714 
iVet nursing milk of another healthy woman is the best sub- 
stitute for maternal nursing when the mother’s supply has failed. 
Expense and the difficulty of obtaining a good wet nurse in this 
country are countervailing circumstances. The wet nurse should be 
a j)erfectly healthy woman free from syphilis or tuberculosis. A 
careful physical examination should be made to ascertain these points. 
Her breasts should be well developed and at nursing time be tense and 
full. A good amount of glandular tissue should be present in the 
breast and pains taken to be assured of that point. The nipple 
should be of normal development and free from cracks or fissures. 
Her blood should be rich, as it is impossible for an aneemic woman to 
give good milk. 
Contrary to what is usually supposed, it is by no means necessary 
that her milk should correspond in age to that of the child. She 
should, however, have been a nursing mother long enough to be able 
to demonstrate by the condition of her child that she has plenty of 
good, nutritious milk. To this end her child should always be in- 
spected before her acceptance. ^'\Tien accepted she should be given 
a fair chance to adjust herself to her novel surroundings before decid- 
ing her incompetent as a nurse, as these conditions may, at first, 
notably affect her supply of milk. 
^Yeaning . — The time at which weaning should take place is sub- 
ject to considerable variations. With an abundant supply, nursing 
may usually be continued to advantage during nine or ten months of 
the first year. Some mothers are able to extend this period through 
the twelfth ‘month. After that time breast feeding is seldom advis- 
able. As a usual thing, the ninth month .marks the time when the 
breast must be supplemented by other food. 
Method of iceaning . — Weaning should be gradually done, both in 
the interests of the mother and the child. Much of the difficulty at- 
tending the gi’adual weaning of infants may be eliminated by accus- 
toming the child to take a bottle from the outset. This may be ac- 
complished by feeding it boiled water from a bottle from the begin- 
ning. In the absence of such measures the experience is too frequent j 
that the child refuses all other food as long as it has access to the ) 
breast, and nothing short of actual starvation will induce it to accept f 
either the bottle or the spoon. 
Weaning during the hot months should be postponed if possible; 
but the harm thus done is not usually so great as the continuance of 
the child on an inadequate breast milk^ 
Indications for sudden weaning weaning may be neces- 
sary at any time on account of the development in the mother of se- / 
vere acute disease, such as typhoid fever or pneumonia; of grave 
systemic disorders, as tuberculosis or nephritis ; from the intercur- ' 
renjie of pregnancy or of disease of the mammary gland. Elinor ill- :! 
