Wet Nursing

In some circumstances, mothers were, and still are not able to produce adequate milk for their babies. Also, certain cultures believed that some mothers should not have to breast feed their young and instead others should take on the responsibility, thus the practice of wet nursing began. Wet nursing refers to an infant breastfeeding from the mother's female relatives, friends or community members. Evidence of wet nursing dates back to 2250 BC and grew to become a widely popular way to nourish children. The practice is even mentioned in the Bible and Koran. In the 13th century, European women were well-paid to wet nurse and by the 16th and 17th centuries, most babies in Europe and North America were fed by wet nurses while their mothers worked or tended to daily tasks. By the early 20th century, the popularity of wet-nursing drastically decreased with the rising awareness of disease and infection. Today, wet nursing is still practiced in some countries but mother's milk and formula are the more popular method of infant nourishment.

Formula & Human Milk Substitutes

By the late nineteenth century, the development of artificial milk substitutes began as a medical and nutritional tool for babies who were not able to breastfeed. Such formulas had a low success rate and resulted in an increase in infant mortality. Later in the century, cow's milk was analyzed and used in a variety of formulas. These improved substitutes seemed more beneficial than the earlier formulas but still did not deliver the total nutrition required for infant health and development. The awareness of disease and infection in the 20th century furthered formula research, and with the improvement of food processing, resulted in powdered or condensed formulas which were easier to use. Significant developments and chemical alterations have been performed since and such condensed formulas are still used, although none provide the total benefits that breastmilk offers.

Milk Banking

The concept of donor milk banking became popular in the last hundred years as physicians interested in the survival of infants and children looked for other ways to provide human milk. Donor milk banking is defined as the collection, screening, processing, and distribution of human milk from volunteer breastfeeding mothers. The first United States donor milk bank was established in Boston in 1911. Mothers received payment for providing their milk to hospitalized infants while continuing to nurse their own babies to maintain a milk supply. The donors were physically examined for disease and milk was pasteurized to kill harmful bacteria. By the late1920's, more milk banks were founded in the United States and in 1943, the American Academy of Pediatrics published guidelines for milk-banking operations.
By the 1970's, neonatology became a field of its own and smaller premature infants began to survive. Donor milk became an integral part of feeding these infants, and numerous donor milk banks existed around the country.

In the early 1980's, the number of donor milk banks drastically decreased with the rapid spread of AIDS and infections. Like blood, breastmilk is also a carrier of such viruses, and the use of formula further increased. Additionally, specific formulas were developed to meet the needs of premature infants and the supply of donor human milk became less critical. Still, infants were not receiving complete nutrition and research began to develop a safe, affordable way to provide human breastmilk to those in need.

Today, breastmilk is the preferred choice of infant nourishment by physicians and pediatricians in North America and other countries. Donor milk is now dispensed only by prescription to babies with medical and nutritional needs including older infants and children with major nutritional or immunological problems. With the continued awareness of human milk banking safety and health benefits, more premature and sick babies are expected to thrive and certain infant diseases will be less of a threat.