THE RESURGENCE OF BREASTFEEDING, 1975–2000 The transcript of a Witness Seminar held by the Wellcome Trust Centre for the History of Medicine at UCL, London, on 24 April 2007 Edited by S M Crowther, L A Reynolds and E M Tansey Volume 35 2009 ©The Trustee of the Wellcome Trust, London, 2009 First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2009 The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183. ISBN 978 085484 119 6 All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/ Please cite as : Crowther S M, Reynolds L A,Tansey E M. (eds) (2009) The Resurgence of Breastfeeding, 1975-2000. Wellcome Witnesses to Twentieth Century Medicine, vol. 35. London: Wellcome Trust Centre for the History of Medicine at UCL. CONTENTS Illustrations and credits v Abbreviations vii Witness Seminars: Meetings and publications; Acknowledgements E M Tansey, L A Reynolds and S M Crowther ix Introduction Rima Apple xxiii Transcript Edited by S M Crowther, L A Reynolds and E M Tansey 1 Appendix 1 Recommended feeding times as recorded in Mayes’ textbook, Handbook of Midwifery, 1937–80 87 Appendix 2 Chairman’s reflections after the event 89 References 91 Biographical notes 111 Glossary 125 Index 131 ILLUSTRATIONS AND CREDITS Figure 1 A mother breastfeeding her child. Lithograph, Wellcome Images. 5 Figure 2 Professor Patrice Jelliffe at the Jelliffe Memorial Lecture, 1993, in memory of her husband, Professor Derrick Jelliffe (1921–92), at the XVth International Congress of Nutrition Conference, Adelaide, Australia. Reproduced by permission of WABA. 6 Figure 3 The Oppé Report, 1974. Crown copyright; reproduced under licence from the Office of Public Sector Information. 10 Figure 4 Nestlé Milk nurses in South Africa, c. 1950. Provided by Mrs Patti Rundall. 16 Figure 5 Good and poor attachment at the breast. Provided by and reproduced with permission from Dr Felicity Savage. 18 Figure 6 24-hour clock, designed by Sir F Truby King (1913). Provided by Miss Chloe Fisher. 22 Figure 7 Aboriginal mother, aged 20 years, with her six children. Provided by Professor Roger Short. 36 Figure 8 Dr Cicely Williams in India, 1950, with severely malnourished child. Reproduced by permission of Healthlink Worldwide. 47 Figure 9 The Royal College of Midwives’ practical guide, 1988. 50 Figure 10 Positioning the baby correctly. From the Royal College of Midwives’ practical guide, Successful Breastfeeding, 1988. Provided by Dr Anthony Williams. 61 Figure 11 Breastfeeding uptake and duration in Norway, 1858 to 1998. Provided by Dr Elisabet Helsing. 63 v Figure 12 Comparison of the composition of cows’ milk with infant formula. Reproduced with permission from Cow and Gate. 71 Figure 13 Comparison of the composition of human milk with infant formula. Reproduced with permission from Cow and Gate. 71 vi AbbrEVIATIONS COMA Committee on Medical Aspects of Food and Nutrition Policy (DHSS) DoH Department of Health DHSS Department of Health and Social Security FAO Food and Agricultural Organization HRP Human Reproduction Programme IBFAN International Baby Food Action Network ISRHML International Society of Research in Human Milk and Lactation LAM Lactation Amenorrhea Method (of contraception) LLLI La Leche League International LLLGB La Leche League Great Britain NCT National Childbirth Trust NICE National Institute for Health and Clinical Excellence ONS Office for National Statistics OPCS Office of Population Censuses and Surveys PAG Protein-Calorie Advisory Group of the United Nations System RDA Recommended Dietary Allowances UNICEF United Nations International Children’s Emergency Fund WABA World Alliance for Breastfeeding Action WHO World Health Organization vii viii WITNESS SEMINARS: MEETINGS AND PUBLICATIONS 1 In 1990 the Wellcome Trust created a History of Twentieth Century Medicine Group, associated with the Academic Unit of the Wellcome Institute for the History of Medicine, to bring together clinicians, scientists, historians and others interested in contemporary medical history. Among a number of other initiatives the format of Witness Seminars, used by the Institute of Contemporary British History to address issues of recent political history, was adopted, to promote interaction between these different groups, to emphasize the potential benefits of working jointly, and to encourage the creation and deposit of archival sources for present and future use. In June 1999 the Governors of the Wellcome Trust decided that it would be appropriate for the Academic Unit to enjoy a more formal academic affiliation and turned the Unit into the Wellcome Trust Centre for the History of Medicine at UCL from 1 October 2000. The Wellcome Trust continues to fund the Witness Seminar programme via its support for the Centre. The Witness Seminar is a particularly specialized form of oral history, where several people associated with a particular set of circumstances or events are invited to come together to discuss, debate, and agree or disagree about their memories. To date, the History of Twentieth Century Medicine Group has held more than 50 such meetings, most of which have been published, as listed on pages xiii–xxi. Subjects are usually proposed by, or through, members of the Programme Committee of the Group, which includes professional historians of medicine, practising scientists and clinicians, and once an appropriate topic has been agreed, suitable participants are identified and invited. This inevitably leads to further contacts, and more suggestions of people to invite. As the organization of the meeting progresses, a flexible outline plan for the meeting is devised, usually with assistance from the meeting’s chairman, and some participants are invited to ‘set the ball rolling’ on particular themes, by speaking for a short period to initiate and stimulate further discussion. 1 The following text also appears in the ‘Introduction’ to recent volumes of Wellcome Witnesses to Twentieth Century Medicine published by the Wellcome Trust and the Wellcome Trust Centre for the History of Medicine at UCL. ix Each meeting is fully recorded, the tapes are transcribed and the unedited transcript is sent to every participant. Each is asked to check his or her own contributions and to provide brief biographical details. The editors turn the transcript into readable text, and participants’ minor corrections and comments are incorporated into that text, while biographical and bibliographical details are added as footnotes, as are more substantial comments and additional material provided by participants. The final scripts are then sent to every contributor, accompanied by forms assigning copyright to the Wellcome Trust. Copies of all additional correspondence received during the editorial process are deposited with the records of each meeting in archives and manuscripts, Wellcome Library, London. As with all our meetings, we hope that even if the precise details of some of the technical sections are not clear to the non-specialist, the sense and significance of the events will be understandable. Our aim is for the volumes that emerge from these meetings to inform those with a general interest in the history of modern medicine and medical science; to provide historians with new insights, fresh material for study, and further themes for research; and to emphasize to the participants that events of the recent past, of their own working lives, are of proper and necessary concern to historians. Members of the Programme Committee of the History of Twentieth Century Medicine Group, 2008–09 Professor Tilli Tansey – Professor of the History of Modern Medical Sciences, Wellcome Trust Centre for the History of Medicine at UCL (WTCHM) and Chair Sir Christopher Booth – WTCHM, former Director, Clinical Research Centre, Northwick Park Hospital, London Mrs Lois Reynolds – Senior Research Assistant, WTCHM, and Organizing Secretary Dr John Ford – Retired General Practitioner, Tonbridge Professor Richard Himsworth – former Director of the Institute of Health, University of Cambridge Professor Mark Jackson – Centre for Medical History, Exeter Professor John Pickstone – Wellcome Research Professor, University of Manchester Dr Helga Satzinger – Reader in History of Twentieth Century Biomedicine, WTCHM Professor Lawrence Weaver – Professor of Child Health, University of Glasgow, and Consultant Paediatrician in the Royal Hospital for Sick Children, Glasgow x ACKNOWLEDGEMENTS ‘The resurgence of breastfeeding, c. 1975-2000’ was suggested as a suitable topic for a witness seminar by Professor Lawrence Weaver, who assisted us in planning the meeting. We are very grateful to him for his input and for his excellent chairing of the occasion. We are particularly grateful to Professor Rima Apple for writing such a useful Introduction to these published proceedings. We thank Mr James Akre, Professor Lars Hanson, Mrs Rachel O’Leary, Dr Felicity Savage and Professor Lawrence Weaver for their help with the Glossary and Dr Elisabet Helsing, Mrs Patti Rundall, Dr Felicity Savage, Miss Chloe Fisher, Professor Roger Short, Dr Anthony Williams and Mr John Wells for help with illustrations. For permission to reproduce images included here, we thank the World Alliance for Breastfeeding Action, Healthlink Worldwide, the Wellcome Trust and Cow and Gate. As with all our meetings, we depend a great deal on our colleagues at the Wellcome Trust to ensure their smooth running: the Audiovisual