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History of Breast Milk Substitutes and How They Came About
Throughout history, each generation has had to develop an alternative to breastfeeding, either because the mother had insufficient milk or chose not to breastfeed. Scientific and historical literature tells us of centuries of efforts to meet the nutritional needs of the infant and replicate the composition and benefits of breast milk.
Infant mortality was high in prehistoric cultures. Like other mammals, only the heaviest babies, nursed by their mothers, survived. In ancient cultures, the first doctors encouraged breastfeeding. If for some reason the mother could not breastfeed, those who could afford it were recommended to breastfeed – replacing the birth mother with a nursing adult woman. Ancient art shows that those who could not afford a wet nurse relied on the milk of domestic animals such as donkeys, camels and goats. Clay feeding vessels designed to transfer milk from an animal to a child have been found in ancient tombs and ruins. Historians of Spartan times reported that succession to the throne was interrupted and given to the younger son because his mother was breast-feeding him and his older brother was ill-fated.
Little was documented about infant feeding from ancient times until the Renaissance. In the Middle Ages, wet breastfeeding was the choice of mothers who could not breastfeed. A pediatric article on breastfeeding describes the qualities of a good wet nurse and provides information about hiccups, diarrhea, and vomiting. In the late 1500s, scientists detailed the therapeutic values of breast milk not only for infants but also for aging men and women. They also recommended using breast milk as a substitute for breast milk if the mother needs it. If the baby could not be nursed, liquid food made of diluted honey mixed with cereal flour or breadcrumbs was poured through the hollow cow horn. However, most attempts to replace breast feeding had failed due to infant intolerance or bacterial contamination.
In 18th century Europe, the greatest danger to mothers was unsanitary conditions or the improper preparation of common breast milk alternatives. Records from the time show that wealthy English women chose not to breastfeed their babies because they believed that breastfeeding aged them and ruined their figures. And while breastfeeding was considered a form of birth control, wealthy women preferred bottle-feeding or hand-feeding, often giving birth to 12 to 20 children.
In France, under Louise XVI and Napoleon, breastfeeding—especially among the wealthy—was considered bourgeois and simply not done. Wet breastfeeding, as well as animal milk and cardboard feeding, were the norm. French founding homes, staffed by wet nurses who carefully regulated their diet and activities, ensured that infants received proper nutrition.
In the 1800s, breastfeeding became popular again. For those who needed an alternative, babies were fed goat’s or donkey’s milk, but this had its drawbacks – high protein and low in essential micronutrients, plus the risk of infection. Cow’s milk, treated with additives (fat, sugar, lime water and cream) to make it more digestible and then diluted, became a common and cheap alternative. Although often used, it was discouraged due to its low protein content, although contamination was no longer a problem thanks to the work of Louise Pasteur and Robert Koch, who discovered how to eliminate pathogenic bacteria.
Urbanization and advances in technology made breastfeeding less popular in the 20th century. The large family became less supportive, and as women left home and entered the workplace in record numbers, they tended to see breastfeeding as an unnecessary burden. In the first half of the 20th century, scientists and doctors began seriously studying the composition of breast milk and looking for ways to imitate it so that substitutes more or less match its digestibility and nutrient content. At first, however, progress was rather slow. However, thanks to technological advances, most manufacturers were marketing bacteriologically safe and nutritionally acceptable baby foods in powdered form even before World War II.
The most important breakthrough in the artificial feeding of babies took place in the second half of the 20th century. American, Swiss and Japanese food technologists, together with pediatricians and chemists, managed to match the important nutrients of mother’s milk into formula, making it usable from the first day of a child’s life. Improvements in the composition of infant formula and improved sanitation and living standards helped reduce the mortality rate of non-breastfed infants from about 80% to less than 2%.
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