Measuring Mamma's Milk: Fascism and the Medicalization of Maternity in Italy (review)

Elizabeth Dixon Whitaker. Measuring Mamma's Milk: Fascism and the Medicalization of Maternity in Italy.Ann Arbor: University of Michigan Press, 2000. ix + 358 pp. Tables. $49.50; £31.00 (0-472-11078-0).

This history of breast-feeding ideas and practices in Italy—set against the economy, society, demography, and health-care practices of that country over the past two centuries—possesses the indubitable heuristic value of research combining anthropological and historical investigation. To discover the cultural changes in the conception of motherhood and infant care, as well as the role played by medicine in this process, Elizabeth Whitaker asks how it happened that modern societies abandoned the traditional and evolutionarily adaptive practices, replacing them with artificial methods suggested by the new hygiene doctrine that were believed to be more effective (and were indeed effective in controlling morbidity and mortality due to infectious diseases). Assuming the physiological and anthropological knowledge of the mechanisms underlying maternity, she argues that the new methods of child rearing (including the imposition of feeding schedules, and nursing techniques that separated the child from the mother) would seem to lead to hardship, and even to new risk of disease.

Whitaker shows how, before the second half of the nineteenth century, medical knowledge concerning maternity and childhood was based essentially on empirical observation and was consonant with popular practices and beliefs. In the nineteenth century the attitude of physicians began to change under pressure from the fight against midwives, the new scientific doctrine of personal and social hygiene, and the establishment of gynecology and pediatrics as medical specialties. Several popular practices began to be considered unhealthy, such as feeding on demand and offering the breast to the child whenever it cries, as well as sleeping with the child attached to the breast all night.

The main point of this volume is that the change in maternity and child rearing during the years of fascism in the 1920s and 1930s corresponded to the government's need to politicize medicine. The aim of fascism was to increase the birth rate. This it failed to do, as improvements in economic standards and the reduction in the prevalence of infectious disease at the beginning of the twentieth century led to declines in both birth rates and infant mortality rates. Fascists blamed this failure on women, attributing low fertility to defeminization and women's work.

Whitaker analyzes the biological policy aimed at rationalizing economic production and human reproduction by alluding to the metaphor of land reclamation (which is found in particular in the writings of the Italian constitutionalist and fascist physician Nicola Pende). She nevertheless does not completely appreciate the close link between pediatrics, land reclamation, and the fascist antimalaria campaign—the most eloquent expression of which is found in the impressive reclamation of the Pontine Marshes. In the early twentieth century, malaria was one of the country's most serious health problems, affecting more than one-third of the population. Means of improving child-rearing conditions in the malarious zones were strongly debated and conducted by persons with considerable clout in Italian medicine, such as the hygienist and malariologist Angelo Celli. The malarial zones were also the training ground of Ernesto Cacace, a key figure in Italian pediatrics who was instrumental in spreading the new hygienist doctrines governing the study and rearing of children. Yet there is no mention of Cacace in Whitaker's book.

In addition, Whitaker fails to address the complex historiographic problem of the origins of the new pediatric doctrines concerning feeding—in particular, the reasons why the amount of milk ingested by the newborn began to be quantified. Nor does she allude to the influential Italian translation in 1905 of the treatise on children's diseases written by the German pediatrician Otto Huebner. The fascist doctrines of maternity and child care were to extend beyond the end of World War II...