This engorgement, or so-called “caking” of the breasts is not due to the milk, but to the infiltration of the connective tissue around the glands with serum and blood which stimulate the glands to secrete. The distention usually disappears in twenty-four or forty-eight hours, especially if the child is sturdy. Massage of the breasts only increases their activity and tends to make the trouble worse. The weight of the glands may be considerable and require the application of a light supporting breast binder. Pillows under them will also give relief at times. In putting the child to breast, the mother should lie on the side with the arm raised and the child is dropped into the hollow thus created, facing the mother (see Fig. 113). In this position the nipple will most easily and conveniently slip into the child’s mouth. The child should nurse fifteen or twenty minutes and then be removed. The toilet of the nipple is made by cleansing with boric solution as previously described, and then placing not gauze but a piece of aseptic cotton cloth over it, after which the binder is readjusted. (See Breast Covers, p. 326.) =The menstrual flow= ceases during lactation as a rule, but not invariably. The flow returns in from four to six weeks after delivery, if the child is not nursing, and about the same time after lactation ceases. There is a popular idea that conception can not occur during lactation, and many women injuriously prolong lactation in the hope of avoiding another child. The theory is fallacious and conception during lactation is not uncommon. =The Bowels.=—A lying-in woman is regularly constipated. Lack of exercise, a nutritious diet, but one with a minimum of wastage, together with relaxed abdominal walls, contribute to a condition that is primarily due to changes in intraabdominal pressure, which follow the delivery. For weeks the intestines have been under pressure and irritation by the growing uterus, and when this is suddenly removed the intestines become sluggish. On the morning of the second day the patient should receive an ounce of castor oil. This dose, suspended in black coffee, beer, orange juice, or sherry wine can be taken by nearly everyone. In from four to six hours a normal saline, or soapsuds enema is given. The enema may be repeated daily, or if this is objectionable to the patient, the castor oil or Russian oil, may be given as a routine. Saline cathartics should not be used unless there is an oversupply of milk. There is sometimes a good deal of gas following labor, which can be removed by the 1–2–3 enema (see Enema, p. 335). In giving enemas, the nurse must use great care to avoid touching or infecting an injured perineum. Many women secrete less gas and are agreeably influenced mentally by a five grain pill of asafœtida taken thrice daily. =Urination.=—One of the commonest difficulties after labor concerns micturition.