Breastfeeding and Wet Nurses
When a mother chooses to breastfeed her own child, she offers a level of protection against diseases to a very young infant unavailable through any other means. Breastfeeding had come in and out of vogue among the wealthy through different time periods, particularly in Europe. Yet poor mothers, if they had the ability to remain home with their infants (whether working for an income or not), generally nursed their children for as long as possible. A mother needing an income outside the home may have sent her infant out to a nurse, often to a region very different from the one in which the child was born in (e.g., from urban to rural). At least half of the infants sent out to a wet nurse died within a year. The causes of death were numerous, and the frequency with which these deaths occurred was suspiciously high. Deaths were often caused by the diseases wet nurses transmitted to their charges. A child being transferred from his birth home in an urban area to a wet nurse in the countryside would be exposed to diseases to which he had no immunity, even if his mother nursed him after birth. The wet nurse’s milk would provide protections against diseases the child was exposed to while in her care, but once the infant returned home, his chances of benefiting from the antibodies in the breast milk were greatly reduced, as he was once again exposed to different diseases to which he and the wet nurse had no immunity.11
Wealthier women bringing nurses to their homes would experience similar problems. Many wet nurses were from poor areas, and living conditions were often unhealthy. Wet nurses brought diseases to children which they would not have been exposed to otherwise. Furthermore, nurses often breastfed multiple children and may not have had enough milk to adequately nourish them all. A nurse’s poor diet would have further reduced her milk supply.12
In the nineteenth century, as wealthy women began to nurse their own children, poor women began to hire wet nurses so that they could work outside the home. As these services were very costly, a wave of abandonment and infanticide began. One infamous wet nurse, Margaret Elis Waters, took illegitimate babies into her home. When they died, as they so often did, she left them in the street. Mrs. Waters was subsequently executed for her crimes. This occurred in London in 1870, when over 244 babies were found in the streets. In another case, a Mrs. Martin was hanged for killing 500 newborns during her profession as a midwife. Many such midwives were convicted of killing newborns with opium cordials. These women were often jailed and ordered to wear two red stars -a sign of infanticide.13
Overlaying a child while breastfeeding or sleeping with an infant, was one of the most common causes of death for babies in the Victorian era. Fifty percent of children that died perished in this manner. This high mortality rate aroused suspicions of intentional smothering by both mothers and wet nurses.14 Some historians have proposed that babies were sent to wet nurses expressly for the purpose of hastening their death.15
Despite the popularity of breastfeeding and nursing practices among both the rich and poor, there were many socioeconomic factors which may have mitigated their positive effects on mothers and babies. New mothers were often advised by midwives, popular among poor women, to avoid feeding colostrum to their babies (a pre-milk with antibodies present in the mother’s breast right after birth) by not nursing their newborns for the first few days, contrary to the advice of physicians (who often serviced the wealthy during childbearing). Further, both the poor and wealthy tended to wean their children when the weather was fair. Disease was more rampant during the summer, and leaving children without the protective benefits of breast milk only contributed to high mortality rates, although in these instances the rich were more likely to survive than the poor.16 For these reasons, it is difficult to make a linear connection between wealth and infant mortality—as circumstances and culture, beliefs of medical professional and other interfering factors would mitigate the effectiveness of breastfeeding.
Breastfeeding also has an effect on the length of birth intervals. A woman usually does not ovulate regularly, or at all, while breastfeeding. Therefore, there is an impact of previous infant mortality on current fertility. If an infant dies, thus halting breastfeeding, then the mother becomes fertile again immediately. An increase in fertility, however, can mean an increase in maternal mortality. While short birth intervals contributed to the poor health and inadequate care of a younger child, the presence of an older sibling had a positive effect on the mortality of a child under the age of one. Over the age of one, older siblings had a negative impact on mortality if the older siblings were brothers. Most importantly, though, a mother’s death and her child’s death were highly correlated.17
The professions of family members also had an impact on mortality if they affected whether a mother would not have to work outside the home, and would therefore be able to nurse and care for her own children. For example, in regions producing iron and steel, where only men could go to work, child mortality was low. In regions where textiles were produced or where there were dairies, mothers who could do this type of work left their children in the care of others. A working mother was highly correlated with child mortality; children always fared better if their own mothers nursed and cared for them.18
While breastfeeding was considered the norm among the working classes, in England for example, social class predicted mortality as socioeconomic status determined nutrition and access to medical facilities. Babies who were illegitimate or twins were likely to be weaned earlier; artificial feeding had a significant influence on the risk of death for those who died of diarrheal diseases. Accordingly, the appointment of a medical officer who supported breastfeeding, moderated illness caused by malnourishment, and educated mothers in proper infant feeding practices (such as avoiding giving children bad food or flour mixed with water in lieu of breast milk) was an essential predictive factor in lowering the childhood mortality rate.