By Margaret Lowenfeld

A good deal of work has recently been done, reports of some of which are on the eve of publication, showing, among other things, the difference between the establishment of lactation in primiparæ and multiparæ—a point not always fully realised. It is owing to the lack of appreciation of this difference that many mothers fail to nurse their first babies. With a primipara the glands. have not previously been in action and the task is therefore that of establishing a new function, and it is to be remembered that every new form of activity has many possibilities of going wrong. On the other hand, in the case of a multi- para all that is necessary is to re-establish a previously existent function. To consider first the primipara. The first thing that occurs in the little bags of cells on the stimulation of suction is that the cell walls nearest the lumen of the duct will break down and the contents of the cells be drawn along towards the nipple. These cells contain the sugar, protein and salts of the milk in solution and also large fat globules.