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‘If We Are to Believe the Psychologists …’: Medicine, Psychoanalysis and Breastfeeding in Britain, 1900–55

  • Katharina Rowold (a1)

Abstract

In 1942, the British Minister of Health commissioned a report from the newly established Advisory Committee on Mothers and Young Children into ‘What can be done to intensify the effort to secure more breast feeding of infants?’. To make their case, the members of the sub-committee put in charge of the report sought expert testimony on the benefits of breastfeeding. They consulted medical officers of health, maternity and child-welfare officers, health visitors, midwives, obstetricians, paediatricians and a physician in private practice. They also consulted five ‘psychologists’ (a contemporary umbrella term for psychologists, psychoanalysts and psychiatrists). It is not surprising that the committee turned to medical professionals, as infant feeding had long been an area of their expertise. However, seeking the views of ‘psychologists’ when establishing the benefits of breastfeeding marked a more innovative development, one which suggested that a shift in conceptualising the significance of breastfeeding was gathering pace. In the interwar period, psychoanalysts and psychoanalytically oriented psychiatrists showed growing interest in early infancy. It led to an extensive psychoanalytic engagement with contemporary feeding advice disseminated by the medical profession. This article will explore the divergences and intersections of medical and psychoanalytic theories on breastfeeding in the first half of the twentieth century, concluding with a consideration of how medical ideas on breastfeeding had absorbed some of the contentions of ‘psy’-approaches to infant feeding by the post-war period.

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Corresponding author

*Email address for correspondence: katharina.rowold@roehampton.ac.uk

Footnotes

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I would like to thank Shaul Bar-Haim, Suzannah Lipscomb, my writing group – Lucy Bland, Carmen Mangion, Clare Midgley, Alison Oram, Krisztina Robert and Cornelie Usborne – and the anonymous reviewers for their thoughtful comments on earlier versions of this article.

Footnotes

References

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1. Ministry of Health, Report of Advisory Committee on Mothers and Young Children on the Breast Feeding of Infants(London: HMSO, 1943).

2. See Deborah Dwork, War Is Good for Babies and Other Young Children: A History of the Infant and Child Welfare Movement in England 1898–1918 (London: Tavistock, 1987); Elizabeth Peretz, ‘Maternal and Child Welfare in England between the Wars: A Comparative Regional Study’ (PhD, University of Middlesex, 1992); Valerie Fildes, Lara Marks and Hilary Marland (eds), Women and Children First: International Maternal and Infant Welfare, 1870–1945 (London: Routledge, 1992). For a history of infant feeding in Western Europe from antiquity to 1800, see Valerie A. Fildes, Breasts, Bottles and Babies: A History of Infant Feeding (Edinburgh: Edinburgh University Press, 1986). For the twentieth century, see Linda Bryder, ‘From Breast to Bottle: A History of Modern Infant Feeding’, Endeavour, 33 (2009), 54–9; for an enlightening comparative study, see Linda Bryder, ‘Breastfeeding and Health Professionals in Britain, New Zealand and the United States, 1900–70’, Medical History, 49 (2005), 179–96.

3. Rima D. Apple, Mothers and Medicine: A Social History of Infant Feeding, 1890–1950 (Madison, WI: University of Wisconsin Press, 1987); Jacqueline H. Wolf, Don’t Kill Your Baby: Public Health and the Decline of Breastfeeding in the Nineteenth and Twentieth Centuries (Columbus, OH: Ohio State University Press, 2001). See also Bryder, ‘Breastfeeding’, op. cit. (note 2).

4. For instance, Cathy Urwin and Elaine Sharland, ‘From bodies to minds in childcare literature: advice to parents in inter-war Britain’, in Roger Cooter (ed.), In the Name of the Child: Health and Welfare, 1880–1940 (London and New York: Routledge, 1992), 174–99; Sally Alexander, ‘Primary mternal preoccupation: D.W. Winnicott and social democracy in mid-twentieth century Britain’, in Sally Alexander and Barbara Taylor (eds), History and Psyche: Culture, Psychoanalysis, and the Past (Houndmills: Palgrave Macmillan, 2012), 149–72; Michal Shapira, The War Inside: Psychoanalysis, Total War, and the Making of the Democratic Self in Postwar Britain (Cambridge: Cambridge University Press, 2013); Michael Roper, ‘From Shell-Shocked Soldier to the Nervous Child: Psychoanalysis in the Aftermath of the First World War’, Psychoanalysis and History, 18, 1 (2016), 39–69.

5. Martucci, Jessica, Back to the Breast: Natural Motherhood and Breastfeeding in America (Chicago: University of Chicago Press, 2015), 3435.

6. Klein, Melanie, ‘The psychoanalytic play technique: its history and significance’, in Mitchell, Juliet (ed.), The Selected Melanie Klein (London: Hogarth Press, 1986), 52, in Martucci, op. cit. (note 5).

7. Richards, Graham, ‘Britain on the Couch: The Popularization of Psychoanalysis in Britain 1918–40’, Science in Context, 13, 2 (2000), 183230.

8. Thomson, Mathew, Lost Freedom: The Landscape of the Child and the British Post-War Settlement, (Oxford: Oxford University Press, 2013) ch. 3; Shapira, op. cit. (note 4).

9. Dwork, op. cit. (note 2).

10. Thane, Pat, ‘Infant welfare in England and Wales, 1870s to 1930s’, in Katz, Michael B. and Sachse, Christoph (eds), The Mixed Economy of Social Welfare (Baden-Baden: Nomos, 1996), 258.

11. For instance, George Newman, Infant Mortality: A Social Problem (London: Methuen & Co., 1906), ch. viii. See Alice Reid, ‘Infant Feeding and Child Health in Survival in Derbyshire in the Early Twentieth Century’, Women’s Studies International Forum, 60 (2017), 111–19.

12. For the concept of scientific motherhood, see, for instance, Rima D. Apple, Perfect Motherhood: Science and Childrearing in America (New Brunswick, NJ: Rutgers University Press, 2006); Hilary Marland, ‘The medicalization of motherhood: doctors and infant welfare in the Netherlands, 1901–30’, in Fildes, Marks and Marland (eds), op. cit. (note 2), 74–96.

13. Pritchard, Eric, The Physiological Feeding of Infants: A Handbook of the Principles and Practice of Infant Feeding, 3rd rev. edn (London: Henry Kimpton, 1909), 20.

14. Bunting, Evelyn, Bunting, Dora, Barnes, Annie and Gardiner, Blanche, A School for Mothers (London: Horace Marshall & Son, 1907), 2, 15; St Pancras School for Mothers, Scrap Book, Camden Local Studies and Archives Centre.

15. Bryder, Linda, A Voice for Mothers: The Plunket Society and Infant Welfare, 1907–2000 (Auckland: Auckland University Press, 2003), xv, 4.

16. Report of the Babies of the Empire Society (1919), 6.

17. Liddiard, Mabel, The Mothercraft Manual (London: J. & A. Churchill, 1924).

18. Truby King, Frederic, Natural Feeding of Infants (London: Whitcombe & Tombs, 1918), 7.

19. Liddiard, M., ‘What Exactly Is the Truby King Method?’, The Nursery World, 430 (31 March 1926).

20. Pritchard, op. cit. (note 13), 13, 14.

21. Truby King, Frederic, Feeding and Care of Baby (London: Macmillan, 1924), 3334.

22. Truby King, Mary, Truby King – The Man: A Biography (London: George Allen & Unwin, 1948), 217.

23. The Children’s Department, The London Hospital. E.1, Notes on the Feeding of Normal Infants (London: Taylor and Francis, published between 1931 and 1939), 15.

24. Frederic Truby King in ‘Babies of the Empire: Public Meeting at the Mansion House. December 17th, 1918’, Archives of the Highgate Literary and Scientific Institution; Mabel Liddiard, The Mothercraft Manual, 10th edn (London: J. & A. Churchill, 1940), 47; For Truby King’s eugenic beliefs, see Philippa Mein Smith, Mothers and King Baby: Infant Survival and Welfare in an Imperial World: Australia, 1880–1950 (Houndmills: Macmillan, 1997), 90–1.

25. Liddiard, op. cit. (note 17), 50.

26. Pritchard, Eric, Infant Education, (London: Kimpton, 1907) ch. 3.

27. Watson, J.B., Psychological Care of Infant and Child (New York, 1928). For the impact of behaviourism on childcare advice, see Urwin and Sharland, op. cit. (note 4), 179–81.

28. Liddiard, op. cit. (note 19).

29. Truby King, op. cit. (note 21), 104.

30. See, for instance, Eric Pritchard, ‘Discussion of Dr F. Truby King’s paper’, in Report of the Proceeding of the English-Speaking Conference on Infant Mortality, held at Caxton Hall, Westminster, on August 4 and 5, 1913 (London: National Association for the Prevention of Infant Mortality and for the Welfare of Infancy, 1913), 268–9; ‘The Standardised Infant’, The Lancet (13 April 1918), 542–3; Hector Cameron, ‘Therapeutic Modification of the Diet in Infancy’, The British Medical Journal (24 December 1927), 1172.

31. Laing, G.D., ‘A Criticism of Some Modern Methods of Infant Feeding’, British Medical Journal, 150 (8 February 1919).

32. Spence, J.C., ‘The Modern Decline of Breast-Feeding’, The British Medical Journal, (8 October 1938), 729, 730.

33. Davis, Angela, ‘Wartime Women Giving Birth: Narratives of Pregnancy and Childbirth, Britain c. 1939–60’, Studies in History and Philosophy of Biomedical Sciences, 47 (2014), 257; Harold L. Smith, Britain in the Second World War: A Social History (Manchester: Manchester University Press, 1996), 5.

34. ‘Breast-Feeding’, Mother and Child, 12 (November 1941), 151.

35. ‘Advisory Committee on the Welfare of Young Children’, London Metropolitan Archives, City of London: PH/GEN/3/10; ‘Alan Moncrieff to Ernest Brown’, 1 July 1942, TNA: MH 55/1536.

36. In 1939, the infant mortality rate (in England and Wales) was 50 per 1000; in 1918 it had been 97 per 1000. See ‘Advisory Committee on Mothers and Young Children’, TNA: MH 55/1536.

37. See ‘Breastfeeding in Relation to Female Labour as It Particularly Affects Birmingham’, Archives of Diseases in Childhood, 18 (1943), 59–64.

38. Gordon, I., ‘Some Social Aspects of Infant Feeding’, Archives of Disease in Childhood, 17, 91 (September 1942), 139146; ‘Notes on Investigation into the Incidence of Breast Feeding’, TNA: MH55/1539.

39. ‘Advisory Committee on Mothers and Young Children. Health Campaigns Sub-Committee. Paper M.C.10’, TNA: MH55/1536. From the studies consulted, the sub-committee estimated that 80% of babies born in hospital and 95% or babies born at home were breastfed at two weeks. By the end of three months, around 50% continued to be breastfed and by the end of six months, approximately 40%. See Ministry of Health, op. cit. (note 1), 2–3.

40. Ministry of Health, op. cit. (note 1), 1.

41. Ministry of Health, op. cit. (note 1), 4.

42. ‘The Fifth Meeting of the Advisory Committee on Mothers and Young Children’, TNA: MH 55/1536.

43. ‘Breast-Feeding’, The British Medical Journal (12 February 1944), 226.

44. Spence, op. cit. (note 32), 732–3; Harold Waller, Clinical Studies in Lactation (London: William Heinemann, 1938), ch. xi.

45. Advisory Committee on Mothers and Young Children: Health Campaigns Sub-Committee: ‘H.C. Paper 12’; ‘H.C. Paper 14’; ‘H.C. Paper 16’; ‘H.C. Paper 21’, TNA: MH 55/1539.

46. ‘Advisory Committee on Mothers and Young Children: Health Campaign Sub-Committee. Final Report (First Draft). H.C. Paper 37’, TNA: MH 55/1539.

47. ‘Advisory Committee on Mothers and Young Children: Health Campaign Sub-Committee. The Views of Psychologists on Breast-feeding’, TNA: MH 55/1539; Ministry of Health, op. cit. (note 1), 9.

48. Klein, Melanie, ‘Weaning (1936)’, Love, Guilt and Reparation and Other Works 1921–45 (London: Vintage, 1998), 298.

49. Shaul Bar-Haim, ‘The Maternalizing Movement: Psychoanalysis, Motherhood and the British Welfare State c. 1920–50’ (PhD thesis, University of London, 2015); Sally Alexander, ‘Psychoanalysis in Britain in the Early Twentieth Century: An Introductory Note’, History Workshop Journal, issue 45 (1998), 139.

50. Urwin and Sharland, op. cit. (note 4), 184.

51. Roper, op. cit. (note 4), 40–1, 55.

52. Thomson, op. cit. (note 8), 77.

53. Urwin and Sharland, op. cit. (note 4), 192; Shapira, op. cit. (note 4), 136.

54. Hutton, Laura, ‘Loneliness in Infancy’, British Medical Journal, 558 (7 November 1942).

55. King, Pearl and Steiner, Ricardo (eds), The Freud–Klein Controversies, 1941–5 (London: Routledge, 1991).

56. Klein, op. cit. (note 48), 297.

57. Winnicott, D.W., ‘Review: On the Bringing Up of Children’, The Collected Works of D.W. Winnicott, vol. 1 (Oxford: Oxford University Press, 2017), 438.

58. Winnicott, D.W., ‘D. W. W. on D. W. W.’, in Winnicott, Clare, Shepherd, Ray and Davis, Madeleine (eds), D. W. Winnicott: Psycho-Analytic Explorations (London: Karnac, 1989), 574.

59. Anderson, C. and Aldrich, Mary M., Babies are Human Beings (New York: The Macmillian Company, 1907).

60. Isaacs, Susan, ‘Habit: with particular reference to training in cleanliness’, in Rickman, John (ed.), On the Bringing Up of Children (London: Kegan Paul, 1936), 127.

61. Schmideberg, Melitta, ‘The Psychological Care of the Baby’, Mother & Child, 6, 8 (1935), 305.

62. Middlemore, Merrell P., The Nursing Couple, first published 1941 (London: Cassell & Company, 1953), 4.

63. Urwin and Sharland, op. cit. (note 4), 185.

64. Isaacs, Susan, The Nursery Years (London: George Routledge & Sons, 1929), 28.

65. Isaacs, Susan, The Nursery Years, rev. edn (New York: Vanguard Press, 1938), 24, 34.

66. Advisory Committee on Mothers and Young Children: Health Campaigns Sub-Committee: ‘H.C. Paper 21’, TNA: MH 55/1539.

67. Freud, Anna, ‘The Psychoanalytic Study of Infantile Feeding Disturbances’, Psychoanalytic Study of the Child, 2 (1946), 125.

68. Klein, Melanie, ‘Weaning’, in Rickman, John (ed.), On the Bringing Up of Children (London: Kegan Paul, 1936), 3156.

69. Grosskurth, Phyllis, Melanie Klein: Her World and Her Work (London: Maresfield Library, 1986), 232.

70. Klein, op. cit. (note 48), 302.

71. Winnicott, D.W., ‘Further Thoughts on Babies as Persons (1947)’, in op. cit., vol. 2 (note 57), 100.

72. D.W. Winnicott, ‘Breast feeding’ (1945, rev. 1954), in ibid., 393.

73. Winnicott, ibid. (note 72), 395.

74. Winnicott, ‘Weaning’ (1949), in op. cit., vol. 3 (note 71), 304.

75. D.W. Winnicott, ‘The value of breast feeding (psychological)’, in op. cit. (note 71), 389.

76. Edward Glover, ‘Introduction’, in Middlemore, op. cit. (note 62), vi.

77. Middlemore, op. cit. (note 62), 5, 170.

78. Winnicott, op. cit. (note 72), 98. See also King and Steiner, op. cit. (note 55), 181.

79. ‘Psychology of Breast-Feeding’, The British MedicalJournal (2 August 1941), 162; Violet Russell, ‘Breast-Feeding’, The British Medical Journal (26 September 1942), 378; ‘Notes, Comments and Abstracts’, The Lancet, 238 (December 1941), 781–2.

80. Middlemore, op. cit. (note 62), 5, 71, 112, 146, 170.

81. Winnicott, op. cit. (note 72), 392.

82. D.W. Winnicott, ‘Infant feeding’ (1945), in op. cit. (note 71), 297.

83. van der Horst, Frank C.P. and van der Veer, René, ‘The Ontogeny of an Idea: John Bowlby and Contemporaries on Mother–Child Separation’, History of Psychology, 13, 1 (2010), 2545.

84. Dicks, Henry V., Clinical Studies in Psychopathology: A Contribution to the Aetiology of Neurotic Illness (London: Edward Arnold & Co., 1939), 20.

85. Bowlby, John, ‘Foreword’, in Suttie, Ian D. (ed.), The Origins of Love and Hate, first published 1935 (London: Free Association Books, 1988).

86. A. Smuts, Interview with Dr John Bowlby, unpublished manuscript (1977), cited in Robert Karen, Becoming Attached: First Relationships and How They Shape Our Capacity to Love (Oxford: Oxford University Press, 1998), 89.

87. Crichton Miller, H., ‘Decline in Breast-feeding’, The British Medical Journal, 812 (15 October 1938).

88. Melanie Klein, ‘The Autobiography of Melanie Klein’, transcribed and annotated by Janet Sayers, Psychoanalysis and History, 15 (2013), 138.

89. Isaacs, op. cit. (note 60); Michal Shapira, “‘Speaking Kleinian”: Susan Isaacs as Ursula Wise and the Inter-War Popularisation of Psychoanalysis’, Medical History, 61 (2017), 525–47.

90. Glover, op. cit. (note 76), vii.

91. Winnicott, D.W., ‘Does Your Child Sleep Well?’, Parents, 77 (1934).

92. D.W. Winnicott, ‘Where the food goes’, in The Ordinary Devoted Mother and Her Baby: Nine Broadcast Talks (London: C.A. Brook, 1950), 12. Ten o’clock was the time for a feed on Truby King’s four-hourly schedule. See Truby King, op. cit. (note 21), 35.

93. Isaacs, op. cit. (note 64), 1. It was not changed in the revised edition, first published in 1931.

94. Klein, op. cit. (note 48), 298.

95. See note 44.

96. Klein, op. cit. (note 48), 298.

97. Winnicott, op. cit. (note 82), 295.

98. Winnicott, op. cit. (note 82), 295–6; Winnicott, ‘Getting to Know Your Baby’ (1945), op. cit. (note 71), 224.

99. Middlemore, op. cit. (note 62), 165–8.

100. Middlemore, op. cit. (note 62), 172.

101. Miller, Emanuel, ‘The Fundamental Psychological Needs of the Child’, Mother & Child, 21 (August 1950), 131.

102. See, eg, ‘British Medical Association Meeting in Oxford: Wasting in Infancy’, contribution by C.K.J. Hamilton, The Lancet (19 September 1936), 685; P.R. Boucher, ‘Infant Feeding’, British Medical Journal (29 July 1944), 60; Alan Brown, ‘The Scientific Construction of the Normal Child’s Diet’, The Lancet (4 December 1948), 878; Ian G. Wickes, ‘Overfeeding in Early Infancy’, British Medical Journal (29 November 1952), 1178–9.

103. Wickes, Ian G., ‘A History of Infant Feeding. Part V: Nineteenth Century Concluded and Twentieth Century’, Archives of Disease in Childhood, 142 (1953), 500; Ian G. Wickes, ‘Breast Feeding – A Historical Review’, Mother & Child, 26, 4 (1955), 91.

104. R.S. Illingworth, ‘Common Difficulties in Infant Feeding’, British Medical Journal (12 November 1949), 1079; Alan Moncrieff (ed.), Practical Motherhood and Parentcraft: A Comprehensive Guide to Successful Parenthood (London: Odhams Press, 1951), 110, 140; Philip Rainsford Evans and Ronald MacKeith, Infant Feeding and Feeding Difficulties, 2nd edn (London: J. & A. Churchill, 1954), 102, 107ff; ‘Changing Ideas in Infant Feeding’, British Medical Journal (18 December 1954), 1469–70.

105. Charlotte Naish, Breast Feeding: A Guide to the Natural Feeding of Infants (London: Oxford University Press, 1948), 14. See also Grantly Dick-Read, Childbirth without Fear: The Principles and Practice of Natural Childbirth, 3rd rev. edn (London: William Heinemann, 1954), 162.

106. Illingworth, Ronald S. and Illingworth, Cynthia M., Babies and Young Children: Feeding, Management and Care (London: J. & A. Churchill, 1954), 37.

107. Bennett, Victoria, The Welfare of the Infant and Child (London: George Routledge & Sons, 1932), 69.

108. Bennett, Victoria E.M., ‘Baby’s Birthright’, Parents, (1940), 226.

109. ‘Factors Influencing the Future Provision of Day Nurseries: Long-Term Policy. A Statement by the Day Nurseries Committee of the Medical Women’s Federation Adopted by the Council of the Federation’, British Medical Journal (9 August 1947), 209.

110. ‘The Importance of Breast Feeding’, Mother & Child, 20 (April 1949), 22.

111. Evelyn Pantin, ‘Artificial Feeding’, Parents (October 1949), 112.

112. Alice Stewart and Celia Westropp, ‘Breast-Feeding in the Oxford Child Health Survey. Part II – Comparison of Bottle- and Breast-Fed Babies’, The British Medical Journal (8 August 1953), 305–8.

113. R.S. Illingworth, ‘Breast-Feeding in Oxford’, BMJ (22 August 1953), 441; Ducan Leys, ‘Breast-Feeding in the Oxford Survey’, BMJ (29 August 1953), 509.

114. Ducan Leys, ibid. (note 113), 509.

115. See, for instance, Joyce Garland, ‘Psychological Aspects of Breast Feeding’, Mother & Child, 26, 4 (1955), 108.

116. Bennett, op. cit. (note 108), 226.

117. Hayward, Rhodri, The Transformation of the Psyche in British Primary Care, 1880–1970 (London: Bloomsbury, 2014), 7577.

118. Halliday, James, Psychosocial Medicine: A Study of the Sick Society (London: William Heinemann, 1948), 115120.

119. Wickes, Ian G., ‘A History of Infant Feeding: Part I’, Archives of Disease in Childhood, 142 (1953), 153.

120. Moscucci, Ornella, ‘Holistic Obstetrics: The Origin of “Natural Childbirth” in Britain’, Postgraduate Medical Journal, 79 (2002), 168173.

121. Dick-Read, Grantly, Introduction to Motherhood (London: William Heinemann, 1950), 44.

122. Dick-Read, op. cit. (note 105), 162.

123. Moscucci, op. cit. (note 120).

124. Dick-Read, op. cit. (note 105), 162.

125. Dr W.C. Petherbridge to Mabel Liddiard, 18.6.1956, Archives of the Highgate Literary and Scientific Institution.

126. Shapira, op. cit (note 89); Anne Karpf, ‘Constructing and Addressing the “Ordinary Devoted Mother” ’, History Workshop Journal, 78 (2014), 82–106.

127. Urwin and Sharland, op. cit. (note 4).

128. Bowlby, John, ‘The Nature of the Child’s Tie to the Mother’, The International Journal of Psychoanalysis, 39 (1958), 350378.

129. ‘Commentary’, Mother & Child, 32 (1961), 188.

I would like to thank Shaul Bar-Haim, Suzannah Lipscomb, my writing group – Lucy Bland, Carmen Mangion, Clare Midgley, Alison Oram, Krisztina Robert and Cornelie Usborne – and the anonymous reviewers for their thoughtful comments on earlier versions of this article.

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