By S Josephine Baker, MD
Director, Bureau of Child Hygiene, Department of Health, New York City
Every once in a while, someone brings I forward the idea that women are becoming less and less able to feed their babies nature’s way. I have never been able to determine that this was true.
There is undoubtedly some basis for the belief that women in some walks of life are less willing to nurse their babies than they used to be, and that the amount of natural nursing that goes on among our foreign population and the more primitive groups of people far exceeds that which is found among the more socialized or even the so-called more intelligent classes.
In nine cases out of ten, a woman’s inability to feed her baby the proper way is due to her lack of willingness to make herself fit to do so rather than to any inherent inability in this line. Experience of many years with many hundreds of thousands of babies and mothers has firmly convinced me that ninety-five percent of all women can nurse their babies if they choose to do so.
In the other five percent, of course, there will always be the group of women who from disease of one kind or another are debarred from this wonderful privilege. Such mothers are to be deeply pitied, for certainly the privilege of nursing one’s own baby is a heaven-sent gift, second only in importance to the coming of the baby itself.
The pros and cons of breastfeeding
If we place the matter on a purely utilitarian basis, there are so many arguments in favor of nursing and so few arguments against it that it would seem as though it ought to be adopted as a universal custom. From the point of view of the mother, the advantages are many. She can set her mind at rest regarding the possibility of her baby having an upset digestion. The summer diseases need not worry her. She has no need to depend upon an erratic milk supply.
From the point of view of the baby, the advantages are just as striking.
The breastfed baby is always stronger than the bottle-fed baby, he has better teeth, firmer muscles, is less apt to have any diseases, his gain in weight is more even and regular; he is usually wwell-nourished strong and vigorous, and his advantage holds good not only during the first year, but it also gives him a certain sturdy preparation for life that is absolutely invaluable and cannot be gained in any other way.
Who are the ignorant mothers?
With all these advantages, it would seem that every mother would nurse her baby without question, yet we find today that wrong feeding is still the second highest cause of baby sickness and death. Owing to their natural inclination and their willingness to accept advice, foreign-born mothers almost universally nurse their babies, and the infant death rates in our big cities today are lower among our Russian, Italian, Polish and other large race groups than they are among the babies of our native-born parents.
Today, the babies of the poor are almost universally breastfed. With the babies of the well-to-do, the habit is not nearly so prevalent. I am not inclined to believe that this is because the well-to-do mother loves her baby any less than does the mother of more limited means. I believe it is because the American mother has net appreciated the tremendous importance of this subject. The truth as it stands today is that it is not poverty that kills babies, but ignorance, and that this ignorance is largely an attribute of our so-called “more intelligent classes.”
Sometimes mothers stop nursing their babies because they cannot do it entirely. This is always a mistake. It should be kept up even if the baby gets only part of the food he needs at each nursing. It is never wise to give a bottle feeding in place of a natural feeding unless one is trying to wean the baby, because it always means that there will be less natural milk next time.
The right way is to weigh the baby before nursing, then have him nurse as much as he can and weigh him again immediately afterwards. In this way, it will be easy to see just how much milk has been taken. The additional amount that is necessary for a full feeding can then be given from a bottle and may be made up of cow’s milk, properly modified. This is what is called a complemental feeding, and is far better than substituting an entire bottle feeding at any one time.
Mother: Stay healthy
If a mother wishes to keep herself in good physical condition to nurse her baby, she can do so with very little effort. It may mean a certain amount of sacrifice as regards late hours, overexercise, too much excitement and fatigue, and possibly she may feel the deprivation of giving up the rich articles that may have been included in her usual diet, but if she will live the ordinary, simple, wholesome life that every woman should, drinking at least one and a half pints of milk a day, which may be taken in the form of cocoa, milk, soups, or even in custards, junket or ice cream, cut down her tea and coffee to once a day only, eat plenty of green vegetables, bread and butter, fruits, with meat not more often than once a day and preferably only three or four times a week, avoid anything except simple desserts, and eliminate rich sauces, gravies, highly spiced foods and pastries from her diet, she will be taking the kind of food that is best suited to her needs.
In addition, if she can spend most of her days in the open air, with enough exercise to keep her in good condition, but not enough to over-fatigue her; if she will sleep in a room with windows wide open winter and summer or, better yet, sleep outdoors; if she can eliminate worry, anger and outbursts of emotion from her life, there is no reason why she should not nurse her baby, and why her baby should not be thoroughly well nourished as a result.
There are some mothers, however, who cannot nurse their babies under any circumstances, and when this situation occurs it is important to know just what the best substitute food may be. There can be no question that when natural milk is not available, cow’s milk is the best substitute. The question of artificial feeding, however, cannot be settled so easily as that.
Babies are not machines
Babies are not machines, to be judged by the same standards. Each one is a law unto himself.
Generally speaking, properly modified cow’s milk, given in sufficient quantities and at appropriate intervals, is the best type of infant food we have, but occasionally we may have to use other foods. When this need occurs a doctor should always be consulted and his directions should be followed explicitly until the baby’s dietary is safely launched and the quantity of food he requires and is able to digest is determined.