It is important to remember that it is by no means only the women in factories who are induced to work as usual during the whole period of pregnancy, and to return to work immediately after the brief rest of confinement. The Research Committee of the Christian Social Union (London Branch) undertook, in 1905, an inquiry into the employment of women after childbirth. Women in factories and workshops were excluded from the inquiry which only had reference to women engaged in household duties, in home industries, and in casual work. It was found that the majority carry on their employment right up to the time of confinement and resume it from ten to fourteen days later. The infantile death rate for the children of women engaged only in household duties was greatly lower than that for the children of the other women, while, as ever, the hand-fed infants had a vastly higher death rate than the breast-fed infants (British Medical Journal, Oct. 24, 1908, p. 1297).
In the great French gun and armour-plate works at Creuzot (Saône et Loire) the salaries of expectant mothers among the employees are raised; arrangements are made for giving them proper advice and medical attendance; they are not allowed to work after the middle of pregnancy or to return to work after confinement without a medical certificate of fitness. The results are said to be excellent, not only on the health of the mothers, but in the diminution of premature births, the decrease of infantile deaths, and the general prevalence of breast-feeding. It would probably be hopeless to expect many employers in Anglo-Saxon lands to adopt this policy. They are too "practical," they know how small is the money-value of human lives. With us it is necessary for the State to intervene.
There can be no doubt that, on the whole, modern civilized communities are beginning to realize that under the social and economic conditions now tending more and more to prevail, they must in their own interests insure that the mother's best energy and vitality are devoted to the child, both before and after its birth. They are also realizing that they cannot carry out their duty in this respect unless they make adequate provision for the mothers who are thus compelled to renounce their employment in order to devote themselves to their children. We here reach a point at which Individualism is at one with Socialism. The individualist cannot fail to see that it is at all cost necessary to remove social conditions which crush out all individuality; the Socialist cannot fail to see that a society which neglects to introduce order at this central and vital point, the production of the individual, must speedily perish.
It is involved in the proper fulfilment of a mother's relationship to her infant child that, provided she is healthy, she should suckle it. Of recent years this question has become a matter of serious gravity. In the middle of the eighteenth century, when the upper-class women of France had grown disinclined to suckle their own children, Rousseau raised so loud and eloquent a protest that it became once more the fashion for a woman to fulfil her natural duties. At the present time, when the same evil is found once more, and in a far more serious form, for now it is not the small upper-class but the great lower-class that is concerned, the eloquence of a Rousseau would be powerless, for it is not fashion so much as convenience, and especially an intractable economic factor, that is chiefly concerned. Not the least urgent reason for putting women, and especially mothers, upon a sounder economic basis, is the necessity of enabling them to suckle their children.
No woman is sound, healthy, and complete unless she possesses breasts that are beautiful enough to hold the promise of being functional when the time for their exercise arrives, and nipples that can give suck. The gravity of this question to-day is shown by the frequency with which women are lacking in this essential element of womanhood, and the young man of to-day, it has been said, often in taking a wife, "actually marries but part of a woman, the other part being exhibited in the chemist's shop window, in the shape of a glass feeding-bottle." Blacker found among a thousand patients from the maternity department of University College Hospital that thirty-nine had never suckled at all, seven hundred and forty-seven had suckled all their children, and two hundred and fourteen had suckled only some. The chief reason given for not suckling was absence or insufficiency of milk; other reasons being inability or disinclination to suckle, and refusal of the child to take the breast (Blacker, Medical Chronicle, Feb., 1900). These results among the London poor are certainly very much better than could be found in many manufacturing towns where women work after marriage. In the other large countries of Europe equally unsatisfactory results are found. In Paris Madame Dluska has shown that of 209 women who came for their confinement to the Clinique Baudelocque, only 74 suckled their children; of the 135 who did not suckle, 35 were prevented by pathological causes or absence of milk, 100 by the necessities of their work. Even those who suckled could seldom continue more than seven months on account of the physiological strain of work (Dluska, Contribution à l'Etude de l'Allaitement Maternel, Thèse de Paris, 1894). Many statistics have been gathered in the German countries. Thus Wiedow (Centralblatt für Gynäkologie, No. 29, 1895) found that of 525 women at the Freiburg Maternity only half could suckle thoroughly during the first two weeks; imperfect nipples were noted in 49 cases, and it was found that the development of the nipple bore a direct relation to the value of the breast as a secretory organ. At Munich Escherich and Büller found that nearly 60 per cent. of women of the lower class were unable to suckle their children, and at Stuttgart three-quarters of the child-bearing women were in this condition.
The reasons why children should be suckled at their mothers' breasts are larger than some may be inclined to believe. In the first place the psychological reason is one of no mean importance. The breast with its exquisitely sensitive nipple, vibrating in harmony with the sexual organs, furnishes the normal mechanism by which maternal love is developed. No doubt the woman who never suckles her child may love it, but such love is liable to remain defective on the fundamental and instinctive side. In some women, indeed, whom we may hesitate to call abnormal, maternal love fails to awaken at all until brought into action through this mechanism by the act of suckling.
A more generally recognized and certainly fundamental reason for suckling the child is that the milk of the mother, provided she is reasonably healthy, is the infant's only ideally fit food. There are some people whose confidence in science leads them to believe that it is possible to manufacture foods that are as good or better than mother's milk; they fancy that the milk which is best for the calf is equally best for so different an animal as the baby. These are delusions. The infant's best food is that elaborated in his own mother's body. All other foods are more or less possible substitutes, which require trouble to prepare properly and are, moreover, exposed to various risks from which the mother's milk is free.
A further reason, especially among the poor, against the use of any artificial foods is that it accustoms those around the child to try experiments with its feeding and to fancy that any kind of food they eat themselves may be good for the infant. It thus happens that bread and potatoes, brandy and gin, are thrust into infants' mouths. With the infant that is given the breast it is easier to make plain that, except by the doctor's orders, nothing else must be given.
An additional reason why the mother should suckle her child is the close and frequent association with the child thus involved. Not only is the child better cared for in all respects, but the mother is not deprived of the discipline of such care, and is also enabled from the outset to learn and to understand the child's nature.
The inability to suckle acquires great significance if we realize that it is associated, probably in a large measure as a direct cause, with infantile mortality. The mortality of artificially-fed infants during the first year of life is seldom less than double that of the breast-fed, sometimes it is as much as three times that of the breast-fed, or even more; thus at Derby 51.7 per cent. of hand-fed infants die under the age of twelve months, but only 8.6 per cent. of breast-fed infants. Those who survive are by no means free from suffering. At the end of the first year they are found to weigh about 25 per cent. less than the breast-fed, and to be much shorter; they are more liable to tuberculosis and rickets, with all the evil results that flow from these diseases; and there is some reason to believe that the development of their teeth is injuriously affected. The degenerate character of the artificially-fed is well indicated by the fact that of 40,000 children who were brought for treatment to the Children's Hospital in Munich, 86 per cent. had been brought up by hand, and the few who had been suckled had usually only had the breast for a short time. The evil influence persists even up to adult life. In some parts of France where the wet-nurse industry flourishes so greatly that nearly all the children are brought up by hand, it has been found that the percentage of rejected conscripts is nearly double that for France generally. Corresponding results have been found by Friedjung in a large German athletic association. Among 155 members, 65 per cent. were found on inquiry to have been breast-fed as infants (for an average of six months); but among the best athletes the percentage of breast-fed rose to 72 per cent. (for an average period of nine or ten months), while for the group of 56 who stood lowest in athletic power the percentage of breast-fed fell to 57 (for an average of only three months).