from the baby.  He must be in a warm cot, in a warm, well-aired, darkened, and silent room, and the necessary handling must be reduced to a minimum.  Sometimes sound sleep will come for the first time if he is placed gently in his mother’s bed, close to her warm body.  If he is apt to bungle at the breast from eagerness and restlessness, it is not wise always to choose the moment when he has roused himself into a passion of crying to attempt the difficult task.  So far as is possible he should be carried to the breast when he is drowsy and sleepy, not when he is crying furiously, and then the reflex sucking act may proceed undisturbed.

In the second place, we must guard against the ill effect which the ceaseless crying of these nervous babies has upon the mother.  She may be so exhausted by the labour that her nerves are all on edge, and she grows apprehensive and frightened over all manner of little things.  The tired mother is apt to fear that she will have no milk, and her agitation grows with each failure on the part of the child.  Now the first secretion of milk is very closely dependent upon the nervous system of the mother.  We have said that within wide limits her physical condition is of less importance, but her peace of mind is essential.  And so it is wise for some part of the day to keep the nervous baby out of hearing of the mother, and so far as possible to choose moments when the child is quiet to put him to the breast.  A nurse with a confident, hopeful manner will effect most; a fussy, over-anxious, or despondent attitude will do untold harm.  We shall sometimes fail if the nervous unrest is very obstinate either in mother or in child, but we shall fail less often if we diagnose the cause correctly in the cases we are considering.  Lastly, it is possible to control the condition in both mother and child by the careful use of bromide or chloral.

It is not, of course, suggested that these drugs should be given freely or as a routine to every hungry baby wailing for the breast, or that we can hope to combat or ward off an inherited neuropathy by a few doses of a sedative.  There are, however, not a few babies in whom there develops soon after birth a sort of vicious circle.  They can suck efficiently and digest without pain only when they sleep soundly.  If they are put to the breast after much crying and restlessness, each meal is followed by flatulence, colic, and renewed crying.  The only effective treatment is to secure sleep and to carry a slumbering or drowsy infant to the breast.  Then the sucking reflex comes to its own again, the breast is drained steadily and well, and digestion proceeds thereafter without disturbance and during a further spell of sleep.  Two or three times in the day we may be forced, as meal-time approaches, to cut short the restlessness of the child by giving a teaspoonful of the following mixture: 

Pot. brom., grs. ii. [2 grains]

Chloral hydrate, gr. i. [1 grain]