The History of Breastfeeding

Since the dawn of time, mothers everywhere have agreed: with the miracle of childbirth comes the not-always-miraculous experience called breastfeeding.

It’s beautiful, it’s bonding, it’s natural and literally life-sustaining… but it can also be uncomfortable and draining. Latching difficulties, low supply, and sore or chafed nipples can all present challenges. As if that weren’t enough, sometimes it can feel difficult or embarrassing to ask for help with something so personal.

At Sarasota Memorial—home to the only hospitals in Sarasota County providing obstetrics services—this was our call to create a community-wide Maternity Services program that would provide comprehensive care and resources for all expectant parents, from pregnancy planning and education to childbirth and early parenthood.

That means building two full-service hospitals with dedicated Mother-Baby units, private birthing suites and 24/7 Obstetrical Emergency Care Centers. It means offering free classes on breastfeeding, childbirth and baby-care to expectant parents, and hosting weekly gatherings for new mothers to find community, share advice, and receive breastfeeding tips from certified lactation experts. It means building the area’s only Neonatal Intensive Care Unit.

But who did struggling mothers turn to before the days of public hospitals?

Each other.

An Egyptian Encyclopedia, the Wild She-Wolf of Rome, and the Nail Test

As long as there have been babies, there have been mothers breastfeeding and mothers needing help. And before modern hospitals and fortified formulas, mothers needed to rely on each other. But what began as sheer need would quickly grow to be a matter of convenience, a symbol of class, and even its own industry governed by enforceable contracts and legal regulation.

Across the ancient world, from Babylon and Mesopotamia to Egypt and Greece, breastmilk was considered sacred and breastfeeding a virtue. But in a world where childbirth was even more dangerous and the human body still largely a mystery, these cultures also well-understood the need for wet nurses and surrogate nursing. In fact, the oldest medical encyclopedia on record, The Papyrus Ebers of Egypt, describes lactation failure and recommends surrogate nursing as a solution.

The ancient Babylonians, Greeks, and Romans all employed wet nurses, if the mother’s milk was unavailable or insufficient for any reason. Surrogate nursing is a repeated theme in Greek mythology, where goddesses could bestow their powers on the babes they nursed, and central to Rome’s founding myth, as the twin brothers Romulus and Remus are saved and nursed by a wild she-wolf. Wet-nursing is even described in Hammurabi’s Code, one of the earliest legal texts in the world, officially recognizing the role as a profession and establishing legal regulations to protect all involved. This probably came as a relief to many Babylonian mothers, as experts of the time recommended breastfeeding for up to three years.

Perhaps unsurprisingly, it didn’t take long before the adoption of a wet nurse became less a question of sacred duty and more a matter of convenience and even a symbol of class. By 950 BCE, Greek women from rich and noble families would often hire wet nurses to feed and care for their children, where they enjoyed an elevated position amongst the household staff. In Homer’s Odyssey, the famous hero is even described as having a loyal wet nurse, and in Plato’s Republic, the philosopher argues that the perfect society would be one where all children are raised by public wet nurses, so familial loyalty never overrides responsibility to the community.

At the height of the Roman Empire, rich families often employed wet nurses to care for the city’s abandoned children, typically girls discarded by families hoping for boys, forging complicated contracts to govern duties and responsibilities on both sides. Unfortunately, these usually ended in the children becoming property of the family and was seen as a relatively cheap way to acquire slaves. The wet nurses were paid well, however, and, as the practice grew, a physician names Solanus of Ephesus even wrote a 23-chapter text detailing the criteria of a good wet nurse, as well as their proper duties and dietary regimen. He would also be first to mention the fingernail test, used to judge the quality and consistency of a woman’s breastmilk.

It would be the standard for the next 1,500 years.

The Renaissance Says ‘No Redheads,’ Leonardo da Vinci Weighs In, and the Nation Goes to Work

Attitudes towards breastfeeding and wet-nursing remained largely unchanged until the Middle Ages, when societal and religious objections began to appear. Some saw nursing a child as the saintly duty and responsibility of the mother, not to be passed along to another. Others claimed that undesirable traits would pass from lower-class wet nurses to their aristocratic wards. Still, the practical reality and the need for wet nurses would largely outweigh these objections, at least for the rich, and the practice thrived, becoming a common source of income for the poorer classes.

Widespread disapproval of wet-nursing grew into the Renaissance period, with philosophers across Europe—all men—writing treatises on the importance of breastfeeding from the natural mother and countless artists, including Leonardo da Vinci, painting portraits of the Virgin Mary nursing the baby Jesus and making a not-so-subtle point. One French obstetrician even tried to argue that a wet nurse may swap one child for another, though he neglected to mention what the supposed motivation would be. He also strongly condemned redheads as wet nurses, claiming their fiery temperament could be passed to the child.

Regardless, just as in the Middle Ages, the wealthy class continued the practice, while the wet nurses themselves bore the societal stigma. In fact, European aristocracy of the 16th-18th centuries would often employ more than one wet nurse, freeing the mother from any such duties, as breastfeeding interfered with social activities, like cards and attending the theater, and prevented one from wearing the fashion of the time. For women from the poorer classes, this created opportunity for a steady and not-insubstantial income that far outweighed possible stigma.

The next great shift in wet-nursing would not occur until the Industrial Revolution, when not only was there a great migration from rural farmlands to urban centers, as workers found jobs in the factories, railyards, machine shops and mines that were sprouting up in cities across the world, but poverty increased. There were more jobs than ever, but with long hours and little pay, women were often forced to enter the workforce in order to supplement the family income and put food on the table. And suddenly, the women who were once wet nurses needed wet nurses of their own.

This would mark a substantial shift in society’s view on breastfeeding and spur on the technological advancement of everything from the modern baby bottle and rubber nipple to formulas, breast pumps, milk banks, and today’s lactation pods, enabling more and more women to nurse their own child without sacrificing employment, mobility, or other aspects of their lives.

Wet nurses would still be employed through the 20th century and into the 21st, but in fewer numbers and most often out of necessity than convenience. And today, more and more laws are being passed on both the state and federal level to protect breastfeeding parents and wet nurses, as well as establish workplace accommodations that promote nursing.

At Sarasota Memorial, we call that progress.

More About Mother-Baby Services at SMH

Maternity Services at SMH

Breastmilk Donation at SMH

Childbirth Education with SMH

Neonatal Intensive Care at SMH

More Articles from the SMH Centennial Series

A Brief History of Anesthesiology

Celebrating Heroes In Medicine: Vivien Thomas

From Experiment to Essential: The History of Blood Donation

How A World at War Changed Medicine

The Medical Miracle of Modern Childbirth

A Hundred Years of Heart

Written by Sarasota Memorial copywriter Philip Lederer, MA, who crafts a variety of external communications for the healthcare system. SMH’s in-house wordsmith, Lederer earned his Master’s degree in Public Administration and Political Philosophy from Morehead State University, KY.