A Social History of Wet Nursing in America: From Breast to Bottle.

By Janet Golden (New York: Cambridge University Press, 1996. xii plus 215pp. $54.95).

This fascinating and well-researched book traces the history of wet nursing in America from the colonial era to the twentieth century. Although wet nursing was the principal solution to infant-feeding problems for most of American history, it has been surprisingly neglected by historians, at least in the American context. Golden uses an impressive array of sources - including diaries, personal correspondence, domestic advice literature, medical tracts, newspaper ads, and the records of hospitals and welfare institutions - to probe the public debates over wet nursing, and the personal experiences of wet nurses and their employers. She sets the transition from breast to bottle in the context of changing ideas about motherhood, the cultural authority of medical science, and widening class divisions between wet nurse and employer.

The discourse on wet nursing illuminates the changing views of women's place. In colonial America, where breast-feeding was the norm, Puritan ministers used what Golden calls the "rhetorical wet nurse" as a trope to rebuke sinful women who shunned their maternal obligations to suckle their infants. Nevertheless, real-life wet nurses were recognized as essential if a mother died, took ill, or was unable to breast-feed successfully. Wet-nursing arrangements varied, from friends who temporarily suckled infants whose mothers were ill to commercial wet nurses who advertised in the newspapers. Some women became wet nurses after their own infants died, but most had a baby whose health needs were weighed against the mother's economic distress.

The rise of bourgeois domesticity in the nineteenth century transformed both the popular view of wet nurses and the structure of the profession. As middle-class mothers were depicted in increasingly sentimental and idealized terms, wet nurses - who were typically young, poor, and often pregnant out of wedlock - were portrayed as immoral and even dangerous. Although colonial-era sucklings were usually sent to live in their nurses' homes, live-in wet nursing predominated in the nineteenth century. This arrangement enabled middle-class mothers to rear their own children and monitor the wet nurse's behavior. It also intensified class conflict in the nursery.

Recent scholarship has shown how bourgeois women sometimes stood up for themselves in ways that disempowered working-class women. The history of wet nursing adds a particularly heart-rending element to that story, for the breast milk provided by wet nurses often saved the lives of the well-to-do at the expense of their own infants. In other words, "wet nursing often involved trading the life of a poor baby for that of a rich one." (p. 97)

Golden's history of wet nursing is not merely about victimization or class conflict, however; it is a complex, and often tragic, tale about the intersection of science, culture, emotion, and power. Golden points out that wet nurses could and sometimes did develop an affection for their sucklings. Even so, she reminds us, "wet nursing, at its core, was a career track paved with misfortune." (p. 127)

The structure of wet nursing that prevailed in the nineteenth century established a hierarchy among wet nurses, as well as a two-tiered system of infant care. The highest ranking wet nurses, in terms of pay, were unmarried mothers who worked for private families. The lowest were women living in almshouses who suckled abandoned or orphaned babies. Wet nurses who took into their own homes the infants of working-class mothers (including other wet nurses) stood in between.

Doctors did not gain control over the organization of wet nursing until the end of the nineteenth century. Even then, Golden notes, "inherent moral and managerial problems (p. 129)" meant that wet nursing could never be fully medicalized; wet nurses were judged by the standards of domestic service as much as medicine. Employers worried about the impact of disease, diet, moral character, and heredity not only on the quality of a nurse's milk, but on relations within the household. As bottle-feeding became safer, the inefficiency and risk of a wet nurse seemed to contrast with the more convenient and scientific alternative of artificial feeding. By the early twentieth century, families hired wet nurses only as a last resort, after formula feeding had failed.

Wet nursing all but disappeared by the mid-twentieth century, as breast milk was pumped, bottled, and sold as a commodity. The bottling of human milk increased the physical and psychological distance between producer and consumer (especially since milk banks pool the milk of a number of women), and toppled the association between milk quality and the personal characteristics of the nurse.

Bottled breast milk remains a necessity for a small number of (mostly premature) infants, yet today most breast milk (like blood) is donated, not sold. Now that breast-feeding is popular among the middle class, it is considered immoral to sell mother's milk to save the life of a child.

A Social History of Wet Nursing in America raises many questions for future research, particularly on the regional and ethnic/cultural variations in wet-nursing practices and policies. This pathbreaking book is a must-read for historians of medicine, the family, and women's work.

Molly Ladd-Taylor York University