The Mansion of Happiness (9 page)

The practice is ancient; contracts for
wet nurses have been found on
scrolls in Babylonia. (Poor women with milky breasts, hired to nurse their betters’ infants, were known as wet nurses, as opposed to governesses, or “dry nurses.”) Some women can’t breast-feed, and wet nurses also save the lives of infants whose mothers die in
childbirth. But in Linnaeus’s time, extraordinary numbers of European mothers—as many as 90 percent of Frenchwomen—simply refused to breast-feed their babies and instead hired servants to do the work. In 1752, Linnaeus wrote a treatise entitled “Step Nurse,” declaring wet-nursing a crime against nature. Even the fiercest beasts nurse their young, with utmost tenderness: surely women who resisted their mammalian destiny were to be ranked as lowlier, even, than the lowliest brute.
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Enlightenment doctors, philosophers, and legislators agreed: women should nurse their children. Rousseau prophesied in
Émile
, “When mothers design to nurse their own children, then morals will reform themselves.” (
Voltaire had a quibble or two about Rousseau’s own morals: the author of
Émile
abandoned his five illegitimate children at birth, at a foundling hospital.) “There is no nurse like a mother,”
Benjamin Franklin wrote in 1785, after learning about an infant mortality rate of 85 percent at a foundling hospital in Paris that relied on wet nurses (the hospital where Rousseau’s children all but certainly died); the discovery may explain why Franklin, in his autobiography, went to the trouble of remarking about his own mother, “She suckled all her ten children.”
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But Franklin’s mother was hardly unusual; wet nurses were not nearly as common in colonial America as they were in eighteenth-century Europe. “
Suckle
your Infant your Self if you can,”
Cotton Mather commanded from his pulpit.
Puritans found milk divine, even the good book gave suck.
Spiritual Milk for Boston Babes, Drawn Out of the Breasts of Both Testaments
was the title of a popular catechism.
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By the end of the eighteenth century, breast-feeding had come to seem an act of citizenship.
Mary Wollstonecraft, in her 1792
Vindication of the Rights of Woman
, scoffed that a woman who “neither suckles nor educates her children, scarcely deserves the name of a wife, and has no right to that of a citizen.” (More commonly, political theorists argued that what made women different from men meant that they could
not
be citizens.) The next year, the French National Convention ruled that women who employed wet nurses could not apply for state aid; not long after, Prussia made refusing to breast-feed a crime.
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There was also a soppy side to the age of reason. In 1793,
Erasmus Darwin
offered, in
Zoonomia; or, The Laws of Organic Life
, a good summary of the eighteenth century’s passionate attitude toward the milky breast:

If, on the one hand, there is nothing more animal about a woman than the milk in her breasts, there is, on the other hand, nothing more divine. Beliefs about mother’s milk, like the
secrets of generation, have often bordered on the mystical; what has changed over time is what kind of mystery people are talking about. A half century after Erasmus Darwin, across the Atlantic, this kind of thing turned into an even milkier cult of motherhood, abundantly illustrated in a craze for mammary photography; archives and museums all over the United States house daguerreotypes from the 1850s of babies suckling beneath the unbuttoned bodices of prim, sober American matrons, looking half Emily Dickinson, half da Vinci’s
Madonna and Child.
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Then, bizarrely and almost overnight, American women seemed to be running out of milk. “Every physician is becoming convinced that the number of mothers able to nurse their own children is decreasing,” one doctor wrote. Another reported that there was “something wrong with the mammary glands of the mothers in this country.”
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That this happened in the latter half of the nineteenth century—just when the first artificial infant foods were becoming commercially available—is no mere coincidence. Cows were proclaimed the new “wet nurse to the human race.” About the time
Milton Bradley was hanging up a shingle in Springfield, setting himself up as a patent solicitor, the Texas beef industryman
Gail Borden, who aspired to be “the World’s Cook,” applied for a patent for condensed
cow’s milk. Not long after, you could buy milk in a can.
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Most of what marketers said were the nutritive and curative properties of cow’s milk—it soothes a burn; it helps you get to sleep; it makes
your bones grow—were claims appropriated from conventional wisdom about human milk. Tragically, very many babies fed on modified cow’s milk died, which is one reason why, in the United States, nineteenth-and early-twentieth-century physicians, far from pressing formula on their patients, urged them to breast-feed. Many women, however, simply refused, not unlike all those eighteenth-century Frenchwomen who hired
wet nurses. Or, actually, what American women did was different: they insisted that they lacked for milk, mammals no more.

Evolution is the organic version of the mechanical idea of
progress. It wasn’t only
machines that could get better and better, by invention; animals could improve, too, by evolution. In 1871,
Charles Darwin published
The Descent of Man
, in which he speculated that the anomalous occurrence in humans of extra nipples represented a reversion to an earlier stage of evolution.
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If our ancestors once suckled litters of four or six, and if—as was supposed—men had nipples because male mammals once produced milk, maybe women, too, were evolving out of the whole business. By 1904, one Chicago pediatrician could argue that “the nursing function is destined gradually to disappear.” Gilded Age white American women considered themselves so refined, so civilized, so delicate. How could they suckle like bovines? (By the turn of the century, the cow’s udder, or even her head, had replaced the female human breast as the icon of milk.) Behind this question lay another, darker and crueler: How could a white woman nurse a baby the way a black woman does? It was so … animal.

Linnaeus had claimed that African women make a prodigious amount of milk: “
Feminis sine pudoris; mammae lactantes prolixae
” (Women without shame; breasts lactate profusely).
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In the United States, generations of black women, slave and free alike, not only nursed their own infants but also served as wet nurses to white babies. In the nineteenth century, racial theorists, who measured heads to classify the “races,” measured milk for the same purpose: they ran microscopic tests of human milk and concluded that the whiter the mother, the less nutritious her milk. Hardly surprising, then, that well-heeled white women told their doctors they had insufficient milk. By the 1910s, a study of one thousand Boston women had reported that 90 percent of the poor mothers breast-fed but only 17 percent of the wealthy mothers. Doctors, pointing out that evolution doesn’t happen so
fast, tried to convince these Brahmins to breast-feed, but by then, it was too late.

The American “epidemic of lactation failure” depended, too, on the evolving design of baby bottles: so sleek, so clean, so scientific, so modern. The industrial-era rise of
processed, bottled, canned, and packaged food was so precipitous that some historians refer to it as the Food Revolution. That age of
machines that had locomotives chugging across the continent brought food from farms to factories, where it was canned and bottled and packaged. Cow’s milk went from farms to factories, too. And, soon, you could pour that cow’s milk that you could buy in a can into bottles that babies could suck. The first U.S. patent for a baby bottle was issued in 1841; the device, shaped like a breast, was to be worn over a mother’s chest, as a prosthetic. But, year by year, bottles came to look less like breasts and more like silos. The familiar cylindrical bottle, called the “Stork Nurser,” dates from the 1910s and is inextricably tied to the rise of the
stork myth: babies come from storks; milk comes from the milkman. Perversely, Freud’s insistence that infants experience suckling as sexual pleasure proved a boon to stork-style repression, too: mothers eager to keep infantile incestuous desire at arm’s length propped their babies in high chairs and handed them bottles.
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Arm’s length, or further: patents for “bottle holders,” taken out beginning in the 1890s, allowed for bottles to be propped on tables, hung from strings suspended from over cribs, and hooked to the tops of prams, not unlike the way water bottles are clasped to the sides of a hamster’s cage.

Meanwhile, more and more women were giving birth
in hospitals. This meant that, for the first time in human history, infants born
prematurely or very small were given a chance of survival—if only there were enough milk and a way to get it out of a woman’s breast and into the belly of a baby too tiny to suck.

In 1910, a Boston doctor,
Fritz Talbot, spent three days searching for a wet nurse. He failed. Exasperated, he established a placement service, the Boston Wet Nurse Directory. Across town,
Frances Parkman Denny, caring for a sick baby, asked a neighbor to hand-express her milk for him. When the infant improved after drinking just three ounces, Denny, a bacteriologist, became convinced of the “bactericidal power” of
human milk. The year after Talbot started his Wet Nurse Directory, Denny opened the first human milk bank in the United States, collecting milk from donors using a breast pump whose design was inspired by bovine milking machines.
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The modern breast pump can be traced to two late-nineteenth-century developments: the birth of neonatology—the word “neonatal” was coined in the 1890s—and the
industrialization of dairy farming. (Milking machines are cited in breast pump patents; at the level of basic engineering, Medela’s Pump In Style wasn’t very different from Dairymaster’s Swiftflo.) Denny’s plan worked better than Talbot’s: families who needed and could afford human milk did not generally like having poor women living with them as in-house
wet nurses; they preferred having their milk delivered in bottles. Talbot stopped placing wet nurses and instead distributed their milk; he renamed his agency the Directory of Mother’s Milk.
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Once milk banks replaced wet nurses, human milk came to be treated, more and more, as a medicine, something to be prescribed and researched, tested and measured, in flasks and beakers.
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Denny’s bottled, epidemiological model prevailed. What happened next is a twice-told tale. Treating milk as a medicine promoted synthetic milk. Laboratory-made formulas improved; aggressive marketing of
processed infant food—not just bottles of formula but jars of mush and all manner of needless pap—grew to something between badgering and downright coercion. The infant food industry grew. By the middle of the twentieth century, the majority of American women fed their babies formula. Babies sucked bottles, not breasts. But, all this while,
Erasmus Darwin’s rhapsodic view of the milky breast endured. “With his small head pillowed against your breast and your milk warming his insides, your baby knows a special closeness to you,” advised
The Womanly Art of Breastfeeding
, first published by La Leche League in 1958. “He is gaining a firm foundation in an important area of life—he is learning about love.”
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In the 1960s, nursing as a mammalian mommy-baby love-in began a comeback, at least among wealthier and whiter women. The history of food appears to follow this rule: when the rich eat white bread and buy formula, the poor eat brown bread and breast-feed; then they swap. Meanwhile, the more scientists studied milk, the less good formula looked. The same science that had brought formula brought a panic about formula. To encourage women to return to breast-feeding not long after they had been persuaded to abandon it (having been told by manufacturers that formula was more scientific), doctors had to talk about human milk as a medicine—a better medicine than formula.

This took some time to become a major public health issue. But in 1997, the American Academy of Pediatrics issued a policy statement on
breast-feeding and the use of human milk, declaring human milk “species-specific” and recommending it as the exclusive food for the first six months of a baby’s life, to be followed by a mixed diet of solid foods and human milk until at least the end of the first year. In that statement and in a subsequent revision, the AAP cited research linking breast-feeding with reduced incidence and severity of, among other things, bacterial meningitis, diarrhea, respiratory tract infection, ear infection, urinary tract infection, sudden infant death syndrome, diabetes mellitus, lymphoma, leukemia, Hodgkin’s disease, obesity, and asthma. The benefits of breast-feeding, the report insisted, are unrivaled, and breast-feeding rates in the United States were abysmally low; the combination made for a public health emergency. In 1990, the Department of Health and Human Services announced a goal of increasing the proportion of mothers who breast-feed their babies “at initiation” (i.e., when they leave the hospital) from a 1998 baseline of 64 percent to a 2010 target of 75 percent; until the age of six months, from 29 percent to 50 percent; and at one year, from 16 percent to 25 percent.

Attempts to improve initiation rates met with spotty success. The
Rush University Medical Center, in Chicago, which established a peer-counseling program called the Mother’s Milk Club, achieved an
initiation rate of 95 percent; nationally, the rate hovered around 70 percent. More difficult was raising the rates at six and twelve months. The CDC, which issued an annual Breastfeeding Report Card, reported that in 2010 the rate of exclusive breast-feeding at six months was only 13 percent (although the rate of
some
breast-feeding at six months had risen to 43 percent); only the initiation rate had been met.
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