Breast or bottle? Breast-feeding Attitudes and Practices in New Zealand 1900-1963

Abstract

This thesis explores breast-feeding attitudes and practices in New Zealand during the first sixty-three years of the twentieth century, and is based on archival material, parenting manuals, newspaper and journal articles, contemporary theses, and infant formula advertisements. The introduction discusses breast-feeding historiography and considers the various ways in which to write a breast-feeding history. Chapter One covers the period 1900-1919. It uses the Auckland St Helens Hospital casebooks as a case study for breast-feeding practices and attitudes at this time, and analyses Dr Agnes Bennett’s thesis on breast-feeding at the Wellington St Helens Hospital. These works revealed that the majority of women in the St Helens Hospitals at this time breast-fed their infants, and that maternal and infant health problems were the leading reasons for mothers bottle-feeding. This chapter also discusses the role of the Plunket Society in the first two decades of the twentieth century, and how it attempted to promote both breast-feeding and particular breast-feeding practices. Forming part of this discussion is an analysis of the book Feeding and Care of Baby by Dr Frederick Truby King, founder of the Society. Advertisements for breast milk substitutes showed how strongly entrenched was the idea that breast milk was the best food for infants. The second chapter charts the period 1919-1939, exploring breast-feeding practices and attitudes from this period with reference to Dr Thomas Corkhill’s textbook for midwives, midwifery examinations, and parenting manuals by Truby King and Dr Maui Pomare. One mother’s story of breast-feeding during the 1930s, the St Helens Hospitals, ante-natal clinics, the medicalization of maternity care, and infant formula advertisements are also examined. During this period, breast-feeding continued to be strongly promoted by health professionals and the Plunket Society. Formula advertisements reflected the popularity of breast-feeding, promoted combining breast and bottle-feeding, and reinforced the idea that bottle-feeding was the scientific method of infant feeding. Chapter Three focuses on the decline in breast-feeding, which occurred in New Zealand during the 1940s, 1950s and early 1960s. It considers the multi-factorial reasons behind this decline from the perspectives of mothers and medical professionals, in addition to changes in breast-feeding practices and attitudes. A variety of childrearing manuals are discussed in this chapter to reflect the growing divergence in ideas about infant feeding. The analysis of infant milk advertising explores how advertisements both reflected and attempted to promote the decline in breast-feeding. This thesis discusses what motivated New Zealand women to breast-feed. The first two chapters explore how concerns about infant health encouraged mothers to breast-feed. The third chapter explains how many of the factors which had previously persuaded mothers to breast-feed were no longer considered as compelling as they had been earlier in the twentieth century. When breast or bottle was no longer thought so important for infant health, and bottle-feeding became more convenient, breast-feeding rates declined in New Zealand. The constraining factors on whether New Zealand women breast-fed showed continuties and changes. Throughout the first sixty-three years of the twentieth century, maternal and infant health problems remained the leading reasons for mothers not breast-feeding. Insufficient support to establish breast-feeding was increasingly cited as a constraining factor for New Zealand women from the 1940s onwards, although references were made to the value of support to intiate and continue breast-feeding from the beginning of the twentieth century. New constraints on women’s ability to breast-feed arose in the 1940s and 1950s and led to declining numbers of women breast-feeding. The constraints included less support in hospital to breast-feed, the new trend for demand feeding at a time when breast-feeding in public was unacceptable, and the increasing sexualisation of the breast. In addition, the new attitude that bottle-feeding was just as good as breast-feeding may have led to less value being placed on breast-feeding in New Zealand society. New Zealand health professionals, for the most part, strongly supported and promoted breastfeeding, as did parenting manuals. The medicalisation of infant care and breast-feeding in New Zealand did not appear to contribute to the decline in breast-feeding as this shift occurred prior to the reduction in numbers of women breast-feeding. Even infant formula advertisements acknowledged the benefits of breast-feeding for much of this period, which was reflective of social attitudes to breast-feeding. This thesis found changes and continuties in breast-feeding practices and attitudes over time. In each chapter there was some divergences of opinion over how mothers should breast-feed, which most commonly related to how breast-feeding should be established and how often infants should be fed. Routine feeding was increasingly encouraged from the beginning of the twentieth century until the early 1950s, when demand feeding first came into vogue. Although New Zealand mothers were encouraged to exclusively breast-feed throughout the twentieth century, mixed feeding was most commonly mentioned in documents from the first four decades of the twentieth century; however by the 1950s this practice was in decline as well as breast-feeding. The most significant change discussed in this thesis is the decline in breast-feeding from the 1940s to early 1960s. Breast-feeding remained, for most writers, the ideal method of infant feeding. However, for increasing numbers of mothers it was no longer their actual method of infant feeding, and more divergent opinions about the value of breastfeeding were voiced during the decline in breast-feeding.