I'm not sure what it says about progress :-)  How come we knew all this in 1923 ???  All Bold emphasis is mine :-)

Infant Feeding Service: Breastfeeding and the Re-Establishment of Breast Milk.  Issued Quarterly to Physicians Interested in Better Babies.  Not sure of author or origins.  Printed in USA but sounds British. 1923 !
Funny note: Printing contributed by the Scientific Department of Mead Johnson & Company, Evansville IN.

In reviewing the pediatric literature of the last five or six years on Breast Feeding one is impressed with  - First, the earnestness of all the contributors and second, the uniform success all have had in bringing about the large percentages of successful maternal feeding and the almost no-mention of the fact that they encountered cases in which the mother's milk disagreed with the infant.

The advantages to   be had from breast nursing are - lowering infant morbidity, mortality, and nutritional disturbances.  Breast milk is an almost sterile homogeneous food that  meets all the requirements for physiologic growth - a food containing, when the mother is properly fed, all food accessories (VItamines, Fat Soluble A and Water Soluble B and C) in sufficient quantities to protect the infant, when placed in good hygienic surroundings with fresh air and sunlight, from deficiency diseases.

In view of the fact that the  mortality in infancy is stated by many writers to be from four to six bottle-fedd  to one breast-fed infant, then the lowering of this mortality means a simple and sane  return to maternal feeding. That more than ninety percent of mothers can, if they are properly instructed in the prenatal period, nurse their infants entirely on the breast, or breast and bottle (complementary feedings),  has been clearly proved by many conscientious observers.  Sedgwick, Jacobi, Griffth, and others state that physiologic failure of lactation  is practically unknown.  We believe that  false teaching has brought about a psychological  condition in the mothers which is responsible for the general belief that many cannot feed their offspring.

Pritchard writes in National Health, July 1922, on this important subject as follows: "If all infants were breast fed and properly breast fe, our Infant Welfare Centres and Infant Consultations might close their doors, for there would be very little work for them to do: but thanks to various counter-attractions, and thanks also to the ignorance of doctors,  nurses, and lay public with respect to details of the management of breast feeding, an enormous number of infants are relegated to the bottle  who, with a little resourcefulness and knowledge, could perfectly be saved this dangerous and ignominious and dangerous substition; hence our high infant mortality rate and the need for welfare centers, not so much to supply dried milk and other substitution, as  to proclaim our original  slogan, 'Back to the Breast'."

Bradkey in a very interesting article, "Feeding the Newborn Infdant", Therapeutic Gazette, January 13, 1923 writes as follows: [skip 2 paragraphs on hx.]

"Possibly more mistakes are made in the first weeks of life than in all the remainder of the infant's first year.  At this time mothers have a scant supply of milk, spastic or retracted nipples, and these conditions are given as a reason for weaning.  The amount of milk secreted by a motherin her first weeks after parturition is no criterion as to what she may be able to secrete later."

Is it not a crushing indictment that civilized man, with all his knowledge and science, has adopted a feeding regime for his offspring that in large measure, cannot compare in safety and efficiency to that of civilized man hundreds of years ago?  [please note the pronoun used, LOL]

Capenter, in the Pennsylvania Medical Journal. May 1918, aptly expresses it in these words:
"When physicians give as much study and thought to breast feeding as they give to artificial feeding, it will only be a short time before almost all infants will be breast fed, at least until they are six months old."

We are agreed that almost all mothers  can breast nurse their infants, and we are agreed that breast milk is the only proper food for the infant.  Then why such a large percent of bottle-fed infants?  There are many reasons:

1. False education.
2. Want of education for the young girl.
3. Want of prenatal education.
4. Neglect of proper instructions at time of birth.
5. Scarcity of breast milk (inderfeeding) first weeks after birth.
6. Retracted and spastic nipples.
7. Infant too weak to nurse.
8. Premature infant
9. The infant gets too much milk, (Overfeeding)

[I especially liked his explanation of #1]

1. False education promoted by commercial interests who continue to fill every home in the land with advertisements and pictures of fat infants, impressing the mother graphically with what certain so-called foods are supposed to do for the growing infant.  From these same sources, feeding instructions are issued daily, which countermand  the doctor's orders and which, when practiced, contribute largely to the causes of infant mortality.  Information in the form of half truth is always most dangerous.

2. The education of the young girl  is sadly neglected in this country.  All  girls should be taught by their mothers and the family physician that breast milk is the natural food for the infant and that every mother can and should nurse her infant.

3. Prenatal instructions from the general practitioner are often neglected.  Before the baby comes [their bold & italics] is a time   in which the more lasting impressions can be made upon the prospective mother as to the practicality, possibility, and also the neccessity for breastfeeding.

4. At the birth  of the child is the next important period in which the mother may be impressed  with the essentials of breast feeding.  The physician  has fulfilled only in small measure his responsibilities to the family and to the infant when he considers his mission ended with the delivery of the infant and care of the mother.  The mother should  be convinced of the fact that she can,  and that  it is her duty, to nurse the infant.  When the mother is convinced of this fact, the remainder of the procedure is simple.

5. Scarcity of the breast   milk in the first few weeks of an infant's life is the cause of weaning in a large number of cases.  Many physicians and mothers imagine that the milk disagrees with the infant or that the infant is having colic, whereas it is crying from hunger.

6.Retracted and spastic [???] nipples are met with in a certain percent of mothers and can be corrected by the simple procedure of expressing the milk from the breast.

7 & 8.  Infants too weak to nurse and premature infants are simply mentioned here as a class and will be considered to a greater extent in the "Treatment."

9. The overfed infant deserves as much space as the underfed.  Infants in this class sometimes in the early weeks of life show overweight.  They are rarely constipated, more often they suffer from diarrhoea, whiich as a rule is watery, green, sour, acid in reaction and excoriates the buttocks.  These infants are the victim of a two hour feeding interval,  or more often, they are fed every time they cry.  The more they cry, the oftener they are fed, ending at last in an endless chain of crying, feeding, diarrhea, and finally weaning.

The booklet goes on to explain treatments and relactation (via hand expression).

In all,  I certainly recognized certain plights that haven't changed since 1923.  :-(   Pat in SNJ

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