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89 B y the 1940s, breastfeeding initiation and duration rates were rapidly declining. An article in Saturday Night, a widely circulated national magazine, commented, “The Canadian baby is fast becoming a parasiteonthecow,andthefemalebreast(toquoteaTorontopaediatrician)fit only for hanging a sweater on” (Howes 1950, 46). Although several scientists, medical researchers, and health professionals continued to recognize and promote the merits of breastfeeding, the value of breastfeeding to individuals in both health settings and the general public was continuing to diminish. Government publications containing infant feeding information continued to describe the benefits of breastfeeding; however, unlike in the 1920s, breastfeeding was no longer a sign of patriotism or a requirement of good motherhood. As well, directions on bottle-feeding, the earlier introduction of solid foods, and earlier weaning began to appear in these publications. The profound shift in government advice on infant feeding over this twentyyear period was accompanied by a seismic structural change in the delivery of maternity care in Canada. In 1940, approximately 35 percent of Canadian women gave birth in hospitals. By 1960, almost every woman birthed in a hospital. The shift towards hospitalized birth resulted in the increasing influence of physicians and nurses in disseminating infant feeding advice. As well, a range of hospital practices both directly and indirectly affected women’s breastfeeding success. In the two decades following the Second World War, federal government attention shifted from concerns about infant mortality to the persistently high rates of maternal mortality, and no real initiatives to support breastfeeding emerged. More troubling were signs that the practical knowledge and skills required to breastfeed successfully were disappearing. Women who were interested or committed to breastfeeding were unable to find the necessary emotional and practical support either in their own social networks or from health professionals. “Emotional barriers” were the reasons commonly cited Chapter 6 Old-Fashioned, Time-Consuming, and a Little Disgusting, 1940–60 90 Chapter 6 by women who chose not to breastfeed. By the 1960s, many women viewed the practice of breastfeeding as burdensome and repulsive, a relic from their grandmothers’ time. “Dr. Couture’s Book”: TheCanadianMotherandChild (1940 and 1949) In 1937, the federal Department of Pensions and National Health announced the formation of the Division of Child and Maternal Hygiene. Ernest Couture, a specialist in obstetrics and gynecology, was appointed the division head and guided its activities between 1937 and 1953. During Couture’s years, the division focused on research (particularly on maternal mortality), consultingwithprovincialhealthdepartments,anddevelopingandproviding educational materials (Lewis and Watson 1991/92; Burns 1967). Building upon the success of The Canadian Mother’s Book, Couture developed a new manual for mothers entitled The Canadian Mother and Child. This guide to motherhood and child care was often referred to as “Dr. Couture’s book.” The first edition was published in 1940, and it quickly became a Canadian bestseller, with approximately two million copies distributed in a thirteenyear period. In 1952, the Division of Child and Maternal Hygiene distributed approximately ten thousand copies a month, which closely corresponded to the number of first births in the population (Department of National Health and Welfare 1952). InTheCanadianMotherandChild,Couture(1940,4)describedmotherhood as “the most glorious achievement in the life of a woman, for, in becoming a mother she fulfills the special purpose of her existence as a woman.” Breastfeeding was a “complete realization of motherhood” (Couture 1940, 108). He insisted that a mother’s love for her child was the greatest incentive to breastfeed: “The very presence of your baby, and your feeling of love for it, should prove more eloquent than words to persuade you to breast-feed your infant, if you are able to do so. In doing this, you are providing it with the best food that Nature can give” (Couture 1940, 108). In contrast to the earlier The Canadian Mother’s Book, Couture suggested that not all mothers were necessarily able to breastfeed. However, the increasing number of mothers who were choosing not to breastfeed was the result of a lack of knowledge regardingtheimportanceofbreastmilkforinfants:“Thefailuretoappreciate this fact … accounts for the widespread tendency to neglect this maternal function” (Couture 1940, 108). Couture was careful to emphasize that “the way a baby is fed during the first year of life, may make a child either strong and healthy, or weak and sickly” (Couture 1940, 120). Couture described the numerous benefits of breastfeeding, including preventing infant mortality and helping to restore women’s “organs of reproduction” following birth. Other topics included instructions on maintaining a cheerful state of mind, the...

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