Prior to formula almost every baby who wasn't breastfed died, and there were
lots of breastfed babies who died too.  What that says to me is that there
have always been women who couldn't or wouldn't breastfeed, or who got bad
help breastfeeding and lost lactations.  Or women who got sick and couldn't
do it.  That is what the history of wet nursing is all about.

 I consider it a romantic notion (right up  there with theories of the noble
savage and the tablula rosa) to think that there has ever been an era in
history when people knew how to perfectly give birth or breastfeed.  These
are learned practices and take skilled assistance or women and children die.
Giving birth and getting a baby to survive infancy have been among the
riskiest endeavors of our species for most of our time on the planet.  My
guess is that everyone has muddled along about the best they could, doing
some things right, but probably maintaining a certain number of beliefs in
the same vein as thinking colostrum is poison, or  that your milk goes bad
if you witness something horrible.  (Modern versions  of this thinking
include the idea that every baby who clicks has thrush.)

Whenever someone talks about how well the people of the past did at
breastfeeding I think of the Spartans, who had to make laws to enforce women
to breastfeed.  Some warm, touch-centered cultures do very well to make
birth and breastfeeding supported and successful events.   But of course,
good public health (ie water and sewers, etc)  is the difference between the
kind of infant and maternal mortality rates then and now in the developed
world, breastfeeding or no breastfeeding.  The human race has survived with
some help from breastfeeding because data supports the idea that when child
survival is uncertain, women have many more children to insure that at least
a few will live.  The first thing that happens when infant mortality
declines is that birth rates decline. (Hanson and Bergstrom, Acta Paed.
Scand, 1990).  Bfg is a cornerstone of child survival, but down through
history, many children have died in infancy, and there has been no golden
age.  If anything, today is a golden age, in spite of all the work we still
have to do to make things more gentle and humane, and to expand the benefits
of good public health to the developing world.

 My mother-in-law still tells the story of how her own mother almost died of
mastitis in the era prior to antibiotics.  Her breast turned black from a
deep abscess.  She lay in bed for months with poltices on her breast to draw
the poison.  At the time she had 6 children.  The baby was weaned to diluted
goats milk and homemade formula because her milk dried up  during the
illness.  She had another baby 2 years later and didn't breastfeed from fear
of going through such an experience again.  My mother-in-law was the oldest
daughter, and the story became one of those horror tales which tend to get
passed down in families, and the only one of the daughters who successfully
lactated was the child too young to have witnessed their mother's
experience.

Existence is tenuous.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html