Wet nurse

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Louis XIV as an infant with his nurse Longuet de la Giraudiere Louis XIV as an infant with his nurse Longuet de la Giraudiere.jpg
Louis XIV as an infant with his nurse Longuet de la Giraudière

A wet nurse is a woman who breast feeds and cares for another's child. [1] Wet nurses are employed if the mother dies, or if she is unable or elects not to nurse the child herself. Wet-nursed children may be known as "milk-siblings", and in some cultures the families are linked by a special relationship of milk kinship. Mothers who nurse each other's babies are engaging in a reciprocal act known as cross-nursing or co-nursing. Wetnursing existed in cultures around the world until the invention of reliable formula milk in the 20th century.

Contents

Reasons

A wet nurse can help when a mother is unable or unwilling to feed her baby. Before the development of infant formula in the 20th century, wet-nursing could save the baby's life.

There are many reasons why a mother is unable to produce sufficient breast milk, or in some cases to lactate at all. Reasons include the serious or chronic illness of the mother and her treatment which creates a temporary difficulty to nursing. Additionally, a mother's taking drugs (prescription or recreational) may necessitate a wet nurse if a drug in any way changes the content of the mother's milk.

There was a greater need for wetnurses when the rates of infant abandonment, and maternal death during and shortly after childbirth, were high. [2] [3] There was a concurrent availability of lactating women whose own babies had died, also not uncommon. [4]

Some women chose not to breastfeed for social reasons; many of these women were of the upper class. For them, breastfeeding was considered unfashionable, in the sense that it not only prevented these women from being able to wear the fashionable clothing of their time but it was also thought to ruin their figures. [5] Mothers also lacked the support of their husbands to breastfeed their children, since hiring a wet nurse was less expensive than having to hire someone else to help run the family business and/or take care of the family household duties in their place. [5] Some women chose to hire wet nurses purely to escape from the confining and time-consuming chore of breastfeeding. [6] Wet nurses have also been used when a mother cannot produce sufficient breast milk, i.e., the mother feels incapable of adequately nursing her child, especially following multiple births.

Eliciting milk

Statuette of a parclose representing a woman who presses her breast to collect milk in a bowl. - Stalls (16th century) of the Basilica of Saint Materne [fr] (11th century) - Walcourt (Belgium). Walcourt - Parclose - Satire d'une nourice.JPG
Statuette of a parclose representing a woman who presses her breast to collect milk in a bowl. – Stalls (16th century) of the Basilica of Saint Materne  [ fr ] (11th century) – Walcourt (Belgium).

A woman can only act as a wet-nurse if she is lactating (producing milk). It was once believed that a wet-nurse must have recently undergone childbirth. This is not necessarily the case, as regular breast suckling can elicit lactation via a neural reflex of prolactin production and secretion. [7] Some adoptive mothers have been able to establish lactation using a breast pump so that they could feed an adopted infant. [8]

Dr Gabrielle Palmer [9] states:

There is no medical reason why women should not lactate indefinitely or feed more than one child simultaneously (known as 'tandem feeding')... some women could theoretically be able to feed up to five babies. [10]

Historical and cultural practices

A Russian wet nurse, c. 1913 A Russian wet nurse, c. 1913.jpg
A Russian wet nurse, c. 1913

Wet nursing is an ancient practice, common to many cultures. It has been linked to social class, where monarchies, the aristocracy, nobility or upper classes had their children wet-nursed for the benefit of the child's health, and sometimes in the hope of becoming pregnant again quickly. Exclusive breastfeeding inhibits ovulation in some women (Lactational amenorrhea). Poor women, especially those who suffered the stigma of giving birth to an illegitimate child, sometimes had to give their baby up temporarily to a wet nurse, or permanently to another family. [11] The woman herself might in turn become wet nurse to a wealthier family, while using part of her wages to pay her own child's wet nurse. From Roman times and into the present day, philosophers and thinkers alike have held the view that the important emotional bond between mother and child is threatened by the presence of a wet nurse. [12]

Mythology

Many cultures feature stories, historical or mythological, involving superhuman, supernatural, human and in some instances animal wet-nurses.

The Bible refers to Deborah, a nurse to Rebekah wife of Isaac and mother of Jacob (Israel) and Esau, who appears to have lived as a member of the household all her days. (Genesis 35:8.) Midrashic commentaries on the Torah hold that the Egyptian princess Bithiah (Pharaoh's wife Asiya in the Islamic Hadith and Qur'an) attempted to wet-nurse Moses, but he would take only his biological mother's milk. (Exodus 2:6–9)

In Greek mythology, Eurycleia is the wet-nurse of Odysseus. In Roman mythology, Caieta was the wet-nurse of Aeneas. In Burmese mythology, Myaukhpet Shinma is the nat (spirit) representation of the wet nurse of King Tabinshwehti. In Hawaiian mythology, Nuakea is a beneficent goddess of lactation; [13] her name became the title for a royal wetnurse, according to David Malo. [14]

Ancient Rome

A funerary stele (akin to a gravestone) erected by Roman citizen Lucius Nutrius Gallus in the 2nd half of 1st century AD for himself, his wetnurse, and other members of his family and household 4796 - Brescia - S. Giulia - Stele di Lucio Nutrio Gallo (sec. I) - Foto Giovanni Dall'Orto, 25 Giu 2011.jpg
A funerary stele (akin to a gravestone) erected by Roman citizen Lucius Nutrius Gallus in the 2nd half of 1st century AD for himself, his wetnurse, and other members of his family and household

In ancient Rome, well-to-do households would have had wet-nurses (Latin nutrices, singular nutrix) among their slaves and freedwomen, [15] but some Roman women were wet-nurses by profession, and the Digest of Roman law even refers to a wage dispute for wet-nursing services (nutricia). [16] The landmark known as the Columna Lactaria ("Milk Column") may have been a place where wet-nurses could be hired. [17] It was considered admirable for upperclass women to breastfeed their own children, but unusual and old-fashioned in the Imperial era. [18] Even women of the working classes or slaves might have their babies nursed, [19] and the Roman-era Greek gynecologist Soranus offers detailed advice on how to choose a wet-nurse. [20] Inscriptions such as religious dedications and epitaphs indicate that a nutrix would be proud of her profession. [21] One even records a nutritor lactaneus, a male "milk nurse" who presumably used a bottle. [22] Greek nurses were preferred, [23] and the Romans believed that a baby who had a Greek nutrix could imbibe the language and grow up speaking Greek as fluently as Latin. [24]

The importance of the wet nurse to ancient Roman culture is indicated by the founding myth of Romulus and Remus, who were abandoned as infants but nursed by the she-wolf, as portrayed in the famous Capitoline Wolf bronze sculpture. The goddess Rumina was invoked among other birth and child development deities to promote the flow of breast milk.

India

By the 1500s, a wealthy mother who did not use a wet nurse was worthy of remark in India. The child was not "put out" of the household, rather, the wet nurse was included within it. The imperial wet nurses of the Mughal court were given honours in the Turco-Mongol tradition. [25]

United Kingdom

Catherine Willoughby, formerly Duchess of Suffolk, and her later husband Richard Bertie, are forced into exile, taking their baby and wetnurse Catherine Willoughby exiled.jpg
Catherine Willoughby, formerly Duchess of Suffolk, and her later husband Richard Bertie, are forced into exile, taking their baby and wetnurse

Wet nursing used to be commonplace in the United Kingdom. Working-class women both provided and received wet nursing services.

Taking care of babies was a well-paid, respectable and popular job for many working-class women. In the 18th-century, a woman would earn more money as a wet nurse than her husband could as a labourer. Up until the 19th century, most wet-nursed infants were sent far from their families to live with their new caregiver for up to the first three years of their life. [26] As many as 80% of wet-nursed babies who lived like this died during infancy. [26]

During the Victorian era, women took in babies for money, and nursed them themselves or fed them with whatever was cheapest. This was known as baby-farming; poor care sometimes resulted in high infant death rates. The wet nurse at this period was most likely a single woman who previously had given birth to an illegitimate child. [27] There were two types of wet nurses by this time: those on poor relief, who struggled to provide sufficiently for themselves or their charges, and the professionals, who were well paid and respected.

Upper-class women tended to hire wet nurses to work within their own homes, as part of a large household of servants.

Wet nurses also worked at foundling hospitals, establishments for abandoned children. Her own child would likely be sent away, normally brought up by the bottle rather than being breastfed. Valerie Fildes, author of Breasts, Bottle and Babies: A History of Infant Feeding, argues that "In effect, wealthy parents frequently 'bought' the life of their infant for the life of another." [28]

Wet nursing decreased in popularity during the mid-19th century, as medical journalists wrote about its previously undocumented dangers. Fildes argued that "Britain has been lumped together with the rest of Europe in any discussion of the qualities, terms of employment and conditions of the wet nurse, and particularly the abuses of which she was supposedly guilty." [29] C. H. F. Routh, a medical journalist writing in the late 1850s listed the evils of wet-nursing, such as the abandonment of the wetnurses' own children, higher infant mortality, and an increased physical and moral risk to a nursed child. [30] While this argument was not founded in any sort of proof, the emotional arguments of medical researchers, coupled with the protests of other critics, slowly increased public knowledge; the practice declined, replaced by maternal breastfeeding and bottle-feeding. [31]

France

The bureau of wet nurses in Paris The bureau of wet nurses in Paris - wet nurses waiting to be Wellcome V0015043.jpg
The bureau of wet nurses in Paris

Wet nursing was reported in France in the time of Louis XIV, the mid 17th century. In 18th century France, approximately 90% of infants were wet nursed, mostly sent away to live with their wet nurses. [32] In Paris in 1780, only 1000 of the 21,000 babies born that year were nursed by their own mother. [33] The high demand for wet nurses coincided with the low wages and high rent prices of this era, which forced many women to have to work soon after childbirth. [26] This meant that many mothers had to send their infants away to be breastfed and cared for by wet nurses even poorer than themselves. With the high demand for wet nurses, the price to hire one increased as the standard of care decreased. [26] This led to many infant deaths. In response, rather than nursing their own children, upper-class women turned to hiring wet nurses to come live with them instead. In entering into their employers home to care for their charges, these wet nurses had to leave their own infants to be nursed and cared for by women far worse off than themselves, and who likely lived at a relatively far distance away.

The Bureau of Wet Nurses was created in Paris, 1769, to serve two main purposes; it supplied parents with wet nurses, as well as helped lessen the neglect of charges by controlling monthly salary payments to wet nurses. [26] In order to become a wet nurse, women had to meet a few qualifications including a good physical body with a good moral character, they were often judged on their age, their health, the number of children they had, as well as their breast shape, breast size, breast texture, nipple shape and nipple size, since all these aspects were believed to affect the quality of a woman's milk. [34] In 1874, the French government introduced the Roussel Law, which "mandated that every infant placed with a paid guardian outside the parents' home be registered with the state so that the French government is able to monitor how many children are placed with wet nurses and how many wet nursed children have died". [26]

Wet nurses were often hired to work in hospitals so that they could nurse premature babies, babies who were ill, or babies who had been abandoned. [32] During the 18th and 19th centuries, congenital syphilis was a common cause of infant mortality in France. [35] The Vaugirard hospital in Paris began to use mercury as a treatment for syphilis; however, it could not be safely administered to infants. [35] In 1780, began the process of giving mercury to wet nurses who could then transmit the treatment to the infants with syphilis through their milk in the act of breastfeeding. [35]

The practice of wetnursing was still widespread during World War I, according to the American Red Cross. Working-class women would leave their babies with wetnurses so they could get jobs in factories. [36]

United States

Enslaved Black woman wet-nursing white infant Wet Nurse.png
Enslaved Black woman wet-nursing white infant

British colonists brought the practice of wet nursing with them to North America. [34] Since the arrangement of sending infants away to live with wet nurses was the cause of so many infant deaths, by the 19th century, Americans adopted the practice of having wet nurses live with the employers in order to nurse and care for their charges. [34] This practice had the effect of increasing the death rate for wet nurses' own babies. Many employers would have only kept a wet nurse for a few months at a time since it was believed that the quality of a woman's breast milk would lessen over time. [34]

Since there were no official records kept pertaining to wet nurses or wet nursed children in the United States, historians lack the knowledge of precisely how many infants were wet-nursed, for how long they were wet-nursed, whether they lived at home or else where while they wet-nursed, as well as how many wet-nursed babies lived or died. [37] The only evidence which exists pertaining to wet-nursing in the United States is found in the help wanted ads of newspapers, through complaints about wet nurses in magazines, and through medical journals which acted as employment agencies for wet-nurses. [34]

In the Southern United States, it was common practice for enslaved black women to be forced to be wet nurses to their owners' children. [32] In some instances, the enslaved child and the white child would be raised together in their younger years. [38] (Sometimes both babies would be fathered by the same man, the slave-owner; see Children of the plantation.) Visual representations of wet-nursing practices in enslaved communities are most prevalent in representations of the Mammy archetype caricature. [39] Images such as the one in this section represent both a historically accurate practice of enslaved black women wet-nursing their owner's white children as well as sometimes an exaggerated racist caricaturization of a stereotype of enslaved black women as "Mammy" characters.

Relationships

"Visite Chez la Nourrice" ("Visit to the Wetnurse") by Victor Adam Visite Chez la Nourrice (Visit to the Wetnurse) (from Journal l'Artiste) MET DP841080.jpg
"Visite Chez la Nourrice" ("Visit to the Wetnurse") by Victor Adam
An infant who has been living with a wet-nurse being taken away from its foster-parents by its natural mother. By Etienne Aubry An infant who has been living with a wet-nurse being taken a Wellcome V0015113.jpg
An infant who has been living with a wet-nurse being taken away from its foster-parents by its natural mother. By Étienne Aubry

Sometimes the infant is placed in the home of the wetnurse for several months, as was the case for Jane Austen and her siblings. The Papyrus Oxyrhynchus 91, a receipt from 187 AD, attests to the ancient nature of this practice. Sometimes the wetnurse came to live with the infant's family, filling a position between the monthly nurse (for the immediate post-partum period) and the nanny.

In some cultures the wetnurse is simply hired as any other employee. In others, however, she has a special relationship with the family, which may incur kinship rights. In Vietnamese family structure, for example, the wetnurse is known as Nhũ mẫu, mẫu meaning "mother". [40] Islam has a highly codified system of milk kinship known as rada . George III of the United Kingdom, born two months premature, had a wet nurse whom he so valued all his life that her daughter was appointed laundress to the Royal Household, "a sinecure place of great emolument". [41]

Current attitudes in Western countries

In contemporary affluent Western societies such as the United States, the act of nursing a baby other than one's own often provokes cultural discomfort. When a mother is unable to nurse her own infant, an acceptable mediated substitute is expressed milk (or especially colostrum) which is donated to milk banks, analogous to blood banks, and processed there by being screened, pasteurized, and usually frozen. Infant formula is also widely available, which its makers claim can be a reliable source of infant nutrition when prepared properly. Dr Rhonda Shaw notes that Western objections to wet-nurses are cultural:

The exchange of body fluids between different women and children, and the exposure of intimate bodily parts make some people uncomfortable. The hidden subtext of these debates has to do with perceptions of moral decency. Cultures with breast fetishes tend to conflate the sexual and erotic breast with the functional and lactating breast. [10]

In addition, the legacy of wet-nursing for African-American women is inherently linked to slavery, and the physical, emotional, and mental abuse that enslaved African-American women endured. While other populations in the United States may be more open to wet-nursing, the cultural attitude within African-American communities towards wet-nursing remains one deeply affected by the generational trauma of wet-nursing during slavery. [42]

For some Americans, the subject of wet-nursing is becoming increasingly open for discussion. During a UNICEF goodwill trip to Sierra Leone in 2008, Mexican actress Salma Hayek decided to breast-feed a local infant in front of the accompanying film crew. The sick one-week-old baby had been born the same day but a year later than her daughter, who had not yet been weaned. Hayek later discussed on camera an anecdote of her Mexican great-grandmother spontaneously breast-feeding a hungry baby in a village. [43]

Current situation elsewhere

Wet nurses are still common in many developing countries, although the practice poses a risk of infections such as HIV. [10] In China, Indonesia, and the Philippines, a wet-nurse may be employed in addition to a nanny as a mark of aristocracy, wealth, and high status. Following the 2008 Chinese milk scandal, in which contaminated infant formula poisoned thousands of babies, the salaries of wet-nurses there increased dramatically. [44] The use of a wet-nurse is seen as a status symbol in some parts of modern China. [10]

Additionally, a woman who is difficult to get pregnant may wet-nurse and rear a relative (especially a poorer one's) new-born as a mancing (Javanese language for "lure").[ citation needed ]

Notable wetnurses

Royal wetnurses are more likely than most to reach the historical record.

In Ancient Egypt, Maia was the wetnurse of King Tutankhamun. [45] Sitre In, the nurse of Hatshepsut, [46] was not a member of the royal family, but received the honour of a burial in the royal necropolis in the Valley of the Kings in tomb KV60. Her coffin has the inscription wr šdt nfrw nswt In, meaning Great Royal Wet Nurse In. [47] Lady Kasuga was the wet nurse of the third Tokugawa shōgun Iemitsu. Lu Lingxuan was a lady in waiting who served as wetnurse to the emperor Gao Wei; she became exceedingly powerful during his reign, and was often criticized by historians for her corruption and treachery. Chinese emperors honoured the Nurse Empress Dowager. Dai Anga was the wetnurse of the Mughal Emperor, Shah Jahan. Shin Myo Myat was the mother of King Bayinnaung of Toungoo Dynasty of Burma (Myanmar), and the wetnurse of King Tabinshwehti. In England, Hodierna of St Albans was the mother of Alexander Neckam and wet nurse of Richard I of England, and Mrs. Pack was a wet nurse to William, Duke of Gloucester (1689–1700). Geneviève Poitrine was a wet nurse of the Dauphin of France, Louis Joseph, son of King Louis XVI of France and Queen Marie Antoinette. Poitrine was accused of transmitting tuberculosis to the Dauphin, and triggering his infant death when aged seven, [48] although since very few pre-adolescent children die from TB this accusation may have been the result of a misdiagnosis. [49]

Some non-royal wetnurses have been written about. Halimah bint Abi Dhuayb was the foster-mother and wetnurse of the Islamic prophet Muhammad. Petronella Muns was, with her employer, the first Western woman to visit Japan. Naomi Baumslag, author of Milk, Money and Madness, described the legendary capacity of Judith Waterford: "In 1831, on her 81st birthday, she could still produce breast milk. In her prime she unfailingly produced two quarts (four pints or 1.9 litres) of breast milk a day." [10]

See also

Related Research Articles

Infant formula

Infant formula, baby formula or just formula or baby milk, infant milk or first milk, is a manufactured food designed and marketed for feeding to babies and infants under 12 months of age, usually prepared for bottle-feeding or cup-feeding from powder or liquid. The U.S. Federal Food, Drug, and Cosmetic Act (FFDCA) defines infant formula as "a food which purports to be or is represented for special dietary use solely as a food for infants by reason of its simulation of human milk or its suitability as a complete or partial substitute for human milk".

Breast pump

A breast pump is a mechanical device that lactating women use to extract milk from their breasts. They may be manual devices powered by hand or foot movements or automatic devices powered by electricity.

Breast milk Milk produced by the mammary glands in the breast of a human female

Breast milk or mother's milk is milk produced by mammary glands, located in the breast of a human female. Breast milk is the primary source of nutrition for newborns, containing fat, protein, carbohydrates and variable minerals and vitamins. Breast milk also contains factors that are important for implications protecting the infant against infection and inflammation, whilst also contributing to healthy development of the immune system and gut microbiome.

Lactational amenorrhea

Lactational amenorrhea, also called postpartum infertility, is the temporary postnatal infertility that occurs when a woman is amenorrheic and fully breastfeeding.

Erotic lactation Sexual activity involving the stimulation of womans breast

Erotic lactation is sexual arousal by breastfeeding on a woman's breast. Depending on the context, the practice can also be referred to as adult suckling, adult nursing, and adult breastfeeding. Practitioners sometimes refer to themselves as being in an adult nursing relationship (ANR). Two persons in an exclusive relationship can be called a nursing couple.

History and culture of breastfeeding

The history and culture of breastfeeding traces changing social, medical and legal attitudes to breastfeeding, the act of feeding a child breast milk directly from breast to mouth. Breastfeeding may be performed by the infant's mother or by a surrogate, typically called a wet nurse.

Breastfeeding in Islam

Breastfeeding is highly regarded in Islam. The Qur'an regards it as a sign of love between the mother and child. In Islamic law, breastfeeding creates ties of milk kinship (known as raḍāʿ or riḍāʿa that has implications in family law. Muslims throughout the world have varied breastfeeding traditions.

Lactivism Activism in favor of breastfeeding

Lactivism is the doctrine or practice of vigorous action or involvement as a means of achieving a breastfeeding culture, sometimes by demonstrations, protests, etc. of breastfeeding. Supporters, referred to as "lactivists", seek to protest the violation of International Code of Marketing of Breast-milk Substitutes by formula companies and industry.

Breastfeeding difficulties

Breastfeeding difficulties refers to problems that arise from breastfeeding, the feeding of an infant or young child with milk from a woman's breasts. Although babies have a sucking reflex that enables them to suck and swallow milk, and human breast milk is usually the best source of nourishment for human infants, there are circumstances under which breastfeeding can be problematic, or even in rare instances, contraindicated.

Breastfeeding Feeding of babies or young children with milk from a womans breast

Breastfeeding, also called nursing, is the process of feeding a mother's breast milk to her infant, either directly from the breast or by expressing the milk from the breast and bottle-feeding it to the infant. The World Health Organization (WHO) recommends that breastfeeding begin within the first hour of a baby's life and continue as often and as much as the baby wants. During the first few weeks of life babies may nurse roughly every two to three hours, and the duration of a feeding is usually ten to fifteen minutes on each breast. Older children feed less often. Mothers may pump milk so that it can be used later when breastfeeding is not possible. Breastfeeding has a number of benefits to both mother and baby, which infant formula lacks.

Breastfeeding in public

The social attitudes to and legal status of breastfeeding in public vary widely in cultures around the world. In many countries, both in the Global South and in a number of Western countries, breastfeeding babies in open view of the general public is common and generally not regarded as an issue. In many parts of the world including Australia, some parts of the United States and Europe, along with some countries in Asia, women have an explicit legal right to nurse in public and in the workplace.

Lactation

Lactation describes the secretion of milk from the mammary glands and the period of time that a mother lactates to feed her young. The process naturally occurs with all post-pregnancy female mammals, although it predates mammals. In humans the process of feeding milk is also called breastfeeding or nursing. Newborn infants often produce some milk from their own breast tissue, known colloquially as witch's milk.

Human milk bank

A human milk bank or breast milk bank is a service which collects, screens, processes, and dispenses by prescription human milk donated by nursing mothers who are not biologically related to the recipient infant. The optimum nutrition for newborn infants is breastfeeding, if possible, for the first year. Human milk banks offer a solution to the mothers that cannot supply their own breast milk to their child, for reasons such as a baby being at risk of getting diseases and infections from a mother with certain diseases, or when a child is hospitalized at birth due to very low birth weight, and the mother cannot provide her own milk during the extended stay for reasons such as living far from the hospital.

Breastfeeding promotion

Breastfeeding promotion refers to coordinated activities and policies to promote health among women, newborns and infants through breastfeeding.

Human–animal breastfeeding

Human–animal breastfeeding has been practiced in many different cultures in many time periods. The practice of breastfeeding or suckling between humans and other species has gone in both directions: women sometimes breastfeed young animals, and animals are used to suckle babies and children. Animals were used as substitute wet nurses for infants, particularly after the rise of syphilis increased the health risks of wet nursing. Goats and donkeys were widely used to feed abandoned babies in foundling hospitals in 18th- and 19th-century Europe. Breastfeeding animals has also been practised, whether for health reasons – such as to toughen the nipples and improve the flow of milk – or for religious and cultural purposes. A wide variety of animals has been used for this purpose, including puppies, kittens, piglets and monkeys.

Infant nutrition is the description of the dietary needs of infants. A diet lacking essential calories, minerals, vitamins, or fluids is considered inadequate. Breast milk provides the best nutrition for these vital first months of growth when compared to infant formula. For example, breastfeeding aids in preventing anemia, obesity, and sudden infant death syndrome; and it promotes digestive health, immunity, intelligence, and dental development. The American Academy of Pediatrics recommends exclusively feeding an infant breast milk, or iron fortified formula, for the first six months of life and continuing for one year or longer as desired by infant and mother. Infants are usually not introduced to solid foods until four to six months of age. Historically, breastfeeding infants was the only option for nutrition otherwise the infant would perish. Breastfeeding is rarely contraindicated, but is not recommended for mothers being treated for cancer, those with active tuberculosis, HIV, substance abuse, or leukemia. Clinicians can be consulted to determine what the best source of infant nutrition is for each baby.

Cracked nipple is a condition that can occur in breastfeeding women as a result of a number of possible causes. Developing a cracked nipple can result in soreness, dryness or irritation to, or bleeding of, one or both nipples during breastfeeding. The mother with a cracked nipple can have severe nipple pain when the baby is nursing. This severe pain is a disincentive for continued breastfeeding. The crack can appear as a cut across the tip of the nipple and may extend to its base. Cracked nipple develop after the birth of the infant and is managed with pharmacological and nonpharmacological treatment.

Latch (breastfeeding)

Latch refers to how the baby fastens onto the breast while breastfeeding. A good latch promotes high milk flow and minimizes nipple discomfort for the mother, whereas poor latch results in poor milk transfer to the baby and can quickly lead to sore and cracked nipples. In a good latch, both the nipple and a large portion of the areola are in the baby's mouth.

In breastfeeding women, low milk supply, also known as lactation insufficiency, insufficient milk syndrome, agalactia, agalactorrhea, hypogalactia or hypogalactorrhea, is the production of breast milk in daily volumes that do not fully meet the nutritional needs of her infant.

Breastfeeding and mental health

Breastfeeding and mental health is the relationship between postpartum breastfeeding and the mother's and child's mental health. Research indicates breastfeeding has positive effects on the mother's and child's mental health. These benefits include improved mood and stress levels in the mother, lower risk of postpartum depression, enhanced social emotional development in the child, stronger mother-child bonding and more. Given the benefits of breastfeeding, the World Health Organization (WHO), the European Commission for Public Health (ECPH) and the American Academy of Pediatrics (AAP) suggest exclusive breastfeeding for the first six months of life. Despite these suggestions, estimates indicate 70% of mothers breastfeed their child after birth and 13.5% of infants in the United States are exclusively breastfed. Breastfeeding promotion and support for mothers who are experiencing difficulties or early cessation in breastfeeding is considered a health priority.

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  13. Native planters in old Hawaii: their life, lore, and environment by Edward Smith Craighill Handy, Elizabeth Green Handy, Mary Kawena Pukui.
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