A History of Infant Feeding: Part V.--Nineteenth Century Concluded and Twentieth Century

Wickes, Ian G.

doi:10.1136/adc.28.142.495

Cited by 35 publications

(7 citation statements)

References 6 publications

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“…In the United Kingdom (UK) a system of clinics and the profession of health visitors – nurses with extra training – were developed during the early decades of the twentieth century in response to concern about the welfare of infants in industrial towns; both were later extended to universal state provision [17,18]. Although health visitors advise on infant feeding, they do not generally receive adequate training on breastfeeding [19].…”

Section: Introductionmentioning

confidence: 99%

Untitled

2006

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BackgroundWeighing breastfed babies has been the subject of some controversy as the previous international growth chart was largely based on data from infants fed infant formula. The concern that professionals may be misled by the charts into suggesting to mothers that they supplement unnecessarily was a major impetus for the World Health Organization's investment in a new growth chart. Evidence of interpretation in practice has been scant.MethodsAn ethnographic study was conducted in a town in the Northwest of England to investigate this issue. In the first phase, women and health visitors were observed in the well-child clinic during clinic sessions and breastfeeding group meetings. In the second phase, longitudinal interviews with 14 women were conducted. Each woman was interviewed up to three times in the first six months after the birth of her baby, with a total of 35 interviews.ResultsMothers and health visitors focussed on weight gain with frequent weighing and attention to even minor fluctuations of the plotted line being evident. Women felt it important to ensure their baby's weight followed a centile, and preferred for this to be the fiftieth centile. Interventions included giving infant formula and solids as well as changing what the mother ate and drank. Women also described how they worried about their baby's weight. Little effective support by health professionals with breastfeeding technique was observed.ConclusionBabies were weighed more often than officially recommended, with weighing and plotting being at the core of each clinic visit. The plotted weight chart exerted a powerful influence on both women's and health visitors' understanding of the adequacy of breastfeeding. They appeared to rate the regular progression of weight gains along the chart centiles more highly than continued or exclusive breastfeeding. Thus weighing and visual charting of weight constituted a form of surveillance under the medical gaze, with mothers actively participating in self monitoring of their babies. Interventions, by mothers and health visitors, were targeted towards increasing weight gain rather than improving breastfeeding effectiveness. Improvements in training are needed for health visitors in weighing techniques, assessing growth patterns – particularly of breastfed babies – and in giving information to women, if the practice of routine weight monitoring is to support rather than undermine breastfeeding.

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Section: Introductionmentioning

confidence: 99%

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2006

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“…2 In contrast, Cadogan, 3 in his essay to the Governors of the Foundling Hospital (London, United Kingdom) in 1748 recommended that infants be suckled only 4 times a day and not at night, because he considered the night feeding to result in breastfed infants' becoming "over fat and bloated." Relaxation of the concept of scheduled breastfeeding was first strongly promoted by Wickes 4 in 1953 and subsequently advocated by community support groups such as La Leche League and the Australian Breastfeeding Association that were at the vanguard of the movement back to breastfeeding in the early 1970s in Western societies. As a result, infants were breastfed more frequently both by day and by night.…”

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confidence: 99%

Volume and Frequency of Breastfeedings and Fat Content of Breast Milk Throughout the Day

et al. 2006

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OBJECTIVE. We aimed to provide information that can be used as a guide to clinicians when advising breastfeeding mothers on normal lactation with regard to the frequency and volume of breastfeedings and the fat content of breast milk.METHODS. Mothers (71) of infants who were 1 to 6 months of age and exclusively breastfeeding on demand test-weighed their infants before and after every breastfeeding from each breast for 24 to 26 hours and collected small milk samples from each breast each time the infant was weighed.RESULTS. Infants breastfed 11 Ϯ 3 times in 24 hours (range: 6 -18), and a breastfeeding was 76.0 Ϯ 12.6 g (range: 0 -240 g), which was 67.3 Ϯ 7.8% (range: 0 -100%) of the volume of milk that was available in the breast at the beginning of the breastfeeding. Left and right breasts rarely produced the same volume of milk. The volume of milk consumed by the infant at each breastfeeding depended on whether the breast that was being suckled was the more or less productive breast, whether the breastfeeding was unpaired, or whether it was the first or second breast of paired breastfeedings; the time of day; and whether the infant breastfed during the night or not. Night breastfeedings were common and made an important contribution to the total milk intake. The fat content of the milk was 41.1 Ϯ 7.8 g/L (range: 22.3-61.6 g/L) and was independent of breastfeeding frequency. There was no relationship between the number of breastfeedings per day and the 24-hour milk production of the mothers.CONCLUSIONS. Breastfed infants should be encouraged to feed on demand, day and night, rather than conform to an average that may not be appropriate for the mother-infant dyad. REASTFEEDING MOTHERS SHOULD be made aware of the variability of milk volumes per breastfeeding, the frequencies of breastfeedings, and the distribution of milk intake by day and by night of healthy breastfed infants. 1 Mothers among the !Kung hunter-gatherers have been observed to breastfeed 4 times every hour during the day and at least once at night. 2 In contrast, Cadogan,3 in his essay to the Governors of the Foundling Hospital (London, United Kingdom) in 1748 recommended that infants be suckled only 4 times a day and not at night, because he considered the night feeding to result in breastfed infants' becoming "over fat and bloated." Relaxation of the concept of scheduled breastfeeding was first strongly promoted by Wickes 4 in 1953 and subsequently advocated by community support groups such as La Leche League and the Australian Breastfeeding Association that were at the vanguard of the movement back to breastfeeding in the early 1970s in Western societies. As a result, infants were breastfed more frequently both by day and by night. It now is recognized that breast milk provides the optimal nutrition for infants, and current recommendations to mothers are that infants be breastfed "on demand" (according to their appetite) exclusively for the first 6 months of life. 5,6 Bangladeshi infants have been found to consume half their daily milk ...

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“…Indeed, an 'acme of stupidity' had been reached with such teachings. 103 It became more common for physicians to suggest that some flexibility in feeding intervals could be a sensible way to proceed with feeding, gradually giving way to endorsing feeding on demand. 104 The shift towards promoting flexibility in feeding times was informed by a changing understanding of the health implications of a feeding routine, as much as by new conceptualisations of infancy and mother-child relations in approaches to infant feeding.…”

Section: Should Babies Be Fed On a Schedule?mentioning

confidence: 99%

‘If We Are to Believe the Psychologists …’: Medicine, Psychoanalysis and Breastfeeding in Britain, 1900–55

Rowold

2018

Med. Hist.

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In 1942, the British Minister of Health commissioned a report from the newly established Advisory Committee on Mothers and Young Children into ‘What can be done to intensify the effort to secure more breast feeding of infants?’. To make their case, the members of the sub-committee put in charge of the report sought expert testimony on the benefits of breastfeeding. They consulted medical officers of health, maternity and child-welfare officers, health visitors, midwives, obstetricians, paediatricians and a physician in private practice. They also consulted five ‘psychologists’ (a contemporary umbrella term for psychologists, psychoanalysts and psychiatrists). It is not surprising that the committee turned to medical professionals, as infant feeding had long been an area of their expertise. However, seeking the views of ‘psychologists’ when establishing the benefits of breastfeeding marked a more innovative development, one which suggested that a shift in conceptualising the significance of breastfeeding was gathering pace. In the interwar period, psychoanalysts and psychoanalytically oriented psychiatrists showed growing interest in early infancy. It led to an extensive psychoanalytic engagement with contemporary feeding advice disseminated by the medical profession. This article will explore the divergences and intersections of medical and psychoanalytic theories on breastfeeding in the first half of the twentieth century, concluding with a consideration of how medical ideas on breastfeeding had absorbed some of the contentions of ‘psy’-approaches to infant feeding by the post-war period.

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A History of Infant Feeding: Part V.--Nineteenth Century Concluded and Twentieth Century

Cited by 35 publications

References 6 publications

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Volume and Frequency of Breastfeedings and Fat Content of Breast Milk Throughout the Day

‘If We Are to Believe the Psychologists …’: Medicine, Psychoanalysis and Breastfeeding in Britain, 1900–55

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