ed until relief is
obtained; or the breast pump may be applied. Hard nodules should not
be allowed to form or to remain in the breasts. Hot compresses (wrung
from boiling water by means of a "potato ricer") may be applied to the
caked breast which is protected from the immediate heat by one
thickness of a dry blanket flannel. These hot compresses should be
removed every three minutes until three have been applied, then an ice
water compress is quickly applied, to be followed by more hot ones and
then a cold; and so on, until as many as four sets each have been
administered.

Gentle massage may again be administered and it will be found that
they empty now with greater ease because of the preceding heat. After
the breasts have been emptied, and thoroughly washed with soap suds
and carefully dried, they should be thickly covered with cotton
batting and firmly compressed against the chest wall by a snug-fitted
breast binder, which serves the double purpose of relieving pain by
not allowing the breasts to sag downward, at the same time preventing
an over-abundant secretion of milk by diminishing the blood supply to
the glands of the breast. In case the persistent manipulation of the
breast and the use of the breast pump do not relieve the condition,
and if the repeated effort day after day seems to avail nothing; then,
as a rule, we must look for a breast abscess to follow if the breasts
are not immediately "dried up." In all such cases of engorgement, the
attending physician should be notified at once.

SORE NIPPLES

The nipple must be kept _dry_ between nursings, which should be
limited to twenty minutes. Regularity should be maintained. The
nipples should never be touched or handled by hands that have not been
scrubbed with soap and a nail brush. During the early nursing days
they are wet much of the time and are subject to much stress and
strain in the "pulling effort" of the baby, as a result of which they
become very tender, chapped, cracked, and often bleed. Allowing the
baby to go to sleep with the nipple in his mouth also exposes the
nipple to unnecessary moisture which increases the possibility of
painful cracking. The pain occasioned by nursing at this time is truly
indescribable, and is most often the cause of absolute refusal on the
part of the mother to nurse her babe--with the result that it is put
on the bottle. Again, the fear and dread of being hurt so often tends
to diminish the flow of milk. It is