Old advertisement depicting a woman seated at a table, wearing a robe and holding an infant. There is a beer on the table

The Magic Liquid that Guarantees the Life of the Infant: Breast Milk as a Superfood

“Try squirting milk on that.” I stopped keeping track of how many times someone recommended healing my newborn’s ailments with a direct application of breast milk. From the time my husband cut a nail too short to a slightly more serious case of pink eye, my friends and family had come to regard breast milk as a superfood akin to coconut oil and goji berries. They weren’t alone. Breast milk’s status as “nature’s original superfood” has led to informal markets catering to adult consumers such as weight lifters looking to build muscle mass and others eager to boost immune health. Anti-vaccination advocates tout breast milk’s antibiotic properties as an additional reason parents can shun what are proven and safe means of preventing disease.

Our tendency to conflate “natural” with clean and healthy could obscure the profound risks of unregulated breast milk sales, not the least of which is the potential to spread HIV. Breast milk’s known antibiotic properties, meanwhile, do not extend to all vaccine-preventable diseases, such as measles.

The presumption that breast milk can prevent illness beyond infancy and position kids for later success, though unproven, can also raise anxiety and depression in new mothers who struggle with nursing. By unreservedly embracing breastfeeding’s benefits we risk erasing maternal wellbeing from the childcare equation, reenacting very old ideas about maternal sacrifice in the twenty-first century guise of superfood.

But why and how did we begin to think of breast milk in terms of nutrition? The answer, in part, dates back to the early twentieth-century Philippines when researchers began studying the composition of breast milk. They were concerned, however, to learn not what made breast milk healthy but why breast fed infants were dying at alarming rates.

A picture depicting Emilio Aguinaldo wearing an official uniform and holding a bottle of tiki-tiki extract
Undated ad depicting Emilio Aguinaldo holding a bottle of “tiki-tiki extract.” Aguinaldo was the president of the first Philippine Republic (1898). Though he came to have a good working relationship with the United States, this advertisement demonstrates the close links between maternal health, infant mortality, and the nationalist movement. (Benito Vergara, Panna Melizah Idowu, and Julia Samungil, Tiki-Tiki: A Simple Cure for Beriberi (Island Publishing House, Inc., 1998), cover.)

Approximately 47% of deaths in the capital of Manila were children aged under one year old in 1907.1 Most of the deaths were attributed to an infant suckling disease called taon or suba, Tagalog for “year” and “convulsion,” respectively. That breast-fed infants appeared to fare worse than supplemented infants led many Filipinos to fear that breast milk caused taon, though they didn’t know how. Philippine physicians, many of whom had ties to the nationalist movement, initially understood taon as a symptom of Spanish and later American colonialism. According to one pediatrician:

It is a single fact unparalleled in the history of medicine that human milk as a food appears a scourge to the Philippine infant, an inverse phenomenon to the experience of other nations where human milk is the strongest bulwark of child hygiene, the magic liquid that guarantees the life of the infant.2

Supplemental feeding was, quite literally, a way to build a modern nation. Filipino physicians and prominent Filipinas founded La Proteccion de la Infancia in 1907. The organization provided poor women with cow or goat milk. As a later iteration called Gota de Leche implied, just “a drop of milk” could save Manila’s infants.

American doctors in the Philippines saw infant mortality — not health — as natural. The first US study on breast milk conflated breast size with milk capacity and quality with race, concluding that the “average Filipino woman is poorly developed” and “usually [has] small breasts, so that the milk giving capacity is at a minimum.”3

Americans also rejected supplemental feeding on the basis that Filipinas were too ignorant, their houses too dirty, and public water too compromised for safe bottle-feeding. The “germ infected nursing bottle,” warned an army physician, was a bigger threat to infants than taon.4

The nascent science of nutrition eased this impasse. Filipino doctors, building on Japanese research, theorized that taon was actually an infantile form of “beriberi” — a severe thiamin deficiency caused by overreliance on mechanically milled rice (the process removes the vitamin-rich pericarp). Lactating women who were thiamin deficient but not symptomatic weren’t able to replenish the reserves of their newborns, which ran out at around 6-8 weeks old.

Unable to metabolize carbohydrates, nurslings went into cardiac arrest. It was a harrowing and decidedly unnatural result of food scarcities caused by colonial trade and warfare. Far from a superfood, breast milk embodied inequality.

Yet the methods Americans used to study breast milk still treated women as little more than disease vectors. In 1912, the chemist Vernon L. Andrews sent an army of assistants into Manila’s poorest neighborhood in search of still lactating women who had lost infants to taon. They asked these women to take newborn puppies home, keep “them warm and comfortable,” and “put them to the breast every two hours.”5 The puppies were checked for signs of beriberi and autopsied after death.

Inter-species nursing was not unprecedented; in 1825, an American physician advised expectant women to nurse puppies in their eighth month of pregnancy to prepare their nipples for birth and improve milk flow.6 But the practice had fallen out of favor in the US by mid-century. For Americans who viewed Filipino homes as germ havens, however, expression into bottles risked the purity of their samples. Asking poor Filipinas to nurse puppies was convenient for researchers, and a mark of the low regard in which they held them.

Old advertisement for tiki-tiki extract showing a pencil drawing of a medicinal bottle and a doctor wearing a breathing mask showing a newborn to a woman in bed
Undated ad for “tiki-tiki extract.” Philippine pharmacist Manuel Zamora created the tincture from thiamine-rich discarded rice hulls. Despite the modern setting depicted here, health clinics distributed the extract to poor urban and rural women throughout the 1920s and 1930s.

The women who participated speak to us only through Andrews’ research notes. He claimed to find “most of them … willing to comply with the request without any recompense whatsoever.”7 Their actions suggest otherwise. Some women said the puppies died for lack of milk, and others “were unwilling to proceed further with the experiment” after a week. One woman refused to nurse a puppy too young to have its eyes open. Out of approximately 20 participants, only four nursed for one month or longer.8 It was enough for Andrews to conclude “that the condition described as infantile beriberi is due simply and solely to the ingestion of the mother’s milk.”9

Philippine women and men took over the colonial health bureaucracy and pioneered methods to fight infantile beriberi and improve maternal health in the 1920s. Child health clinics distributed tiki-tiki, a tincture made from discarded rice hulls, to poor urban and rural mothers. The clinics also provided tutoring on nutrition and encouraged women to plant kitchen gardens. They are a testament to the fact that successful nursing and “healthy milk” requires social and economic support. Yet as a San Miguel beer advertisement boasting the milk-boosting benefits of its dark ale demonstrates, women’s anxieties about the quality and quantity of their milk persisted until thiamine-enriched rice and bread became the norm after World War II.

Our understanding of breast milk as a superfood stems from the revolution in nutritional knowledge of which these studies were a part. But by losing site of the crisis in infant mortality precipitating this research and of the women who participated, we tend to assume breastfeeding is purely natural, and breast milk always beneficial. Keeping these women and Manila’s lost infants in mind should remind us that intimate practices are political, and that support for mothers may yet be the best way to guarantee infant health.

Notes

  1. George Richmond and William E. Musgrave, “Infant Feeding and its Influence Upon Infant Mortality in the Philippines,” Philippine Journal of Science 2, no. 4, 362. Return to text.
  2. Jose Albert, “La Mortalidad infantile en Filipinas comparada con la mortalidad infantile en Europa y de los Estados Unidos,” Bulletin of the Manila Medical Society (November 1910), 1-6, cited in a 1935 reprint of Albert, “Studies on Five Hundred Fourteen Cases of Infantile Beriberi,” The Philippine Journal of Science 45, no. 2 (1931), (General Printing Press: Manila, 1935), 1. Return to text.
  3. George Richmond and William E. Musgrave, “Infant Feeding and its Influence Upon Infant Mortality in the Philippines,” Philippine Journal of Science 2, no. 4, 364. Return to text.
  4. Major E.C. Carter, quoted in Richmond and Musgrave, “Infant Feeding and its Influence Upon Infant Mortality in the Philippines,” 363. Return to text.
  5. Andrews, “Infantile Beriberi,” 81. Return to text.
  6. See Samuel X. Radbill, “The Role of Animals in Infant Feeding,” in Wayland D. Hand, American Folk Medicine: A Symposium (Berkeley: University of California Press, 1976), 21-30. Return to text.
  7. Andrews, “Infantile Beriberi,” 81. Return to text.
  8. Andrews, “Infantile Beriberi,” 81. Return to text.
  9. Andrews, “Infantile Beriberi,” 84. Return to text.

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