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  • Childcare, Health and Mortality at the London Foundling Hospital, 1741–1800: “Left to the Mercy of the World.” by Alysa Levene
  • Marjorie Levine-Clark
Alysa Levene. Childcare, Health and Mortality at the London Foundling Hospital, 1741–1800: “Left to the Mercy of the World.” Manchester: Manchester University Press, 2012. xi + 223 pp. Ill. £14.99 (978-0-7190-7355-7).

In this short, tightly argued book, Alysa Levene provides a quantitative and qualitative analysis of the infants and children of the London Foundling Hospital and their wet nurses. While her study spans the 1740s to the end of the eighteenth century, she focuses on the period of the “General Reception,” 1756–60, when the hospital opened its doors to all infants abandoned there and received thousands of foundlings a year as opposed to the tens and hundreds in other periods. Levene makes a significant contribution to our knowledge about the foundlings, their health experiences and survival chances, and their lives with their nurses. The book also has much to offer about the history of wet nursing itself.

The establishment of the hospital in 1741 by Thomas Coram was very much embedded in the eighteenth-century emphasis on national strength in numbers, new ideas about philanthropy, and concerns about the Poor Law. Levene argues that abandonment was not always a callous, anonymous process, but rather should be seen as part of the mixed economy of welfare, in which poor mothers, unable to care for a child, imagined a better life for an infant sent out to nurse through the hospital. Her evidence challenges assumptions that the London Foundling Hospital received predominantly illegitimate children and shows that infants from all over the country were brought to the hospital, often sent by a parish wishing to avoid Poor Law expenses, to place their welfare burden elsewhere.

Levene provides rich demographic data, with chapters covering the characteristics of foundlings and nurses, infant and childhood mortality of foundlings, their likelihood of survival in the hospital and their nurses’ communities, their life [End Page 605] chances compared to those of other infants and children, and the relationships between foundling health and the local disease environments into which they entered. For example, Levene clearly shows that infants were much more likely to die from their conditions when they entered the hospital than from the environment in the hospital itself, and that this was especially true during the period of open admissions. Their poor state upon arrival resulted in a much higher mortality rate than in London at large, but for infants who survived into childhood, their life chances were no worse than others in London. Indeed, the hospital was often at the forefront of innovative health practices such as vaccination, which was required for all foundlings to protect them as well as their nurses and the new communities to which they were sent. Infants who remained in the hospital itself rather than being sent to nurse, however, did not have good survival prospects. Levene argues that these foundlings most likely were already so weak upon entry that there was little chance of their thriving so they were not sent to nurse.

Levene’s chapters on nursing itself are fascinating, as she identifies a “nursing network” (p. 90) that the hospital drew on to place its foundlings. Nurses existed all over the country, overseen by inspectors, who reported back to the hospital on the health and safety of the children entrusted to their regions. According to Levene, wet nursing (and the subsequent caretaking of children who remained with their nurses for years) provided a significant employment opportunity for poor women, who often took in more than one foundling or a succession of foundlings. Levene stresses that the majority of nurses integrated foundlings into their households, challenging “the common depiction of nurses as careless and blameworthy” (p. 114). Analyzing case studies of four communities that took in large numbers of foundlings, and using microhistorical methods and family reconstitution, Levene closely examines the health and welfare of these infants and children within their local contexts. She illustrates the demographic impact of foundlings on their communities, showing that while these children did not affect the local disease environment, their...

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