Diets, stress, and disease in the Etruscan society: Isotope analysis and infantile skeletal palaeopathology from Pontecagnano (Campania, southern Italy, 730-580 BCE).

Susceptibility to morbidity and mortality is increased in early life, yet proactive measures, such as breastfeeding and weaning practices, can be taken through specific investments from parents and wider society. The extent to which such biosocialcultural investment was achieved within 1st millennium BCE Etruscan society, of whom little written sources are available, is unkown. This research investigates life histories in non-adults and adults from Pontecagnano (southern Italy, 730-580 BCE) in order to track cross-sectional and longitudinal breastfeeding and weaning patterns and to characterize the diet more broadly. Stable carbon and nitrogen isotope analysis of incrementally-sampled deciduous and permanent dentine (n = 15), bulk bone collagen (n = 38), and tooth enamel bioapatite (n = 21) reveal the diet was largely based on C3 staple crops with marginal contributions of animal protein. Millet was found to play a role for maternal diet and trajectories of breastfeeding and feeding for some infants and children at the site. The combination of multiple isotope systems and tissues demonstrates exclusive breastfeeding was pursued until 0.6 years, followed by progressive introduction of proteanocius supplementary foods during weaning that lasted between approximately 0.7 and 2.6 years. The combination of biochemical data with macroscopic skeletal lesions of infantile metabolic diseases and physiological stress markers showed high δ15Ndentine in the months prior to death consistent with the isotopic pattern of opposing covariance.

Children of the grave: Investigating non-adult feeding practices in medieval and early modern Estonia through stable isotope analysis.

Studying infant diet and feeding practices through stable isotope analysis provides direct insight into the life and health of vulnerable population groups in the past. Although the general diet in medieval and early modern Livonia has been reconstructed from written sources, little is known about childhood diet during this tumultuous period of Eastern European history. This study presents a comparative investigation of the staple non-adult diet in urban/rural communities during the 13th-17th centuries AD, with a special focus on feeding practices. We aim to reveal the impact of socio-economic circumstances on early childhood nutrition, which affects the physical development and overall survival of this susceptible population group. Bone collagen samples from 176 individuals between the fetal and the 7-15 age categories from four urban/rural South-Estonian cemeteries were cross-sectionally analyzed via EA-IRMS (Elemental Analysis with Isotope Ratio Mass Spectroscopy) for δ13C and δ15N. Results suggest that South-Estonian children had a staple terrestrial C3 diet integrated with animal proteins. Significant divergences were observed between urban and rural sites and slight variation occurred among rural subgroups, possibly resulting from a wider food choice available in towns, different consumption of C4 foods, and/or secular changes. This study provides the first data regarding infant feeding practices in medieval and early modern Livonia. These practices were similar among the different contexts, indicating comparable cultural traditions in child rearing. Breastfeeding was likely practiced for 1-2 years, with supplementary foods introduced around 1 year of age. The weaning process was probably concluded around the age of 3. The δ13C and δ15N values of older children are comparable to those of the adults from the same sites, indicating their diets became similar after weaning, when they started working and obtained a more mature social status.

La relación entre la leche y la mortalidad en la infancia: un problema de salud pública en Chile (Santiago, 1930-1962) / The relation between milk and mortality in childhood: a public health problem in chile (Santiago, 1930-1962)

This article analyzes the relationship between infant mortality and milk consumption in the Province of Santiago during 1930-1962. The process studied begins with the Pasteurization Law, which by sanitizing milk reduced the number of children with gastrointestinal diseases and indeed mortality, and ends with the inauguration of milk distribution programs. It is argued that the scarcity and insufficient hygiene of this product, added to the cultural and housing conditions that surrounded the children, are explanatory factors for the high mortality of infants, while recognizing the State as a fundamental promoter of public policies to correct the demographic catastrophe. The research, supported by newspapers, medical journals, degree theses, statistical yearbooks, and government documents, concludes that the set of laws, regulations and state programs produced a set of changes among State actors, reflected in practices and approval discourses and rejection of the importance of sanitizing milk, which, ultimately, did not prevent a considerable decrease in the number of children who died for food reasons

Este artículo analiza la relación entre la mortalidad en la infancia y el consumo de leche en la Provincia de Santiago durante 1930-1962. El proceso estudiado comienza con la Ley de Pasteurización que al higienizar la leche redujo las cifras de niños con enfermedades gastrointestinales y en efecto la mortalidad, y finaliza con la inauguración de los programas de distribución de leche. Se argumenta que la escasez y la higiene insuficiente de ese producto sumadas a las condiciones culturales y habitacionales que rodeaban a los niños son factores explicativos de la mortalidad alta de infantes, a la vez que reconoce en el Estado un promotor fundamental de políticas públicas para subsanar la catástrofe demográfica. La investigación, sustentada en periódicos, revistas médicas, tesis de titulación, anuarios estadísticos, y documentos gubernamentales, concluye que el conjunto de leyes, reglamentos y programas estatales produjo un conjunto de cambios entre los actores del Estado, reflejados en prácticas y discursos de aprobación y rechazo hacia la importancia de higienizar la leche que, en última instancia, no impidieron una disminución considerable de niños muertos por razones alimentarias.

Tracking breastfeeding and weaning practices in ancient populations by combining carbon, nitrogen and oxygen stable isotopes from multiple non-adult tissues.

This paper explores the potential of combining different isotope systems from different tissues to improve resolution when reconstructing breastfeeding and weaning practices (BWP) in archaeology. Additionally, we tested whether changes in diet can be detected in deciduous teeth. Rib collagen samples from 22 infants/children from the archaeological site of Bacuranao I (Mayabeque, Cuba) were processed for nitrogen (δ15N) and carbon (δ13Cco) stable isotopes and assessed using a Bayesian model (WARN). In addition, enamel of 48 teeth from 30 infants/children were analyzed for oxygen (δ18Oen) and carbon (δ13Cen) stable isotopes. Data revealed that the timing of weaning cannot be characterized precisely by analyzing either δ18O or δ15N. While a depletion in both δ15N and δ13Cco is only evident after one year, the WARN model suggested that the weaning process started at around 3 months and ended around 1.7 years. Most teeth were enriched in δ18Oen compared to deciduous incisors, suggesting a breastfeeding signal. However, a high variability in δ18O was found between similar teeth from the same individuals. Higher enrichment in δ18Oen, and variability, was observed in tissues formed during the first six months of life. A δ13C enrichment of 1.0‰ was observed among deciduous teeth and ribs. While most individuals enriched in δ15N showed enrichment in δ13C, the δ18O values were more variable. Our data suggests that stable isotopes of deciduous teeth, especially δ13Cen, can be used to detect changes in diet during the weaning process. It is also possible that the δ18O enrichment observed in M1 is influenced by the effects of cooking techniques on weaning foods. The combination of multiple isotope systems and tissues overcome some of the limitations posed by single tissue approaches.

Ensayos nutricionales sobre lactancia artificial en la España ilustrada: el trabajo de Joaquín Xavier Úriz en Pamplona / Nutritional trials on artificial lactation in Enlightenment Spain: the work of Joaquín Xavier Úriz in Pamplona

Introducción: la continuidad actual de publicaciones sobre la infancia abandonada durante la Ilustración española, desde las mismas perspectivas del control social que se establecieron a finales del siglo XX, desvirtúa el esfuerzo de algunos ilustrados por encontrar alternativas de nutrición artificial a la lactancia mediante nodrizas. Objetivo: analizar los ensayos nutricionales efectuados por Joaquín Xavier Úriz (1747-1829) en la inclusa de Pamplona. Método: revisión, análisis e interpretación de su obra "Causas prácticas de la muerte de los niños expósitos en sus primeros años" , publicada en 1801. Resultados: tras justificar su necesidad, plantear objetivos y diseñar un experimento controlado, realizó dos ensayos con lactantes, uno con niños sanos mediante suplementos de agua de arroz a la leche de nodriza y otro con niños enfermos mediante lactancia mixta de cabra y nodriza. Ambos se realizaron inicialmente con uno y dos sujetos, respectivamente, para ampliarlo tras buenos resultados a una muestra mayor no aleatorizada (12 sujetos en el caso de los enfermos). Aunque los resultados iniciales no fueron concluyentes, se constata un descenso de la mortalidad lactante posterior. Conclusiones: los ensayos responden a la aplicación de un método científico más apreciable que el observado en textos didácticos de autores más relevantes, como es el caso de Iberti. El utilitarismo imperante no oculta el valor dado a la vida del expósito sobre cualquier otro, siendo Úriz un claro ejemplo de las excepciones al enfoque predominantemente punitivo de la historiografía. El descenso posterior de la mortalidad del lactante sugiere la posibilidad de una exitosa causa-efecto de los ensayos (AU)

Introduction: the current continuity of publications on abandoned children during the Spanish Enlightenment, from the same perspectives of social control that were established at the end of the 20th century, undermines the efforts of some Enlightenment scholars to find artificial nutrition alternatives to breastfeeding through wet nurses. Aim: to analyse the nutritional trials carried out by Joaquín Xavier Úriz (1747-1829) in the Pamplona foundling home. Method: review, analysis and interpretation of his work "Causas prácticas de la muerte de los niños expósitos en sus primeros años" , published in 1801. Results: after justifying its necessity, setting out objectives, and designing a controlled experiment, he carried out two trials with infants, one with healthy children using rice water supplements to the wet-nurse's milk and the other with sick children using mixed goat and wet-nurse breastfeeding. Both were initially conducted with one and two subjects, respectively, to be extended after good results to a larger, non-randomised sample (12 subjects in the case of sick children). Although the initial results were inconclusive, a decrease in subsequent infant mortality was noted. Conclusions: the trials are based on the application of a more appreciable scientific method than in didactic texts by more relevant authors, as in the case of Iberti. The prevailing utilitarianism does not hide the value given to the life of the foundling over any other, Úriz being a clear example of the exceptions to the predominantly punitive approach of historiography. The subsequent decline in infant mortality suggests the possibility of a successful cause-effect of the trials (AU)

La Institución de la Gota de Leche en la provincia de Toledo (1906-1966) / A Instituição de Gota de Leche na província de Toledo (1906-1966) / The Institution of the Drop of Milk in the province of Toledo (1906-1966)

The objective of this historical investigation is to discover if the Institution called "LaGota de Leche" existed in Toledo. Methodology by means of the heuristic method, the historicalpress is analyzed and other primary archival sources are reviewed. Results, although its creationwas tedious and its operation was subject to criticism, its benefits were soon seen through thematernal and child health indicators. The institution between 1906 and 1966, was present in boththe urban and rural areas of Toledo. Since the creation the mother received health care throughoutthe gestational period; she acquired habits on child hygiene and obtained health education toestablish adequate breastfeeding. Conclusion La Gota de Leche Toledana was a School ofChildcare and Maternology, a fact that allowed to carry out prevention, care and educationactivities throughout the gestational period. Thus, the results obtained were extremelysatisfactory, since it was possible to reduce infant mortality during the first half of the 20thcentury, through the improvement of maternal and child health indicators

El objetivo de esta investigación histórica es descubrir sí en Toledo existió la Institucióndenominada «La Gota de Leche». Metodología por medio del método heurístico se analiza laprensa histórica y se revisan otras fuentes primarias archivísticas. Resultados, aunque su creaciónfue tediosa y su funcionamiento estuvo sujeto a críticas, sus beneficios pronto se dejaron ver, através de los indicadores salud materno-infantil. La institución entre 1906 y 1966, estuvo presentetanto en el ámbito urbano como rural de Toledo. Desde la creación la madre recibía atenciónsanitaria durante todo el periodo gestacional; adquiría hábitos sobre higiene infantil y obteníaeducación sanitaria para establecer una lactancia materna adecuada. Conclusión La Gota de LecheToledana fue una Escuela de Puericultura y Maternología, hecho que permitió llevar a caboactividades de prevención, asistencia y educación durante todo el periodo gestacional. De modoque los resultados obtenidos fuero sumamente satisfactorios, pues se logró reducir la mortalidadinfantil durante la primera mitad del siglo XX, a través de la mejoría de los indicadores de la saludmaterno-infantil.

O objetivo desta investigação histórica é descobrir se a Instituição chamada "La Gota deLeche" existia em Toledo. Metodologia por meio do método heurístico, a imprensa histórica éanalisada e outras fontes arquivísticas primárias são revisadas. Resultados, embora sua criaçãotenha sido tediosa e seu funcionamento sujeito a críticas, seus benefícios logo foram percebidosatravés dos indicadores de saúde materno-infantil. A instituição entre 1906 e 1966, esteve presentetanto na zona urbana como rural de Toledo. Desde a criação a mãe recebeu cuidados de saúdedurante todo o período gestacional; adquiriu hábitos de higiene infantil e obteve educação emsaúde para estabelecer o aleitamento materno adequado. Conclusão La Gota de Leche Toledanafoi uma Escola de Puericultura e Maternologia, fato que possibilitou a realização de atividades de123Cultura de los Cuidados. 1º Cuatrimestre 2022. Año XXVI. nº 62prevenção, cuidado e educação durante todo o período gestacional. Assim, os resultados obtidosforam extremamente satisfatórios, uma vez que foi possível reduzir a mortalidade infantil durantea primeira metade do século 20, por meio da melhoria dos indicadores de saúde materno-infantil.

Nodriza: La lactancia entre el lujo y la miseria / Wet Nurse: Lactation between luxury and misery

A lo largo de la historia, la lactancia materna ha sido la forma ideal de alimentar al ser humano. Por lo general, la madre es la encargada de amamantar al recién nacido, pero cuando por diversas circunstancias ella no pudo se recurrió a la nodriza para amamantar al neonato. Las primeras referencias de esta figura aparecen en los códigos babilónicos, aunque la etimología del término proviene del vocablo latino nutricia, expresión utilizada para referirse al salario entregado a la mujer por el desempeño de la función de amantar [Fragmento de texto] (AU)

Woman, Mother, Wet Nurse: Engine of Child Health Promotion in the Spanish Monarchy (1850-1910).

In Spain, the wet nurse increased the survival of children through care and breastfeeding of other women's children. They had a great development together with the Spanish monarchy between 1850 and 1910. The aim is to identify the role of wet nurses in the Spanish monarchy and the survival of the royal infants (s. XIX-XX). A scoping review is presented to study documents about the wet nurse in the Spanish monarchy. Applying the dialectical structural model of care (DSMC). Recognizing five thematic blocks that shape the historical-cultural model. Books, decrees and databases were analyzed: Scopus, Scielo, Dialnet, Cuiden, Medline/Pubmed, CINAHL, Science Direct and Google Scholar, from January to July 2020. The selection process was rigorous because it was difficult to choose. They had to overcome medical and moral exams. The selected rural northern wet nurses emigrated to Madrid. The contract was regulated by laws and paid. Wet nurses were hired by the monarchy due to health problems of the biological mother and a need for greater offspring. The wet nurse wore a typical costume, a symbol of wealth. The northern wet nurses hired by the monarchists have been the engine that has promoted the health of infants through the breastfeeding process.

Lactancia materna: transición alimentaria durante la guerra y posguerra española (1936-1949) / Breastfeeding: food transition during the Spanish war and post-war period (1936-1949) / Amamentação: transição alimentar durante a guerra espanhola e o período pós-guerra (1936-1949)

Durante los años 1900 hasta 1936, la salud infantil comenzaba a ganar importancia en Europa. En España, la mortalidad infantil era elevada. Para contrarrestar esta situación, el estado propuso medidas sanitarias, educativas y alimentarias. OBJETIVO: Analizar la Guerra Civil Española (1936-1939), que continuó con los "años del hambre" durante la posguerra (1939-1949), conocidos por el racionamiento de alimentos y decadencia de la salud materno-infantil. MÉTODO: Estudio histórico descriptivo con fuentes primarias y secundarias. Que trata sobre, el contexto sociosanitario y la transición alimentaria, que vivieron los infantes durante la guerra y posguerra española (1936-1949). RESULTADOS: El gobierno realizó una promoción de la lactancia materna guiada por pediatras de la época, no obstante, la leche de fórmula ganó importancia, debido a la modificación de la estructura familiar básica. La figura clásica de la mujer se fracturó, en favor del trabajo en las fábricas o, en última instancia, como participantes activas en la guerra. CONCLUSIONES: Las instituciones sanitarias, se centraron en el cuidado de heridos, cuestión que repercutió en la atención del niño enfermo. Esta situación dio lugar a altas tasas de morbimortalidad infantil, las cuales se mantuvieron hasta el final de la posguerra

During the years 1900 to 1936, children's health began to gain importance in Europe. In Spain, infant mortality was high. To counteract this situation, the state proposed health, educational and food measures. OBJECTIVE: To analyze the Spanish Civil War (1936-1939), which continued with the "hungry years" of the post-war period (1939-1949), known for food rationing and the decline of mother and child health. Method. Historical descriptive study with primary and secondary sources. It deals with the socio-health context and the food transition experienced by infants during the Spanish war and post-war period (1936-1949). RESULTS: The government carried out a promotion of breastfeeding guided by pediatricians of the time, however, formula gained importance, due to the modification of the basic family structure. The classic figure of the woman was fractured, in favour of working in factories or, ultimately, as active participants in the war. CONCLUSIONS: Health institutions focused on the care of the wounded, an issue that impacted on the care of the sick child. This situation resulted in high rates of child morbidity and mortality, which continued until the end of the post-war period

Durante os anos de 1900 a 1936, a saúde das crianças começou a ganhar importância na Europa. Em Espanha, a mortalidade infantil foi elevada. Para contrariar esta situação, o Estado propôs medidas sanitárias, educativas e alimentares. OBJECTIVO: Analisar a Guerra Civil Espanhola (1936-1939), que continuou com os "anos de fome" do pós-guerra (1939-1949), conhecida pelo racionamento de alimentos e pelo declínio da saúde materna e infantil. MÉTODO: Estudo descritivo histórico com fontes primárias e secundárias. Trata do contexto sócio-sanitário e da transição alimentar vivida pelos bebés durante a guerra espanhola e o período pós-guerra (1936-1949). RESULTADOS: O governo realizou uma promoção da amamentação orientada por pediatras da época, mas a fórmula ganhou importância, devido à modificação da estrutura básica da família. A figura clássica da mulher foi fracturada, a favor de trabalhar em fábricas ou, em última análise, como participante activa na guerra. CONCLUSÕES: As instituições de saúde concentraram-se no cuidado dos feridos, uma questão que teve impacto no cuidado da criança doente. Esta situação resultou em elevadas taxas de morbilidade e mortalidade infantil, que se mantiveram até ao final do período pós-guerra

Tolstoy's Life Lessons on Breastfeeding and Reducing Child Mortality.

The article is devoted to Leo Tolstoy's ideas about breastfeeding that he expressed eloquently in his novels, educational articles, and philosophical essays. Tolstoy's perspective on breastfeeding is discussed in his novella The Kreutzer Sonata and in his nonfiction of the late 1880s. His basic ideas had been shaped through his own experience and family life. Also important was his correspondence with the American physician, Alice Bunker Stockham, MD, an author of Tokology: A Book for Every Woman, and Tolstoy's editorial work on the medical brochure written by the head of Moscow Children's Hospital, E.A. Pokrovsky. Tolstoy's literary and historical accounts of breastfeeding promotion can help to understand the current day practices and ways in which cultural traditions are incorporated into infant care in contemporary Russia.

Growing up in Ancient Sardinia: Infant-toddler dietary changes revealed by the novel use of hydrogen isotopes (δ2H).

Detailed information about the lives and deaths of children in antiquity is often in short supply. Childhood dietary histories are, however, recorded and maintained in the teeth of both juveniles and adults. Primary tooth dentinal collagen does not turn over, preserving a sequential record of dietary changes. The use of nitrogen (δ15N) and carbon (δ13C) isotope values of incrementally sampled dentin are used in the study of breastfeeding practices but evidence for the addition of weaning foods, both in terms of mode and, particularly, duration, has remained analytically inaccessible to date. Here, we demonstrate how the novel use hydrogen isotope (δ2H) values of sequentially micro-sampled dentin collagen, measured from individuals excavated from a Punic cemetery, in Sardinia, Italy, can serve as a proxy for weaning food type and duration in ancient childhood diet. The weaning rate and age, based on the decline in δ15N and δ13C values of permanent first molars and the concomitant increase in δ2H, appears to be broadly similar among six individuals. Hydrogen isotopes vary systematically from a low value soon after birth, rising through early childhood. The early post-birth values can be explained by the influence of 2H-depleted lipids from mother's breastmilk and the later δ2H rise is consistent with, among other things, a substantial portion of boiled foodstuffs, such as the higher δ2H values observed in porridge. Overall δ2H in dentin shows great promise to elucidate infant and childhood feeding practices, and especially the introduction of supplementary foods during the weaning process.

Back to the Breast: An Historical Overview of the Perceived Connections Between Sudden Infant Death Syndrome and Breastfeeding.

In the late 19th century, physicians in the United States and Europe grew concerned about an increasingly visible subset of infant mortality: sudden infant death. Over the next 100 years, physicians worked variably to combat the problem, modifying and refining their conceptions of sudden infant mortality many times over the process. Physicians' overlapping revisions of sudden infant mortality ultimately helped to produce the categorization of Sudden Infant Death Syndrome (SIDS), and their ensuing, fluctuating efforts to resolve this problem shed light on social and medical perceptions of the roles that biology, the environment, and infant care practices played in sudden infant death. SIDS's official medical classification was a watershed; not only did the formal medical label establish its "authenticity" as a medical phenomenon, but the label also asserted the inexplicability of (at least some) sudden infant death episodes while simultaneously conveying that affected parents were deserving victims of a tragic loss. In the modern history of sudden infant death in the United States, breastfeeding, in particular, was understood variably as a possible cause for unnecessary infant mortality in the decades surrounding 1900; inconsequential to the occurrence of SIDS in the mid 1900s; and finally as an important and healthful way to reduce the risk for SIDS beginning in the late 1900s.

Historical Antecedents of Breastfeeding for African American Women: from the Pre-Colonial Period to the Mid-Twentieth Century.

INTRODUCTION: African American women have much lower breastfeeding rates than other racial and ethnic groups in the USA. While researchers are beginning to explore contemporary factors contributing to this inequality, much less research has been devoted to the historical conditions that have contributed to these disparities. AIM: The aim of this paper was to describe the social, economic, and political factors that have influenced African American breastfeeding behavior in the USA from the colonial era through the mid-twentieth century. METHODS: A thematic analysis was conducted across multiple databases and sources. A social history framework, which focuses on the experiences of ordinary people and events, was used to identify and integrate themes found within the reviewed literature. RESULTS: Three themes emerged: (1) Labor forces and other socio-cultural factors affected feeding practices and communal caregiving; (2) history of supplementation; and (3) influence of medicalization of birth and mobility on infant feeding in the twentieth century. These themes illustrate how African American women's ability to breastfeed has been significantly constrained throughout the U.S. HISTORY: Supplementation with non-human milk substitutes and communal caregiving helped African American women navigate infant rearing under adverse socioeconomic circumstances. CONCLUSIONS: Social, political, and economic factors have contributed significantly to African American women's ability to breastfeed throughout the U.S. HISTORY: Understanding the influences of historical antecedents on breastfeeding decisions over time may be key to finding effective interventions that might increase breastfeeding rates within this population.

Multi-proxy stable isotope analyses of dentine microsections reveal diachronic changes in life history adaptations, mobility, and tuberculosis-induced wasting in prehistoric Liguria (Finale Ligure, Italy, northwestern Mediterranean).

OBJECTIVE: To reconstruct breastfeeding and weaning practices, metabolic stress including tuberculosis-induced wasting, and residential mobility of children in Neolithic and Metal Ages to infer their local ecologies. MATERIALS: Seven permanent teeth from individuals dated to the Neolithic, Copper, Bronze, and Iron Ages buried in nearby caves in western Liguria, Italy. METHODS: Carbon, nitrogen, and sulfur stable isotope analyses on dentine microsections. Tooth maturation was used to calculate age at death. RESULTS: Two Neolithic children present longer pattern of weaning and appear to have been weaned using animal protein in contrast to the earlier weaning of Metal Ages children, which were probably weaned with vegetable resources. Sulfur isotopes suggest local origin of Neolithic and Cooper Age children, and non-local origins for Bronze and Iron Age children. Intense catabolism in the last two years is apparent in the adolescent with tuberculosis. CONCLUSIONS: Shortening in weaning patterns during the Metal Ages are likely driven by the intensification of agricultural practices and cultivation of new crops during Bronze and Iron Ages. Neolithic food choices and delayed weaning patterns may represent one of the strategies to maximize growth and immune potential in a local economy/ecology with high-infectious load. Tuberculosis was a chronic and long-lasting disease. SIGNIFICANCE: The first combined carbon, nitrogen, and sulfur analysis on prehistoric dentine microsections revealing changing human life history adaptations within the same region. LIMITATIONS: Small sample size. SUGGESTIONS FOR FURTHER RESEARCH: Increase the sulfur isotope dataset, use new EA-IRMS equipment, and provide data on amino acid to better define weaning food composition.

Prenatal Provider Support for Breastfeeding: Changes in Attitudes, Practices and Recommendations Over 22 Years.

BACKGROUND: Prenatal care providers play a central role in breastfeeding outcomes. A survey on obstetricians' support of breastfeeding was conducted in 1993 in Monroe County, NY. Since the landscape of prenatal care and breastfeeding support has changed significantly in the past 2 decades, we repeated and extended this survey in 2015. RESEARCH AIM: To determine changes in breastfeeding support by prenatal care providers over a 20 year period. METHODS: We sent a 46-item on-line or paper questionnaire to all categories of prenatal care providers identified by an online search. A breastfeeding support score was created based on the prior survey, with a maximum score of 3. One point was awarded for: (1) personally discussing breastfeeding; (2) generally suggesting breastfeeding; and (3) commonly receiving questions from patients. Data were analyzed using Chi-square. RESULTS: We had 164 participants (response rate 80%). More current participants, compared to 1993, reported discussing (97% vs. 86%, p < .001) and recommending (93% vs. 80%, p = .001) breastfeeding. Only 10% of 2015 participants gave infant formula samples, compared with 34% in 1993 (p < .0001). Improvement in the support score was seen, with 98% of current participants having high scores compared to 87% in 1993 (p < .001). Similar numbers reported receiving breastfeeding education, though more reported that the education was inadequate (54% vs. 19%, p < .0001). CONCLUSION: Breastfeeding support improved significantly over time, even though breastfeeding education has not improved in quality or quantity. Improving education of prenatal care providers may help future providers be more prepared to support breastfeeding.

Reconstructing breastfeeding and weaning practices in the Bronze Age Near East using stable nitrogen isotopes.

OBJECTIVES: Breastfeeding and childhood diet have significant impact on morbidity and mortality within a population, and in the ancient Near East, it is possible to compare bioarchaeological reconstruction of breastfeeding and weaning practices with the scant textual evidence. MATERIALS AND METHODS: Nitrogen stable isotopes (δ15 N) are analyzed here for dietary reconstruction in skeletal collections from five Bronze Age (ca. 2,800-1,200 BCE) sites in modern Lebanon and Syria. We employed Bayesian computational modeling on cross-sectional stable isotope data of collagen samples (n = 176) mainly from previous studies to test whether the bioarchaeological evidence aligns with the textual evidence of breastfeeding and weaning practices in the region, as well as compare the estimated weaning times to the global findings using the WARN (weaning age reconstruction with nitrogen isotope analysis) Bayesian model. RESULTS: Though the Near East sites in this study had different ecological settings and economic strategies, we found that weaning was introduced to the five sites at 0.5 ± 0.2 years of age and complete weaning occurred around 2.6 ± 0.3 years of age on using the WARN computational model. These weaning processes are within the time suggested by historical texts, though average estimated weaning age on the Mediterranean coast is later than inland sites. DISCUSSION: Compared globally, these Near Eastern populations initiated the weaning process earlier but completed weaning within the global average. Early initial weaning may have created short spacing between pregnancies and a high impact on demographic growth within these agricultural populations, with some variation in subsistence practices accounting for the inland/coastal discrepancies.

La nodriza pasiega: transición de la actividad biológica a la laboral (1830-1930) / The Pasician wet nurse: transition from biological activity to work (1830-1930) / A mãe Pasiege: transição da actividade biológica para a actividade laboral (1830-1930)

Las nodrizas son las encargadas de la lactancia, educación y cuidados de hijos ajenos. Estas mujeres han tenido un papel en la sociedad desde la Antigüedad. Esta figura adquirió especial relevancia en España durante 1830-1930 ligada a la monarquía. El contrato de sus servicios tenía como causa problemas de salud de la madre biológica, pero se convirtió en un privilegio. La elección de estas mujeres se basaba en exámenes realizados por médicos y sacerdotes, que garantizaran la buena salud física y moral. Las amas de leche norteñas comenzaron a ser demandadas, especialmente las procedentes del Valle del Pas, las cuales emigraron a las zonas urbanas, como Madrid. Estas mujeres eran consideradas más saludables y aptas para realizar este oficio debido a su estado físico de robustez y su vida en la naturaleza. El contrato tenía implícito un sueldo y estaba regulado por leyes (1904 Protección a la Infancia y Real Decreto 1910). Sus servicios se realizaban en casas de expósitos y en hogares de las familias, incluso de la realeza. Cabe destacar la importancia de la nodriza, en un periodo histórico con altas tasas de mortalidad infantil, ya que fomentaron la supervivencia de los recién nacidos

The wet nurses are in charge ofbreastfeeding, education and care of other people's children. These women have had a role in society since ancient times. This figure acquired special relevance in Spain during 1830-1930 linked to the monarchy. The contract for their services had as a cause health problems of the biological mother, but it became a privilege. The choice of these women was based on examinations carried out by doctors and priests, which guaranteed good physical and moral health. Northern women began to be sued, especially those from the Pas Valley, who migrated to urban, such as Madrid. These women were considered to be healthier and more suitable for this trade due to their robust physical condition and their life in nature. The contract had an implicit salary and was regulated by law (1904 Child Protection and Royal Decree 1910). Their services were carried out in houses of foundlings and in the homes of families, including royalty. It is worth noting the importance of the wet nurse, in a historical period with high infant mortality rates, as they encouraged the survival of newborns

As enfermeiras húmidas são responsáveis pela amamentação, educação e cuidados com os filhos de outras pessoas. Estas mulheres têm tido um papel na sociedade desde os tempos antigos. Este número adquiriu especial relevância em Espanha durante 1830-1930, ligado à monarquia. O contrato dos seus serviços tinha como causa problemas de saúde da mãe biológica, mas tornou-se um privilégio. A escolha destas mulheres baseou-se em exames realizados por médicos e padres, que garantiam uma boa saúde física e moral. As mulheres do Norte começaram a ser processadas, especialmente as do Vale do Pas, que migraram para zonas urbanas, como Madrid. Estas mulheres foram consideradas mais saudáveis e mais adequadas para este comércio devido ao seu robusto estado físico e à sua vida na natureza. O contrato tinha um salário implícito e era regulado por lei (1904 Protecção da Criança e Decreto Real de 1910). Os seus serviços foram realizados em casas de fundição e nas casas das famílias, incluindo a realeza. É de salientar a importância da enfermeira húmida, num período histórico com elevadas taxas de mortalidade infantil, uma vez que incentivavam a sobrevivência dos recém-nascidos

Societal perceptions and lived experience: Infant feeding practices in premodern Japan.

OBJECTIVES: A change in how children were treated and valued occurred in premodern Japan, as popularized ideas of an inheritance-based family system led to more careful and affectionate child-rearing practices by lower social-status groups. A number of books were written, advising that breastfeeding should last approximately 3 years. The objective of this study is to reconstruct and compare breastfeeding and weaning practices before and after the transition, to illuminate the impact of documented changes in child-rearing practices on subadults' lived experience. MATERIALS AND METHODS: Carbon and nitrogen stable isotopic data were obtained from 40 subadult skeletons excavated from the Sakai Kango Toshi 871 (SKT871) site (late 17th-19th century, Osaka, Japan). Isotopic results from SKT871 were compared with previously reported results from the Hitotsubashi site (AD 1657-1683, Tokyo, Japan). Hitotsubashi and SKT871 represent urban populations of lower status before and after the transition of societal perception of subadults. RESULTS: The most probable age at the end of weaning reconstructed in SKT871 was 1.9 years (1.4-2.7 years with a 95% credible interval) and was lower than that in Hitotsubashi (2.1-4.1 years with a 95% credible interval). DISCUSSION: The age at the end of weaning became younger after the transition of societal perception toward subadults, and this younger weaning age is inconsistent with written recommendations for the duration of weaning in premodern Japan. It is possible that an increased need for inheritors under the inheritance-based family system led to earlier weaning and shorter inter-birth intervals, but authorities recommended an ideal practice of a longer breastfeeding period.