Book Review: White Blood: A History of Human Milk

Dr. Lawrence Trevelyan Weaver is a pediatrician, gastroenterologist, and nutritional scientist, and he has researched infant feeding markedly in his career. Dr. Weaver is a fitting author for this topic, having extensive medical knowledge about child nutrition and a special interest in history. In White Blood, Dr. Weaver focuses on the history of practices of infant care and feeding, and illuminates how these have influenced the health of infants and families. Having studied the social factors influencing infant feeding in my own research, I was excited to read this book. I was hoping for a historical view of the changing movements in infant feeding that informs current practices and issues within the larger picture of human milk history. White Blood is a well-researched history and a balance of ideologies of the time and their impact on infant feeding.

This work provides a historical view of infant feeding practices and opinions throughout time, starting with antiquity. First, Dr. Weaver gives a background for the current knowledge and practices of infant feeding today. He starts with a technical but comprehensive overview of current knowledge of lactation and human milk. While Dr. Weaver suggests some readers may wish to skip this section, I encourage the reader to give this chapter thorough attention. This chapter serves as a resource for those that work with infants and mothers and provides a useful overview of the current medical knowledge about human milk.

After this contemporary overview, the author moves chronologically through time, starting with Ancient Greece and Rome and then moving to humoralism, alchemy, science, nature, pediatrics, puericulture, and techno-biology. Each chapter is a balance of background about the philosophies of infant care of the time and a detailed explanation of infant feeding practices. The implications of these practices are discussed, using historical records of infant and child mortality.

Throughout the book, human milk is presented as the optimal infant feeding choice, although suboptimal feeding practices are covered in depth. The main thesis strung throughout the historical review is that how infants are fed “matters.” Connections to outcomes are highlighted, most notably infant mortality. For example, there is detailed explanation about the business of wet nursing and the widespread movement from wet nursing to artificial milks.

The book has four themes, which are outlined in the first chapter and used throughout the book. The first theme is the vitality of human milk. Dr. Weaver views harmful infant feeding practices, comparing them to historical works that highlight the preventative, curative, or remedy-like qualities of human milk. The second theme is the transformation or transmutation that occurs in the production of human milk. This is the inspiration for the title of the book; the idea that throughout time people believed the origins of human milk were from mother’s blood transformed into “white blood.” Interestingly, the author highlights how this view was perpetuated as late as the 18th and 19th centuries. Childrearing and infant death rates have often been attributed to improper feeding and infectious disease. As the medicalization of childbirth and infant feeding grew, experimentation and the scientific method developed an increased understanding of biological processes, although this did not extend to human milk and to the process of lactation for some time. The third and fourth themes interwoven in the book are reproduction, nutrition, and morbidity.

The strengths of White Blood are that the author consulted an extensive variety of primary sources, including historical documents about child rearing and medical texts that inform the dominant philosophies of the time periods discussed. In addition, the frequent illustrations, artwork, diagrams, and figures included in the book are useful additions to supplement the writing. These supplements give an added element of interest and speak for the culture of the time.

The author outlines a transition in infant feeding; the shift in thinking that human milk substitutes are equal to breastmilk. This shift in thinking is a notable problem in infant feeding, and at times people have incorrectly considered human milk substitutes to be superior to human milk (Apple, 1987). For those aiming to change the discourse about infant feeding today, White Blood is of interest and this contextual explanation could be appreciated. Infant feeding scholars and practitioners’ today aim to promote feeding human milk as the standard way to feed an infant and to challenge misconceptions that human milk and formula are equal choices. After reading White Blood, the reader has a better understanding of how current infant feeding practices, ideologies and issues fit within the broader human history of infant feeding. For those who are concerned with the historical, anthropological, or sociological perspectives of infant feeding, White Blood is considerably informative.

However, White Blood focuses much of the history of infant feeding in Europe, especially in London and Paris. This Eurocentric focus overlooks important infant feeding history and practices in cultures outside of Europe. White Blood could have explored additional historical documents of medical literature and historical artifacts. For example, in the ancient Near East medical documents establish the high value placed on human milk, including use in remedies for conditions like cataracts and burns (Fildes, 1986). Writers from the Near East also recommended regimes for mothers including notions about ideal diet, exercise, sexual intercourse, and pregnancy during lactation. While White Blood briefly covers Islamic views, much of the focus is review of religious doctrine influences, specifically the interaction of Christianity with infant feeding. The author could have provided a fuller picture of infant feeding through exploration of various cultural differences and similarities.

In conclusion, White Blood is a worthwhile read for those interested in the topic. Scholars and researchers would be particularly interested in this dimension of infant feeding, especially since there are clear connections from past practices to current practices.