The History of Formula

I talk rather a lot about how great breastfeeding is. Helping mothers have the best breastfeeding experience possible is something that I’m passionate about. Today, though, I thought I’d switch things up a bit and discuss the history of infant formula, both good and bad. I hope you find it as interesting as I do.

Prior to the 20th century the overwhelming majority of infants were breastfed. There simply wasn’t a viable alternative. If a mother couldn’t breastfeed, or chose not to, she employed a wet nurse. Or, failing that, the infant was fed some sort of home-made substitute. The situation was dire for those who weren’t breastfed. In foundling homes (think orphanages), only one in three of those who were wet nursed survived to age 5. Those who were artificially fed had only a one in nine survival rate. Infants who were artificially fed at home had a fatality rate in excess of 99%.

Even using a wet nurse was not an ideal situation. The market was not controlled, and women were not screened for diseases. Neither were babies. Pathogens were sometimes transmitted from the baby to the wet nurse or vice versa. Women in slavery were forced into wet nursing. Their own babies suffered as a result. There is a very real history of impoverished wet nurses facing subjugation at the hands of wealthy families.

Henri Nestle was horrified by this situation. He was the 11th of 14 children, half of whom died in infancy. He decided to use his background as a pharmacist’s assistant to create an infant formula. In the 1860s and 1870s Nestle and his competitor Justus von Leibig developed and introduced the first powdered infant formulas. Although the products represented an advancement over existing breast milk substitutes, they were slow to catch on. By the 1910s, the manufacturers realized that developing a close relationship with the medical community would help them sell their product, and that helped grow their market.

The number of mothers using infant formulas increased slowly through the early part of the 20th century. Partly, this had to do with the norms of childbirth and infant care. In 1900, 95% of babies were born at home. By 1940 that number had dropped to 50%, and by the 1950s about 95% of babies were born in the hospital. Birth and baby care became highly medicalized. Doctors were men, and science was king. Formula feeding rates skyrocketed in the 1950s and 1960s, reflecting these prevailing attitudes.

Breastfeeding rates reached their all-time low in 1971 in the US, when fewer than 25% of mothers attempted to nurse their babies. In addition to societal attitudes more and more women were working outside the home, meaning mothers and babies were separated during the early months. Formula feeding was the norm, and few women even attempted to breastfeed. We developed the culture that still exists today where baby bottles and soothers are ubiquitous symbols of infancy. With the baby came the bottle and the formula, along with the diapers and the itty bitty clothes.

But then some things changed. Childbirth practices started to shift. Groups like Lamaze took hold and more women took prenatal classes and sought natural childbirth. Hospital policies evolved to promote early bonding, with practices such as keeping mothers and babies in the same room. These changes supported breastfeeding by keeping the mother-baby pair together and alert during the critical early days.

Formula companies also started to comme under attack in the 1970s for their marketing practices in the developing world. A brochure called The Baby Killer claimed that the use of infant formula in the third world was leading to infant death or illness. Infant formula is expensive. This can lead impoverished families to use less formula powder than they should when mixing it. Compounding that, many people in developing countries do not have reliable access to safe drinking water. Using this water to mix up formula for very small babies is a recipe for disaster. But once mothers have stopped nursing, re-establishing exclusive breastfeeding is very difficult or impossible, leaving them with few options.

The accusation was made that companies such as Nestle were deliberately marketing their products as ‘safe’ when they knew full well they weren’t. They encouraged families who weren’t in a position to use formula properly to switch, and then their babies paid the price. There was some backlash, and an ongoing boycott was launched against Nestle in 1977.

Today breastfeeding initiation in the United States is over 70% and climbing. Formula use is on the decline, and human milk banks are opening across North America. The trend is positive, but there is a lot of work left to be done. Our recent formula-feeding history remains strong, and many people don’t have access to good breastfeeding information and support. The result is that while many women try to breastfeed, the success rates are much lower than they should be. I wish that this wasn’t the case, but I am happy that a generally safe alternative to breastfeeding exists. Now I hope that we can restore a breastfeeding culture so that fewer women need to use it.

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    1. Interesting summary! Thank you for sharing!

      Formula saved a lot of lives, from the sounds of it, to help babies who’s mom’s couldn’t breastfeed, or weren’t able to have access to breastmilk. But… then became the convenience of choice with our ever expanding and busy lives. I have had friends make the choice to give formula because they simply didn’t want the inconvenience of nursing. ACK! I respect their choice, but inside I am writhing and screaming to tell them how silly that is. How much more convenient is a portable, and always ready foodsource? How convenient is the concept of FREE food for your baby, instead of $35 cans of formula? I mourn for the colostrum that they never use, and the antibodies and nutrition they never give their children.

      I breastfed exclusively for six months, and introduced a small amount of formula a month before we went off to day care with our son (I had to go back to work and could not pump to completely provide BM during the day). I still pumped some and sent bottles to the day care, but he got some formula too. Slowly, we have weaned from breastmilk during the day onto formula, and now milk from formula. He gets a bottle of formula before bed, and then breastfed when he wakes up in the wee hours. I will continue to breastfeed at night until he doesn’t want it anymore.

      I advocate breastfeeding, and encourage my friends in their endeavours if they decide to. I believe it is the best gift you can give your child, and yourself. But… I am also glad for Nestle and the high quality of their GoodStart formula, which has been wonderful for our busy situation, and for some friends, who even with donperidone, could not nurse.

      I wonder how easy it would be, in developing countries with less clean water, to provide ready-made formula like you see in the bottles at the store. Could it be mixed into big jugs and simply put into bottle portions by the mothers?

      (sorry for the uber-long comment *blush*… oi. Got ahead of myself here….)
      .-= caroline´s last post ..Two Feet =-.

    2. Great summary! Worth noting, too, that prior to formula, other animal milk was used as a proxy, particularly goat’s milk, both by women who couldn’t supply a full amount of breastmilk and those in circumstances where the mother was not available for nursing.
      .-= Gayle´s last post ..Blueberry jam and happiness =-.

    3. Interesting article. Both my parents were raised on dairy farms, so when it came time to feed us my mom’s choice was breastfeeding. She breastfed me for 2 years, my middle brother for 3 years, and my youngest brother for over 4 years, for almost 10 total years of breastfeeding. That’s dedication :)
      .-= abbie´s last post ..Imaginary Dinner Party =-.

    4. I love the way you always do your homework and provide context for your blogs. Understanding the good place formula came from and the need it does fill for some mom’s today is important.

      So much of our society today comes from those few decades where convenience and commerce ruled. I’m so glad to see some of those trends reversing. (and yes I see the irony in that I am a marketer)

      In the 90s I did some work with Infact producing some creative posters promoting breastfeeding. I took a look back at them, and they are just as relevant today. I sometimes still see them in community nurse facilities. And Infact still sells them
      .-= Tracey´s last post ..Branding my Kid =-.

    5. Should also add that there is an image from Infact that still lives with me today. It was an image from Africa of a woman with twins. One plump happy and healthy. The other thin sick and dying. She had been told she could only breastfeed one and had formula fed the other. It doesn’t take much to figure out which baby was which.
      .-= Tracey´s last post ..Branding my Kid =-.

    6. Thank you so much for writing this! I think we all need to know the history of formula. Nestle didn’t start out as an evil entity killing babies to make a profit, and we can return it to it’s original purpose.

    7. Great post, with lots of links for further reading. Thanks!
      .-= Johanne´s last post ..Win the Essential Guide to Breastfeeding =-.

    8. Very interesting story. I never heard of the formula origin. My mother found it strange that I wanted to breastfeed because growing up, mother’s breastfed when they didn’t have enough money to buy formula. My mother found it weird. Luckily, she grew to understand and appreciate the reasons for breastfeeding and became an advocate of it by the time my second son was born.
      .-= Maria@Conversations with Moms´s last post ..Random Tuesday – Scams, Garbage and Bow Tie Pasta =-.

    9. Excellent post Amber! I didn’t know the story of Mr. Nestle so this is definitely something to hold onto for future reference.
      .-= Melodie´s last post ..Monday Musings: Aligning Your Body Image with Self Image =-.

    10. I love that ideology has been shifting to more natural practices of breastfeeding. Wouldn’t it be wonderful to start to see a shift away from medicated births and c-sections too?
      .-= Heather´s last post ..Family Fun Time =-.

    11. Thank you for posting this. It is so good to hear that breastfeeding is making a “come back.” I nursed my son (and my son through adoption) and it was a difficult start. Many people (including a lactation consultant!) tried to discourage me from continuing. But I was determined. In the end we have two happy, healthy boys and I credit their amazing immune systems to the fact we nursed. Keep up the good work spreading the word!
      .-= Jane´s last post ..“Beautiful” People =-.

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    1. […] couple of years ago I read about the history of infant formula. I concluded that the current commercially-available formulas represent a significant advantage […]

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