Breast Milk and Artificial Infant Feeding

Antoinette Fauve-Chamoux. Cambridge World History of Food. Editor: Kenneth F Kiple & Kriemhild Conee Ornelas. Volume 1. Cambridge, UK: Cambridge University Press, 2000.

The importance of maternal breast feeding is considerable for infant survival until weaning and beyond. In addition to nutrition, it also provides many of the mother’s immunological defenses to a baby whose own defenses are weak at birth. In the past, however, the protective (as well as the nutritive) qualities of maternal milk were unknown, and wet-nursing practices were common for social, cultural, and economic reasons. In the West, maternal breast feeding in the first year of life was most common in rural areas. But animal milks and solid food were given to babies everywhere when breast feeding was not possible, practical, or convenient, or when it was considered insufficient.

Maternal Breast Feeding

During the first year of life, mortality should be independent of the purely nutritional factor. It has been demonstrated that even undernourished mothers, subsisting on around 1,500 calories a day, are able to nourish their babies adequately through breast feeding (Livi-Bacci 1991). Nonetheless, in the past, infant mortality figures (which were usually high) varied enormously with maternal feeding practices. Babies not breast-fed are easily prone to gastrointestinal infections in summer and to respiratory infections in winter. Thus, environmental circumstances and child care were secondary factors of survival when compared with the manner in which infants were nourished.

Mother’s milk is in itself complete nourishment for a new infant. However, compared to the milk of a new mother (which comes in response to the direct demand of the suckling child), the milk of a wet nurse has neither the “age” nor the exact composition required for neonates, because usually the nurse has given birth to a child of her own some months earlier. Nevertheless, female milk is preferable to animal milk. Our ancestors were perfectly aware of the age of the milk—its color and consistency—when choosing a wet nurse. Yet before the 1750s, they did not fully appreciate the qualities of human milk and the superiority of a mother’s milk for her own child.

The Qualities of Human Milk

The constituents of human milk—water, protein, fat, carbohydrates, minerals, vitamins, lactose, casein, and so forth—have all been examined, and comparisons made with cow’s milk and other animal milks (Paul and Palmer 1972; Davidson et al. 1975; Souci, Fach-mann, and Kraut 1981). Such studies have demonstrated the advantages of human milk, and they show why cow’s milk cannot safely be given to very young children unless it has been processed. This procedure involves dilution with water, to reduce the excessive protein concentration, and also the addition of sugar. Moreover, before pasteurization, cow’s milk presented other dangers. Since the milk was not boiled, and bottles and other instruments were not sterilized, artificial feeding could easily produce fatal infections.With direct sucking, however, such consequences were avoided.

The Wasted Colostrum

In European societies, there was a common and widespread belief that a mother’s first milk, the colostrum, was not good for the newborn baby, who had to get rid of his or her meconium. Thus, another lactating woman frequently suckled the child for the first four or five days. Unfortunately, delayed lactation for new mothers could result in milk fever, painful milk retention, and unprepared nipples that could discourage her from ever breast-feeding (Fauve-Chamoux 1983).

Nor was such a procedure good for the baby. Although people of many cultures—from ancient Greeks to Mexican Indians (Soranus of Ephesus 1956; Kay 1981)—have shared the belief that the colostrum may be dangerous (indigestible, heavy, and corrupt), it is, although lightly purgative, actually well assimilated and very protective in the antibodies it delivers.

Yet until the middle of the eighteenth century, or even later, medical literature condemned the colostrum. Samuel Tissot, for example, in his bestselling handbook, Avis au peuple sur sa santé (1782: 379), wrote:

The stomach and bowels of the child, when he comes to the world, are full of a thick and sticky substance called meconium. This substance must be evacuated before the child is fed with milk, otherwise it would corrupt the milk; it would turn very bitter and produce two kinds of severe problems the child would not survive.

This excrement may be evacuated (1) if no milk is given during the first 24 hours. (2) If water is given during this time, with a little sugar or honey in it; resulting in a dilution of the meconium, a better natural evacuation and perhaps vomiting. (3) To ascertain that all the substance has gone, it is recommended to give, every four or five hours, an ounce of syrup made of composite chicory, added with a little water. This diet is of great advantage; it should be common practice, as it is now here [in Switzerland] since the last years; this syrup is better than any others, particularly better than almond’s oil.

If the baby is very weak, and if some food is requested during the first day of life, some biscuit, soaked in water, is usually given, or a light panade [bread soup].

Most children of preindustrial rural families were fortunate enough to have this treatment succeeded by maternal breast feeding. But for many less-fortunate urban children, it was followed by a regimen of wet nursing and complementary foods.

Control of the Milk Supply

According to the Greek physician Soranus, active in Rome and Alexandria about A.D. 100, a nurse’s milk should be regularly tested for consistency and quantity. In order to maintain a good milk supply, any nursing woman had to follow a regimen of diet, rest, and some exercise. Earlier, around A.D. 60, Pliny the Elder in his Naturalis Historia, had indicated that some foods helped increase one’s milk supply. These included cabbages, fennel, Agnus castus seeds, anemone, and the boiled stalk of sow thistle (Pliny 1601; Soranus 1956; Knibiehler and Fouquet 1980).

In late–nineteenth-century literature, it was often recommended that a lactating woman eat good meals, with cereals, lentils, and chocolate. In addition, it was believed that drinking beer, cider, or even coffee would help maintain a “humectant” diet (Delahaye 1990). However, it is interesting to note that, before the 1830s, such literature was astonishingly silent about beverages. From antiquity on, treatises recommending maternal breast feeding seem oblivious to the importance of drinking liquids.Yet 87 percent of human milk is water, and so a lactating mother should drink extra liquid to feed the child.

Indeed, this may be one of the reasons that so many urban women of the past complained about not being able to produce sufficient milk: They simply did not drink enough liquids. In European urban areas, water pollution was so general that water might have been used for cooking soup but not for drinking, and unboiled water was dangerous to health.

In rural areas, by contrast, peasants knew the respective qualities of various water sources and frequently had easier access to fresh spring water than urban dwellers, although it is true that even in the country, unusual pollution occasionally resulted in serious epidemics. The generally greater access to clean water supplies, however, helped ensure that breast feeding not only remained a predominantly rural practice but was also a paying occupation of peasant women, because they were regarded as fit to produce human milk on demand for several years at a time. In addition to earning money, country nurses probably also knew that lengthy lactation might help them avoid another pregnancy.

Delaying Conception: Milk versus Blood

Acting through a complex hormonal mechanism, lactation can inhibit ovulation under optimal circumstances. However, both ethnographic and demographic data indicate that the relationship between breast feeding and anovulation is not perfect (Corsini 1979). In addition, other data help to disguise the importance of sexual abstinence during the postpartum period. In fact, many historical and/or demographic studies are difficult to interpret because they are mute about breast-feeding habits. When a mother is the sole source of infant nourishment, anovulation is frequent, and many populations have depended on the contraceptive effect of breast feeding for the spacing of births. Yet despite many recent historical studies using family reconstitution methods, the exact role of breast feeding in causing postpartum amenorrhea in past Western societies has eluded quantitative elucidation.

The age of the nurse, her nutrition, body weight, and fatness are all unknown parameters to which sexual behavior should be added (Knodel and Van de Walle 1967; Chamoux 1973b; Corsini 1974; FauveChamoux 1983). Hippocrates and Soranus shared the idea that pregnancy could not occur without menstruation, the resumption of which, they thought, was encouraged by sexual intercourse, with the result that this specific blood altered the milk. Thus, many authorities insisted on the necessity of sexual abstinence during breast feeding (Van de Walle and Van de Walle 1972), but it seems that the great majority of European couples never accepted this taboo.

Soon after birth, part of the mother’s blood was said to be transferred to the breasts as milk. “After helping a new life in the maternal uterus, blood goes up to breasts, following an admirable, natural and economic way, and becomes a sweet and familiar food” (Verdier-Heurtin 1804: 30). Before conception, the female’s extra blood was thought to be evacuated every month. Thus, after birth, if the mother did not lactate, her milk might be dangerously “driven back” and could make her sick. If menstruation or pregnancy occurred while wet-nursing, the milk was considered “spoiled” (Chamoux 1973b; Sussman 1982; Fauve-Chamoux 1985; Fildes 1988); in consequence, the milk of a pregnant nurse had a very bad reputation (Kay 1981; Fildes 1988).

Medical literature of the eighteenth century, which is replete with discussions of maternal breast feeding versus mercenary nursing, defended the Hippocratic principle of respect for nature: The free circulation of “humors” should be encouraged, and any impediment to this natural principle might create severe physical and moral troubles. Also common in the literature were references to the dangers of physical and moral contamination: “A child would have been honest if he had suckled his own mother’s milk; instead he was a villain, a libertine, a vicious man with a bad temper; from suckling a bad wet-nurse he got all her vices and defaults” (Dionis 1721: 57).

A lascivious or hysterical nurse was believed to transmit her character through her milk, along with various eventual diseases—especially those of a venereal nature. Despite this, however, menstruating wet nurses were numerous, and those who were employed did their best to hide their monthly visitations (as well as any pregnancies) so as to continue nursing.

The Length of the Nursing Period

According to Soranus, the nursing period in his era ranged from 18 to 24 months—until the child could chew. Russian children of the eighteenth century were weaned after some 10 to 15 months of nursing (Chamoux 1973b; Ransel 1988). In Brittany at the beginning of the twentieth century, the weaning limit was 18 months, and “[t]hen my mother definitely closed her shirt and corselet,” related Pierre Jakez Hélias (1975). “Then I had to eat my bouillie alone.” Another tradition indicated that a child could be weaned when he had grown twenty teeth. In France, children of the rich could be suckled by their wet nurses until age 20 or 22 months.

By contrast, at the end of the ancien régime, the great majority of foundlings who survived were officially weaned when 12 months old. In the Rheims region, however, 54 percent of illegitimate babies were weaned when 12 months old, and 31 percent when 13 months old, for a very simple administrative reason:Wet nurses had a monthly salary, and thus the change took place on the first day of the month. But unfortunately, weaning concerned only the 30 percent of children who survived to secure access to a nurse’s breast in the first place. Legitimate city children sent to wet nurses in the country were not returned to Paris before 19 or 20 months of age, although they had been weaned some months before. Because treatises of the Enlightenment period did not recommend breast feeding exclusively (Hecquet 1708; Lerebourg 1767; L’Epinoy 1785), semisolid food was also a part of the infant’s diet. Thus, some children could be weaned as early as 6 months or even less. The weaning schedule depended on a question of money: A dry nurse was cheaper than a wet nurse, and peasant women could officially sell their milk as soon as their own child reached 7 months (Code des nourrices de Paris [1715] cited in Delahaye 1990). It seems, however, that cheating was the norm in Paris as far as this regulation was concerned, and the age of the nurse’s milk could be only a guess.

Mercenary Breast Feeding in Europe

Until the middle of the seventeenth century in Europe, the practice of putting a child out to nurse was reserved for the aristocracy. It was standard behavior to hand over an aristocrat’s newborn child to a paid nurse, although the nurse was usually strictly supervised by the family. Much later, in the nineteenth century, bourgeois families utilized the system of an “on-the-spot” wet nurse who was given board and lodging and was, like her earlier counterpart, closely supervised. But in between these two periods—during the seventeenth and eighteenth centuries—newborn babies of those who could afford it were often sent to the country, and thus placed out of range of their mothers’ control. We do not know how extensive this phenomenon was throughout Europe. In France, it was limited primarily to residents of the main towns (Chamoux 1973a), and in Renaissance Florence, there was a long tradition of urban parents sending infants out to nurse (a balia) soon after birth (Klapisch-Zuber 1985).

In preindustrial England, such a practice was never so widespread as in some other parts of Europe, but well-to-do urban families of merchants, lawyers, physicians, and clergymen—especially those residing in London—tended to employ country women a few miles away from the city (Fildes 1988). Similar situations existed in Warsaw, Hamburg, Stockholm,Vienna, and Madrid.

Parental Behavior and Social Norms

In the past, paternal feelings for children who had not yet reached the age of reason were frequently negative. Michel de Montaigne, for example, wrote in his Essays (1580), without mentioning his wife’s opinion: “I cannot feel that passion necessary to kiss a barely-born child, with neither movement of his soul, nor a recognizable shape to its body, by which it might make itself pleasing to me. Nor have I been inclined to have them fed close by me.” He continued that it was “a good school to send them [the small children] to the country, to bring them up in the lowest and commonest way to live under popular and natural law.”

Basically, Montaigne’s “natural” educational model did not differ very much from that of Jean-Jacques Rousseau. Following the fame he had acquired from the articulation of his philosophy of child care in Émile (1762), in 1789 Rousseau wrote in his Confessions (1959): “I have neglected my duties as a father, but the desire to do them harm did not enter my heart, and my fatherly entrails could hardly cry out for children who have never been seen.” The latter remark was a reference to a wet-nursing arrangement that distanced the mother from her infant. As an earlier observer had lamented:

I am quite at a loss to account for the general practice of sending infants out of doors, to be suckled, or dry-nursed by another woman, who has not so much understanding, nor can have so much affection for it, as the parents; and how it comes to pass, that the people of good sense and easy circumstances will not give themselves the pains to watch over the health and welfare of their children (Cadogan 1748: 24).

Clearly, a bond between nurse and child frequently replaced that between mother and child, and many medical writers followed Soranus of Ephesus—the most famous gynecological and obstretrical writer of antiquity—who thought that a good wet nurse helped in protecting the mother’s health and youth. In the time of Soranus, however, the nurse was present in the family, and her behavior was under strict supervision. In the eighteenth century, this was not the case, and even a mother’s quest for elegance and parental desires for tranquillity cannot fully account for putting children out to nurse. Nonetheless, this was a widespread social phenomenon, which resulted in half the babies in Paris being sent outside the capital, no matter what their sex or birth order. The explanation seems to be that it had become common middle-class behavior.

Urban Females and Breast Feeding

Refusing the maternal duty of breast feeding, however, also extended to the lower classes, especially in preindustrial European towns. A French writer in Lyon in the 1860s explained:

Shopkeepers’ wives have, in general, as much importance in their business as their husbands, they cannot nurse for themselves; and besides, they usually live far from their shops, so they have to resort to the wet nursing bureaux. It is the same with female silk workers, who earn almost as much as their husbands and have an interest in putting their children out to nurse in the country (Sussman 1982: 104).

A century before, when women were working hard for the manufactures, a police officer in Lyon observed that “[t]heir situation, work, condition do not allow the women any time, any freedom, to feed their own children” (Prost de Royer 1778).

There may, however, have been other reasons, not related to the work of the mothers, for sending children away. To send the newborn child to fresh air, in the belief that the bad urban air spoiled maternal milk, was doubtless one reason. Another may have been the perception that the diet of urban females did not contain enough in the way of appropriate beverages and good-quality proteins. Indeed, in France, consumption of meat in urban areas was very low at the end of the ancient régime (Livi-Bacci 1991). Thus, poor women of the countryside may even have had a better diet than their urban counterparts. Nonetheless, we are forced to wonder again what meaning “motherhood” held for those couples who put their children out to unsupervised country nurses, or what it meant for those mothers, often alone, who abandoned their babies to charity.

Love and Premodern Motherhood

It is doubtful that people of the past did not realize that putting a child out to nurse was risky, and that abandoning a child was to condemn it to death. This makes it difficult to explain how, in those days of enlightened philosophers, the widespread practice of abandonment of newborns (which in pre-Pasteur times usually amounted to infanticide) could coexist with a clear renewal of interest in children (Aries 1962; Shorter 1975; Badinter 1981; Bardet, Corsini, Perez Moreda, et al. 1991).

Indeed, it is morbidly fascinating that Rousseau, the herald of individual morality, seems to have had no difficulty adopting the behavior of contemporary Parisians with regard to bastard children: He abandoned his own children to the Paris foundling hospital. His reasons for this choice are very clear (Rousseau 1959),but the mentality that inspired them remains incomprehensible to us. Rousseau did not belong to any of the social groups regularly acquainted with child abandonment, such as domestic servants, urban workers, or impoverished day laborers, but his children were all bastards, and raising them was apparently not among his priorities. The same held for Thérèse Levasseur, his companion, who seemingly did not fight to keep her children, nor did she try to suckle her succession of babies, boys or girls. In Europe, as many boys were abandoned as girls (Bardet et al.1991).

An abundant eighteenth-century literature encouraging maternal breast feeding stirred little interest in French, Italian, Russian, Polish, or English urban societies (Hecquet 1708; Lerebourg 1767; L’Epinoy 1785). It was the case that some grand ladies (who could afford to) breast-fed their children and then boasted about it as a way of returning to nature. Similarly, it was fashionable to have one’s portrait painted when breast-feeding, like a Madonna (Fauve-Chamoux 1985).All of this was a way to affirm one’s modernity and to symbolize an advanced feminism, but it was also the case that men frequently did not wish their wives to breast-feed. Thus, often, aristocratic women who breast-fed their infants only did so during the day; at night, maids or nurses took care of the babies. The day for the child, the night for the husband; the sum was a compromise with God.

Serving the Husband before the Child

Since polygamy is not tolerated in most Christian societies, theologians and confessors have had great difficulty in establishing a hierarchy of sins: A woman was supposed to do everything possible to avoid a too-ardent husband, and, of course, also to avoid adultery. Yet neither could she refuse her wifely duty for too long, even if her aim was to preserve her milk, which helps to explain why confessors finally justified the practice of putting children out to nurse as being the lesser of two evils:”If the husband is in danger of lacking restraint, the woman must, if she is able, put her child out to nurse in order to tend to her husband’s infirmity,” said the Abrégé du dictionnaire des cas de conscience by M. Pontas (1764).

Certainly such a practice preserved the peace of the household by ensuring the father permanent access to his wife’s bed. This aristocratic habit was popularized in France and reveals the importance placed by the Catholic Church on conjugal relations. The Church favored the relationship between the parents and relegated the child’s interest to second place (Aries 1962; Noonan 1966; Flandrin 1973).

Religious attachment also influenced attitudes with respect to childbearing and nursing. Protestant women generally bore fewer children than their Catholic counterparts and nursed them more often themselves. Infant mortality was, thus, much higher in Catholic than in Protestant families during the seventeenth century (Knodel and Van de Walle 1967). But despite dechristianization and an enormous literature in favor of maternal care, there was no widespread return to maternal feeding at the end of the eighteenth century, and France remained a cornerstone of the nursing industry. Families characteristically had fewer children, but the practices of wet nursing and artificial feeding continued, and until World War I, the custom of putting infants out to nurse remained widespread and infant mortality remained high (Rollet-Echalier 1990). In short, the status of infants did not improve greatly in France (or in western Europe, for that matter) before the first decades of the twentieth century.

Differential Infant Mortality

The consequences of this apparent unconcern for the welfare of the young were of considerable importance. Putting babies out to nurse raised the infant mortality level and, in the absence of contraceptive practice, accelerated the rate of successive pregnancies. France’s infant mortality, much higher than that of England, Sweden, or Denmark, was clearly a function of less breast feeding and poor child care.

Among Parisian craftsmen who kept their children in the eighteenth century, one baby out of every four died before his or her first birthday. But in Lyon in the 1780s, the “Society for Helping Poor Mothers” paid women 9 pounds a month if they breast-fed their own children during the first year of life. The infant mortality level soon fell to 1 out of 6 babies; the drop was considered a large success. By contrast, however, when infants were systematically put out to nurse, the infant mortality rate at least doubled. Thus, 40 percent of legitimate babies in Rouen died if they were put out to a wet nurse. But when their mothers nursed them, infant mortality dropped to 20 percent, showing the vital importance of maternal breast feeding (Bardet 1973). In Lyon, only one-third came back alive from wet nursing, and in Paris, only between one-half and one-third of legitimate children survived mercenary nursing (Prost de Royer 1778).

From the Refusal of Breast Feeding to Contraception

Rejection of the newborn was accompanied in France by a progressive diminution of family size. In Rheims, at the end of the seventeenth century, women who married before age 20 bore an average of 11 or 12 children. But in the late eighteenth century, on the eve of the French Revolution, women were having only 6 children (Fauve-Chamoux 1985). The conjugal practices of urban elite groups had undoubtedly shown the way with regard to contraception. As early as the 1670s, the leading families of large cities like Rheims or Rouen (Bardet 1973; Fauve-Chamoux 1985) were successfully limiting the number of their children, and social differences in this regard were strongly marked.

During the eighteenth century, behavior that would later be called “Malthusian” took root in the middle class. This was a “family-planning” outlook that implied deep changes in attitude toward the Christian religion, and toward love and procreation. But, for the lower classes, little had changed. Poor mothers, frequently without husbands, often considered that they had no choice but to abandon their children, whether legitimate or not. And this custom continued to confront societies with moral as well as practical questions concerning the care and feeding of the young.

Artificial Infant Feeding

Feeding Foundlings

About one-third of the children abandoned in Paris during the eighteenth centur y came from the provinces and, thus, were at least a few days old and already sick and underfed. Many of these babies died before reaching the ancient hospital, the Hôtel-Dieu, which also served as a foundling home. Among other things, these deaths tended to skew mortality data and make it appear that, at the Hôtel-Dieu, the mortality of children from the provinces was lower than that of children born and abandoned in Paris. In 1772, the king prohibited this transfer of infants to Paris, but the flow continued. The ban was renewed in 1779 but with no better results, and at the end of the ancien régime, between 6,000 and 7,000 newborn babies were being abandoned in the capital each year.

The mortality of these children was horrifying. More than 80 percent died, with 7 out of 10 deaths occurring during the first month of life and resulting from lack of appropriate food and nursing. Three-quarters of those who died were estimated by the authorities to be of illegitimate birth. European urban hospitals of the time, like the Hôtel Dieu, were transformed into depositories for abandoned children.

Paradoxically, however, such institutional efforts may have encouraged the phenomenon of infant abandonment all over Europe (Bardet et al. 1991).

The scarcity of wet nurses for such children was general throughout Europe: Institutions paid low wages and the women they employed were poor, often unfit for proper breast feeding, and frequently without enough maternal milk. Therefore, French hospitals experimented with different methods of nourishing abandoned young children, trying cow’s, goat’s, and donkey’s milk, and often combining the animal milks with water and barley or with “rice water.” At the Hôtel-Dieu in Paris, and at similar institutions in Rheims and Milan (where abandoned children were numerous), feeding with animal milks led to the use of feeding bottles and special feeding horns, called cornets. These became part of a baby’s equipment when leaving the foundling hospital for the wet nurse’s home, and they provided a ready means of dry nursing and early weaning.

In Paris at the end of the eighteenth century, there were 208 cradles for foundlings that were permanently occupied. Each saw an ultra-rapid turnover, and each had a personal crystal bottle attached (Chamoux 1973b).

Animal Milk and Baby Food

Cow’s milk, mixed with “barley water” in the Paris foundling hospital during the eighteenth century, probably contributed to the death of many children during the first weeks of life.”Wheat water” was also given as a separate drink. A common milk lightener was “lentil water,” with a dilution as high as 50 percent for “healthy babies,” according to the French physician Dr. J. Tenon, 1 who explained that this liquid was made available “in a porc bladder equipped with a teat or in a feeding-bottle when the children were crying” (Tenon manuscripts, Bibliothèque Nationale, Paris).

Milk from goats was widely known to be lighter, and therefore better, for infants than that of cows. A sixteenth-century observer near Bordeaux, for example, wrote of country women whose breasts did not contain enough milk to feed their infants and consequently called upon goats “to help them” (Montaigne 1580). In 1634, goats were employed by Paris’s Hôtel Dieu to feed the foundlings, as had been done successfully in Italy in the previous century (Lallemand 1885).

Such nourishment was certainly good when the babies were directly suckling the animals. But unfortunately, bottles, with all their attendant germs, were often used as intermediaries, and if another liquid was added—for example, herb tea of chiendent (“couch grass”)—it made for a dangerous diet. Goats were easier to maintain in an urban institution than donkeys, whose milk had enjoyed a good reputation for its digestibility since Roman times (Table III.2.1). In Paris in the 1880s, donkeys were used for direct suckling at the stable of the Hospice des Enfants Malades. But they were troublesome because lactation could not be prolonged unless the animals fed their own foals, and the experiment did not last long. Direct animal suckling, however, was usually a practice in hospitals for syphilitic children, who, because of fear of contagion, were never breast-fed.

Wine was said to be a “tonic” when given in dilution and in small quantity. It was often employed when no milk was available, particularly when the child was being transported without any nurse. For example, it had the effect of keeping abandoned children quiet when they were taken by slow carriage to the Parisian foundling hospital from far away. But alcohol was also believed good for infants when they suffered from gastrointestinal complaints (Fildes 1988). Calvados, champagne, or other spirits may, on occasion, have been ritually added to feeding bottles to celebrate baptisms or like events.

European Bouillies

Solid food for infants consisted of a kind of porridge, called bouillie in French. This was a food usually reserved for a weaning diet and for older children. In much of France, wheat was preferred for the porridge (oats were considered a food for animals), but the use of corn was common in southern France after the end of the ancien régime. There, a porridge called millias, cooked in a pan, served as a main course for both adults and children. This dish was similar to Romanian mamaliga or Italian and Iberian polenta (Livi-Bacci 1991).

It is fortunate that such complementary foods were not strictly reserved for weaning or for mercenary nursing but rather were given, along with milk, to very young children in both European and colonial societies. This explains why marasmus—the result of a grossly deficient intake of both proteins and calories (Gift, Washbon, and Harrison 1972; Livi-Bacci 1991)—was not a common type of malnutrition in past Western societies. By contrast, many Occidental babies died of too much unaccustomed solid food and too little of their own mothers’ milk. One example of such an imbalance was a “biscuit soup” prepared every day in a London foundling hospital. The apothecary complained in 1759 that milk was often forgotten in the mixture: “The biscuit is directed to be boiled in water to a proper consistence and afterward mixed with a proper proportion of milk, but it is now and has been given to the children without any milk at all” (Fildes 1988: 169).

During the 1770s, Tenon collected information from all over France and Europe about artificial baby food. He understood that any artificial food was usually a killer when the very young baby was not or was no longer breast-fed.”Those foods,” he wrote,” given as supplements to breast milk, as thick bouillies made of ordinary milk, flour, yolk, and wine, sweetened with sugar, destroy the positive effects from the very little milk they happen to suckle; those foods are too thick and too heavy for a delicate baby’s stomach” (Chamoux 1973b: 415).

When mother’s milk was lacking, Alsatian and German women gave their own children a cream made from rice or bread. In seventeenth-century Brittany, rural mothers often fed their children with a finger, after first warming the bread soup in their own mouths (Lemieux 1985). Certainly, in the past, the easiest food to give a baby, other than milk, was wet and mashed bread.

Such a panade figured prominently in the weaning process, which came about when the mother could not, or no longer wanted to, breast-feed her own child. This was often the case when a woman was wet-nursing another child. In Salpétrière Hospital in 1755, for example, children of employed wet nurses were served a portion of bouillie in the morning and another in the evening, and given soup at lunch time. A “portion” was half of a big spoonful, and 17 portions were prepared twice a day in a cooking pot called a bonet. Most of those children, who rarely received mother’s milk, also consumed a daily supplement of a pint of animal milk.

Tenon, who commented so extensively on eighteenth-century baby food, was, for his time, a rare defender of cow’s milk, apparently because he was influenced by positive reports of Russian customs. Muscovite children, he wrote, were treated roughly but seemed to become accustomed very early to animal milk and solid food. Indeed, from the very first day of life, Russian babies were fed with salted, mashed bread and cow’s milk.”The woman in charge puts the milk in her own mouth to get it warm and spits it in a feeding horn for the baby. When aged ten months, the child is given cacha, a sort of gruel from sarrazin (buckwheat)—cooked with milk, a much better bouillie than the one made in our countries.” Three other kinds of traditional Russian baby foods and pastes are mentioned by Tenon. One was made of mashed bread, butter, and beer, another of mashed bread with honey, and still another of mashed bread with premasticated meat. And when the babies cried, they were given, as early as one month of age, a light narcotic made from poppy seeds, commonly used for making traditional pastries (Tenon Manuscripts, Bibliothèque Nationale, Paris).

This diet, Tenon noted with admiration, “never results in edema,” which is a well-known symptom of malnutrition still observed in twentieth-century developing countries. Sometimes it is called kwashiorkor and is the result of a deficiency of protein even when caloric intake is relatively adequate (Gift et al. 1972). In light of Tenon’s observation, it seems that Russian children may have enjoyed more good-quality protein in their diet than any dry-nursed babies in western Europe, who were never given meat or fish but only cereals, and who often suffered from edema.

It turns out, however, that Tenon was misled by the French edition of a book concerning the new foundling hospitals of Russia established by Catherine the Great; he believed that Russian women did not usually breast-feed their children (Betzy 1775). Today we know that at the end of the eighteenth century, the feeding of foundlings was as much a problem in Moscow and St. Petersburg as it was elsewhere in Europe. Fully 14,000 babies were registered annually by the Moscow Foundling Hospital (Ransel 1988), and their mortality was estimated to be at least 60 percent, which was roughly comparable to French figures.

During the 1880s, wet nursing became a common female profession in Russia: “The majority of new mothers from our area,” wrote a Russian physician, “do not think merely of how it would be best to nurse their baby but how they might best draw advantage from their breast milk; this unfortunate phenomenon is expressed in two forms—either becoming a [private] wet nurse or by taking a foundling, and sometimes not one but several” (Ransel 1988). Such a situation had long been common in most of Europe, but it was one that was in the process of change for the better.

The Swan Song of the Wet Nurse

Many significant changes in baby care occurred during the nineteenth century. Among the middle classes in Europe, in Paris and Lyon as well as in London, Madrid,Vienna, and Moscow, it became expected that the wet nurse would reside in the home of the infant (Fay-Sallois 1980; Sussman 1982; Fildes 1988). In England, however, during early Victorian times, when an unmarried wet nurse left her own baby of six weeks to sell her milk in a London bourgeois family, she condemned him or her to death. Infants of the poor still rarely survived artificial feeding, and the absence of human milk and early weaning sacrificed most illegitimate, as well as many legitimate, children.

In Britain, the Infant Life Protection Bill was passed in 1872, but this failed to stop baby farming and wet nursing. In France, the Roussel Law (1874) had no more immediate effect, but it did oblige families to register all children who were nursed outside the home, to provide the name and address of the wet nurse, and to indicate the fate of the children. This permitted the calculation of regional and national statistics on infant survival and the impact of feeding methods. In Marseille, during 1875, 50 percent of parents employed wet nurses. From the data available, it would seem that 20 percent of wet nurses lived in the homes of the infants and 10 percent lived close to the baby’s city. But 70 percent lived far away from the baby’s home, sometimes more than 100 miles.

In the 1890s, the importance of pasteurization was understood, and artificial feeding at last became less dangerous. Nevertheless, some baby bottles were impossible to clean properly, especially those with a long tube attached to them.

Conclusion

Information from the World Fertility Survey (Population Reports 1986), as well as from recent studies conducted in developing countries where diarrheal diseases are a major problem for infants, shows how important breast feeding can be to infant survival (Carballo and Marin-Lira 1984). In most of western Europe, North America, and Japan, the potential impact of low breast-feeding rates has been attenuated by improved water supply and sanitary systems. But such major changes occurred less than a century ago with the advent of pasteurization techniques in conjunction with cultural, economic, and social changes. In fact, the so-called 3 Ps (Pasteur, Politics, and Progress) worked together to make artificial feeding safer. Therefore, little effort was exerted from the 1940s to the early 1970s to promote breast feeding, and by 1973, the prevalence of maternal breast feeding had fallen to 25 percent in the United States, with a mean duration of three months or less.

However, in the 1980s and 1990s, a return to breast feeding was noticeable in many industrialized countries, and especially among the better-educated mothers (La Leche International 1981).They became aware both of the immunological and antimicrobial properties of their maternal milk and of the “bifidus factor” concerning the intestinal flora of their babies. In addition, mothers understood that breast feeding benefits their infants with less exposure to contaminants, and finally, they realized that their own milk has superior nutritional properties to animal milks.

In the past, mothers had no such knowledge, however, and if babies died in innocence and purity they were supposedly blessed in heaven. Thus, putting children out to nurse remained a common practice during the nineteenth century throughout the Western world and particularly in France. In addition, before the systematic pasteurization of milk and the provision of sterilized bottles, artificial feeding frequently sent babies, especially those abandoned in European institutions, to their graves. Maternal breast feeding remains, as it was in the past, a matter of culture, family norms, and religion.