A History of Breastfeeding in Canada
by Susan Miller, BScN
Recently I had the pleasure of attending a presentation by Tasnim Nathoo about breastfeeding in Canada. Nathoo, with co-author Aleck Ostry, researched this topic by reviewing historic Canadian statistics, government health reports and other archival sources. Their book titled The One Best Way? Breastfeeding History, Politics and Policy in Canada, (Wilfred Laurier University Press, 2009) examines breastfeeding in Canada over the last 150 years, and illustrates how our knowledge and value of breastfeeding has been influenced by such factors as the advent of infant formulas and changing social attitudes. As a consequence, breastfeeding was not always considered the “best” way to feed infants and we are now struggling to recapture the breastfeeding knowledge that was traditionally passed from one generation to another. Today there is indisputable scientific evidence to support the benefits of breastfeeding for the individual mother, her child, and for the health of the entire population. Here are some of the highlights of the history of breastfeeding in Canada.
Before the arrival of European settlers, aboriginal women breastfed their infants for two to three years or longer. In the 1600s and 1700s settlers began to arrive from England and France and these women also breastfed for long periods. With no adequate alternative to breastmilk, infants who were not breastfed rarely survived. Wet-nursing was the only way to feed an infant whose mother could not feed it herself. In Europe, wet-nursing was a luxury available only to upper class women. In the colonies, however, wet-nursing was a necessary measure to ensure the survival of an infant. In Quebec City in 1772, the colonial government agreed to pay for the cost of wet-nurses for “foundlings” who were typically infants of unmarried mothers. Through the 1800s, charitable organizations continued to find wet-nurse foster homes for foundlings and the wet-nurses were paid by the government. Foundling infants who were “dry-nursed” or fed a breastmilk alternative rarely thrived and there was an 88 per cent mortality rate for these infants in their first year of life.
By 1900, women were tending to breastfeed for shorter periods and supplementing their breastmilk with raw cow’s milk, breastmilk substitutes and other foods. Social and cultural changes in the urban industrial centers saw more women going out of the home to work. This decrease in breastfeeding duration meant infants had less immunological protection and were more likely to develop the often fatal “weanling diarrhea” from contaminated or spoiled cow’s milk and various gastrointestinal viruses.
In the early 20th century, physicians adamantly agreed that the best and safest way to feed an infant was to breastfeed. Around this time medical science also began to discover the importance of vitamins. It was believed that if a breastfeeding mother was not adequately nourished, her infant would be at risk of illness, particularly scurvy and rickets. This belief led to a reliance on artificial milks to nourish infants thought to be at risk. Physicians began experimenting with alternatives to breastmilk and created a range of modified cow’s-milk and customized formulas for the frail infants in their care. These preparations were often not well tolerated by the infants and their digestive problems were thought to be due to the wrong balance of proteins, fat and sugar in these laboratory milks.
By 1930, there was still great concern with the high rate of infant mortality, and mothers were urged to breastfeed for at least nine months to ensure a healthy thriving baby. In May 1934, the Dionne quintuplets were born in a rural northern Ontario town. Born two months early and being multiples, these tiny babies were not expected to survive. Their doctor fed them sugar water on the first day of life and on their second day he was able to obtain donated breastmilk from nursing mothers in the area. The quints thrived on donated breastmilk from Canada and the USA for their first year. The publicity around the Dionne quintuplets re-affirmed the health benefits of breastmilk for infants.
As time went on, the message about the value of breastmilk was being lost because of an increased trust in the scientific approach to infant nutrition and parenting. Physicians were now regarded as the authorities on these matters and mothers were advised to put their infants on four-hour feeding schedules and to avoid feeding during the night time. Regimented patterns of sleep, exercise, elimination and feeding were the prescribed “best way” of raising children. Even though mothers were told to love their children, hugging, kissing and other signs of affection were thought to spoil the child. Gradually, women lost faith in their most basic mothering instincts as they were advised to focus on cleanliness, schedules, and monitoring the weight gain of their infants. Bottle-feeding became more and more prevalent because bottles could be sanitized and the feedings could be measured. Mothers of the time were also competing with each other to produce the chubbiest baby since a chubby baby was considered to be a healthier baby. Breastmilk alternatives and products such as Eagle Brand Evaporated Milk helped to pack on the pounds!
Growing up in the 1950-60s, I don’t think I ever saw a mother breastfeeding and our generation didn’t even know that the human breast was designed to feed a baby! The female breast had become sexualized in society and “nice girls” were careful not to expose any part of their breasts when going out. By 1960, almost every woman gave birth in a hospital, and physicians and nurses were giving infant feeding advice around formula feeding. Other hospital practices at the time both directly and indirectly affected women’s breastfeeding success.
In the 1970s, Canadian breastfeeding initiation rates increased from approximately 25 per cent to 65 per cent. La Leche League, the lay breastfeeding support organization was gaining more members each year and mothers were once again able to learn breastfeeding skills and knowledge from each other. In the 1980s, the introduction of family-centered maternity and newborn care provided a more supportive environment (such as rooming in) for breastfeeding families while in the hospital. Medically managed birth practices were being questioned as more women were demanding the natural approach to birth and early post-partum. By the 1980s, 75 per cent of Canadian mothers were initiating breastfeeding. In British Columbia by 1998-99 the initiation rate was 95.2 per cent.
The New Millennium
In the past 10 years, the focus has shifted from convincing mothers to breastfeed to helping mothers to be successful with breastfeeding. There is still a strong influence from formula companies who market formulas as being “just as complete” as a mother’s breastmilk, but no manufacturing process can duplicate the complexities and special qualities of “living” breastmilk. For many women, breastfeeding presents significant challenges in the beginning and it can be tempting to turn to formula feeding when discouraged. Women need sound encouraging advice based on best practices when they are learning to breastfeed their infants. More and more health professional today are being educated about the intricacies of lactation and how to give timely advice and support to breastfeeding mothers.
How far have we come as a society that really values and encourages breastfeeding? We are making small steps in the right direction. One year of maternity leave has given women more opportunity to breastfeed exclusively for the first six months, and to continue during the first year and beyond as desired. Hopefully in time, our society will view breastfeeding an infant in a public place to be just as natural as feeding an older child their lunch of a sandwich and fruit.
Susan Miller R.N. BScN is a Perinatal Educator and Certified Breastfeeding Counsellor and has worked with pre and post-natal families in Greater Victoria for 30 years.