What Did People Do Before Infant Formula Was Invented?

Well before bottles and formula came along, babies still had to be fed. Many parents turned to wet nurses to get the job done when they couldn't, or in some cases, wouldn't. As early as 2000 B.C.E., these lactating women were employed (or in some cases volunteered) to breastfeed children who weren't their own. (In some cases, wet nurses were slaves as well.)

Wet nurses were commonly hired for affluent families from ancient times throughout the 19th century. Wet nurses still exist, although its status as a paying profession has largely died out. Today, there are even women who form "cross-nursing" groups, in which they take turns feeding each other's children in order to provide support, and also bond with multiple children in a community effort.

Women who couldn't breastfeed, or who lacked wet nurse access, often turned to animal milk to nourish their infants. In fact, this was, the most common type of artificial feeding until the close of the 19th century. Although most parents used cow's milk, milk from goats, donkeys, camels, horses, pigs and sheep were also used, depending on where the parents lived and what was available.

Another common method in the 16th to 18th centuries was to make a mix called pap or panada, made of bread soaked in milk, or cereal cooked in water. This was fed to the baby via a spoon, a rag or a special device called a pap boat. But people didn't yet know about the importance of sterilizing objects babies were drinking out of. By the early 19th century, one-third of all babies fed with feeding devices (which may have been improperly cleaned or contained spoiled milk) died during their first year of life.

Eventually, enterprising chemists decided to try to more closely mimic human breast milk, and in 1865 Justus von Liebig created what's believed to be the world's first infant formula. It was made of wheat, cow's milk, malt flour and potassium bicarbonate. In 1867, pharmacist assistant Henri Nestle launched "Farine Lactée Nestlé," which was made with similar ingredients but was easier to prepare. By 1883, there were at least 27 brands of infant food available. While these would fatten up a child, they usually lacked some of the necessary vitamins for infant health.

Another milestone in infant formula occurred when people figured out how to preserve foods through canning, which gave rise to condensed milk and evaporated milk in the 1800s. In fact, many pediatricians recommended evaporated milk to mothers for their babies in the 1930s and '40s.

The first non-powder formula hit the marketplace in 1951, to great fanfare. "That was a turning point in history when the developed world embraced artificial infant formula and it became the feeding method of choice for many, regardless of ability to breastfeed," says Dr. Hillary Bashaw, a pediatric gastroenterologist at Children's Healthcare of Atlanta and assistant professor at Emory University College of Medicine, in an email interview. "By the 1970s, many were turning back to breastfeeding and now, we live in an era where there are many accepted and safe ways to feed infants."

Infant formula is made up of a careful blend of fats, proteins, carbohydrates, vitamins and minerals. The most common protein is cow's milk, with vegetable oil for fat and lactose for carbs. With formula currently in short supply, many are wondering if they can make their own version at home, but experts are quick to caution people against doing this.

"Making your own formula at home could lead to major health problems or even death," explains Bashaw. "Infants require specific nutrients with careful fluid and electrolyte balances that are nearly impossible to recreate at home."

Indeed, Bashaw notes that homemade formula recipes are nutritional duds, with far too many saturated fats and proteins for a sensitive young stomach. They also don't have nearly the amount of essential fatty acids or vitamins that an infant needs to thrive, and often feature products like corn syrup, which many babies cannot tolerate.

"Significant nutritional deficiencies and developmental and growth delays could result from using homemade formulas," she adds. Lest you think she's being overly dramatic, babies used to die of malnutrition, diarrhea and bottle contamination all the time, thanks to the crude feeding practices of the day.

Modern commercially produced formulas, by contrast, are heavily regulated, thanks in large part to the Infant Formula Act of 1980, which was updated in 1986. "There is constant development to make formula as close to human milk as possible — both for improved formula tolerance and to ensure babies on all sources of nutrition grow and develop well," says Bashaw.

Currently, she notes that there are minimum levels for 29 nutrients and maximum levels for nine nutrients in infant formula, because babies require a special balance to thrive to their fullest potential. "All formulas must be within the ranges allowed by law."

Most parents prefer to pick a formula type and stick with it to minimize risk of upsetting the baby's gut. However, in these lean formula times it might be necessary to deviate from the norm and take whatever you can get. This is likely to be just fine, says Bashaw. "Most babies can be given different types of formulas provided they do not have a medical condition requiring a specialty formula," she says. "A baby that can tolerate a cow's milk formula will likely do fine with a plant-based (soy) formula if that is what is available. Similarly, babies on brand-name formula should do well on the generic counterpart of that formula."

However, parents with any concerns about switching things up should keep an open line of dialogue with the child's pediatrician, especially those that have medical conditions that require specialty formulas. "In addition, they [infants who have to switch formulas] might need help managing mild gastrointestinal symptoms that might occur with a formula change," she says.

In dire situations, the American Academy of Pediatricians says cow's milk can be given to infants over 6 months (who normally take regular formula) but for no longer than one week. However, you should talk to your pediatrician first.