The task of locating healthy wet nurses remained a difficult one for late nineteenth- and early twentieth-century physicians, despite the development of institutions housing large numbers of new mothers. New York pediatrician Louis Fischer complained in his 1901 textbook, Infant-Feeding: In its Relation to Health and Disease, that there was no easy means for finding acceptable candidates. “As no licensed agencies, exist,” he wrote, “a few people having so-called influences procure wet-nurses by friendship, or something similar, from superintendents and house physicians where obstetrical work is done.” The procurers bedeviled Fischer by sometimes referring women with only “colostrum-milk” or, in one case, offering a seventeen-year-old who had given birth prematurely, “evidently an abortion,” and whose milk was “thin water.” Just as a previous generation had found itself at the mercy of the proprietors of intelligence offices and maternity home operators, early twentieth-century physicians believed themselves to be preyed upon by a new kind of entrepreneur, succinctly labeled by Fischer as “people who traffic in wet-nurses for a fee.”

Although Fischer's observations regarding the lack of a reliable system echo those of an earlier generation of physicians, his specific allegations suggest that doctors had more resources at hand than in previous decades. The “traffickers” Fischer wrote of mediated between hospital-based physicians and physicians who worked for private families. Their niche was made possible by the rise of obstetric facilities serving poor women, the development of hospital internships, and the growing expectation that physicians, not individual families, would inspect and hire wet nurses.