Don't Kill Your Baby: Public Health and the Decline of Breastfeeding in the Nineteenth and Twentieth Centuries (review)

Jacqueline H. Wolf begins her social history of breast-feeding in the United States with a stark statement of fact: "For every one hundred babies born in the United States in the late nineteenth century, close to thirteen of them died before their first birthday. Since many of the dead died of diarrhea, physicians laid much of the blame on an entirely preventable cause: the growing use of cow's milk as an infant food" (p. 1).

What to feed—or not to feed—one's baby at the opening of the last century was a serious business. Indeed, heated battles over the bottle, breast-feeding, and the development of safe and nutritious "artificial" cow's milk-based formulae were the central research foci of cutting-edge pediatricians of the day. Moreover, critics of bottle-feeding were hardly shy about expressing their opinions. For example, the famous Baltimore journalist H. L. Mencken sarcastically noted in 1910: "The best possible food for a baby is mother's milk, and this is what it should get whenever possible. The mother who permits social 'duties,' laziness or any other such excuse or motive to interfere with her highest of privileges is a woman unfit to bring human beings into the world."¹ As with so many topics related to gender, Mencken was, of course, decidedly wrong. A large number of women during this era responsibly and carefully chose not to breast-feed for a variety of reasons, and this is a trend that continues to the present. While there exists today a great effort by children's health professionals to encourage mothers to breast-feed their babies during the first year of life, fewer than 20 percent of American babies six months or older are breast-fed.

Building on the scholarship of Rima Apple, Richard Meckel, Janet Golden, and a growing list of other historians of children's health in the United States, Wolf covers the history of infant feeding between the 1890s and the 1930s, especially as it played out in the city of Chicago. Unlike other scholars of this topic, however, Wolf documents how, "rather than being instrumental in altering women's infant-feeding habits, physicians' experimentation with breast milk substitutes and even the products of commercial infant food companies were actually a reaction to changes in infant-feeding practice already instituted by women" (p. 2). Moreover, she demonstrates that many mothers' preference for bottle-feeding over breast-feeding was firmly established by the end of the first decade of the twentieth century, rather than in the 1930s or 1940s as many scholars have previously contended.

Wolf presents a wide array of historical actors in this debate; the sociocultural forces that prompted women and physicians to seek methods of infant feeding other than breast-feeding; the benefits and consequences of these choices; the public health perspectives of these changes over time; and the medical community's proposed alternatives to breast-feeding. An epilogue covers the changing views of physicians between the 1930s and the "rediscovery" of the values of breast-feeding over the past quarter-century. Her aim in writing this book was to help explain something of the role played by mothers in infant nutrition in the United States, and she succeeds. Don't Kill Your Baby is an important contribution to a critical topic in the social and cultural history of motherhood and children's health.