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Breasts for Hire and Shared Breastfeeding: Wet Nursing and Cross Feeding in Australia, 1900–2000
Virginia Thorley
Wet nursing and cross-nursing both involve the breastfeeding of a baby by someone who is not the baby's mother. They differ in that wet nurses were usually employees in paid situations and the breastfeeding was not reciprocated, whereas cross-nursing was between peers and was usually unpaid and could be reciprocal. In Australia at the turn of the twentieth century wet nurses were employed in private homes or institutions. By the 1920s, finding a wet nurse had become extremely difficult, but informal cross-feeding existed long after this. This study examines both practices in twentieth century Australia, 1900–2000, and includes a discussion of the decline of human milk banks, another means of sharing mothers' milk.
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When "mother's milk" is other mothers' milk | |
| Today 'breastfeeding' is generally understood as feeding at the maternal breast. At the beginning of the twentieth century, however, breastfeeding by the baby's mother was not the only mode of breastfeeding available to the Australian baby. Although the increasing use of artificial feeding was replacing it, wet nursing was still an option, but a declining one, as the classified advertisements and the advice literature demonstrate. By 1910 newspaper advertisements seeking wet nurses had become infrequent. By the 1920s and 1930s a few medical sources still advocated employing them, but they acknowledged the unlikelihood of finding one. Few historians have discussed wet-nursing in Australia, and those who have largely concentrated on the nineteenth century.1 The study from which this paper is drawn adds to the limited literature and is the first to be devoted to the twentieth century alone. |
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Wet nursing was not, however, the only form of breast sharing practices in twentieth century Australia. Women also shared breastfeeding on an informal basis as a kindness, often between sisters or close friends, where one would offer her breast to the baby of the other in the mother's absence or for other reasons. This practice has been termed 'cross-feeding' or 'cross-nursing.' 'Cross-nursing' is the North American usage, as used by Judith Z. Krantz and Nancy S. Kupper,2 while the variation 'cross-feeding' has been used in Australia and New Zealand.3 Women unaware of these terms have referred to their experiences breastfeeding the babies of their peers as 'wet nursing,' too. While wet nursing and cross-feeding share similarities, they differ in that wet nursing involves two women who usually are not social equals and payment of the wet nurse, whereas cross-feeding involves social equals.4 Wet nursing is never reciprocal, whereas cross-nursing may involve a reciprocal arrangement. Wet nurses in early–twentieth century Australia were found through private doctors, midwives and other intermediaries, or through classified advertisements. Cross-nursing, as a private arrangement, was seldom spoken of and only limited information on this informal practice could be found for the first three decades of the twentieth century. However, anecdotal reports, recommendations by medical sources during the interwar years, and mothers' written accounts from the 1970s onwards suggest that it had always existed.5 |
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Two recent studies, by Debbi Long (2003) and Rhonda Shaw (2004), suggested fear of community disapproval and cross-infection were the reasons why women at the turn of the twenty-first century seldom acknowledged having been a party to cross-nursing.6 Shaw has shown that some individuals were uncomfortable with the idea because it seemed to transgress the exclusive mother-infant bond, while others were repulsed by the idea of sharing a bodily fluid.7 |
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Criteria provided by English physicians in the sixteenth and eighteenth centuries for selecting a wet nurse appear to have lingered to influence the advice provided to potential employers of wet nurses in early–twentieth century Australia. Thomas Phaire addressed the hiring of wet nurses in his 1545 text, The boke of chyldren, in which he paid scant attention to the unfashionable idea of breastfeeding by the baby's own mother.8 He advised that the wet nurse should have given birth no longer than two months previously, be of good character, have a pleasant disposition, and not be a drunkard. Phaire's advice that her milk should not taste salty is in line with current knowledge that saltiness can be a marker of subclinical mastitis or minimal milk production.9 Two hundred years after Phaire, the influential eighteenth century physician William Cadogan recommended the wet nurse should be clean and healthy, 'middle-aged' (defined then as twenty to thirty years old), and should have delivered a healthy baby within the previous two or three months.10 Rosemary Mander has revealed the social dimension in the selection of wet nurses in her analysis of the notebook kept by Scottish surgeon James Young Simpson in the early–1840s.11 In the 1920s, Dr. Alfred Jefferis Turner, the Director of Infant Welfare Services in Queensland, used his contacts at the Brisbane Salvation Army maternity home to find wet nurses when they were otherwise unprocurable, to provide milk for premature infants.12 It is likely that such contacts were used by others, especially in cities where 'wet nurse wanted' advertisements were not found in early–twentieth century newspapers. |
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This paper describes cultural practices involving the breastfeeding of an infant by someone other than the biological or adoptive mother in twentieth century Australia, specifically wet nursing and cross-feeding (also called cross-nursing). Human milk banking will be mentioned briefly. |
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Wet nursing, early–twentieth century | |
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Employment | |
| My research has confirmed three key factors that historian Lisa Featherstone identified in her paper on wet nursing in late–nineteenth century and early–twentieth century Australia. They were: the two main forms of employment open to wet nurses; involvement by the medical profession in their selection; and the focus on the well-being of the baby who was being nourished, rather than on the wet nurse's baby and the two women involved.13 Shurlee Swain has described the complex networks of midwives, nurses and baby farmers in late–nineteenth century Melbourne, who provided varying levels of care for the babies of poor mothers obliged to work.14 Some of this care involved wet nursing but much of it involved 'dry-nursing' (artificial feeding) of the babies, a risky business for the often unhealthy infants in poor circumstances. |
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Others have also described the two categories of work available to poor women obliged to support themselves by breastfeeding other women's children prior to the early–twentieth century in Europe and America.15 These categories were: private work in the employer's or wet nurse's home; or institutional work nourishing the babies of the destitute. Both of these work situations were advertised in Australia in the 1900–10 period in the 'Situations Vacant' columns of the Melbourne newspaper, the Age (Table 1–2). Searches of morning newspapers of the same period from the cities of Sydney and Brisbane, examining three consecutive months for each year sampled, was unable to find similar classified advertisements under 'Situations Vacant' or 'Servants Wanted.' The reason why these positions were advertised in a Melbourne newspaper—but not in these other cities—has not been determined. Remuneration was rarely mentioned in the advertisements in the Age. However, a 1904 advertisement offered ten shillings weekly.16 This was less than a foster mother or wet nurse employed by the Neglected Children's Department could earn in the late – nineteenth century and, according to Swain's figures, domestic servants could earn more.17 The need to pay for their babies' care restricted the options of many single working women to cheap backstreet care. My work supports Swain's observation that institutional work for wet nurses outpaced private work. Table 1 shows that seventy six percent of the fifty wet nurse positions advertised in the 'Situations Vacant' of the Age for the months September–December 1902 were for institutional work, with the Receiving House in Park Street in the suburb of Brunswick predominating. A recurring advertisement by this institution for a wet nurse unencumbered by her own baby appeared in the Age through the 1900–05 period, under 'Situations Vacant,' and read:
WETNURSE wanted, reference; own baby dead. Receiving House, Park-st., Brunswick.18
This institution advertised almost daily for a wet nurse from October 1902 to the end of that year, and less frequently at other times; the text of the advertisement remaining consistent with that used in 1900. In similar advertising in 1905, the institution at the Park Street address had a name change to the Girls' Depot.19 Other Melbourne institutions advertised less frequently for wet nurses. In May 1905, Nurse Basser of Drummond Street, Carlton—the proprietor of a private lying-in hospital— advertised for a wet nurse whose own baby had died, as did a Receiving House in the Melbourne suburb of Royal Park. However, the Infant and Foundling Hospital in East Melbourne occasionally advertised for a wet nurse without any stipulation about the nurse's baby, a typical advertisement reading:
WETNURSE wanted. Monday morning, Lady Superintendent, Infant and Foundling Hospital, Berry-st., E. Melb.'20
Likewise, advertising of wet nurse positions at the Neglected Children's home in the suburb of West Brunswick made no mention of the wet nurse's own baby.21 |
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| Name of Institution |
Number of Advertisements |
Wet Nurse's Baby Mentioned |
| Receiving House, Park St. |
37 |
Yes ('own baby dead') |
| Infant and Foundling Hospital, Berry St. |
1 |
No |
| Private Advertisers |
12* |
No |
* Includes one from a wet nurse seeking a position, and misplaced in the 'Situations Vacant.'
Table 1. Institutional and Private Advertisements for Wet Nurses, 'Situations Vacant,' Age, September–December 1902 (4 months).
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| Name of Institution |
Number of Advertisements |
Wet Nurse's Baby Mentioned |
| Receiving House, Park St. |
6 (May–Aug)
7 (Sept–Dec) |
Yes ('own baby dead') |
| Infant and Foundling Hospital, Berry St. |
Nil |
N/A |
| Sunnyside, George St. |
7 (May–Aug)
1 (Sept–Dec) |
No |
| Private Advertisers |
13* |
11, not mentioned
2, 'own baby dead' |
* An additional two appeared in the 'Situations Wanted' columns.
Table 2. Institutional and Private Advertisements for Wet Nurses, 'Situations Vacant,' Age, 1904.
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Private employment for a wet nurse, at least in the positions advertised in the Age, typically included work in the employer's home, but sometimes the wet nurse was required to take the infant into her own home, as an advertisement in the Age on 4 August 1900 demonstrated.22 In another advertisement on the same day, the employer was willing to accept the wet nurse's baby, implying a live-in position.23 Such a situation saved the nurse the cost of boarding out her own baby. Among the 'wetnurse wanted' advertisements in the Age, a few were by women seeking employment as wet nurses. Three examples from this period include two women who advertised after the loss of an infant. While the third example does not specifically state that the wet nurse's baby had died, the 'age' of her milk and her urgent need to use this asset, her breast of milk, suggests either a stillbirth or early neonatal death.
WETNURSE. – Woman, young, thoroughly healthy requires position as Wetnurse. G., Footscray P.O.24
WETNURSE. – Baby to wetnurse, own baby dead; medical reference. 173 Newry-st., N. Carlton.25
WETNURSE. – Baby wanted, own home, at once, milk 3 days old. 94 Evans-st., Port Melb.26
Only rarely did advertisements by householders for private positions specify a wet nurse whose own baby was dead, as in a 1902 example.27 Some advertisements for private employment used intermediaries as contacts, such as a doctor, a pharmacist, a newsagent, or the newspaper office, and usually did not mention the wet nurse's own baby. An example of an advertisement placed by a doctor was:
WETNURSE, infant under 3 months. Between 9, 11 a.m., or 1.30, 2.30 p.m., Dr Lillies, High-st., Armadale.'28
Other classified advertisements, apparently for private work, provided little information, other than 'WETNURSE wanted,' and an address.29 |
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Some authorities in the early–twentieth century recommended a wet nurse in situations where the mother's own milk was unavailable, despite the ready availability of a plethora of foods that were promoted for infant-feeding and the common use of liquid, dried or condensed cow's milk for this purpose. In a 1906 article, an anonymous woman doctor wrote in the Woman's Budget magazine that 'a good healthy wet nurse' should be the preferred choice for infants unable to receive their own mother's milk.30 Only in the absence of a suitable wet nurse should artificial feeding be attempted, she advised her comfortably off readers. Medical approval should be sought in the selection of the wet nurse, who should be at the same stage of lactation as the age of the baby. The stipulation in articles in 1902 issues of the New Idea magazine that medical direction be sought, or that the wet nurse be healthy,31 increased the chances that a wet nurse with obvious signs of syphilis or tuberculosis could be excluded to protect the infant from being infected. These were not idle concerns for congenital syphilis was far from rare among infants who died in late–nineteenth century Melbourne, as attested to by the death certificates researched by Swain.32 The Wasserman test for syphilis was devised in 1906 and soon came into use. Infants with congenital syphilis, that is, born with it because of infected parents, could also infect wet nurses.33 Another member of the medical profession who wrote for a women's magazine did not share the views of the Budget's medical writer. The New Idea's columnist 'Domesticus', writing in 1908 for comfortably off readers, considered artificial feeding on 'a suitable brand of milk' as a satisfactory way to rear a baby.34 Wet nursing was not mentioned. By 1910 classified advertisements for wet nurses appeared only infrequently in the Age.35 (Table 3) In the 1920s, when wet nurses had become difficult to find, some were recruited from unmarried mothers' refuges, at least for institutional work.36 |
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| Type of Employment |
Number of Advertisements |
Wet Nurse's Baby Mentioned |
| Institutional (all institutions) |
Nil |
N/A |
| Private Advertisers |
4 (of which one advertisement appeared twice, i.e. 3 positions were advertised) |
No |
Table 3. Advertisements for Wet Nurses, 'Situations Vacant,' Age, April–May, 15 July–15 September 1910 (4 months).
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Selection criteria | |
| Some books on domestic economy continued to offer advice on the selection and diet of a wet nurse—despite the prevalence of artificial alternatives and the decline in availability of poor women willing to earn a living as breasts for hire. Such advice was included in a chapter in The Australian Household Guide, published in Western Australia in 1916,37 and the 1923 guide, Home Nursing and Ailments of Children, by W. Howard James.38 Elements of the advice provided in the sixteenth and eighteenth centuries by Phaire and Cadogan survived into the twentieth century in household management books such as these and Australian women's magazines. In contrast to the preference of institutions such as the Brunswick Receiving House for hiring mothers of dead babies, writers of early–twentieth century Australian texts on household management and home health reflected these earlier authors' opinions in recommending that the baby of a prospective wet nurse should be healthy and well-nourished. This would be proof that the wet nurse had a sufficient supply of milk and was not diseased. The chapter on infant feeding by an anonymous medical writer in the 1916 Australian Household Guide included information on breastfeeding that the author stated applied equally to the mother or wet nurse; indeed, one section was headed, 'Diet of mother or wet nurse.'39 The advice on the selection of a wet nurse included an examination by 'a medical man.'40 The main health concerns were transmission to the infant of syphilis or tuberculosis.41 In the 1920s the physical attributes that James's home nursing book advised mothers to look for in a prospective wet nurse included well-shaped nipples and firm breasts with prominent veins.42 Furthermore, she should be twenty to thirty-five years old, have a healthy child of the same age as the baby to be nursed, have a good constitution and be free from disease. |
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Some of the early–twentieth century Melbourne advertisements reflected the traditional advice that the 'age' of the milk should ideally be the same as that of the baby. For instance, a would-be wet nurse advertised that her milk was three days old, and a household required a wet nurse whose milk was a fortnight to three weeks old, while a local doctor sought a wet nurse with an infant under three months, apparently for private work.43 However, the 1916 Australian Household Guide disagreed with the ancient proviso that the wet nurse's child should be the same age as the employer's baby.44 |
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Wet nursing was not something with which the doctors and nurses active in the 'infant welfare movement' generally concerned themselves. Consequently, they did not provide criteria for the selection of wet nurses in their advice books for mothers, because many of these publications appeared after wet nursing had declined. Instead, they placed their emphasis on encouraging every mother to breastfeed her own infant or, if this failed, to feed the baby artificially, preferably with a home-modified cow's milk mixture. This advice was consistent whether they were followers of state-based systems of infant care—which held sway during the interwar period and beyond—or of the New Zealander Dr. Frederic Truby King. An exception in the infant welfare movement was Dr. Alfred Jefferis Turner in Brisbane, who graduated in medicine at University College, London, in 1884 (MD 1886) and whose contributions to paediatrics began before the leaders of the infant welfare movement in Australia emerged.45 He preferred the milk of a wet nurse if the milk of a premature infant's own mother was unavailable but by 1926, the donated milk was expressed and bottle-fed to the infant.46 Turner advised that the wet nurse should continue to breastfeed her own child.47 Turner reported that the prematures did poorly on the milk provided by two of the wet nurses, who nevertheless had thriving infants of their own, and on analysis he found that the fat content was unusually low.48 (It is not known if the wet nurses drew off milk for the premature infants before feeding their own babies, in which case the donated milk would have been of lower fat content than the 'hind' milk extracted by their own babies afterwards.) |
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At the beginning of the twentieth century wet nurses were a convenient target for American MD William Lee Howard to blame in strongly worded comments in the New Idea, published in Melbourne. He warned against alcohol ingestion during breastfeeding, which he believed would set babies on the path to becoming drunkards.49 This reflected Phaire's advice, four and a half centuries earlier, that the wet nurse should not imbibe too freely. Featherstone, writing in 2002, also discussed the choice and supervision of the wet nurse in Australia in the context of her moral and physical attributes.50 The wet nurse, she wrote, was an unequal substitute for the mother, and chosen for her moral and physical attributes, in the context of concerns that an intemperate wet nurse—in temperament or, alcohol or opium abuse—would be a negative influence on the employer's baby. These, at least, were concerns of employers in comfortable circumstances who had choices. Howard's strong words suggested that drinking beer or ale was a common practice among wet nurses, who claimed, probably correctly, that they were doing it on medical advice.51 Indeed, the medical author of the infant feeding chapter in the 1916 household guide suggested beer or stout to increase the quantity of milk, though he was obviously of two minds about this advice as he admitted he preferred the mother or nurse to abstain.52 Contemporary admonitions to Australian mothers to refrain from dosing infants with opiates, for fear of creating drunkards in later life, suggest why Howard's article was considered relevant for reprinting in an Australian magazine.53 |
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Class prejudice underlay Howard's vehement criticism of wet nurses, as they were drawn from the poor classes. Jan Kociumbus has argued that by the end of the nineteenth century, the low-class wet nurse was regarded with suspicion by the welfare sector in Australia, even though employing a wet nurse continued to be recommended by family doctors.54 She attributed this ambivalence to perceptions that, although the wet nurse's milk was desirable, she was making money from her body (which respectable women did not do) and contributing to the disinclination to breastfeed on the part of women who could afford to pay for her services. Class prejudices and suspicions about infanticide by lower-class mothers were part of this nineteenth century undercurrent of belief, which had not disappeared by the early years of the twentieth century.55 However, Featherstone considered there was less overt criticism of the practice of wet nursing in the Australian community than in nineteenth century Britain, where reports could be scathing about the lack of concern for the wet nurse's own baby on the part of those hiring her.56 Nevertheless, in nineteenth century Australia concerns had been raised by some authorities about the fate of the babies of wet nurses, sent to inner-city 'baby farms' where infant mortality was high.57 |
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Decline of wet nursing | |
| Featherstone has suggested that the decline of the wet nurse was at least partly because other forms of employment were available that were less restrictive than wet nursing; for instance, factory work.58 Another important factor was the plethora of foods marketed for infant feeding throughout Australia, some of them solely for feeding infants, others being advertised for 'infants, invalids and the aged.'59 The general lack of interest in wet nursing by the emerging mothercraft experts may have been a contributing factor in a minor way, although it is likely they simply responded to a situation where there was no longer a supply of women willing to hire themselves out as wet nurses and only a limited demand for them. Table 1–3 show trends in 'wet nurse wanted' advertisements in the Melbourne Age in the first decade of the twentieth century. |
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In the light of these factors, in the 1920s wet nurses were seldom available, and by 1930 there was little chance of hiring a wet nurse, and so evidence of the practice occurring in Australia after this date is sparse.60 Nevertheless, an Australian textbook for medical students on infant feeding, published in 1939, recommended the hiring of a wet nurse if the mother were 'unable' to breastfeed a premature or feeble infant.61 This would suggest that the author had not recently attempted to procure a wet nurse for a patient and assumed an availability that no longer existed. Much later, Valerie Fildes provided an example from 1987 of wet nursing arranged though a classified advertisement in a Western Australian newspaper for a wet nurse on days when the baby's mother attended classes.62 The advertisement was reported on the front page of the newspaper because it was rare.63 All four applicants declined to be paid, as they considered the sharing of breastfeeding to be a way women could support other women.64 The advertised position was clearly that of a wet nurse, since it was advertised in the employment columns and the arrangement was not reciprocal. Although the willingness of these 1980s women to support another woman by providing their milk freely might also be interpreted as a feminist statement, the antecedents of this behaviour are a developing view that breastmilk should be freely given, which underpinned the unpaid donation of breastmilk by mothers to hospital milk banks in Australia. Janet Golden has written of this late–twentieth century shift, in the American context, likening it to the gift of another bodily fluid, blood, to blood banks.65 In Australia, too, blood donors are unpaid. |
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Human milk banking | |
| Human milk banking is an extension of the practice of women providing their milk for other women's babies, and is more at arm's length than direct breastfeeding. Golden discussed the establishment of human milk banks in early–twentieth century America as an example of the commodification of human milk after the decline of wet nursing.66 In America, banked milk was initially provided by poor, single mothers, the group from which wet nurses had previously been drawn, and they were paid. Golden described how banked human milk shifted 'from commodity to gift,' that is, donated milk given freely by volunteer mothers.67 In Australia, most mothers gave birth at home, or in small midwife-owned lying-in hospitals, or other private hospitals until late in the interwar years, although the desperately poor had given birth in the large maternity hospitals since the nineteenth century.68 A shortage of staff during World War II sounded the death knell for some of the smaller facilities.69 After the usual place of birth had moved to the hospital, banked milk was usually provided by mothers of all classes who were encouraged, while in-patients, to express their milk after feeds. This pooled milk was available for their own babies or for premature or sick infants.70 The annual report of Queensland's Division of Maternal and Child Welfare for 1952–53 noted that a breastmilk bank had been established at the Lady Goodwin Hospital in Rockhampton, the city's public maternity facility.71 In Brisbane in the post–World War II years, surplus expressed breastmilk (EBM) from maternity patients was delivered daily to the Maternal and Child Welfare (MCW) residential facilities where premature babies were cared for.72 |
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The practice began a slow decline from 1960 to 1961, when specially equipped milk rooms for preparing artificial feeds were established in the Brisbane Women's hospital. Milk from in-patients was still being pooled by maternity and MCW after-care hospitals in Queensland several years after this date.73 In Melbourne EBM from mothers of hospitalized infants was still being pooled and used for sick babies in the 1970s.74 In Canberra, according to a report in the Nursing Mothers' Association of Australia Newsletter in 1974, staff at the Woden Valley Hospital had requested the association's members to donate their EBM for several premature infants.75 This would suggest that in maternity units the expressing of breastmilk after mothers fed their newborns—a former source of EBM—was no longer routine practice there. In 1977 the Nursing Mothers' Association of Australia (NMAA) drafted guidelines for donations of EBM to hospitals by its members. Later policies permitted the advertising of 'Accredited Milk Banks' in the association's publications, but milk donation was made solely the responsibility of the mothers concerned, and not of the NMAA.76 |
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An innovative human milk bank that drew on regular collection of milk donated by mothers in the community—not in the maternity ward—and processed, stored and dispensed at the Townsville General Hospital was described in the Medical Journal of Australia in 1978.77 This milk was stored in the paediatric ward. The HIV/AIDS epidemic was responsible for the closing of this and other milk banks in Australia—despite the fact that Holder pasteurisation at 62.5 degrees Centigrade destroys the HIV virus and the continuance of a number of human milk banks in other countries.78 At the time of this writing, two new human milk banks have begun to operate on opposite sides of Australia, one on the Gold Coast in southeast Queensland, the other in Perth, Western Australia, but both are seeking funding in order to continue and expand.79 The milk dispensed is donated milk from mothers in the community. |
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'Cross-feeding': Breast sharing among family and friends | |
| Accounts of women's experiences breastfeeding the infants of friends or family members usually agree on two requirements. They are the need for both women concerned to be healthy and for the sharing of breastfeeding to be consensual. In some Aboriginal communities during the twentieth century, the breastfeeding of a baby appears to have been matter-of-factly shared, on occasion, if the mother were unavailable when the child was hungry.80 Anecdotal reports from Queensland in the 1990s suggest that the tradition of sharing the feeding in the mother's absence was still followed by young mothers in a Queensland Aboriginal community, but with bottles substituted for breasts, though cross-feeding still occurred in remote communities.81 Anglo-Celtic Australian and New Zealand mothers also occasionally shared breastfeeding, but as Rhonda Shaw has pointed out, seldom spoke of it openly for fear of criticism.82 Consequently, until the 1990s the evidence for the existence of cross-feeding in Australia consisted of largely anecdotal accounts found in newsletters and books.83 |
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Because of the difficulty of finding a wet nurse in 1926, Turner suggested an arrangement with a relative or friend, if the mother's own milk were unavailable and a wet nurse could not be found.84 In 1930 an authoritative article on the feeding of premature infants, provided to the Brisbane Courier by Turner's Queensland baby clinics, recommended a cross-feeding arrangement within the family circle.85 It is not known to what extent this advice was followed. After stating that the mother's own milk was best, the article advised:
failing this the milk of another healthy mother is the next best thing. Sometimes a relative can be found who has a healthy baby of her own, and so is able to act as foster mother. It does not matter if the foster mother's baby is some months old; the milk will not hurt the premature baby on that account, though it may be necessary to dilute it ...86
The writer cautioned that, in the event of any doubt about the foster mother's health, her milk should be boiled and fed to the baby by spoon, until a medical examination and 'a test' could be done.87 The test was most likely the Wasserman test for syphilis. |
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Through the 1970s and 1980s, publications of the NMAA (now the Australian Breastfeeding Association), suggested that mothers who wanted to stimulate lactation for adopted babies might benefit from borrowing a friend's baby to stimulate milk flow; at the same time, the adopted baby would learn how to suckle effectively at the full breast of the friend.88 While none of the mothers who contributed to a 1982 Nursing Mothers' Association of Australia Newsletter feature on breastfeeding their adoptive babies mentioned following this advice, others did. A Melbourne mother who adopted a baby girl in 1971 shared breastfeeding with two friends for a short time. One swapped babies with her for two feeds a day for two weeks, and the other provided 300 ml of EBM each day.89 An NMAA member, who re-established lactation after early weaning, wrote that she followed the suggestions of the Womanly Art of Breastfeeding (which did not recommend cross-feeding) and the NMAA leaflet on inducing a milk supply (which did).90 Although she did not identify the source of the human milk she used while her own lactation was being re-established, she wrote, 'a supply of expressed breast milk was arranged.'91 A Sydney mother who breastfeed her adopted children during this period used EBM provided by friends to supplement her own milk with her second adopted baby in the mid–1970s, and again with her third baby, born by surrogacy.92 In another surrogacy situation involving two sisters in the 1980s, the sister who had given birth expressed colostrum and breastmilk for the baby, while frozen breastmilk was provided by an acquaintance.93 |
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The need for the arrangement to be consensual is illustrated by the distress remembered by a Queensland mother whose baby, born in 1940, was unable to extract milk at her breast and was highhandedly taken away by the midwife-proprietor of the lying-in hospital and put to the breast of another mother, also unsuccessfully.94 As well as lack of respect for the feelings of the mother of the baby, no thought was given to the slight possibility of cross infection. In a consensual arrangement in another Queensland country hospital about twenty years later, another new mother temporarily breastfed her friend's newborn when the latter's milk was slow coming in.95 |
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Anecdotal reports of cross-feeding in the 1980s and 1990s include the informal sharing, by two unrelated Australian mothers, of the breastfeeding of their babies, born six weeks apart in 1984, who credit this with the special bond formed between all parties.96 The Western Australian mother who advertised for a wet nurse in 1987 had previously shared breastfeeding with a group of close friends in another city.97 In the 1990s, the personal accounts of women who had breastfed the babies of friends or relations were featured in the Nursing Mothers' Association of Australia Newsletter.98 Most described the satisfaction they felt in doing so. Predictably, there was a wider range of reactions among women from the broader community interviewed for newspaper reports in the early–twenty-first century, than in the NMAA accounts. The consensus among those who regarded the practice favourably was that breastfeeding someone else's baby is acceptable if the baby's mother agrees but unacceptable without her permission, and that the parties should be sure that the provider of the milk meets health criteria.99 |
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These anecdotal accounts have been supported by Debbi Long's ethnological study conducted at the end of the twentieth century in an urban Australian maternity hospital, in which she included questions about cross-feeding.100 As in the anecdotal reports, many of the mothers in this study who had cross-fed enjoyed helping their friends, but there were some areas of ambivalence, points that were also made by Krantz and Kupper.101 Women in Long's study who were strongly positive about breastfeeding, when the breast was that of the baby's own mother, were uncomfortable with the idea of another woman's breast being substituted. They were more comfortable with the idea of the same milk being expressed and fed to the baby by bottle, perhaps because of the distancing this provided.102 Rhonda Shaw, a New Zealand sociologist, who spoke with women in Australia and New Zealand who had cross-fed, found they usually avoided admitting to this experience in the face of community ambiguities about whose breast was appropriate, as well as negative attitudes towards bodily fluids and medical concerns about the transmission of viruses such as Hepatitis C and HIV.103 These sources all suggested that cross-feeding was more common than women admitted;104 community attitudes were seemingly a barrier to open discussion. |
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The NMAA had no stated policy on this practice, leaving it to the individual mothers, whereas La Leche League International (LLLI) discouraged the practice.105 LLLI's viewpoint was based, firstly, on arguments concerning the wellbeing of the individual mother-baby bond and the confusion some babies were believed to show when they discovered themselves at a different mother's breast, although an Australian mother who regularly cross-nursed in a circle of friends in the 1980s disagreed.106 LLLI's policy was based, secondly, on concerns about the difficulty of being sure that both mothers and their partners were disease-free.107 The concerns about infection were largely about HIV or other viruses, in contrast with concerns about syphilis and tuberculosis at the beginning of the twentieth century. Karleen Gribble raised similar issues in her case report on breastfeeding a medically fragile foster child, which was done with the approval of the social worker.108 As this occurred in a long-term foster situation it was not, strictly speaking, a cross-feeding situation. The daughter born to Lindy Chamberlain in 1982 after she was gaoled was also breastfed by her first foster mother.109 |
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Conclusion | |
Wet nursing as an occupation gradually died out in Australia in the early years of the twentieth century. However, other forms of breast sharing continued. At least from the middle of the century, there were in-house milk banks at maternity hospitals and some women informally shared breastfeeding or breastmilk with a sister or friend. The incidence of cross-feeding at various times is unknown as mothers who share this information may face disapprobation from friends and the community, because of negative attitudes towards sharing a bodily fluid outside of the situation of a mother breastfeeding her own child. Nevertheless, in the studies and anecdotal reports that exist, mothers and others have discussed the positive factors, such as convenience and sharing, as well as discussing the potential risks and how to minimise them.
University of Queensland
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Notes
1. Lisa Featherstone, "Whose Breast Is Best? Wet Nursing in Late Nineteenth Century Australia," Birth Issues 11 (2002): 41–6; M.J. Thearle, "Infant Feeding in Colonial Australia 1788–1900," Australian Paediatric Journal 21 (1985): 75–9; Jan Kociumbas, "Azaria's Antecedents: Stereotyping Infanticide in Late Nineteenth-Century Australia," Gender and History 13 (2001): 138–60; Shurlee Swain, 'Toward a Social Geography of Baby Farming', History of the Family 10 (2005): 151–9.
2. Judith. Z. Krantz and Nancy S. Kupper, "Cross-nursing: Wet Nursing in a Contemporary Culture," Pediatrics 67 (1981): 715–7. 'Cross-feeding' and 'cross-nursing' will be hyphened as this is the spelling used in the new literature on this practice.
3. Debbi Long, "Breast Sharing: Cross-feeding among Australian Women," Health Sociology Review 12 (2003): 103–10; Rhonda Shaw, "The Virtues of Cross-nursing and the 'Yuk Factor'," Australian Feminist Studies 19 (2004): 287–98.
4. Any difference in social class between the wet nurse and the baby she breastfed blurred in institutional work.
5. Several women the present author has recently interviewed for an unpublished study, and who have themselves shared breastfeeding with other mothers, have referred to cross-feeding by their mothers in the 1970s One informant's grandmother, whose first two children were born before World War I and the last in 1931, had assisted other women by breastfeeding their babies when the need arose. Virginia Thorley, "Mothers' Experiences of Sharing Breastfeeding or Breastmilk: Australia 1970–2007," (2008 unpublished); C. Stephenson to author, personal communication, 30 November, 1 December, 2007. See also notes 83, 89, 92, 93.
6. Long, 103–10; Shaw, 287–98.
7. Rhonda Shaw, "Contemporary Meanings of Cross-Nursing," Breastfeeding Communique 16 (2005): 12–4. Shaw drew on reactions in 1996–97 and 2003.
8. Thomas Phaire [also Phayer], The Boke of Chyldren (London: 1545).
9. M.C. Neville et al., "Studies on Human Lactation. I. Within-feed and Between-breast Variation in Selected Components of Human Milk," American Journal of Clinical Nutrition 40 (1984): 635–46.
10. William Cadogan, An Essay upon Nursing, and the Management of Children, from Their Birth to Three Years of Age (London: J. Roberts, 1748), facsimile reproduction in Morwena Rendle-Short and John Rendle-Short, The Father of Child Care: Life of William Cadogan, 1711–1797 (Bristol: Wright, 1966), 26.
11. Rosemary Mander, "An Analysis of Simpson's Notebook Data on the Wet Nurse," Midwifery 19 (2003): 46–54.
12. A. Jefferis Turner, "Infant Feeding," Medical Journal of Australia I (1926): 667–72.
13. Featherstone, 41–6.
14. Swain, 151–9.
15. Valerie Fildes, Wet Nursing: A History from Antiquity to the Present (Oxford: Basil Blackwell, 1988), 270–2; Janet Golden, A Social History of Wet Nursing in America: From Breast to Bottle (Columbus: Ohio State University Press, 2001), 179–204.
16. "Situations Vacant," [Melbourne] Age, 5 October 1904, 5.
17. Shurlee Swain, "Maids and Mothers: Domestic Servants and Illegitimacy in 19th Century Australia," History of the Family 10 (2005): 461–71.
18. "Situations Vacant," Age, 4 May, 1900, 8. Since classified advertisements were charged by the word, it was cheaper to spell 'wetnurse' as one word.
19. "Situations Vacant," Age, 11 May, 1905, 10
20. "Situations Vacant," Age, 20 September, 1902, 6
21. "Situations Vacant," Age, 3 July 1909, p. 8, and other dates.
22. "Situations Vacant," Age, 4 August 1900.
23. Ibid.
24. "Situations Vacant," Age, 20 December, 1902, 5
25. "Situations Vacant," Age, 13 June 1904, 10.
26. "Situations Vacant," Age, 20 July 1904, 5
27. "Situations Vacant," Age, 26 November 1902, 9.
28. "Situations Vacant," Age, 1 December 1902, 9
29. "Situations Vacant," Age, 1900–10.
30. "Infant Feeding: No. 1," Woman's Budget, 22 May 1906, 3.
31. New Idea, 26 November 1902, 9; New Idea, 18 December 1902, 10. This particular New Idea was a magazine for women from comfortable backgrounds and, although both were published in Melbourne, it had no connection with the later magazine published under that name.
32. Swain, "Baby Farming," 151–9.
33. World Health Organization, Venereal Diseases: A Survey of Existing Legislation (Geneva: WHO, 1956).
34. "Doing the Best for the Baby," New Idea, 6 May 1908, 304.
35. "Situations Vacant," Age, 16 April 1910, 10; 15 August 1910, 3 (repeated on 17 August); and 8 September 1910, 5. There was one advertisement in the "Situations Wanted" columns by a wet nurse seeking a baby or to give 'drinks daily'. See "Situations Wanted," Age, 23 August 1910, 3.
36. Turner, 667–72.
37. "The Australian Baby," in The Australian Household Guide, edited by Deborah Buller-Murphy and Lady Hackett (Perth: E.S. Wegg, 1916), 46–7.
38. W. Howard James, Home Nursing and Ailments of Children (Warburton: Signs Publishing Company, 1923), 327–8.
39. "Australian Baby," 46–7.
40. Ibid.
41. V.L. Collins, Infant Feeding (Melbourne: W. Ramsay, 1939), 27. The author, Dr. Vernon Leslie Collins, was born in 1909 and graduated in medicine in 1933. He was thus a young man when he wrote this text and not of the generation in medical practice when wet nursing was more common. It is unclear whether he meant an informal arrangement.
42. James, 327–8.
43. "Situations Wanted," Age, 30 July 1904, 5; "Situations Vacant," Age, 19 May 1904, 10; "Situations Vacant," Age, 1 December 1902, 9.
44. "The Australian Baby," 46–7.
45. Michael John Thearle, "Dr. Alfred Jefferis Turner: His Contribution to Medicine in Queensland" (MD thesis, University of Queensland, 1987). Thearle's biography of Turner shows him to have been 'a man ahead of his time' who made a contribution in linking lead poisoning in Queensland children to lead-based paint, managing the bubonic plague epidemic at the turn of the twentieth century, maternal and child health, and entomology.
46. Turner, 669.
47. Ibid., 667–72.
48. Ibid.
49. William Lee Howard, "How Children Are Made Drunkards: A Forcible Warning to Mothers," New Idea, 6 March 1908, 168.
50. Featherstone, 41–6.
51. Howard, 168.
52. "Australian Baby," 47.
53. "Children and Opiates," New Idea, 1 September 1902, 110.
54. Kociumbas, 138–60.
55. Ibid.
56. Featherstone, 41–6; Lancet 1 (1850): 513; Virginia Phillips [Virginia Thorley], "Children in Early Victorian England: Infant Feeding in Literature and Society, 1837–1857," Journal of Tropical Pediatrics and Environmental Child Health 24 (1978): 158–66.
57. Thearle, 75–9; Kociumbas, 138–60.
58. Featherstone, 41–6.
59. Examples of foods advertised for infant feeding in the first ten years of the twentieth century included a number of brands of condensed milk and dried milk; Arnott's Milk Arrowroot Biscuits advertised frequently in the Sydney Morning Herald, the Brisbane Courier and the World's News during this period; and Allenbury's Food. There were others. Foods advertised for 'infants and invalids' included Benger's Food, Mellin's Food, Horlicks, Nestle's Condensed Milk and Nestle's Milk Food.
60. Turner, 667–72; Queensland Baby Clinics, "Our Babies: The Premature Baby," Brisbane Courier, 11 September 1930, 9.
61. Collins, 27.
62. Fildes, 270–72.
63. The mother who advertised was later interviewed by Fiona Giles. See Fiona Giles, Fresh Milk: The Secret Life of Breasts (Sydney: Allen and Unwin, 2003), 24.
64. Ibid.
65. Golden, 201.
66. Golden,179–204.
67. Ibid.
68. Wendy Madsen, "Working from Home: Lying-in Hospitals of Rockhampton, 1916–30," Health and History 7 (2005): 49–66. In Queensland the Maternity Act of October 1922 promoted hospital births, although maternity wards were only gradually built across the state, with the Brisbane Women's Hospital only opening in 1938. For a full discussion, see Wendy Selby, "Motherhood in Labor's Queensland 1915–1957," (PhD thesis, Griffith University, 1992).
69. "Matron Says Staff Taken," [Brisbane] Courier-Mail, 1 August 1945. During the war years the Manpower Directorate of the Department of Labor and National Service was tasked with the distribution nationally of essential services staff, including nurses, and small hospitals suffered.
70. Virginia Thorley, "Feeding Their Babies: Infant Feeding Advice Received by Queensland Women in the Postwar Period, 1945–1965" (MA thesis, University of Queensland, 2000), 131, 135, 168.
71. Annual Report of the Health and Medical Services of the State of Queensland for the Year 1952–53 Queensland, 1953.
72. Thorley, 168.
73. Ross Patrick, The Royal Women's Hospital Brisbane: The First Fifty Years (Brisbane: Boolarong, 1988), 128–9; Thorley, 135. The present author experienced the practice of expressing and pooling milk in 1965, in the Queensland Maternal and Child Welfare's Corberry Street facility in Rockhampton.
74. The Nursing Mothers' Association of Australia Newsletters from the 1970s provide numerous instances. See Glenyse Harmer, "Hospital Based Milk Banks," Nursing Mothers' Association of Australia (hereafter NMAA) Newsletter 10 (1974): 14. This mother described her experience of two years before. Other mothers mentioned the 'hospital breast milk pool' or 'milk bank' at the Royal Children's Hospital in Melbourne in the 1970s. See Beverley Allison, "A Green Plastic Bowl a Poor Substitute for a Baby!" NMAA Newsletter 11 (1975): 10; Valda Connelly, "Breast Feeding Drew: A Spina Bifida Baby," NMAA Newsletter 11 (1975), 1–3. A few years later another mother described expressing her milk for the mothers' milk bank at a Sydney hospital. See Jane Lohse, "Breast Feeding through Baby's Illness and Heart Surgery," NMAA Newsletter 14 (1978).
75. NMAA Newsletter 10 (1974): 11.
76. NMAA, "Guide to Donation of Expressed Breast Milk by Nursing Mothers' Association of Australia" (draft only), 25 July 1977, author's collection. For later policy, see also Australian Breastfeeding Association Manual, B.40: "Human Milk Banks," 2007. The policy had been amended in 1999 and 2007.
77. D. Beal, L. P. Ashdown, and M. Mackay, "The Organization of a Human Milk Bank in a North Queensland Hospital," Medical Journal of Australia I (1978): 8–10.
78. Douglas B. Tully et al., "Donor Milk: What's in It and What's Not," Journal of Human Lactation 17 (2001): 152–5.
79. Lindy Brophy, "Even Nature's Best Needs Help," University of Western Australia News 25 (2006): 1–2; Mothers Milk Bank, Submission no. 217, "Inquiry into the Health Benefits of Breastfeeding," House of Representatives Committee, http://www.aph.gov.au/house/committee/haa/breastfeeding/index.htm (accessed 10 August 2007), 2007.
80. Catherine Berndt, letter to author, c1968; Letter, Michael Ryan to Virginia Phillips [Thorley], cited in NMAA Newsletter 3 (1967): 14; N.E. Hitchcock, "Infant Feeding in Australia: An Historical Perspective, Part 3: Australian Aborigines and Recent Arrivals," Breastfeeding Review 2 (1990): 78–81; Thorley, Feeding Their Babies, 136 (note 106).
81. Queensland Lactation College Minutes, 15 May 1999, in Papers of Virginia Thorley, Fryer Library, University of Queensland Library, UQFL282; Julie-Anne Darling, "Awakening Life: Handing on of Knowledge to Awakening of Life: Australian Aboriginal Women Explain Their Breastfeeding Technique," Essence 43 (2007): 14–6
82. Shaw (2005), 12–4.
83. Mary Goldfinch, "Adoptive Breastfeeding," in Tamar Boas, Emma Hazell, and Simone Casey, eds. Lives Touched by Breastfeeding (Melbourne: Australian Breastfeeding Association, 2006), 67–71; NMAA Newsletter 30 (1994): 13–8; Giles, pp. 24–6; Maggie Kirkman and Linda Kirkman, My Sister's Child (Melbourne: Penguin, 1988), 276, 282, 304, 309, 318. See also note 5.
84. Turner, 671.
85. Queensland Baby Clinics, 9.
86. Ibid.
87. Ibid.
88. Virginia Phillips [Thorley] and Anne Hapke, Establishment of Lactation for the Breast Feeding an Adopted Baby and Re-establishment of Lactation after the Weaning of a Breast Fed Baby: Research Information Sheet No. 4 (Melbourne: NMAA, 1971); Adoptive Breastfeeding and Relactation (Melbourne: NMAA, 1984, 1989), 14. This advice was dropped from the 1992 revision.
89. Freda Irving, "Mothers Who Breastfeed the Babies They Adopt," Woman's Day (Australia), 10 April 1972, 7–8.
90. Lyn Hermann, "From Bottle to Breast (Relactation)," NMAA Newsletter 10 (1974): 10–1.
91. Ibid.
92. Mary Goldfinch, "Nursing Our Chosen Children," NMAA Newsletter 16 (1980): 3–4; Goldfinch, "Adoptive Breastfeeding," 67–71.
93. Kirkman and Kirkman, 276, 282, 304, 309, 318.
94. Thorley, "Feeding Their Babies," 136.
95. Ibid., 166
96. Lyn Crichton, personal communication with author, 16 August 1998, and on other dates.
97. Giles, 24–6.
98. NMAA Newsletter 30 (1994): 13–8.
99. Laura Pratt, "Modern Wet Nurses Step in for Friends," Toronto Star, 25 November 2005, F.01. See also Viv Groskop, "Not Your Mother's Milk," [UK] Guardian, 5 January, 2007; Shannon Henry, "Banking on Milk," Washington Post, 16 January 2007, HE01; Jeninne Lee-St. John, "Outsourcing Breast Milk," Time, 19 April 2007; Tralee Pearce, "Breast Friends," [Canada] Globe and Mail, 1 May 2007.
100. Long, 103–10.
101. Krantz and Kupper, 715–7.
102. Long, 103–10.
103. Rhonda Shaw, "Contemporary Meanings of Cross-nursing," Breastfeeding Communique 16 (2005): 12–4.
104. See also Judy Minami, "Wet Nursing and Cross Nursing," Leaven 31 (1995): 53–5; NMAA, 13–8. For more recent La Leche League International regulations, see "Milk Donations," in LLLI Policies and Standing Rules Notebook, cited by Cathy Eng on Lactnet, 8 April 2007.
105. Minami, 53–5
106. Minami, 53–5; Krantz and Kupper, 715–7. See also Giles, 24–6.
107. Ibid.
108. Karleen D. Gribble, "Breastfeeding of a Medically Fragile Foster Child," Journal of Human Lactation 21 (2005): 42–6.
109. Lindy Chamberlain, Through My Eyes: An Autobiography (Melbourne: William Heinemann, 1990), 325–8. See also: "Azaria Remembered at Sister's Wedding," The Australian, 19 November 2007. The Chamberlain case, popularly referred to as the 'dingo baby case,' was hotly debated in Australia in the 1980s.
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