Recently, I was reading a historical fiction biography of Mary Todd Lincoln and Abraham Lincoln (Love is Eternal, by Irving Stone) and came upon a beautiful section where after the birth of her fourth child, she nurses the child of a neighbor who has become ill with childbed fever until the other mother recovered. I was struck by the notion that this sort of generosity in relation to breastfeeding has largely become unheard of in our formula-accessible world.

In fact, in America at least, the whole concept of a woman nursing a child that is not her own raises all sorts of negative reactions in many different situations. When even as recently as 150 years ago in the Lincoln’s narrative, cross-nursing and wet nurses were not considered uncommon or inappropriate, there are strong taboos against such behavior today.

And while it is fairly universally acknowledged that “breast is best,” going through any “extraordinary” measures to obtain breast milk – adoptive nursing (induced lactation), milk sharing between mothers, or obtaining milk from a milk bank – much less the now bizarre notion of hiring a wet nurse or having a friend nurse one’s baby still raises eyebrows among most people. In fact, when Selma Hayak nursed a starving baby that was not her own in Sierra Leone, Entertainment Weekly dubbed the video the eyebrow raiser of the day.

It’s not clear when our society changed so dramatically. As portrayed in Stone’s novel on the Lincolns in the 1850s a future United States President personally fetched a neighbor’s baby every four hours around the clock for about a week while the mother recovered. When she did, she came to the Lincoln’s home with a gift and words of immense gratitude for saving her baby’s life.

I can only imagine now the reaction of the country if it surfaced that Michelle and Barack Obama were ever involved in such an event. And when a baby in Chicago was delivered accidentally to the wrong mother in the middle of the night in a hospital for a feeding, the mother who nursed the baby sued, despite the absence of any resultant health consequences for anyone involved, she found the incident so upsetting.

Before formula, a friend or acquaintance acting as a breastfeeding surrogate, or a formal wet nurse were the most realistic and healthful options when, for whatever reason, a baby could not receive breast milk from his or her mother. And while it is still wonderful when we have formula when no other options is available, it is bizarre that the existence of artificial milk has all but eliminated the practice of cross-nursing even for necessity, much less convenience or assistance.

I have only seen personally of one friend who nursed her niece when babysitting her on afternoons when her sister-in-law attended a class. And a best friend and single mom became quite ill with the flu, I offered to take her two daughters, and nurse her one-year-old if she became to sick to handle them (this did not become necessary). In both these instances, even as an avid breastfeeding advocate, I had to struggle with an inexplicable aversion to this idea, so ingrained is this taboo in our society.

The reality is, if practiced between mutually consenting mothers (presumably friends) both of whom are aware of and honest about and infectious disease status and aware of any probable or potential effects of diet on the other baby, there is realistically likely little or no physical risk to cross-nursing. As with many things, it it lacks any sort of the societal or organizational support (even by La Leche League) because of the vague possibility of a problem, and the resultant liability for anyone who recommends it.

As such, as a health professional, I can not practically recommend cross-nursing myself. But I suspect if the insane liability aspect were removed from the equation, I suspect more doctors and professionals could provide mothers with counsel on this issue based upon actual statistics and science instead of fear and legal sidestepping. And with formula such an easy work-around, it seems ridiculous to take the risk.

However, I will say that formula use has documented risks and significant deficiencies as compared to breastmilk, though they are usually well-masked from being considered as such in favor of the notion that “breast is best” rather than then equally true “formula is worse.” Any mother considering cross-nursing or formula use should make that personal decision based upon their own knowledge and beliefs on the respective costs and benefits.

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