I recently purchased a book at a Goodwill Store called “Expectant Motherhood”. It was written by one of the authorities of the time – Nicholas Eastman, M.D. and was originally published in 1940. The copy I have is a 4th edition – last copyright date 1963.
Of course I turned to the breastfeeding section to see how much has changed in how we teach about breastfeeding 60 years later.
According to Dr. Eastman, “nervous, worried, high-strung women usually have less milk than the happy-go-lucky type.” No pressure there. And a “large intake of fluids, particularly cow’s milk, unquestionably stimulates milk production.”
Avoid alcohol as it passes into the milk, but “nicotine appears in the milk…but the amounts are so small as to be of no concern.”
The schedule seems to have been set by the doctor (vs. the mother – - or here’s a thought – the BABY). ”Some physicians start the baby on the breast twelve hours after delivery, others twenty-four hours afterward; some begin at once with four hour schedule, others prefer a six-hour interval until the milk comes it. After lactation has once begun, it is common practice to bring the baby to the breast every four hours. ….. With small babies, some physicians prefer three-hour feedings…… If a four hour schedule is employed, both breasts are nursed for ten minutes each, as a rule. With the three hour interval, it is customary to use alternate breasts at each feeding, the duration of nursing being extended slightly.”
Nipples needed special care! Who knew? (This has been confirmed as a practice by some nurses I work with who have been in this field for decades.) You were to wash them before feedings with sterile water or a boric acid solution. In between feedings, you’d keep a sterile cotton gauze up against the nipple, holding it in place with a light binder. And if you wore a nursing bra, it would prevent “subsequent sagging of the breasts.”
Then I reached the section on Teaching the Baby to Nurse. It definitely brought me a smile in how this teaching was presented.
“Although the baby is born with an active suckling reflex, not a few babies have difficulty in coordinating their efforts when the nipple is first put into their mouths. (Ok – that’s not changed!) This sometimes seems to be the result of over-enthusiasm, the baby going at the nipple with such excited gusto that he clumsily bobs the nipple out of his mouth and then loses his temper over the whole business and starts to wail. Sometimes, since he gets only a few drops of colostrum during the first few days, the baby appears to become disgruntled over the meager fare at his new boardinghouse, and after a brief trial gives every evidence that he prefers sleep to such a futile and tantalizing procedure. (quite the comedic approach)
However this may be, the mother should understand that the chief purpose of putting the baby to the breast these first two days is to educate him (and also her) in the serious business of nursing. The baby should be held in such a manner that he need exercise no effort to contact the breast, that is, he should not be made to stretch his neck forward to reach the nipple.”
When he discusses the concept of “Breast versus Artificial Feeding” – apparently the “old problem” (debate over what to do) is not new.
“On the one hand, we are led to believe that artificial, or bottle, feeding, being based on modern, scientific calculations, is actually superior to the “old-fashioned method”. On the other hand, we are told that the mother who fails to nurse her baby condemns it to an appalling hazard, to sundry diseases, to an ugly lower jaw and even to a faulty background in filial piety. (WHOA!)
All of the advantages of breastfeeding he lists do not sound all that different from teaching today. It’s digested more easily than cow’s milk, it’s clean, GI disturbances less often in breastfed baby, more calories per ounce in breastmilk (which has largely been fixed after publication of this book with commercial formula), hastens involution of uterus, usually more convenient, more economical. But a couple of his advantages of “artificial feeding” are interesting: Less tiring, mom can more easily control her weight, and avoid sagging breasts. It also “takes less out of her” and people can help her. Sagging breasts seem to be epidemic among breastfeeding mothers!
His conclusion about whether a mom should or should not nurse her baby: “Should you nurse your baby? The answer is “Yes, if at all possible.” Must you nurse your baby? “No, if circumstances make it quite impossible.” The woman who is able to nurse her baby should consider herself fortunate. On the other hand, the woman who is unable to do so can rest assured that artificial feeding, if meticulously carried out, will usually yield results which are equally good.”
Cracked nipples existed decades ago, too. There seemed to be no connection to a poor latch in this time period. Recommendations included ointments, or a breastfeeding rest – with use of a pump. A nipple shield may be used – but the description of a shield is foreign to me. “A nipple shield is a round, glass cup which fits tightly around the outer edge of the nipple; attached to it is a rubber nipple which the child nurses.” Thankfully, we have silicone nipple shields today for times when one is needed. And we know work on fixing the latch as a solution to the problem!
Discharge time was beginning to move towards one to three days post-delivery. But when this book was written, the time of going home varies between “the fourth and tenth day, as a rule. The average is near the fifth or sixth day.” I believe my own mother stayed six days with me and my sister (1958, 1961).
A baby might have gotten a bath immediately after birth with warm mineral oil. The ID of the baby was confirmed by the beaded ankle bracelet with mom’s name or a “piece of tape with mom’s name affixed to the baby’s back. ” That sounds secure. :-)
So breastfeeding advice given at the time I was born had some truths, and some things taught then we know now were not true. And based on my job experience, most moms still need at least some support, education, more support, information, reassurance, support – when it comes to learning how to breastfeed their babies.