The mother’s part is to a great extent a passive one, provided that she can supply one essential—­a nipple that is large enough for the child to grasp properly.  Within wide limits what the mother eats or drinks, whether she be robust or whether she has always been something of an invalid, matters not at all.  A frail woman may naturally not be able to stand the strain of nursing for many months, but that is not here the point in question.  We are dealing only with the establishment of lactation and with the milk supply of the early days and weeks which is of such vital importance for the child.  If the mother is ill, if, for example, she has consumption, we may separate her from the child in the interests of both; but if this is not done, she will continue to secrete milk for a time as readily as if she were in perfect health, and the breasts of many a dying woman are to be seen full of milk.  Mothers are too apt to attribute the disappointment of a complete failure to nurse to some weakness or want of robustness in their own health.  This is never the reason of the failure, and the fault, if the mother has a well-formed nipple, is generally to be found in some disturbance in the child.  Prematurity, with extreme somnolence, breathlessness from respiratory disease, nasal catarrh, which hinders breathing through the nose, infections of all sorts, are common causes of this failure to suck effectively.  But perhaps the most common cause of all is the inhibition from nervous unrest of that reflex act of sucking which works so well in the placid and quiet child.  It is a point to which too little attention is paid, and mothers and the books which mothers read commonly neglect the nervous system of the child and devote themselves to such considerations as the relative merits of two-hourly and four-hourly feedings—­important points in their way, but less important than this.

The matter is complicated in two other ways.  In the first place, the nervous baby, just because he is so active and wakeful and restless, is apt rapidly to lose weight and to have an increased need for food.  The restlessness is generally attributed to hunger, and this is true, because hunger is soon added to the other sensations from which he suffers, and like them is unduly acute.  It is difficult not to give way and to provide artificial food from the bottle.  Yet if we do so we must face the fact that these restless little mortals are quicker to form habits than most, and once they have tasted a bottle that flows easily without hard suction, they will often obstinately refuse the ungrateful task of sucking at a breast which has not yet begun to secrete readily.  The suction that is devoted to the bottle is removed from the breast, and the natural delay in the coming in of the milk is increased indefinitely.  At the worst, the supply of milk fails almost at its first appearance.  We must devote our attention to quieting the nervous unrest by removing all unnecessary sensory stimulation