NURSING. 301 



approaching illness that, when it has shown itself, the patient should be watched 

 with the utmost anxiety. 



The secretion of milk is not usually established until the second or third 

 day; now and then, however, it makes its appearance earlier. This event is 

 sometimes accompanied with a little constitutional disturbance, which soon 

 subsides. When the breasts are becoming so full and hard as to be painful, 

 great relief will be afforded by fomenting them every few hours, and support- 

 ing them, in the meantime, as in a sling, by a handkerchief tied over the oppo- 

 site shoulder. (See page 193.) This condition will generally soon subside if the 

 child be applied at regular intervals. Nurses must beware of meddling too 

 much with the breasts, and especially avoid rubbing them, except under special 

 direction from the doctor. The nipples and surrounding parts should be 

 carefully washed each time the child leaves the breast, and should be excluded 

 from the air by covering them with a small piece of linen rag on which a little 

 vaseline or simple ointment has been spread. 



As soon as it becomes clear that the supply of breast-milk is insufficient, 

 it is unwise to keep putting the child to the breast, as this only produces irrita- 

 tion and is very liable to set up inflammation and abscess. Similarly, if the 

 nipples are extremely sore, so that, even when they are protected by a nipple- 

 shield, the application of the child is attended each time with intense pain, or 

 if they are so depressed that neither the efforts of the child nor the cautious 

 use of the breast-pump will draw them out, it is running a great risk of excit- 

 ing breast-abscess to persevere beyond twenty-four hours in an attempt to 

 suckle. 



If the nurse notices a patch of redness on a patient's breast, and finds that 

 the skin at that spot is painful and tender to the touch, she should take means 

 to acquaint the medical attendant as soon as possible, for an abscess has actu- 

 ally formed; it should be opened with as little delay as possible, lest it spread 

 and become much more formidable. 



Still-Born.— When the child is still-bom, or when, from any other cause, 

 it is not going to be suckled, there is often great anxiety expressed about the 

 dispersion of the milk. It is astonishing, however, how quickly it becomes 

 absorbed if left to Nature. If the patient will only submit to the discomfort 

 arising from the fullness of the breasts for a few hours, without insisting on 

 their being partially emptied from time to tune by the use of the breast-pump, 

 or other similar means, whereby the breasts are stimulated to fresh secretion and 

 the evil is aggravated, she will soon have the satisfaction of finding them softer 

 and less painful, and will be amply rewarded for her patience. Should the 

 feeling of tension be excessive, it will be best relieved by hot fomentations 

 applied every few hours; if not excessive, the application for a few days of 

 bella'donna plasters with a hole in the centre for the nipple, is often all that is 

 necessary. In ordering these plasters the nurse should furnish the druggist 

 with paper patterns showing the size required. 



