and various kinds of lotions or ointments. Though one, or all of these measures are still employed, in some cases, the general practice is to avoid manipulating the breasts but to empty them regularly by the baby’s nursing; support them and allow Nature to make an adjustment between the amount secreted and the amount withdrawn. [Illustration: FIG. 122.—A simple method of supporting heavy breasts by means of three folded towels; one fastened about the waist, one over each shoulder, crossing front and back. ] Free purging is sometimes employed and the amount of fluids reduced until the engorgement and discomfort subside. This happy issue is practically always reached if the baby nurses regularly and satisfactorily, as there is a spontaneous adjustment between the amount secreted by the mother and that withdrawn by the baby. But as abscesses may follow in the wake of caked breasts, particularly if the nipples are sore, it is of great importance that the nurse watch closely for the first evidence of painful lumps. The prompt application of a supporting bandage and ice bags (Fig. 123) or hot compresses will, in the majority of cases, give speedy and complete relief. So widely is this believed that many doctors regard the care of the breasts, including the prevention of breast abscesses, as a nursing question, entirely, and conversely are likely to regard the occurrence of a breast abscess as an evidence of careless nursing. [Illustration: FIG. 123.—Ice caps held in place on painful breasts by straight binder with darts pinned in under breasts and supported by shoulder straps of muslin bandage. ] Certain it is that breast abscesses are almost never seen where the nurses have this sense of responsibility, and habitually watch the breasts closely and promptly use support and either heat or cold when the breasts become heavy and sensitive. There are innumerable bandages and methods for supporting heavy breasts, any one of which is efficacious so long as it meets the two chief requirements: to lift the breasts, suspending their weight from the shoulders, and, while fitting snugly below to avoid making pressure at any point, particularly over the nipples. One of the most satisfactory and widely used supports is the Y-bandage, (Figs. 124, 125, 126), another, the Indian binder (Fig. 127.) [Illustration: