Speculative Speculum

For thousands of years, mothers have relied on breast milk for the survival of their babies and young children; however, today more mothers than ever now choose to formula-feed their infants for the first year of their life. Infant feeding can take one of four forms: breast milk received directly from the mother’s breasts, breast milk received from expressed milk from the mother’s breasts, artificial formula from a bottle, and breast milk received from a donor either through wet nursing or from milk banks. This change from natural to bottle feeding in nineteenth and twentieth century America occurred as a result of a variety of factors highlighting the role that women play in the home and the expected norms to which women should adhere. Ultimately, the interplay between the declining use of wet nurses; the wide-spread introduction of nipples and advent of artificial formula; and changing social attitudes of breastfeeding in favor for the scientific model promulgated the near extinction of breastfeeding in the United States.

Abandonment of Wet Nurses
Before the advent of artificial formula in the 1860s, women had limited choices in how they chose to feed their infants. These choices included “dry nursing” which meant feeding an infant the milk from cows, goats, mares, and donkeys with a variety of utensils ranging from spoons, cups, and make-shift bottles. Those were wealthy employed a lactating woman to feed a baby until the child was weaned. Although wet nursing, or the act of a lactating mother feeding an infant not directly hers, was almost a necessity for infants whose mothers could not provide nutrition themselves either due from death or sickness of the mother, there were religious and social consequences families who chose this method of infant nutrition. In colonial America, religion dictated that women who hired wet nurses were in disobedience with God because they were essentially neglecting their children in favor for increased freedom. These religious undertones carried through to the nineteenth century as wet nursing became viewed as a selfish act which could potentially expose the infant to disease.

Women who conscientiously chose wet nurses in favor over feeding their own infants using natural means did so in order to be able to resume sexual relations with their spouses who were often socially proscribed during the period of lactation during this era, the perception of increased social status, and alleviation of the never-ending duties of motherhood. Wet nursing fell out favor for several reasons other reasons. Upper and middle class women often disliked the expense and inconvenience of having a lactating woman in the home. Furthermore, the use of formula became refuted as cheaper and superior to the milk provided by wet nurses and relieved the mother of the possibility that her infant could contract a disease or character flaw by suckling on another woman’s breasts. The risk of endowing the lowly character of the wet nurse onto the baby was enough for many women to choose bottle feeding than to expose her child to traits of the wet nurse who most certainly had to be worse than the traits of the wealthier mother. By 1920s, wet nursing had become nearly extinct of in the United States.

Artificial Nutrition and Methods
It had been observed by the nineteenth century that proper infant feeding was critical to the development and welfare of the child. Without the correct mix of nutrients, the rate of infant morbidity and mortality increased dramatically. Accordingly, up to an appalling rate of 100 percent of infants at some foundling hospitals in America and Europe succumbed to inadequate nutrition from hand-feeding efforts during the 1700 and 1800s. Recognizing that a relationship existed between the approach to infant feeding and the wellbeing of the infant, Johann Simon, made the first comparison between human and bovine milk using chemical analysis. Justus Von Leibig would later confirm earlier findings that different foods provide varying quantities of fats, carbohydrates, and proteins. He speculated that the human body needed these nutrients in specific amounts, and these findings would later influence the commercial baby food industry to decide what recipe or formula should be used for making artificial milk. Nestle became one of the first successful manufactures of artificial milk in the 1860s and began widespread marketing campaigns of their product which consisted of flour, cow’s milk, and sugar.

Formula became “the most perfect substitute for mother’s milk,” and with the combination of the rubber nipple by Elijah Pratt in 1845, mothers had a viable new option for feeding their infants. Nestle and other formula companies took advantage, and advertisements endorsed the safeness and ease of bottle feeding. In 1890, advancements in formula came again when Thomas Rotch discovered that human milk varied according to the age of the infant and was in a state of constant transformation –an understanding very different from the static view of breast milk. This led to a more complex system of feeding that relied on frequent composition changes in the formula. Ironically, the goal of the formula makers became to devise a milk product identical to human milk while persuading women that bottle feeding was easier, more luxurious, safe, and even healthier than breastfeeding and using wet nurses.

Scientific View
Before the invention of formula, the act of infant feeding was directly linked to the role of motherhood because breastfeeding represented an act of biological necessity. A mother’s feeding choices were further influenced by the changing scientific view that inventions and modernity were always better than nature. These views were endorsed by physicians who reinforced these views with their patients. Artificial nutrition was no different from other discoveries in the nineteenth century, and the pubic felt that formula was nutritionally better, more sterile, and safer than human breast milk. Once a mother made the choice to exclusively bottle feed her infant the relationship between physician and mother became more closely intertwined. This was because mothers needed the direct guidance of physicians to recommend feeding schedules and alterations in formula according to the health and development of the individual baby.

By the early twentieth century, the scientific view of infant nutrition pervaded child welfare education. Accordingly, mothers were encouraged to bottle feed their infants at least once daily which served two purposes –to make the eventual weaning process easier on mother and baby and to afford the mother more freedom from her suckling infant. This advice was even given to mothers who had no apparent deficiency in the amount or quality of their breast milk. Likewise, those mothers who had difficulty with breastfeeding were given information of formula feeding instead of trying to correct simple complications of breastfeeding first. Since breastfeeding works by supply and demand (meaning the more that an infant suckles, the more milk is produced), the less that an infant nurses resulted in more difficulties in breastfeeding.

Breastfeeding had been the mainstay of infant nutrition and well-being for centuries. Today, initial breastfeeding rates are at an all-time low, and prolonged breastfeeding efforts beyond the world health organization’s recommendation that babies should be breastfeed until two years of age is extremely rare in economically advanced countries. The historical perspective of the transition from breast to bottle lends to new insights into how the current maternal care of infants has been influenced by a decline in the use of wet nurses during the early nineteenth century, the advancements in alternatives of nutrition for infants, and the scientific view of the mother’s role in the welfare of her child. By understanding the changing tides in breastfeeding practice that have occurred, mothers can better evaluate the decision to either breast or bottle feed their newborns.

Bibliography
Apple, Rima. Mothers and Medicine: A Social History of Infant Feeding, 1890-1950. Madison: University of Wisconsin Press, 1987.
Black, Rebecca. The Support of Breastfeeding. Toronto: Jones and Bartlett, 1990.
Golden, Janet. A Social History of Wet Nursing in America: From Breast to Bottle. Columbus:
Ohio State University, 2001.
Oakley, Ann. Essays on Women, Medicine, and Health. Oxford, Edinburgh University Press,
1993.
Riordan, Jan. Breastfeeding and Human Lactation. Sudbury: Jones and Bartlett, 2005.
Seear, Michael. An Introduction to International Health. Toronto: Canadian Scholars’ Press, 2007.
Spaulding, Mary and Penny Welch. Nurturing Yesterday’s Child: A Portrayal of the Drake
Collection of Paediatric History. Toronto: Natural Heritage, 1994.

If you want to learn more about the history of bottlefeeding please visit The Bottle Feeding Museum.