INFANT-LIFE PROTECTION
_Introductory._--The protection of infant life is all the more
necessary in view of the fact that it is during infancy that human
beings are least able to withstand injurious external influences.
The success of the campaign against excessive child mortality
depends above all upon the success of our measures for infant-life
protection. During intra-uterine life the relationship between
the child and the mother is of such a kind that the legislator
must protect the mother if he wishes to protect the child. The
institutions described in the last chapter relate chiefly to the
mother, and it is indirectly only that they redound to the advantage
of the child. After birth the relationship between the child and
its mother is a different one. The child is no longer a part of the
mother’s body, but is obviously and unmistakably a separate human
being, although for nine or ten months after birth (that is to say,
for a period about equal in duration to the period of intra-uterine
life) the child remains absolutely dependent on the mother. It is
characteristic of all the mammalia that the individual young should
be suckled by an animal of its own species; for the milk of every
species contains certain substances peculiarly adapted for the needs
of that species, so that suckling by a mammal of another species
is likely to exercise an injurious influence. Man is also one of
the mammalia, and in the case of human beings suckling by any other
mammal is almost excluded from possibility. There are important
differences between human milk and the milk of all other mammals.
For example, human milk contains certain substances which exercise a
preventive influence against certain human diseases, but cow’s milk
contains these substances in much smaller proportion, or not at all.
It follows from this, that in the nourishment of a human infant we
cannot without danger replace human milk by the milk of any other
mammal--and cow’s milk is an especially dangerous substitute for
human milk. For this reason, numerous methods of treating cow’s milk
are employed to make it resemble human milk, such as dilution, the
addition of sugar, &c.
_Advantages of the Natural Feeding of Infants._--The natural method
of nourishment--that is to say, suckling at the maternal breast,
is the only method of infant-feeding which properly complies with
natural requirements. The adoption or non-adoption of this method
is a matter of decisive influence upon the subsequent health of the
child. The ideal is that the child should be suckled until it is nine
months old. But, at least, we should insist upon the mother giving
suck for the first weeks of the infant’s life, two months being
regarded as an irreducible minimum. After two months, the dangers
of artificial feeding are considerably less. Within certain limits,
the longer infants are suckled, the lower are their disease-rate and
death-rate, the greater is their power of resistance to disease, and
the higher is their mental capacity. When we compare the results
of natural feeding with those of artificial feeding of infants,
we cannot fail to recognise that the former method gives children
greater powers of resistance to and recovery from those diseases
which are inseparable from the nutritive processes. Artificial
feeding frequently leads to illness, life-long debility, premature
death, &c. In children suckled by their own mothers, digestive
disorders are usually trifling; in children suckled by a wet-nurse,
such disorders are more frequent and more obstinate, but are seldom
really dangerous; in artificially-fed infants, such disorders are
extraordinarily common, their course is extremely serious, and a
fatal issue is far from rare.
Statistical data prove beyond question that methods of feeding have
a great influence upon infant mortality. The death-rate is higher
in proportion to the degree to which the mode of nutrition diverges
from the natural method of suckling by the child’s own mother; the
death-rate is higher in children suckled by wet-nurses than in those
suckled by their own mothers; it is much higher in children fed on
cow’s milk than in breast-fed children. Among 1000 children dying
during the first year of life, medical returns show that 450 succumb
to digestive disorders and marasmus. Many physicians go so far as
to ascribe 70 per cent. to 80 per cent. of all infantile deaths to
artificial feeding. A statistical error arises in this way, that
children dying immediately after birth, before they could have been
put to the breast at all, are apt to be included among the deaths due
to artificial feeding, whereby, of course, the evil effects of this
practice are overestimated. Where artificial feeding is badly carried
out, the infantile mortality is enormous. The children that escape
death tend to become rachitic, anæmic, or weakly, and later in life
readily succumb to tuberculosis.
The enormous importance of natural feeding, and the extent of the
difference between artificial and natural feeding, are manifested by
the following examples: The statistics of child mortality invariably
show that in those European countries in which most children are
suckled by their mothers, child mortality is lowest. In Sweden and
Norway, where even the wealthiest mothers suckle their own children,
mortality during the first year of life hardly amounts to 10 per
cent., whereas in other European countries the infantile death-rate
is 12 per cent. to 15 per cent., or even more. It is erroneously
believed that there is a law in Sweden making it obligatory upon
mothers to suckle their children. No such law exists. During the
siege of Paris, in the years 1870-71, the infant mortality in that
city fell from 30 per cent. to 17 per cent. The reason for this fall
was that the Parisian women were forced to suckle their own children,
for, owing to the siege, cow’s milk was unattainable, and the usual
supply of wet-nurses from the country was cut off.
Natural feeding is not only better than artificial, but also cheaper.
Of course, in considering the question of the cost of artificial
feeding, the method employed has to be taken into account. For
example, artificially-fed infants are often given much more milk than
they really need. But artificial feeding is artificial, and whereas
instinct prescribes the methods of natural feeding, it gives no
guidance in the matter of artificial feeding. The changes occurring
in the female breast in consequence of pregnancy and childbirth
draw a woman’s attention to the fact that she has certain maternal
duties to fulfil. The neglect of nature’s commands commonly entails
disorders to health. It remains uncertain whether disease germs can
be transmitted to the infant through its mother’s milk. It is still
more questionable whether, in the act of suckling, vitally important
maternal qualities can be transmitted from mother to child. There
is some doubt whether the continuance of lactation is a fairly sure
preventive of the occurrence of a fresh pregnancy. If this question
can definitely be answered in the affirmative, there can be no doubt
that for a mother to suckle her infant gives an increased chance
of life not to that infant only, but to the other children in the
family, because thereby these children are relieved of the dangers
entailed by too large a family.
_History of Artificial Feeding._--It is uncertain during what
respective periods of human history the practice of rearing infants
by means of wet-nurses, and the practice of rearing them by
artificial feeding, first made their appearance. To-day, certainly,
both these methods of rearing infants prevail very widely--far more
widely than at any former time. No official statistics exist showing
the proportion of all infants born alive that are suckled by the
mother, suckled by wet-nurses, and artificially fed, respectively.
According to some private investigators, in large towns less than
half of all infants are suckled by their own mothers, and in France
the proportion of those which are otherwise nourished is said to
range from 60 per cent. to 70 per cent. Certainly, the conditions
with regard to this matter are worse in France than they are
elsewhere.
Many physicians believe that the constitutional incapacity of women
to suckle their children is increasing. They point out that an unused
organ tends to atrophy; and they consider, not merely that the
incapacity to suckle is transmitted by inheritance, but that when
so transmitted, the incapacity persists throughout all subsequent
generations. But this view, whose soundness would deprive us of
our most effective weapon in our campaign against excessive infant
mortality, is erroneous. The recent investigations of various medical
practitioners especially interested in the diseases of children
have shown that (even in districts in which for generations mothers
have almost completely abandoned the practice of suckling their
children), when properly advised, 90 per cent. of all women proved
capable of suckling, if not for the full nine months, at any rate
for a considerable period, before it was necessary to have recourse
to cow’s milk. There are doubtless women who are really unable to
suckle their children; and there are others who could do so, but in
whom suckling is contra-indicated, either in their own interest or in
that of the child. For example, a woman who is pregnant cannot give
suck, for the human organism is not adapted to bear the common strain
of pregnancy and of lactation. In the interest of the child that
is being suckled, it is necessary that weaning should be effected
directly a new pregnancy begins. Women suffering from chronic
alcoholism and those addicted to morphine should not suckle their
children, for the reason that a comparatively large quantity of the
alcohol ingested, or of the morphine, as the case may be, is excreted
in the milk. A child suffering from an infective disease, such as
syphilis or tuberculosis, should be artificially fed, owing to the
danger of infection.
_Causes of the Failure to Suckle._--The reasons for a mother’s
failure to suckle her infant may be classified under two main heads:
she will not, or she cannot. Unwillingness plays a great part among
the upper classes of society. Dread of inconvenience, laziness, fear
of the loss of physical charms, social duties and pleasures to which
such women devote a great deal of time, and which they are unwilling
to renounce--such are the considerations operative in these cases.
Inability to suckle is a more frequent cause among women of the
proletariat. In consequence of their poverty, such women are often
forced to work away from home the whole day long. It is not yet
definitely ascertained whether constitutional inability to suckle is
commoner among proletarian women than among women of other classes.
It is a greater evil for a proletarian mother to fail to suckle her
infant than it is for a mother of the upper classes similarly to
fail. The proletarian mother cannot afford to pay a wet-nurse, and
the child must therefore be artificially fed. In this event, the
proletarian mother is likely to feed her child less well than an
upper-class mother who also adopts artificial methods of feeding, for
the former is too poor to obtain the best milk, and she lacks time to
prepare the milk properly, and to give it to her child in suitably
small quantities and at suitably short intervals.
The idea that a smaller proportion of mothers of the poorer classes
suckle their children than among the well-to-do is erroneous. But
it is a fact that of those children who are not suckled by their
own mothers, among the upper classes a much larger proportion are
suckled by wet-nurses than among the lower classes; it is also the
case that when children of the upper classes are not suckled by their
own mothers, they commonly have wet-nurses in their own homes, and
are not entrusted to the care of foster-parents; and finally, when
we come to hand-fed children, among the upper classes a greater
proportion of these are comparatively well fed than among the lower.
A smaller percentage of illegitimate than of legitimate children are
suckled by their own mothers; a larger percentage of the illegitimate
than of the legitimate are artificially fed. The unmarried mother is
in most cases poor, the birth of the child makes her poverty extreme,
and by no means always does she receive a maintenance allowance
from her child’s father. To be able to live, she must either act as
wet-nurse to another woman’s child, or must go out to work.
_Wet-Nurses._--Poverty not only makes it impossible for many women
to suckle their own infants, but forces them to suckle the child of
another. The great majority of wet-nurses are recruited from the
ranks of the proletariat, and, indeed, for the most part, belong
to the class of unmarried mothers. Married women are less inclined
to sacrifice their own child for the good of the child of another
woman. The readiness of many mothers to renounce the duty of suckling
their children is perhaps referable to the fact that wet-nurses may
be procured so easily and at such small cost. Thus poverty is also
an indirect cause of the fact that many upper-class mothers fail to
suckle their children. The children of wet-nurses are either fed
artificially, or suckled by another woman. The sad position of such
children, and their enormous death-rate during the first years of
life, are only too well known. When a woman takes employment as a
wet-nurse, two children suffer--(_a_) the child she suckles, and
(_b_) her own child, which would otherwise, in all probability, be
suckled by its own mother. In favour of the traffic in wet-nurses, it
is frequently maintained that the children of wet-nurses, owing to
the good wages earned by their mothers, are well cared for, whereas
otherwise they would be badly cared for. The sophistical character of
this argument is sufficiently obvious.
If a child is not suckled by its own mother, it is either suckled
by another woman, or else artificially fed; and the child may
either remain in its maternal home, or it may be sent to be reared
elsewhere. If the infant is sent elsewhere, either its relatives or
some benevolent society may arrange for its care. Wet-nurses are thus
resident or non-resident. In foundling hospitals, those wet-nurses
who give suck to children in the institution are known as resident
wet-nurses. From the standpoint of civil law, resident wet-nurses
have entered into a contract of service with their employer, and
the latter undertakes to provide in return for their services a
stipulated remuneration. A non-resident wet-nurse, on the other
hand, undertakes to provide in a certain manner for the infant
boarded with her. It is obviously preferable that an individual child
should be suckled by a resident wet-nurse, since in such conditions
the wet-nurse can be supervised much more strictly than when she
receives the infant in her own home. But in the case of children in a
foundling hospital, it is preferable that they should be boarded out
with non-resident wet-nurses, for in the present condition of medical
science, the institutional care of infants is a very difficult matter
to carry out with success.
But the choice of a wet-nurse involves other considerations in
addition to those just stated. A woman can safely be employed in
this capacity only if her own confinement has taken place some
little time before. By suckling the child of another the wet-nurse
deprives her own child of its natural nourishment. The wet-nurse may
be suffering from some infective disorder, and may transmit this
disorder to her nursling. Conversely, the nursling may be suffering
from congenital syphilis, or from tuberculosis, and may infect the
nurse. It is very difficult in infants-in-arms to recognise syphilis
with certainty. For these reasons it is only to healthy wet-nurses,
for whose own children a proper provision can be made (for instance,
when the wet-nurse’s child has already been suckled for six months,
or when it has died), that the local authorities give permission
to suckle the child of a stranger. This applies both to resident
and to non-resident nurses. In the case of the latter, in view of
the fact already mentioned, that they cannot be properly supervised
by the child’s relatives, supervision by the local authority is
indispensable. There are no physiological difficulties in the way
of suckling two infants, either simultaneously or successively. The
latter procedure is, however, to be preferred. In all civilised
countries baby-farming has been subjected to legal regulations.
Although these regulations vary greatly in different countries, they
relate not only to infants, but also to older children. The age at
which supervision of such children ceases is a very variable one. As
an example may be mentioned the French law of the year 1874. This
law deals with children boarded out by foundling hospitals, but only
to those under two years of age received for a money payment. It is
becoming obvious to-day to most persons that children boarded out by
their relatives require official supervision, even if the children
are received gratuitously.
_Cow’s Milk._--Pure cow’s milk is the best substitute for the
maternal milk. Where milk is to be used for infant-feeding, it
should be drawn in a properly-kept cowshed, it should be cooled,
placed for delivery in vessels of a suitable size for an individual
infant’s meal, diluted or otherwise prepared as demanded by the age
and special necessities of the case, and used as soon as possible.
To-day the price of cow’s milk suitable for infant-feeding is so
high that the lower classes find it almost impossible to obtain it.
It is a matter of very great importance that good milk should be
rendered available for the lower classes at a low price. Recently
much attention has been paid to the improvement of the technique
of milking, of the transport of milk, and of the care of milk
when delivered. The local authorities supervise the production and
transport of milk as a part of their public-health administration.
Improvements in cattle-breeding, a thorough organisation of
the cowsheds and dairies and of the methods of milking, and an
organisation of the entire dairy business have effected much
improvement. Both private associations and the local authorities
begin to lay stress on the supply of milk for infants, especially in
towns, in which the provision of good milk is even more important
than it is in country districts. We must leave the question open
whether infants can be infected by the milk of cows suffering from
_Perlsucht_ or bovine tuberculosis; it certainly cannot be a matter
of indifference whether the milk contains tubercle bacilli. At the
present time, unfortunately, in the anything but hygienic dairies
of our country districts, many of the cows are suffering from
_Perlsucht_.
In many countries, especially France, Germany, and England, Infant’s
Milk Depots (_Gouttes de Lait_) have been founded, at which the poor
can obtain infant’s milk gratuitously or very cheaply. The deficit
is made up by individual contributions, by public grants-in-aid, or
by the profit on milk sold to the well-to-do. Of late years a few
English municipalities have begun to administer such Infant’s Milk
Depots themselves. Such Infant’s Milk Depots appear to do more harm
than good. By providing milk gratuitously or very cheaply they give
a premium to those mothers who feed their children artificially, and
this leads many who would otherwise suckle their children to bring
them up by hand. Vainly in France are prizes offered to mothers, and
especially to unmarried mothers, to induce them to suckle their own
children, when simultaneously institutions are founded to reward
mothers who bring up their children by hand. Infant’s Milk Depots
must be under continuous medical supervision, such supervision to
include the mothers and children attending the depot, since in
default of this there is no guarantee that the mothers would use the
milk properly in the nourishment of their infants. Of late it has
been found necessary, especially in France, to associate with the
administration of the Infant’s Milk Depots the continuous medical
supervision of the infants, medical advice to the mothers, control of
the use of the milk, and advice to the mothers to suckle their own
children. The French Infant’s Milk Depots are now associated with the
giving of advice to mothers (_consultation de nourrissons_), so that
the mothers can be properly instructed regarding all matters bearing
on infant-feeding. Several times a week mothers’ classes are held,
at which all possible stress is laid on the need for women to suckle
their own children, this theoretical advice being re-enforced by the
giving of prizes. If natural feeding is rejected or is impossible,
advice is given as to suitable artificial feeding. Domiciliary
visits are made to see that this advice is properly followed. Thus
the Infant’s Milk Depots tend more and more to develop into centres
for the general care of infancy; their original aim will pass more
and more into the background as advice to mothers becomes associated
with children’s clinics (such as we find already in many university
towns), or with hospitals for infants, schools for midwives, and
lying-in hospitals. Such a development may be expected in the near
future.
Infant’s Milk Depots, advice to mothers, and all the institutions
and measures forming part of the campaign to lower infant mortality,
must invariably have the general aim of promoting the public welfare,
and must never assume the form of Poor-Relief, otherwise many who
need their services will fail to avail themselves of these, for,
as is well known, a great many people are frightened away from
any institution connected with the system of Poor-Relief. It is
sufficiently proved that those Infant’s Milk Depots in which the
milk is given in accordance with individual medical prescriptions,
which are subjected to medical supervision, which are associated
with the giving of advice to mothers, which give milk free or at
a low price only to those whose infants are kept under regular
observation, promote breast-feeding by the mothers, and effect a
notable diminution in infant mortality.
_Other Methods of Artificial Feeding._--Nothing more need be said
here of the other methods of artificial feeding--that is, of those in
which no cow’s milk is used--beyond this, that they are in opposition
to the essential principles of hygiene, and that they are of less
than no value. Everyone who has the interest of society at heart
should do all in his power to secure the complete discontinuance of
such methods.
_Institutional Care of Infants._--The institutional care of infants,
if it is to be carried out in accordance with hygienic principles,
is too costly. Hence it is applicable only in the case of weakly
and sickly infants, and is out of the question for the permanent
care of healthy infants. With regard to the institutional care of
healthy infants, it is asserted that, even in the most modern and
best-managed foundling hospitals and hospitals for infants, epidemic
diseases--such as pneumonia, contagious ophthalmia, and intestinal
catarrh--inevitably appear, and in such circumstances are extremely
difficult to treat with success. It is, however, necessary to
consider the following facts. Unquestionably, the institutional care
of infants was formerly far from satisfactory. Certain diseases,
the seeds of which have been sown in the institution, only develop
in full severity after the child has been boarded out. This depends
upon: (_a_) the primary lack of resisting power of the infants, which
is the disastrous sequel of the unfavourable conditions of life
to which they were exposed before entering the institution; (_b_)
the lack of proper individualisation (for example, the continuous
lying in bed, bad air, lack of sufficient cleanliness)--the
so-called “hospitalism” or “hospital-marasmus” is referable to these
influences; (_c_) a failure to meet the demands of hospital hygiene,
so that the origination and the development of the infectious
diseases are facilitated; (_d_) artificial feeding, by which the
working of these evil influences is powerfully reinforced. But all
these errors are avoidable. Nothing more is requisite for their
avoidance than strict observance of the rules of modern hospital
hygiene, with individualisation in all departments, and especially
in the matter of diet, which should whenever possible be carried
out through the instrumentality of wet-nurses. Since wet-nurses of
the best quality are difficult to obtain in sufficient numbers, it
is best that the hospital for infants should be associated with a
lying-in hospital.
_The Crèche._--In the families of the poor, the elder children have
in most cases to work for their living, so that even these are not
continuously available for the care of the younger children. This
applies especially to those families whose members work away from
home, and in places to which the younger children cannot be taken.
When a peasant with his wife and his elder children works in the
fields, it is possible to take even quite little children to the
place of work and to keep an eye on them there; but when a workman
with his wife and his elder children works in a shop, a factory,
or a workshop, to take the younger children there is impossible.
But young children must on no account be left without supervision,
for this exposes them to all kinds of dangers--to burns and scalds,
falling out of window, &c. Moreover, an infant-in-arms cannot be
entrusted to the care of the older children, if only for the reason
that this is injurious to the latter alike in body and in mind. They
have, for example, to drag the baby about with them wherever they
go, are kept away from school, &c. To board out an infant is, in the
first place, costly, and, in the second place, separates the infant
completely from its parents. In many cases it is only by the fact
that she keeps her child with her, and becomes attached to it, that
an unmarried mother is restrained from adopting an immoral life.
Thus there is need of a place to which the children may be sent,
either permanently or only during the hours in which the family are
at work. Institutions for this purpose actually came into existence
only as a sequel of the development of the factory system. They are
known as crèches, and provide for the care, not of infants merely,
but of children up to the age of three. The need for and value of
such institutions is obvious. It is a real service to parents of the
poorer classes, if not far from their dwelling or from their place of
work there exists an institution at which, either gratuitously or for
a nominal payment, their little children can be properly cared for.
Early in the day the mother takes her infant to the crèche, during
the midday pause goes there if necessary to suckle the child, and
fetches it home in the evening.
Illegitimate children are in many places refused admission to the
crèches. This refusal merits our strongest disapproval. The reasons
alleged for this course are of two different kinds. First, we are
told that we must not encourage girls to be immoral; secondly, it is
said that married mothers will hesitate to entrust their children to
a crèche which also receives illegitimate children. The injustice of
this practice is more and more generally understood, and the better
course more commonly prevails. Of course, only such illegitimate
children should be received at a crèche as are cared for by their
own mothers during the hours of the day when they are not at the
institution. Illegitimate children boarded out with foster-parents
should not be admitted to a crèche, because foster-parents who send
to a crèche the child entrusted to their care are not properly
fulfilling the duty they have undertaken, and those who cannot look
after the foster-child themselves should not receive one at all.
In most countries crèches are founded and maintained by private
benevolence, and are merely supervised by the State. Only in a
few countries--Hungary, for instance--has the State imposed upon
the local authorities the duty of founding and maintaining such
institutions; and the central authority has itself founded and
maintained such institutions, and in these the matrons of the Public
Homes for Children (_Kinderbewahranstalten_) receive their training.
To-day various defects exist in these crèches. Not infrequently the
attendants lack the necessary experience in the care of children,
medical supervision is often inadequate, the building is unsuitable,
the infants are artificially fed, the crèche is often too far from
factory, workshop, or home, so that artificial feeding or feeding by
a wet-nurse is encouraged. Before long crèches will become national
institutions. They will become more numerous; they will be used more
readily; their faults will be corrected.
Particular mention must be made of factory crèches and family
crèches. (_a_) Many factory owners construct crèches and
feeding-rooms for the infants of women working in their factories,
and arrange for such women to leave work at intervals to suckle their
children. The employers do this, not so much from the goodness of
their hearts, as with an eye to their own well-considered interest.
The working time they lose amounts to very little, and they
hope that their benevolent actions will secure the goodwill, and
consequently the hearty co-operation, of their workpeople. (_b_)
A recent development is the family crèche. Adequate maintenance
and free house-room are guaranteed to a widow, in return for her
undertaking to care during the day for a restricted number of
infants (and in some cases, also, children of school age). Family
crèches share to some extent the advantages of the family care of
infants. Their great and obvious advantage lies in the fact that
they facilitate decentralisation--that is, the crèche can be nearer
to the homes of the infants’ parents. Their main defect lies in
their failure, as a rule, to satisfy the demands of modern hygiene;
a second disadvantage is that systematic occupation for the older
children is usually difficult to arrange in the family crèche. For
these reasons it is unlikely that they will ever become very general.
_Proposed Reforms._--Proper training and discipline are requisite,
not only for midwives, but also for medical practitioners. Proper
training of mothers is also necessary. Most young mothers seek advice
above all from midwives, and these latter often advise very badly.
In the first place, there are many matters connected with the care
of infancy about which midwives have no expert knowledge. Secondly,
midwives often advise mothers not to suckle their children, but to
bring them up by hand, because the case is sooner done with and the
midwife has less to do when the mother does not suckle.
In many German towns, a number of the institutions for the care
of infants, and also the offices for the registration of births,
distribute printed instructions regarding the care of infants, with
especial reference to the matter of infant-feeding. The principle of
these attempts is sound, but unfortunately many such leaflets are
rather long-winded, and consequently remain unread.
It has been suggested that every woman entering upon marriage should
have to display a knowledge of the elements of the hygiene of infant
life, and more especially of the principles of infant-feeding; or
else that the duty should be imposed upon women of acquiring the
requisite knowledge within six months after marriage--by attendance
at one of a number of schools to be founded with this end in view.
The idea of this proposal is sound, but it is one which it is hardly
possible to put into practice precisely in the form here stated.
_Radical Solution of the Problem._--It is one of the most important
aims of child-protection that during the first year of life the
infant should be nourished at the maternal breast. Every possible
effort must be made to secure that the infant should not be separated
from its mother; and if separation from the mother is unavoidable,
that the child should not be hand-fed, but suckled by a wet-nurse.
Finally, when artificial feeding of the infant is inevitable, it is
the aim of child-protection to secure that the technique of this
feeding should be the best possible.
Two of the institutions of modern civil law are of such a nature as
to favour wet-nursing and hand-feeding, and to hinder the attainment
of the primary aims of child-protection. The first of these is that,
within limits, the parents are free to determine how their child
shall be brought up; so that, for instance, the mother is free to
entrust her child to a wet-nurse, or even to have it brought up by
hand. Hence the reform of these matters must begin with legislation
securing that the legal position of legitimate and of illegitimate
children shall be identical; and, secondly, imposing it upon all
mothers as a legal obligation to suckle their own children when they
are physically competent to do so.
The last-named measure is by some considered too radical, on the
ground that its enforcement would infringe the sacred principle of
the freedom of contract, and would violate the sanctity of family
life. But these are merely empty phrases; and such considerations
cannot for a moment counterbalance the urgent need for the proper
protection of infant life. Even to-day, it is an accepted legal
principle that in the case of contracts involving the personal
service of the contracting parties within the limits of family life,
the contract cannot be fulfilled by proxy. Thus, in the matter of
the nourishment of an infant during the first months of life--that
is to say, in respect of the performance of an act which is merely
the continuation and the sequel of the physiological state brought
into being by sexual intercourse and by pregnancy, the demand that
no substitution be allowed, that lactation by proxy be prohibited, is
a logical application of existing and accepted legal principles. In
the sphere of family life, the principle of the freedom of contract
finds even to-day no more than a restricted application; and with
the disappearance of the economic order based upon free competition,
the principle of the freedom of contract is destined altogether
to disappear. Beyond question, the suggested reform would involve
a very serious limitation of personal liberty. But the limitation
would be no greater than those that are imposed in most modern
States by various ordinances affecting the right of the individual
to the free disposal of his own body--for instance, compulsory
military service, compulsory vaccination, and compulsory removal to
a hospital for infectious diseases. The proposed reform would knit
closer the bonds between mother and child, and it would curtail the
love of personal luxury and the pleasure-seeking of the women of the
well-to-do classes. The legal measure here suggested was known to
the old Prussian law, and to this law alone. It does not appear in
any legal code of to-day. The two reasons that prevent its immediate
adoption by any modern State are these: in the first place, it would
affect the women of the upper classes much more than those of the
lower, and would expose the former in especial to punishment; in the
second place, a necessary corollary of any such law would be the
provision for women of the lower classes of a suitable allowance for
maintenance during the period of lactation.