Among the fierce debates raging among mothers on parenting forums none are more intense than Breast vs Bottle. The British government is even trialling a pilot scheme paying mothers 120 pounds (nearly $200) in shopping vouchers if they breastfeed their baby for 6 weeks rising to 200 pounds if they keep nursing for 6 months. It’s tempting to think that the reluctance or inability of many mothers to breastfeed is something new—but it isn’t.
The use of cow’s milk or formula was established during the 19th century following the industrial revolution. Using a bottle is quicker than breastfeeding, allowing women to work longer hours. Such was the pressure on women to trade nursing for newer, more intensive ways of working that bottle feeding increased in use despite as many as a third of bottle-fed babies in the early 1900s dying before their first birthday.
In the 20th century, better bottles, formula and hygiene made bottle feeding acceptable and commonly preferred throughout society. Women continued to enter the workforce, babies were fed regularly and all was right with the world. Then we learned that formula-feeding could be bad for your child’s future health, for example by increasing the risk of diabetes and obesity.
This is going to be a very tough genie to force back into the lamp. Women didn’t suddenly wake up to an alternative to breastfeeding during the industrial revolution. It started much, much earlier than that. The baby bottles of the 19th century swept away one of the oldest professions—wet nursing (breastfeeding another woman’s baby). The first records of wet nursing date back thousands of years to ancient Israel, Egypt and Greece. Wet nurses were needed when a mother couldn’t feed her own baby herself—and employed by women whose social position encouraged and enabled them to pay another woman to nurse their child.
Women today who find breastfeeding difficult or impossible may meet criticism or even disbelief. How can so many women find this difficult—surely the human race would have died out? One of the earliest known medical encyclopedias (from Egypt, c. 1550 BC) gives remedies for lactation failure, such as rubbing the mother’s back with the oiled warmed bones of a swordfish. Such remedies recur thoughout medical historical records, so clearly problems with breastfeeding are nothing new.
Wet nursing for social convenience was very widespread in families that could pay. Wealthy Romans of 300–400 BC would employ wet nurses to feed abandoned girl babies to become a source of cheap slave labour (an example of the exploitation of women at every level). In Europe, disapproval of wet nursing picked up during the Middle Ages because people thought the baby might take on the characteristics or ailments of the wet nurse. Wet nursing later became infamous as ‘baby farming’ when babies were sent away to be raised by wet nurses, some of whom took little or no care of these children.
But wet nursing was not just a profession. Throughout human history, women have been cooperative breeders relying on the support of other women of all ages; both kith and kin (see Hrdy, 2009). Nursing another mother’s baby is well-documented among hunter-gatherers and would always have been an essential support for new mothers experiencing problems. The fact that such support would counter selection to eliminate such difficulties must have been a comparatively small price to pay—in the same way that the benefits of the big human brain compensated for increasingly difficult labours.
A study just published on breastfeeding among Australian mothers calculated that breastfeeding took an average of 5 hours per week more than bottle feeding (which seems a vast underestimate to me personally). The authors, Smith and Forrester, consider how a busy mother can be supported with household help, maternity leave, suitable childcare and workplace lactation breaks—because nursing women all work, whether it’s at home or elsewhere. There was no golden age in our ancient history when mothers nursed their babies while reclining in flowery meadows all day, only taxing themselves to plait each other’s hair.
Although Smith and Forrester talk about the economic cost to the nursing mother, they stop short of suggesting that a mother could actually be paid to nurse her own child—to become her own wet nurse paid by the state. For the less economically privileged mothers targeted by the pilot scheme, an extra 200 pounds will be especially welcome. But 200 pounds can hardly compensate for the loss of actual wages if paid work is incompatible with nursing. And, it can’t stop the deep discomfort many women are made to feel in public because women’s breasts are only expected to be revealed in the shower, the bedroom or on TV.
The work that mothers do, both inside and outside the home, has changed radically. And they do this work increasingly alone, without the support of other women. There is no doubting the real benefits of breastfeeding and I hope the pendulum swings back to it being a part of normal, everyday life. But if we had 100% of mothers breastfeeding—it would be for the first time in human history.
Smith, J. P. and Forrester, R. 2013. Who pays for the health benefits of exclusive breasfeeding? An analysis of maternal time costs. Journal of human lactation, 29(4): 547-55.
Stevens, E. E., Patrick, T. E. and Pickler, R. 2009. A History of Infant Feeding. The Journal of Perinatal Education, 18(2): 32-39.