Ensayos nutricionales sobre lactancia artificial en la España ilustrada: el trabajo de Joaquín Xavier Úriz en Pamplona / Nutritional trials on artificial lactation in Enlightenment Spain: the work of Joaquín Xavier Úriz in Pamplona

Introducción: la continuidad actual de publicaciones sobre la infancia abandonada durante la Ilustración española, desde las mismas perspectivas del control social que se establecieron a finales del siglo XX, desvirtúa el esfuerzo de algunos ilustrados por encontrar alternativas de nutrición artificial a la lactancia mediante nodrizas. Objetivo: analizar los ensayos nutricionales efectuados por Joaquín Xavier Úriz (1747-1829) en la inclusa de Pamplona. Método: revisión, análisis e interpretación de su obra "Causas prácticas de la muerte de los niños expósitos en sus primeros años" , publicada en 1801. Resultados: tras justificar su necesidad, plantear objetivos y diseñar un experimento controlado, realizó dos ensayos con lactantes, uno con niños sanos mediante suplementos de agua de arroz a la leche de nodriza y otro con niños enfermos mediante lactancia mixta de cabra y nodriza. Ambos se realizaron inicialmente con uno y dos sujetos, respectivamente, para ampliarlo tras buenos resultados a una muestra mayor no aleatorizada (12 sujetos en el caso de los enfermos). Aunque los resultados iniciales no fueron concluyentes, se constata un descenso de la mortalidad lactante posterior. Conclusiones: los ensayos responden a la aplicación de un método científico más apreciable que el observado en textos didácticos de autores más relevantes, como es el caso de Iberti. El utilitarismo imperante no oculta el valor dado a la vida del expósito sobre cualquier otro, siendo Úriz un claro ejemplo de las excepciones al enfoque predominantemente punitivo de la historiografía. El descenso posterior de la mortalidad del lactante sugiere la posibilidad de una exitosa causa-efecto de los ensayos (AU)

Introduction: the current continuity of publications on abandoned children during the Spanish Enlightenment, from the same perspectives of social control that were established at the end of the 20th century, undermines the efforts of some Enlightenment scholars to find artificial nutrition alternatives to breastfeeding through wet nurses. Aim: to analyse the nutritional trials carried out by Joaquín Xavier Úriz (1747-1829) in the Pamplona foundling home. Method: review, analysis and interpretation of his work "Causas prácticas de la muerte de los niños expósitos en sus primeros años" , published in 1801. Results: after justifying its necessity, setting out objectives, and designing a controlled experiment, he carried out two trials with infants, one with healthy children using rice water supplements to the wet-nurse's milk and the other with sick children using mixed goat and wet-nurse breastfeeding. Both were initially conducted with one and two subjects, respectively, to be extended after good results to a larger, non-randomised sample (12 subjects in the case of sick children). Although the initial results were inconclusive, a decrease in subsequent infant mortality was noted. Conclusions: the trials are based on the application of a more appreciable scientific method than in didactic texts by more relevant authors, as in the case of Iberti. The prevailing utilitarianism does not hide the value given to the life of the foundling over any other, Úriz being a clear example of the exceptions to the predominantly punitive approach of historiography. The subsequent decline in infant mortality suggests the possibility of a successful cause-effect of the trials (AU)

Milk of ruminants in ceramic baby bottles from prehistoric child graves.

The study of childhood diet, including breastfeeding and weaning, has important implications for our understanding of infant mortality and fertility in past societies1. Stable isotope analyses of nitrogen from bone collagen and dentine samples of infants have provided information on the timing of weaning2; however, little is known about which foods were consumed by infants in prehistory. The earliest known clay vessels that were possibly used for feeding infants appear in Neolithic Europe, and become more common throughout the Bronze and Iron Ages. However, these vessels-which include a spout through which liquid could be poured-have also been suggested to be feeding vessels for the sick or infirm3,4. Here we report evidence for the foods that were contained in such vessels, based on analyses of the lipid 'fingerprints' and the compound-specific δ13C and Δ13C values of the major fatty acids of residues from three small, spouted vessels that were found in Bronze and Iron Age graves of infants in Bavaria. The results suggest that the vessels were used to feed infants with milk products derived from ruminants. This evidence of the foodstuffs that were used to either feed or wean prehistoric infants confirms the importance of milk from domesticated animals for these early communities, and provides information on the infant-feeding behaviours that were practised by prehistoric human groups.

Historia de la nutrición clínica española (1): Nutrición artificial y su incorporación al ámbito clínico español / The development of clinical nutrition in Spain (1): integrating artificial nutrition into the Spanish clinical setting

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Historia de la Nutrición Clínica Española (2): La contribución de SENPE y de la revista Nutrición Hospitalaria / The development of clinical nutrition in Spain (2): the contribution of SENPE and «Nutrición Hospitalaria» journal

Se aborda la aportación que ha realizado la Sociedad Española de Nutrición Parenteral y Enteral (SENPE) a la nutrición clínica, a través del análisis de los principales elementos que han configurado su proyecto de asociacionismo científico: los inicios y el contexto científico y asistencial que determinó su puesta en marcha, las características y la evolución de los socios y de las juntas directivas, los congresos y las reuniones científicas organizadas, la importancia que ha adquirido la revista Nutrición Hospitalaria como referente para la comunicación científica en el ámbito de las ciencias de la nutrición y las actividades encaminadas a promover la investigación y la formación continuada (grupos de trabajo, publicaciones, etc.) (AU)

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Technical inventions that enabled artificial infant feeding.

Artificial feeding of infants, called hand-feeding, was unsafe well into the 19th century. This paper aims to identify technical innovations which made artificial feeding less dangerous. In rapid succession from 1844 to 1886, the vulcanization of rubber, production of rubber teats, cooling machines for large-scale ice production, techniques for milk pasteurization, evaporation and condensation, and packing in closed tins were invented or initiated. Remarkably, most of these inventions preceded the discovery of pathogenic bacteria. The producers of proprietary infant formula made immediate use of these innovations, whereas in the private household artificial feeding remained highly dangerous - mostly because of ignorance about bacteria and hygiene, and partly because the equipment for safe storage, transport, preparation and application of baby food was lacking.

Pap, gruel, and panada: early approaches to artificial infant feeding.

This paper collects information on artificial infant feeding published before 1860, the year when commercial formula became available. We have extensive artifactual evidence of thousands of feeding vessels since the Bronze Age. Special museum collections can be found in London, Paris, Cologne, Fécamp, Toronto, New Mexico, and elsewhere. The literature on the use of animal milk for infant feeding begins with Soranus in the 2nd century CE. Literature evidence from the very first printed books in the 15th century proves that physicians, surgeons, midwives, and the laity were aware of the opportunities and risks of artificial infant feeding. Most 17th to 19th century books on infant care contained detailed recipes for one or several of the following infant foods: pap, a semisolid food made of flour or bread crumbs cooked in water with or without milk; gruel, a thin porridge resulting from boiling cereal in water or milk, and panada, a preparation of various cereals or bread cooked in broth. During the 18th century, the published opinion on artificial feeding evolved from health concerns to a moral ideology. This view ignored the social and economic pressures which forced many mothers to forego or shorten breast-feeding. Bottle-feeding has been common practice throughout history.

Perpetuating "scientific motherhood": infant feeding discourse in Parents magazine, 1930-2007.

Although breastfeeding initiation rates have recently been at an all-time high, duration continues to be considerably low. Given the health benefits associated with extended breastfeeding, this discrepancy is cause for concern. This research examined the messages conveyed about infant feeding in a popular parenting magazine, Parents magazine, from 1930 through 2007. Findings indicated that the messages about infant feeding shifted in accordance with changing ideologies about the means of infant feeding-from bottle-feeding to breastfeeding. However, even with changing attitudes toward infant feeding, writers used scientific evidence and the advice of "experts" to justify the dominant form of feeding. The absence of practical advice regarding breastfeeding challenges, especially from "real" women set up false expectations about the breastfeeding experience, painting it as "natural" and best for the baby. The dependency on experts and lack of practical advice in popular media, like Parents magazine, may help explain a societal trend that downplays breastfeeding obstacles, giving insight into the vast discrepancy between breastfeeding initiation and duration.

From breast to bottle: a history of modern infant feeding.

In the early twentieth century, mothers began to turn towards scientific infant-feeding formulae as an alternative to breastfeeding their babies. This is strange because the benefits of breastfeeding were widely recognised. The extraordinary rise of the formula feed therefore demands a special explanation, one that includes an appreciation of key changes in public health, the emergence of paediatrics as a profession, commercial interests and advances in the sciences of bacteriology and nutrition. All these factors conspired to propel the formula feed to the fore.

Breast-feeding, bottle-feeding and Dr. Spock: the shifting context of choice.

In today's environment, breast-feeding represents both a medical gold standard for infant feeding and a moral gold standard for mothering. The morally charged character of this discourse makes the notion of choice in infant feeding particularly problematic and fraught with difficulty. From an historical content analysis of selected editions from 1946 to 1998 of Dr. Spock's famous child-care manual, this paper explicates the process through which the breast versus bottle discourse has shifted over the last half-century, and how these shifts have shaped the context of choice within which mothers must make their infant-feeding decisions.

[Not only bottles. Glass baby's bottles in between the second half of XIXth century and the first decades of the XXth]. / Non solo bottiglie. I poppatoi di vetro tra la seconda metà dell'ottocento e i primi decenni del novecento.

Mother's milk is the best food for the baby. The need to use foods other than mother's milk has always represented a challenging problem to be solved. The author warns that the high mortality during the first year of life during the early years of the XXth century (20%) peaked at an amazing 80% in children artificially fed at orphanages. In the considered years, the usage of baby's bottle spread among babies that could not be fed by mothers or wet-nurses. The idea of rubber teat 1845 and of automatic devices for the production of glass bottle - 1903 - contributed to the diffusion of the baby's bottle. First baby's bottles were variously shaped. However, the finding of severe gastroenteritis caused by a long rubber tube attached to the rubber teat (the so-called death-bottle), together with the necessity of a careful cleaning and the diffusion of Soxhket's system (sterilization of many bottles in the same container) will lead to the choice of large mouthed cylindrical bottles, very similar to the plastic bottles used nowadays.

Medicalization and women's knowledge: the construction of understandings of infant feeding experiences in post-WW II New Zealand.

For most of the twentieth century infant feeding knowledge has been constructed by medical scientists and health professionals. However, for a short time around the 1970s, New Zealand women (re)claimed the power to author their own knowledge based upon experience. This coincided with a dramatic return to breastfeeding on a national scale. Using New Zealand women's narratives of their infant feeding experiences over the past 50 years, this article brings to the foreground the importance of women's subjective construction of knowledge, their positioning within it, and the suppression of rudimentary discourses when that power is removed or relinquished in the process of remedicalization.

Infant feeding in the 20th century: formula and beikost.

The early years of the 20th century were notable for improvements in general sanitation, dairying practices and milk handling. Most infants were breast-fed, often with some formula feeding as well. Availability of the home icebox permitted safe storage of milk and infant formula, and by the 1920s, feeding of orange juice and cod liver oil greatly decreased the incidence of scurvy and rickets. Use of evaporated milk for formula preparation decreased bacterial contamination and curd tension of infant formulas. From 1930 through the 1960s, breast-feeding declined and cow's milk and beikost were introduced into the diet at earlier and earlier ages. Although commercially prepared formulas, including iron-fortified formulas replaced home-prepared formulas, few infants were breast-fed or formula fed after 4-6 mo of age. Iron deficiency was prevalent. From 1970 through 1999, a resurgence of breast-feeding was associated with a prolongation of formula feeding and an increase in usage of iron-fortified formulas. By the end of the century, formula feeding of older infants had largely replaced feeding of fresh cow's milk and the prevalence of iron deficiency had greatly decreased.