How could such a simple substance like milk be a matter of life or death for infants? A special installation on view on the fourth floor of the New-York Historical Society through November, 28, 2021 explores how, at the turn of the 20th century, babies who were not breastfed faced mortal danger with every sip of milk. Innovations in technology and the regulation of the dairy industry spurred massive changes that impacted mothers’ decisions—alongside urbanization, the growing understanding of germ theory, the rise of medical expertise and male physicians’ increasing authority over family life, and changing employment opportunities for women. Through these upheavals, babies’ survival depended on women’s caregiving labor—as mothers, wetnurses, and professional nurses and social workers.

Glenn Castellano, New-York Historical Society.

Nursing Babies

Before technological developments made it possible to safely store and serve cows’ milk and other alternatives, breastfeeding was widely considered the only safe way to nourish babies. But not all mothers wanted or were able to nurse their babies themselves, leading to a complex marketplace for wetnurses that reflected and reinforced hierarchies of class and race.

George E. Stonebridge. Portrait of Bessie Nursing Little Bill, ca. 1917-18. Patricia D. Klingenstein Library, New-York Historical Society.

New York Herald, 1869. Library of Congress, Chronicling America: Historic Newspapers.

In urban centers like New York, wetnurses seeking employment were often unmarried mothers with few other options, forced by circumstance to feed other women’s children. Historian Janet Golden has analyzed how newspaper classifieds provided parents seeking wetnurses and lactating women a way to find one another, sometimes utilizing third-party organizations (such as hospitals or infant asylums) or male physicians to vet their candidates in the urban marketplace. Wetnurses seeking employment in advertisements, such as the one pictured, emphasized their respectability, health, religious affiliation, ethnicity, and references, as well as the “freshness” of their milk. Some of the women seeking employment specify that their own children have died—employers seeking wetnurses preferred for their own children to have exclusive access to their wetnurses’ milk. For wetnurses’ with children, this practice often led their own infants to languish, and sometimes eve starve to death. Forced by economic circumstances, especially the lack of a social safety net or economic opportunities for unwed mothers, wetnurses had to make a trade off in which their own children suffered. As Golden puts it, “at its core,” wetnursing “was a career track paved with misfortune.”

Some charitable organizations were founded to assist wetnurses and their children, yet did so with a prevailing moralism that blamed individual women for what reformers saw as personal failures. The Patricia D. Klingenstein Library holds the records of one such institution, the Nursery and Child Hospital, founded by Mary Ann Delafield  DuBois, the wife of a tobacco merchant. According to an address given by Rev. Dr. Anthon at its 1857 cornerstone-laying ceremony, the hospital was meant to alleviate the “poverty, where the mother is compelled to surrender her own flesh and blood,” acknowledging the dire circumstances wetnurses faced. However, the address continues by admonishing the wetnurse who “gives nourishment to the child of the rich, while she herself fares sumptuous at the rich man’s table…while the damp cell, the fretted vault, the crowded attic, steamed with poisonous and pestilential vapors, is the home of her own child—not happy, not beautiful, not in the bloom of health, but yet innocent.” While the children of wetnurses might be pitied and taken after, mothers themselves were viewed with disdain even by those seeking to help them.

Interracial wetnursing was more common in the south than north. The satirical caption on this envelope reveals northern prejudices against it, disparaging the practice of utilizing enslaved wetnurses in the “Cotton States Aristocracy,” implying that the milk of Black women would impair white babies. Historian Stephanie Jones-Rodgers has written about how southern white women negotiated the practice of selling or hiring out enslaved, lactating women, separating these Black mothers from their children. In doing so, white women “were crucial to the further commodification of enslaved women’s reproductive bodies, their breast milk, and the nutritive and maternal care they provided to white children.”

From Swill to Staple: Breastfeeding Alternatives

Why would parents turn to a wetnurse rather than bottle-feeding? From the difficulties of cleaning nursing bottles to the challenges of obtaining unadulterated milk or nutritious, chemical alternatives, mothers faced off against deadly threats to their babies’ health when they attempted to feed off the breast. However, medical and technological developments in the late 19th century radically transformed cows’ milk and infant formulas from a death sentence to a staple of children’s diets. At the same time, the increasing commodification of these forms of “artificial feeding” led to decreasing rates of breastfeeding and the near disappearance of wetnursing after the 1920s.

The installation features several examples of nursing bottles from the 19th century, representing the diversity of forms and materials utilized by mothers in the 19th century to feed their babies when breastfeeding was not possible. The development of the glass bottle with the Industrial Revolution provided a more hygienic model than earlier vessels made of cow horn, silver, or pewter. Most would have been used with nipples: before the rubber nipple was patented in 1845, babies suckled from pieces of leather, sponge, or rags. The difficulty of cleaning and sterilizing both bottles and nipples made “hand-feeding” a potentially dangerous act even if the milk itself was unspoiled; one model has been subsequently coined the “murder bottle” because its long rubber tube was particularly susceptible to dangerous bacteria growth.

Even if a bottle could be safely cleaned, every subsequent step of the process of bringing milk into urban centers during the 19th century posed a potentially deadly threat, as historians such as Golden have detailed. As she quotes a Harvard medical professor, “a city’s milk supply is so often richer in bacteria than its sewage.” An infamous exposé in Frank Leslie’s Illustrated Newspaper in 1858 highlighted one danger: Much of the urban milk supply came from cows feeding on the “slops” of liquor distilleries. Historian Richard Meckel cites one contemporary account’s estimate that between 50-80% of the milk supply in Northeastern cities came from these swill dairies. This “swill” milk, Leslie’s Newspaper claimed, was “poison that deals death to the mothers and children.” The paper called for a major public health campaign and was a major turning point for social reformers to turn their attention to the regulation of milk.

William Davis Hassler. Unidentified dairy worker using a milk-cooling apparatus in the spring house, ca. 1913. Patricia D. Klingenstein Library, New-York Historical Society.

However, danger lurked even past the distillery slops. Cows might be diseased; the cans used for transport could be contaminated; the railway trains or carts used to transport milk to the city were rarely refrigerated, and it could take days for milk to travel from cow to consumer. Once in the city, milk might be diluted with polluted water so that vendors could increase their sales. Chemicals, dye, or chalk might be added to disguise its smell or color. Rather than bottling milk at its origin, vendors would distribute milk from large, unsanitary cans directly to consumers.

Regulation of milk was complicated: According to Meckel, New York City’s milk in 1900 “came from 35,000 dairies situated in five different states, passed through 400 processors and over 12 lines of transportation, and was handled by 150 wholesalers and 12,000 retailers.” Federal and local regulations, like the first federal Food and Drugs Act in 1906 and New York State’s 1912 prohibition against unpasteurized milk, would transform the milk supply. 

Milk was also made safer with by technological developments in refrigeration. The cost of ice was prohibitive for most working-class families, and most iceboxes were not able to maintain temperatures low enough to prevent milk from spoiling during the summer. Electric refrigeration did not become widespread among American households until the 1930s.

Nestle’s Food advertisement, 1892. Babyhood: The Mother’s Nursery Guide, Volume 9

On the other hand, the late 19th century also saw developments in another alternative to breastfeeding: infant formulas. The first canned milk factory in the United States opened in 1856, and the innovation became widespread during the Civil War as an easy way to feed troops. The first infant formula was developed in Europe during the mid-1860s and came onto the American market by 1873, building on these developments in evaporated and condensed milks. Advertisements and label packaging instructed mothers to mix formula with either cows’ milk or water—both of which were subject to contamination in urban settings. The powdered formulas were of questionable nutrition—historian Jacqueline Wolf finds that physicians at first “detested” what were then-called proprietary or commercial infant foods—but they were easy to carry and store. Additionally, they were advertised in magazines and by door-to-door salesmen targeting new mothers as “scientific” alternatives to breastfeeding, making them an attractive option for mothers increasingly working out of the home and anxious about their own capabilities of adequately nourishing their children. These advertisements sought to convince them that infant formula was safer than not only competing products or cows’ milk, but also human milk. They assured women that only their products would help children thrive, encouraging early weaning or an end to breastfeeding altogether.

Milk Stations in New York City

The story of how regulated milk was distributed to communities reveals how socioeconomic, racial, and gender hierarchies can be embedded in everyday life. Physician Abraham Jacobi and philanthropist Nathan Straus began the first milk station in New York City’s Lower East Side in 1893 to reduce infant mortality rates in tenement districts by pasteurizing raw milk and regulating its supply. 

 “Rock-a-bye, baby, up on the boughYou get your milk from a certified cow”—Anonymous, Forecast: A Magazine of Home Efficiency, 1915.

This development emerged at the same time that pediatrics was founded as a new, distinct medical specialty in the late 19th century: The inaugural meeting of American Pediatric Society, for example, was held in 1889, just four years before the first milk station. Pediatricians focused especially on the new science of infant feeding and the growing understanding of germ theory. As the professional specialty development, male physicians took on the mantle of expertise, denigrating midwives’ and other women’s traditional knowledge around infant care. As pediatrician Wiliam Cadogan declared, childrearing “has been too long fatally left to the management of women who cannot be supposed to have the proper knowledge.” As historian Rima Apple has argued, this led to an inherent tension: Mothers were considered responsible for their babies’ health but “incapable of that responsibility.”

_Poster, ca. 1910. Patricia D. Klingenstein Library, New-York Historical Society.

Social reformers sought to implement physicians’ recommendations and reduce the incidence of deadly diarrheal diseases that killed babies by providing clean milk for free or low cost, especially during the summer months when milk spoiled more quickly. Other charities and the city emulated Jacobi and Strauss’s model across New York City and other urban areas, and infant death rates dropped dramatically. New employment opportunities opened for middle class women as nurses, home visitors, and social workers.

Orrin Sage Wightman. City Hospital nurse training program on Blackwell’s Island, 1916. Patricia D. Klingenstein Library, New-York Historical Society

New York City Milk Committee, Look for the Blue Fronts [Yiddish],1911, Courtesy of the New York Academy of Medicine Library

Materials from the New York Milk Committee in New York City reveal reformers’ assumptions. As a fundraising pamphlet attests, the Committee sought to bring clean milk into “poverty-smitten and congested” districts where they assured funders “little white hearses” would otherwise pass through. Pure milk, they assert, alongside the expertise of the station’s doctors and nurses, prevented sickness and death. Their educational materials, distributed in Yiddish (as pictured) as well as English, Italian, and Czech, sent a clear message to mothers about the efficacy of regulated milk. A similar circular questioned expecting mothers’ own instincts, warning: “Do not forget that you owe it to your unborn babe to bring it into the world well and strong.” This, it continues, means relying on the Committee’s expertise: “This you can do if only you are willing to learn how.” 

Philanthropic and public organizations offered milk stations across the city in low-income neighborhoods, but how these functioned on the ground differed according to their perception of the neighborhoods’ population. For example, several organizations operated milk stations in the predominantly Black neighborhood, San Juan Hill  (largely torn down midcentury for the development of Lincoln Center). As Saidiya Hartman quotes the white social reformer and co-founder of the NAACP, Mary White Ovington, the neighborhood gained its name from the tense racial segregation that shaped its geography: “Whites dwelt on the avenues, colored on the streets, and fights between the two gave the hill it’s name; black men were required to battle as fiercely here as they had on San Juan Hill during the Spanish American War.”

Columbus Hill Health Center Album—Woman with Five Children and Nurse, ca. 1919. Columbia University Rare Book and Manuscript Library, Community Service Society Collection.

As historian Tanya Hart has detailed, reformers’ assumptions about race shaped how milk stations in the neighborhood operated. At least one of the neighborhood’s milk stations, located in the Columbus Hill Health Center, required syphilis testing for recipients because of a misguided belief that  Black women were more likely to carry the disease than other women. Reformers of the the Association for Improving the Condition of the Poor (AICP) falsely assumed that the disease was the source of higher rates of Black infant mortality rather than environmental issues, but in reality syphilis only accounted for a fraction of infant deaths in the neighborhood. As she puts it, “Black infants died from diarrheal diseases because their impoverished mothers could not stay home but instead” were more likely than white mothers to work in domestic service and less likely to breastfeed.

Mulberry Health Center Album—Woman Handing Milk to Nutritionist, ca. 1919. Columbia University Rare Book and Manuscript Library, Community Service Society Collection

Hart also analyzes the founding of the Mulberry Health Center in New York’s predominantly southern Italian neighborhood that is now Little Italy. As Hart puts it, the AICP “targeted the Mulberry District for its next coordinated health work because of its racial and gendered distinctiveness.” The center was opened to stave off the immigrant community’s preference for local midwives’ care, and saw its services as an “entering wedge,” with its clean milk enticing women to rely on medical expertise and “rupturing their traditional birthing methods” to intervene in the entire community.

_Milk program, ca. 1913-30s. Patricia D. Klingenstein Library, New-York Historical Society, Children’s Aid Society Collection

Just like today, women’s decisions at the turn of the 20th century about how to feed their babies were shaped by personal preference as well as technological innovations, shifting medical advice, and social, cultural, and economic pressures and practices. Examining the monumental shifts of this distinct period illuminates how the decisions we assume are intimate, personal choices are impacted by broader structures and cultural norms.

Written by Anna Danziger Halperin, Andrew W. Mellon Postdoctoral Fellow in Women’s History and Public History, Center for Women’s History

Top image: A. Tennyson Beals. Henrietta School/Columbus Hill Day Nursery, ca. 1920s. Patricia D. Klingenstein Library, New-York Historical Society, Children’s Aid Society Collection