252 THE POSSIBILITIES OF MATERNAL NURSING 



Having disposed, to some extent, of this charge of willful 

 refusal to nurse, the question is still unanswered why so many 

 mothers who are both willing and anxious to do so do not nurse 

 their infants. A number of these cannot or should not nurse 

 their babies. Among those who should not, are mothers with 

 active pulmonary tuberculosis, advanced diseases of the kidneys, 

 insanity, severe epilepsy, some abscesses of the breast and puer- 

 peral fever. Prolonged febrile conditions lead to loss of milk and 

 relieve us of any choice in the matter. 



Under proper management, however, the vast majority of 

 other mothers whose children are bottle-fed, upon various pleas 

 of the mother's unhealth, would be definitely benefited rather 

 than injured by performing their natural function. While ex- 

 tremely neurotic mothers do not secrete the best of breast milk, 

 a ridiculous number of women are excused or restrained from 

 fulfilling their maternal duties upon this and the other insuffi- 

 cient grounds. 



Another small proportion of mothers cannot nurse because of 

 actual insufficient mammary development, or of malformed and 

 depressed nipples. While the prevention of these conditions is 

 to be sought in better hygienic and physical care of the rising 

 generation of potential mothers, the number of the former class 

 is unquestionably smaller than it now appears, and more of the 

 latter could nurse if they really received intelligent and skillful 

 care both before and after the birth of the child. 



Yet the classes of mothers hitherto mentioned even if we 

 add to them those who from shame abandon their babies and 

 those who are obliged to give them over to the bottle in order 

 to earn their daily bread do not, when taken altogether, consti- 

 tute any large majority of those who do not nurse their babies, 

 or else wean them in the first weeks of life. What then, of the 

 large remainder? As the result of an earnest inquiry into all 

 cases coming under my observation, I am prepared to affirm 

 that it is chiefly due to general and lamentable ignorance of the 

 whole subject of human lactation. Astounding as it may seem, 

 I am convinced that as many infants are removed unnecessarily 

 from the breast as there are those whose mothers are actually 

 unable to nurse them. No function of the human body has re- 

 ceived, in all its important relations, so little study as that of the 

 secretion of milk by the breasts. Even collateral information 

 and methods offered by much more extensive study of certain 

 lower animals, have not been generally accepted or applied. 



The human race has always taken it for granted that a woman 

 either could nurse her infant or could not. There was no mid- 

 dle ground. Milk either came into the breasts abundantly and 

 was good, or it came in scantily and was useless. There have 



