Historical Research: The Origin of 'Formula': State of the Science, 1890s.

In 1900, 13% of infants in the United States died before their first birthday, most of dehydration from diarrhea. As part of a nationwide effort to "save the babies," pediatricians focused on several endeavors-experimenting with commercially made infant-food products; working with dairy farmers to clean up cows' milk; lobbying to pass municipal and state legislation regulating the dairy industry; and devising mathematical "formulas" that represented instructions to chemists on how to "humanize" cows' milk for the needs of a particular infant. Pediatricians dubbed the latter endeavor "percentage feeding" and, from the 1890s to the 1920s, they deemed percentage feeding a lifesaving scientific achievement. The complex, virtually infinite array of mathematical formulas that comprised this infant-feeding system is the origin of the word "formula" as used today to describe artificial baby milk.

Use of Starch and Modified Starches in Infant Feeding: A Historical Perspective.

There is a long history of the use of starch in infant feeding. Proprietary infant foods (1867-1920) contained added starch from either cereal grains or malted carbohydrates. When evaporated milk became available in the 1920s, the use of proprietary foods fell out of favor. Evaporated milk formulas were a mixture of milk, water, and modified starch or milk sugar (lactose). By the late 1920s, however, corn syrup became the most common modified starch added to evaporated milk formulas as it was widely available, inexpensive, and readily accepted. The ongoing development of the modern calorie-based infant formula, made from non-fat cow's milk, lactose, oleo and vegetable oils, largely replaced the evaporated milk formulas in the 1960s. On the other hand, after 1940, added starch and modified starch became increasingly important in the production of pureed fruits and vegetables. Not surprisingly, this included their use in the modern "industrialized" food for use in infants, including their use in a proliferation of grain based fortified infant cereals. This coincided with the increasing production largely due to the earlier introduction of complementary foods, commonly before 3 months of age by 1958. After 1969, the increasing public awareness and media scrutiny of infant foods lead to a growing criticism of the use of modified starches. Even though the National Research Council and the American Academy of Pediatrics concluded that modified starches were safe for use, continued public pressure led to their removal from most infant foods in the 1990s. This paralleled the natural food and organic food movements in the United States. Though modified starches are still used in infant dinners of mixed foods today, their use has been minimized and this issue is not currently of significant concern to the public.

Selection criteria for wet-nurses: Ancient recommendations that survived across time.

This article will describe the content of the key criteria for the selection of wet nurses that persisted across time and the authors who transmitted this advice. Where relevant, it will include variations, such as additional recommendations or a different weighting being given to one or other criterion by a particular author. The focus is on the selection of a wet nurse for the employer's baby. The factors that led a woman to enter this employment and the consequences for her own baby will not be addressed here as they will be discussed elsewhere. The article is an historical one, drawing on primary sources, where possible, and important secondary sources. Guidelines for the selection of wet-nurses have existed from antiquity to the early 20th century. The key recommendations managed to survive across the centuries because they were considered useful by influential ancient and Early Modern and later authors who passed them on through copying and translations. It is tempting to assume that the prescriptive advice was followed by physicians and mothers. However, the discussion will raise doubts about whether the criteria were adhered to by physicians and parents, particularly when wet nurses were in scarce supply.

From royal wet nurses to Facebook: The evolution of breastmilk sharing.

Wet-nursing was an essential practice that allowed for infant survival after many mothers died in childbirth. The story of wet-nursing is complicated by both religious pressures and cultural expectations of women. It is likely that these historical practices have shaped our current social, political and legislative environments regarding breastfeeding. The aim of this article is to provide a historical perspective on the practice of wet-nursing, with a focus on: 1) social views of wet nurses, 2) breastmilk evaluation and 3) the ideal wet nurse. Historical perspectives from Ancient Egypt, Ancient Greece and Rome, 19th and 20th century America and current practices are examined. An appreciation for the evolution of breastmilk sharing provides clinicians and lactation advocates with the historical origins which provided the template for current practice as it relates to donor milk, breastfeeding culture and relevant legislation.

[Historical journey to infant feeding].

The article provides an overview of the available literature on problems of infant nutrition, and shows the historical development of the principles of infant feeding. It discusses in greater detail the use of goat milk as a basis for infant nutrition. It notes the need for a comparative analysis of breast milk substitutes, and for clinical studies evaluating the value of goat milk in infant nutrition.

Pap, gruel, and panada: early approaches to artificial infant feeding.

This paper collects information on artificial infant feeding published before 1860, the year when commercial formula became available. We have extensive artifactual evidence of thousands of feeding vessels since the Bronze Age. Special museum collections can be found in London, Paris, Cologne, Fécamp, Toronto, New Mexico, and elsewhere. The literature on the use of animal milk for infant feeding begins with Soranus in the 2nd century CE. Literature evidence from the very first printed books in the 15th century proves that physicians, surgeons, midwives, and the laity were aware of the opportunities and risks of artificial infant feeding. Most 17th to 19th century books on infant care contained detailed recipes for one or several of the following infant foods: pap, a semisolid food made of flour or bread crumbs cooked in water with or without milk; gruel, a thin porridge resulting from boiling cereal in water or milk, and panada, a preparation of various cereals or bread cooked in broth. During the 18th century, the published opinion on artificial feeding evolved from health concerns to a moral ideology. This view ignored the social and economic pressures which forced many mothers to forego or shorten breast-feeding. Bottle-feeding has been common practice throughout history.

INCAP studies of vegetable proteins for human consumption.

This article describes the efforts of the Institute of Nutrition of Central America and Panama (INCAP) to develop a relatively low-cost vegetable protein mixture suitable as a complementary food for infants and young children. As it turned out, the resulting product became popular with older children and adults, and its superior nutritional benefits were widely recognized by the population. This effort led to broader studies by INCAP of the nutritional quality of vegetable protein mixtures, including raw materials, processing to convert them into human-grade products, product formulation, and commercialization.

Feeding babies in the battle to combat infant mortality a century ago.

At the end of the nineteenth century Glasgow, like many large industrial European cities, had an infant mortality rate (IMR) of well over 100 deaths per 1000 live births. Recognition that 'improper feeding' was a significant factor in accounting for this prompted public health authorities to establish infant milk depots, to support breast-feeding mothers and to provide artificial milk feeds for their babies if necessary. The initiative was led by the medical officer of health of Glasgow, Archibald Chalmers, who promoted welfare services for mothers and infants during the first decade of the 20th century. However these initiatives were questioned by an up-and-coming paediatrician, Leonard Findlay, who was to go on to be Glasgow's first professor of medical paediatrics in 1924. Nevertheless IMRs started to go down from 1900 and have continued steadily ever since; and while artificial infant milks clearly posed a risk to the health of babies, attention to infant nutrition, growth and feeding may have played a part in initiating and perpetuating this decline in IMR and improving infant survival and welfare during the last century.

Infant welfare, philanthropy and entrepreneurship in Glasgow: Sister Laura's Infant Food Company.

Laura Smith was sister-in-charge of the Children's Dispensary in Glasgow from 1897 to 1922. In 1911 she established Sister Laura's Infant Food Company to market a special milk formula of her own invention.The directors of the Dispensary were not amused. As the 'outdoor' department of the Royal Hospital for Sick Children (Yorkhill), the Dispensary was at the forefront of efforts to combat child ill health and malnutrition. This paper considers Laura Smith's initiative within the context of the health and care of infants of the time - high infant mortality, public and professional concerns for infant welfare, technological advances in food science, changing recommendations and practices of infant feeding and ambiguous relations between medicine and commerce.

[Brazilian guidelines for marketing baby food: history, limitations and perspectives]. / Norma brasileira de comercialização de alimentos para lactentes e crianças de primeira infância: histórico, limitações e perspectivas.

The objective of this paper is to present and discuss Brazilian policy concerning actions to protect breastfeeding, especially the history, international and national background, limitations, and perspectives of the Brazilian Guidelines for the Marketing of Baby Food, Pacifiers and Bottles. The Brazilian Guidelines, which play a crucial role in protecting breastfeeding against industry marketing strategies, were based on the International Code of Marketing of Breastmilk Substitutes, proposed by the World Health Organization in 1981. The first version of the Brazilian Guidelines was released in 1988, and there were subsequent revisions in 1992 and 2001/2002. In 2006, the Guidelines became national law. However, the strides made over this period in terms of regulation have been few because the law is not always observed. Thus, it is essential that all actors involved, including government officials, manufacturers and sellers of baby food and other baby products, teaching and health professionals and their associations, international bodies, and non-governmental organizations make a commitment to enforce the current law.

Norma brasileira de comercialização de alimentos para lactentes e crianças de primeira infância: histórico, limitações e perspectivas / Brazilian guidelines for marketing baby food: history, limitations and perspectives

The objective of this paper is to present and discuss Brazilian policy concerning actions to protect breastfeeding, especially the history, international and national background, limitations, and perspectives of the Brazilian Guidelines for the Marketing of Baby Food, Pacifiers and Bottles. The Brazilian Guidelines, which play a crucial role in protecting breastfeeding against industry marketing strategies, were based on the International Code of Marketing of Breastmilk Substitutes, proposed by the World Health Organization in 1981. The first version of the Brazilian Guidelines was released in 1988, and there were subsequent revisions in 1992 and 2001/2002. In 2006, the Guidelines became national law. However, the strides made over this period in terms of regulation have been few because the law is not always observed. Thus, it is essential that all actors involved, including government officials, manufacturers and sellers of baby food and other baby products, teaching and health professionals and their associations, international bodies, and non-governmental organizations make a commitment to enforce the current law.

Safety of soy-based infant formulas containing isoflavones: the clinical evidence.

Soy protein has been used in infant feeding in the West for nearly 100 y. Soy protein infant formulas have evolved in this interval to become safe and effective alternatives for infants whose nutritional needs are not met with human milk or formulas based on cow's milk. Modern soy formulas meet all nutritional requirements and safety standards of the Infant Formula Act of 1980. They are commonly used in infants with immunoglobulin E-mediated cow's milk allergy (at least 86% effective), lactose intolerance, galactosemia, and as a vegetarian human milk substitute. Largely as a result of research in animal models, concerns have been voiced regarding isoflavones in soy infant formulas in relation to nutritional adequacy, sexual development, neurobehavioral development, immune function, and thyroid disease. We discuss the available clinical evidence regarding each of these issues. Available evidence from adult human and infant populations indicates that dietary isoflavones in soy infant formulas do not adversely affect human growth, development, or reproduction.

Medicalization and women's knowledge: the construction of understandings of infant feeding experiences in post-WW II New Zealand.

For most of the twentieth century infant feeding knowledge has been constructed by medical scientists and health professionals. However, for a short time around the 1970s, New Zealand women (re)claimed the power to author their own knowledge based upon experience. This coincided with a dramatic return to breastfeeding on a national scale. Using New Zealand women's narratives of their infant feeding experiences over the past 50 years, this article brings to the foreground the importance of women's subjective construction of knowledge, their positioning within it, and the suppression of rudimentary discourses when that power is removed or relinquished in the process of remedicalization.