Breastfeeding History

One of the global reform campaigns of our time is the effort to persuade women to breastfeed their babies. Michele Obama has made this plea in the United States. There is an active global campaign to dissuade mothers in developing countries from turning to bottled formula. One difficulty in making the case, especially in poorer nations, is that bottle feeding seems so modern and chic, so fashionable. It is a bit odd to think of such a “natural” process as feeding newborns as a matter of fashion, but it is – and so it was in American history, too.

Although mothers nursing their infants seems to meet a basic biological drive, the history of breastfeeding in the United States shows that what is “natural” is very much shaped by cultural influences; such influences can wax and wane and so embracing the “natural,” too, can cycle. Breastfeeding as the ideal way to mother has gone in and out of fashion.

Pushing Breastfeeding in Early America

A recent paper by Nora Doyle, subtitled “Breast-Feeding and the Maternal Ideal in America, 1750-1860,” inspires this post. Doyle looks at the mothering advice manuals of the day and at the diaries of the middle-class and upper-class women who read those manuals.

Around 1800 such writers increasingly emphasized that breastfeeding was not only healthier, but that it was also natural, that women would find pleasure in it, and that it was route to fulfilling their God-given role as the nurturers of family life. But what else could mothers of that day do but breastfeed?  Some tried feeding their babies a mash, which usually did not work, and many more hired a wet nurse to suckle the child. Wet nurses worked for women who could not themselves nurse and also for well-off women who preferred not to nurse.

The movement to encourage middle-class women to breastfeed was part of America’s 19th century sentimentalization of motherhood. Advice-writers spoke of “the sacred and delightful task of suckling,” worth even struggling through pain and discomfort. And if husbands watched the feeding, the experience would bind the nuclear family that much closer together.

Those middle-class mothers themselves often had mixed feelings about breastfeeding; it did not always seem to work that well for either mother or child. But they largely accepted that it was right thing to do; it was part of their emerging role as “the affectionate and spiritual guardian[s] of society.” And so, at least in principle, breastfeeding became part of ideal bourgeois, Victorian family life.

Then…

The 20th-century experience further demonstrates the power of culture over biology. (I draw in particular from here and here.) Breastfeeding among the middle and upper middle classes had indeed become the ideal at the turn of the century, but many women still – for reasons of need or preference – turned to substitutes. This was not yet the bottle, but still most often wet nurses. Because human milk was clearly preferable to cow milk or other foods, doctors insisted that women who could not or would not nurse themselves hire a wet nurse. But the relationships with wet nurses were fraught.

Wet nurses were almost always poor immigrant or black women, and they were distrusted by their employers. Often they were barred from bringing their own children into the employers’ households and sometimes wet nurses’ babies died of neglect even as their mothers sustained the lives of the employers’ children. Wet nursing in households and in orphanages continued into the 1920s and ‘30s, but by then many wet nurses instead sold their breast milk to be bottled.

The Bottle Comes and It Goes

The real decline of wet nursing came, of course, with the rise of formula bottle-feeding, which began in the 1910s.  Bottle feeding was convenient (especially for women busy outside the home); it was “scientific”; and it was “modern” – it was what mothers who were “with it” did. From that point of view, only primitive or unenlightened women breastfed. By the middle of the 20th century an estimated 80% of American mothers used bottles. The bottle had displaced the breast.

Then, the tide turned fully around (again).

Now, 75% of American mothers start out breastfeeding, up from 24% only four decades ago. And it is the more educated women in America and women in western nations who are leading the move back to the breast. Modern advice-givers have become less tolerant of bottle-feeding and they send the clear message (as does Michele Obama) that the good mother is the breastfeeding mother: It is healthier for the child, both physically and emotionally. (Ironically, this shift away from bottles has come just as research improved the nutritional quality of formula.)

Given that some women find breastfeeding difficult and painful, their quest to be “natural” is a sacrifice to their ideal of the virtuous mother – just as it was about a century ago, before the rise of the bottle. (A couple of papers on issues in the contemporary breastfeeding campaign are here and pdf.)

So, today, we are perhaps where we were two centuries ago in America, with breastfeeding again on the ascent after a period of seeking alternatives. And much of the discussion is about what is “natural.” What seems natural is often entangled with what is fashionable.

(This column was cross-posted on The Berkeley Blog on September 28, 2011.)