At first glance, the acute shortage of baby formula seems like an advertisement for breast-feeding. If only women did what came naturally, the thinking might go, maybe there wouldn’t be a problem at all.
This argument would draw on evidence that multinational corporations like Nestle did much to persuade women to give up breast-feeding in favor of formula. Their 20th-century marketing campaigns ended in consumer boycotts and public disgrace for the formula makers and contributed to the deaths of infants.
But this shameful episode obscures an earlier, more complicated history. The business of nursing and sustaining newborns has long been far more vexed than advocates of either breast-feeding or formula-feeding would have us believe.
In a perfect world, babies would be breast-fed. The health benefits of human breast milk are well documented. But not all babies or mothers find breast-feeding simple to master. Yes, it’s natural. Nonetheless, parents have pursued alternatives for thousands of years.
In some cases, breast-feeding didn’t come naturally. In ancient times, as now, some infants failed to latch, leaving desperate parents scrambling. In other cases, mothers came out of childbirth with their health compromised as they recovered from infections like puerperal fever, which often suppressed milk production.
Before the advent of modern medicine, a staggering number of women died in childbirth. Conservative estimates suggest that 1 out of every 40 births ended in the death of the mother in antiquity, a figure that largely held constant through the 18th century. Absent an alternative source of nourishment, the baby would perish as well.
One solution, which dated back to the domestication of animals, involved feeding infants milk from cows, horses, sheep, goats and even pigs. Sometimes, parents put the baby at the animal’s teat; more often, they poured the milk into clay containers, often designed to resemble an animal, that allowed infants to sip the substitute.
But the milk of other animals proved a poor proxy for human breast milk, particularly in the first months of life. A superior choice was another nursing mother, better known as a wet nurse. These women might hail from the same family. More often, they were strangers or servants paid for their service.
In the Roman Empire, for example, elaborate business contracts governed this lifesaving act, along with advice literature designed to guide parents on hiring the ideal wet nurse (described as a young, celibate, not-too-attractive Greek woman). Unfortunately, it could be difficult to find a good wet nurse. Many worked for slave traders who rescued infants (girls, mostly) abandoned on trash piles, selling them once they had come of age.
Wet nurses also worked for elite mothers who didn’t want to breast-feed their babies. Some feared that doing so would ruin their beauty; others sought to resume their pre-pregnancy social lives. Whatever the reason, the practice of hiring women of lesser social status to nourish babies became commonplace in western societies into the medieval and early modern eras.
The practice provoked unease. Some supposed medical experts speculated that the traits of the wet nurse might be communicated to the baby through some kind of milk magic. The early 17th-century French obstetrician Jacques Guillemeau was typical of a new generation of wet-nurse skeptics. He worried most about the effect that red-headed wet nurses – you know, fiery temperament and all – might have on babies.
Not that animal milk was considered risk-free. In what may be the first book on pediatrics published in the English-speaking world, Thomas Phaire confidently claimed in 1545, “If children be fed the milk of sheep, then their hair will be soft as that of a lamb, but if they be fed the milk of the goat, the hair will be course.” Far better, perhaps, to roll the dice on a redhead.
Well into the 19th century, elite women continued to rely on wet nurses – slaves, in some cases – while doctors and nurses running orphanages turned to them to keep their charges alive. As the industrial revolution gathered steam, working-class women also began relying on wet nurses so that they could work for wages in factories.
But the growing reliance on wet nurses went hand in hand with increased stigma. As one Chicago pediatrician complained, wet nurses demanded a “price above rubies and they made the family pay for it in submission to their whims, accessions to their demands, and forbearance with their bad habits.”
The most obvious alternative – germ-laden animal milks – had evident pitfalls. But this became far less of an issue after health reformers launched clean-milk campaigns that made pasteurized cow’s milk available to mothers in cities. By the end of the 19th century, pasteurized cow’s milk effectively supplanted wet nurses, paving the way for the adoption of formula.
In other words, contrary to a nostalgic view of the past, plenty of women had already given up breast-feeding a couple of centuries ago, either by choice or necessity. Formula didn’t destroy breast-feeding so much as capitalize on trends already underway. Recent archaeological research has lent credence to this point.
The new formula makers included the German chemist Justus von Liebeg, who marketed a concoction in the late 1860s that combined cow’s milk with flour and potassium bicarbonate. Henri Nestle introduced his Farine Lactee around the same time. Much like modern formula, this powdered blend of cow’s milk, malt, sugar and other ingredients could be mixed with water.
Over the course of the 20th century, formula makers increasingly marketed their wares as comparable to breast milk, if not actually superior. They worked closely with the medical profession to lend legitimacy to this spurious claim. But this was a gradual development, one that would take many years to come to fruition. By the time the backlash began – the La Leche League was founded in 1956 – formula makers had become a convenient villain in a compelling, but not wholly accurate, morality tale.
One potentially controversial modern alternative to formula would be to bring back some version of wet nursing. This isn’t as outlandish as it might seem. In the United States, breast-milk banking has gained adherents, though it’s largely meant for at-risk infants. But the prospect of largely white, upper-middle-class mothers outsourcing breast-feeding to poorer women is apt to run afoul of contemporary sensibilities.
In the short term, then, formula will remain the best bet for many women, if only supply chains would cooperate.
Stephen Mihm, a professor of history at the University of Georgia, is coauthor of “Crisis Economics: A Crash Course in the Future of Finance.”