Feeding newborn babies is a fairly straightforward process, at least for the majority of mothers who are healthy and have adequate milk to nourish their young. Mothers worldwide have always breast-fed their babies. This has been considered the safest, easiest, healthiest, and least expensive means to ensure an infant's survival. Studies today show that breast milk contains certain antibodies, nutrient proteins, lipids, vitamins, and minerals to help a baby ward off various diseases, infections, and allergies. Until physicians and medical advisors began to investigate the subject and write about it, women carried on as tradition dictated, breast-feeding their infants by instinct to meet their babies' nutritional needs.
Most mothers in the North American colonies breast-fed their infants. Details of these breast-feeding practices are scarce, however, since many women could not read or write, had little free time, or felt too constrained by the intimacy of breast-feeding to write about it. Using a wet nurse never became common practice among North American settlers as it had been among the European elite, due to different life styles, the frontier character of colonial settlement, and the paucity of wet nurses. Mothers intuitively understood that breast-fed babies had the best chance of surviving childhood. They also noted that breast-feeding helped to delay conception, providing a natural, even if not a completely reliable, means to space their children.
Of course, not all babies could be breast-fed by their mothers. Some women did not have enough milk or were too sickly or exhausted to feed their infants. A woman with swollen, impacted, or infected breasts found it too painful to have a baby suckle. If a mother died during childbirth, which happened far more often than it does today, a source of milk had to be found. A family might turn to a female neighbor, friend, or relative who was feeding her own baby or they might hire a wet nurse. Families also advertised in newspapers, stipulating the desired qualifications. Wet nurses were usually nursing their own or another baby or had just weaned their child. Many myths developed about nursing a baby. In cases where a baby needed a wet nurse, medical advisors warned parents that the type of woman hired to feed a baby was critical. For instance, parents were urged to avoid a wet nurse with red hair, for this apparently implied a volatile temperament that could affect the woman's milk.
In the antebellum South, elite women might use a slave woman to feed their babies, though this custom was less common than myth has led us to believe. When they did so, southern white mothers rarely expressed concern about a black woman feeding their infants, even though racial sensitivities affected other areas of southern life. In a few cases, white women fed slave babies when the slave mother had died or was unable to breast-feed her own newborn. The most important issue was to keep a baby alive. Slave mothers took their own babies to the field where they would hang them from a tree or lay them on the ground and breast-feed them as needed. Babies living on large plantations were often left in the care of an older slave woman, and mothers would rush back to the slave cabins to feed their infants.
Artificial feeding was always an option, usually a pragmatic response when other possibilities failed. If no woman was available to breast-feed, the baby was hand fed with what historians call artificial food. This often consisted of softened bread soaked in water or milk and fed from what was called a pap boat or pap spoon. Mothers fed their babies cow's or goat's milk, various teas, or clear soups from a suckling bottle or nursing can made of glass, tin, pewter, or other metal. They sometimes masticated table food in their mouths or mashed or strained adult foods for the babies–anything to feed hungry infants.
A few mothers made a conscious decision not to breast-feed their babies or nursed their infants for only a brief period of time, despite society's encouragement to breast-feed. Some women found it impossible to feed a baby and also help run the family business or work in the fields. Vanity influenced a handful of wealthy mothers who did not want to bother with the demands of nursing and who were eager to resume their social life. Husbands may have influenced the decision not to breast-feed since many people believed that it was inadvisable for a nursing mother to resume sexual relations. Hiring a wet nurse or hand feeding the baby were options in these cases.
By the mid- to late-nineteenth century, doctors became increasingly involved in obstetrics and infant care. Medical practitioners and advisors discussed numerous issues related to child rearing. They urged women to breast-feed their young, recognizing it to be the best way to keep a baby alive. One of the infant diseases that most concerned doctors and parents was cholera infantum, a severe form of diarrhea that affected especially those babies who were hand fed or who were being weaned from breast milk to artificial foods. Breast-feeding also fit the period's image of women and their central role as mothers. What made a better statement about a woman's commitment to her maternal duties than breast-feeding?
An issue that fostered debate among physicians and new mothers was whether to feed a newborn right after birth. The appearance of colostrum from a mother's breast fostered some uneasiness. To an observer, this watery liquid did not seem to provide adequate sustenance to ensure a newborn's survival. Lacking the scientific evidence we have today, people did not know that colostrum contains antibacterial ingredients and nutrients perfectly suited to protect a baby against certain diseases and infection. But wary mothers who could afford to do so might find another woman to feed their newborns temporarily until their breast milk flowed. Gradually, mothers and doctors began to accept the healthy aspects of colostrum.
Another concern was the proper age for weaning a baby off breast milk. As records reveal, up through the nineteenth century, many families had children spaced about two years apart, suggesting that the normal length for breast-feeding was about a year. Women often ceased breast-feeding when a baby's teeth came in, and nursing became uncomfortable. Mothers also stopped breast-feeding if they became pregnant, for they felt it could harm both the fetus and the infant to be simultaneously drawing vital sources from the mother. The timing of weaning also depended on the season of the year; the safest time was felt to be fall or spring in order to avoid the extreme temperatures of summer and winter. The process of weaning a baby from breast milk could be traumatic for both mother and baby. Mothers developed various strategies. Some covered their nipples and breasts with a nasty-tasting salve. Others left home for a few days, leaving the child in the hands of someone who hand fed it. Some sent the baby to a neighbor or nurse until the infant had become accustomed to artificial food and substitute liquids.
By the late nineteenth and early twentieth centuries, with the nation's increasing interest in children's health and wellbeing, doctors grew alarmed at the startlingly high INFANT MORTALITY rates in the United States, especially among the urban poor. A 1911 study of Boston showed that one in five infants who were bottle-fed died before they were a year old compared to only one in thirty babies who were breast-fed. Despite advances in scientific thinking related to infant feeding, especially knowledge about bacteria and pasteurization, doctors and social reformers still had to work hard to reduce high infant mortality. Urban health departments took a lead in establishing milk stations where poor mothers could obtain fresh, clean milk for their young. Cities passed laws requiring the inspection of dairies that delivered milk for urban consumption. In 1910 New York City passed a law stating that milk sold or distributed there had to be pasteurized; in 1912 it imposed a grading system on milk. Health departments sent agents to neighborhoods to advise mothers on proper infant care. Some communities set up milk banks where women could contribute their excess breast milk, which was then dispensed through a directory to needy infants. This system still exists through the Human Milk Banking Association of North America.
Significant changes took place by the early twentieth century as more mothers began to depend less on breast-feeding and more on artificial foods and a modified form of cow's milk or infant formula. The reasons for this change are numerous, though historians debate the importance of each. For one thing, companies like Nestlé in Switzerland and Mellin's and Gerber's in the United States found safe, effective methods to process baby food. Companies hired chemists to develop baby formulas that would replicate mother's milk as closely as possible. Baby food producers eventually created and sold dozens of strained food and cereal products. They pitched their products to doctors and advertised widely in magazines.
Artificial baby foods and milk products became safer and more healthful. With an understanding of bacteria and sepsis, there was more emphasis on the need for sanitary bottles and pasteurized liquids, so infants would be less likely to get sick from artificial foods and unclean bottles. The development of rubber bottle nipples replicated the feel of mothers' breasts and made it easier to hand feed. As more women began to enter the paid work force, they welcomed the freedom and flexibility offered by artificial feeding. Further aiding the acceptance of artificial feeding was the development by baby food companies of pre-mixed, prepared formulas, soy milk products, and disposable bottles.
By the 1950s a majority of women in the United States no longer breast-fed their babies, a dramatic shift from past practice. A number of factors explain this change: the importance of PEDIATRICS as a medical specialty, the ready availability of manufactured formula and infant food, sanitary bottles, an increase in hospital rather than home births, the changing role of women as more moved into the public sphere and wage work, and the close relationship between food manufacturers and doctors. Baby food companies convinced doctors that babies would be healthy if artificially fed. By 1971 only 25 percent of mothers in the United States breast-fed their babies, and only 20 percent of those did so for more than six months.
However, change occurred again in the 1980s, and by 1990, 52 percent of mothers in the United States breast-fed their infants. Even as feminists encouraged women to pursue higher education and jobs outside the home to achieve self-fulfillment, they also encouraged maternal breast-feeding as a natural, healthful approach that was best for both mother and baby. Breast-feeding, they insisted, fostered bonding between mother and infant. Also, the LA LECHEEAGUE, organized in 1956 by a group of Christian women, played a major role in raising awareness of the benefits of breast-feeding. Today, almost a third of mothers who breast-feed do so until their baby is six months old, paralleling a recommendation by the American Academy of Pediatrics that mothers should breast-feed their babies exclusively for six months, avoiding any supplemental liquids or food.
At the start of the twenty-first century, the number of mothers of all races and classes in the wage work force has created new challenges for those who feel that breast-feeding is best for babies. Almost 70 percent of mothers breast-feed their babies, at least for a month or two. Some companies and institutions have set up on-site day care centers and nurseries, giving mothers who work there the opportunity to breast-feed their infants. Most companies, however, leave it up to new mothers to handle childcare on their own. Mothers have found some flexibility by using a breast pump to produce maternal milk that their baby can drink when they are apart. But not all women do this. Other working mothers cut short breast-feeding and turn to artificial feeding or never start nursing in the first place.
Discussion about this important maternal duty continues. Physicians and mothers debate the advisability of feeding an infant on demand and at what age other foods should be introduced into the baby's diet. The suitability of breast-feeding in public fosters discussion, some of it heated. No matter what the debates, the majority of women will continue to ensure the good health of their newborns, through sensible, healthful sustenance, whether that means breast-feeding or giving the baby artificial foods.
See also: Wet-Nursing.
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SALLY G. MCMILLEN