Psycholog ic d iffere and bottle feeding1

Ni/es Newton2

nces

between

breast

It is a common

assumption

in our

society

today that the bottle-fed baby held in his mothers arms is receiving an experience emotionally and behaviorally equivalent to that of breast feeding. This culturally determined belief has become so prevalent that current research may omit consideration of lactation as one of the pertinent variables.

baby, dependis used. For this reason, before analyzing the various specific aspects of breast feeding, general patterns of breast feeding will be described to clarify the nature of the phenomena discussed.
different ing on which breast feeding style Unrestricted breast feeding. Unrestricted

for

both

mother

and

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For instance, Bowlby 1969 book, Attachment

in his comprehensive and Loss (1), covers

in an extensive manner the problems of the early mother-child relationships. Yet the index contains no reference to breast feeding, lactation, or nursing. There is, instead, much reference to sucking, a word that applies equally to both breast and bottle feeding as if they were psychologic equivalents. The purpose of this paper will be to examine the hypothesis that breast and bottle are psychological equivalents, drawing on empirical data gathered from the whole range of behavioral science from the psychophysical to the psychosocial. Special caution should be used in considering the results of the many statistical
associative involves and bottle respects. feeding ure may studies. Because a large measure of it are is related to breast personal attitudinal feeding choice and

breast feeding proceeds without rules that materially restrict sucking. The infant is helped to the breast whenever he cries or fusses. He usually sleeps in the same bed as his mother, or at least in the same room, so that he has easy access to the breast during the night. In the daytime he is carried around by his mother close enough so that his crying can be quickly quieted by sucking. There are typically ten or more feedings a day during the early weeks, gradually diminishing to about five to six feedings a day during the latter half of the 1 St year, although more are given when the baby feels fretful,
strange, or upset for any reason. No bottles

are add
the

given to the baby. significant amounts

infant can and begin swallow

Other foods begin to of calories only after

solids easily without the readicontinues

because feeders

gagging, ness to

when teeth indicate to chew. Breast milk

personality

factors,

no
likely

groups
to be

of
equal

breast
in of but

and
other breast meassimply core-

to be a major source of nourishment infancy into early childhood.

beyond

Therefore the to any particular not be cause due this to and other reason,

relation psychosocial effect,

This

type

of breast

feeding

has been

prac-

the differences variables. For

uncontrolled infrahuman

search will be mentioned when pertinent, because research designs using nonhuman mammals can be sufficiently controlled so that the effect of lactation on behavior can be studied. Patterns of breast feeding

ticed by most preliterate, preindustrial, and historic cultures, to an extent which those of us who live in token breast-feeding cultures, have difficulty visualizing (2). For instance, an American pediatric textbook in 1906 (3), an era when unrestricted breast feeding frequently occurred in the United States, recomSupported in part Professor, by the John R. and of Doris J.

Haire
2

Associate

Foundation.

Division

Psychology, UniverAvenue,

Breast feeding is practiced in such diverse ways that its emotional impact may be quite
The American Journal of Clinical Nutrition 24:
AUGUST

Department sity Medical

of Psychiatry, School, 303

Northwestern East Chicago

Chicago,
1971,

ill.
Printed in U.S.A.

pp. 993-1004.

993

994

NEWTON

mended

diminishing

ten nursings a day for the 1st month, gradually to six nursings a day during the otn to 1 Ith months. Nursing every 2 hr was still commonly recommended in England around 1915 (4). Weaning comes late with unrestricted breast feeding. A study of 46 preliterate cultures disclosed that 3 1 of them weaned
infants

likely
sides

to have
Oreast

had
milk.

found
snouici

that

44

much other sustenance beA survey ot 49 ptiysicians ot them believe breast feeding
(1 1). Ifle custom oi

De supplemented

beginning

at

or

years were

of reported,

age,

whereas
No

only

I 3 began
around

weaning
1 year

at 1 8 months.

weanings

but one preliterate society weaned at 6 months and none before this (5). Another example comes from the traditional culture of Pakistan where a study of 127 babies aged between 18 months and 2 years revealed that every one of them was still getting some breast milk (6). Even in the United States between 19 1 1 and 1 9 1 6 studies on over 22,000 city babies indicated 58 % were breast fed in the 1 2th month of life (7). Token breast feeding. Token breast feeding is characterized by severe limitation of sucking by social customs from the day of birth to the day of eventual total weaning, which usually occurs within a few weeks. There are rules restricting the number of feedings, the duration of feedings, the amount of time between feedings, and the amount of mother-baby contact that stimulates the urge to suck. Infants and mothers are frequently housed in different rooms. Sleeping in bed with the mother is considered dangerous. The strength of the infants breast sucking is urnited by teaching it bottle sucking techniques, by dulling the appetite with glucose, water, formula and semisolid foods. The practice of feeding the baby by the clock may result in a baby too worn out with crying to suck well, or a baby too sleepy to show persistent strong sucking. in addition, excessive engorgement of the breast due to the restricted sucking causes the grasp on the nipple to be tenuous, or may block the babys nose. In certain cases medication given mothers during labor adversely affects the infants ability to suck adequately for several days, thus further limiting sucking during the crucial phase of lactation (8, 9). Such severe sucking limitations lead to failure to establish a secure milk supply and total weaning usually takes place within weeks (10). Even during this brief time the infant is

teedmg cereat at a very early age regarwess of ieeuing method may be very common. Of the inlants studied in one recent survey, /9.4o received cereal by 1 month ot age (II). Token breast feeding is the most common pattern of breast feeding in some fully industrialized countries, and is closely related to total artificial feeding. For instance, a recent sample of all women (1,476) delivered at a umversity teaching county hospital in a Midwest low income city neighborhood indicated that 1 1 % of the mothers tried to breast feed. Of those who tried to nurse, 69% gave up breast feeding within 4 to 6 weeks after
delivery (12).

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The longer,

partial
mothers months their before

occasional mother who does nurse still usually appears to practice only breast feedmg. Of a sample of Boston who nursed their babies for three or longer, 70% also gave bottles to babies, and 7 1 % introduced solid foods the baby was 3 months old (13).
differences

Maternal

The difference between the non-nursing mother and the breast feeding one depends in large part on the type of breast feeding practiced, although some measurable differences occur even between mothers who plan to breast feed and those who do not. These differences occur in the area of initial experience, psychophysiologic reactions at the time of nursing, long-term psychophysiologic reactions,

maternal

behavior

and interests,

sex-

ual behavior sonality and tions.

Initial

and attitude adjustment,

toward men, perand social varia-

In American culture and in other societies in which artificial feeding is the customary way of feeding a baby, the initiation of bottle feeding is likely to be the least stressful for the mother. She is conforming to cultural expectations. The formula is available in adequate quantities at all times, and the rubber nipples usually allow most babies to withdraw milk quickly and in amounts satisfying to the mother. In contrast, the initiation of token breast
experience.

probably

PSYCHOLOGIC

DIFFERENCES

995

feeding may leave the mother feeling madequate and in severe pain (14-17). The babys failure to suck well may be felt by her to be a rejection of her by the baby. These feelings become compounded when an insufficiency of milk supply becomes apparent. The sensitivity of the breast region makes nipple lesions and engorgement markedly painful.

menstruation breast feeding

extent frequently

(24, 25). However, stops the menstrual

not recognized

unrestricted cycle to an
in artificial

feeding

These occur with regularity when sucking is restricted. The initial experience depends, of course, on the cultural surroundings. Artificial feeding for a village baby in Egypt or India is reported to be a virtual death sentence (18, 19), so in this case it has a totally different emotional impact on the mother. Initiating
unrestricted experience tions ing. that this breast when is the feeding there only can be an easy

Nigerian women who nursed on the average of 1 8 to 22 months found that they experienced their first menstrual periods on an average of 16 months after delivery (26). In non-nursing women, menstruation is reported to appear on the average of 55 to 58.9 days after delivery (24, 27).

cultures.

study

of

374

Other as physiological fully lactating

are
way

cultural
to do during

expectait.
nurs-

Psychophysiological

reactions

yet not fully identified psychodifferences probably exist. The woman may be subjected to the effects of repeated high levels of prolactin and oxytocin, which may trigger other physiological changes with psychological effects. Research with animals suggests that such difference between lactators and nonlactators may be extensive. Thoman and her co-workers compared lactating and nonlactating rats

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In feeding,
breast unique

regard to reactions during a typical the mother practicing unrestricted

feeding situation. is psychophysiologically Her nipples are stimulated in a

in

by the gentle stroking of the babys sucking over a long period of time. The responsiveness of this area is indicated by the fact that when nipples and breasts are involved in sexual foreplay, some women experience orgasm (20). During unrestricted sucking the stimulation is usually gentler, but it occurs probably around 3,000 to 4,000 or more times in the
course so the of a fully cumulative unrestricted effects of lactation cycle, the experience

their resistance to various stresses (28, 29). Lactators showed a suppression of adrenocortical activity in response to ether and pentobarbital anesthesia, surgical trauma,
and electric shock. They were also uniquely resistant to disruption tion usually produced thesia.

of temperature by pentobarbital

regulaanes-

The psychologic significance summarized by Thoman (28) The present experiments do

there pears is a unique to

protect

may be appreciable. In addition to receiving the sensations of sucking, the mother

a generalized ture of the body response. The

pleasurable experiences
tempera-

large variations process of lactating. considerable

of this is who states, indicate that buffering system which apthe lactating female from in responsiveness during the
Inasmuch as there which exists indicates

information

mammary skin rises (21), and the uterus contracts rhythmically (22). Only mothers who experience these generalized lactation reactions are likely to continue to full breast feeding. Failure to have a sufficient rise in mammary skin temperature (21) and uterine contractions, perceived as uterine pain on nursing on the second postpartum day (23), has been shown to be related to failure to produce adequate supplies of milk. Long-term psychophysiologic reactions. In addition to specific sensations and reactions at nursing time, the woman practicing unrestricted breast feeding is not subjected to the
mood cycles connected with ovulation and

that maternal factors have profound and longlasting effects on the psychophysiological function of offspring in adulthood, the existence of such buffering systems in the lactating females would appear to be of importance in the mother-young interaction. Maternal interests and behavior. Maternal interests and behavior are related to lactation to some extent, but the relationship is selective and does not affect all caretaking behavior. Mothers rated as greatly pleased at the first sight of their babies later significantly more frequently reported to another investigator a desire to breast feed more frequently than mothers judged indifferent or disgusted in the delivery room (30). Rat-

996

NEWTON

ings of mothers behavior at breast feeding time in the hospital were found to be highly correlated (0.648) with their maternal interests, as disclosed in a lengthy interview (10, 3 1). Two investigations involving the questioning of nulliparous women in pregnancy about feeding choice, reported that bottle feeding choice was significantly correlated with mother-centered reasons for feeding choice, whereas those planning to breast feed tended to give reasons concerning the welfare of the baby (32, 33). Studies concentrating on the behavior of mothers of older children with past attempts to breast feed indicate that the type of feeding practiced may be a factor. Freemans (34) study on mothers of children who had breast-fed infants 1 year or more as cornpared with those nursing 1 month or less found markedly higher levels of overprotection in the prolonged breast feeders and
rejection in the token breast or bottle feed-

consistently demonstrable relation to lactation. This type of behavior is manifested by virgin females, intact males, castrated males, ovariectomized, hypophysectomized, and mammectomized females (38-43). However, in tests in which barriers were placed between the lactating mother and her offspring, she made vigorous efforts to reach them, comparable to her efforts to reach food and water when hungry and thirsty and greater than her efforts to reach a male while she was in heat (44, 45). A recent study (37), more extensively controlled than previous ones, involved placing

adoptive

litters

with

pairs

of females,

both

of
Downloaded from ajcn.nutrition.org by guest on April 10, 2014

ers. Two more on populations largely of the

ference significant

recent studies have been where breast feeding

done was

token
only
of

kind.
at the

One

found

no dii(35)

the
was

others
in the

found
area

0.05 level one difference,

of

and which

acceptance

sexuality

attempt to control the social variamay compound differences between breast feeding and bottle feeding mothers, Newton et a!. (37) formed pairs of mothers matched for parity and educational level but differing in breast feeding behavior. All were drawn from the same obstetrical practice and were studied at the postpartum check-up. One member of the matched pair was breast feeding totally without supplements and the other was feeding the baby totally artificially. Significantly more breast feeding mothers stated they sometimes or often slept or rested in bed with the baby (71 % versus 26%). No significant differences were found on three other items of reported behavior. Recently, much carefully controlled animal behavior research has concentrated on caretaking behavior, particularly in relation to hormonal stimulation. Nestbuilding and simple retrieving, licking, and crouching over the young are types of behavior often defined as maternal. These appear not to have a

(36). In an bles that

whom had delivered within the same 24-hr period. One of the adoptive pairs of mothers had had all her nipples previously removed, whereas the other had received a sham operation. The behavior of the lactating mouse toward the adoptive pups was compared with the behavior of the nonlactating mouse toward the same pups. The lactators significantly more frequently crossed an electric grid to get to their pups, and significantly more frequently tried to burrow under an inverted sieve that contained their adoptive pups the first two times they were placed in this situation. This is in keeping with the cross-cultural observations (2) and the statistically matched pairs study in humans (37), suggesting a greater drive for body contact in the lactating female. The possibility that operant conditioning may be a factor involved, as well as possible hormonal differences, should be considered. Sexual behavior and attitude toward men. Breast feeding behavior and attitudes may be allied to sexual behavior and attitudes toward the opposite sex. Milk ejection has been observed during sexual excitement in women, with the amount of milk ejected appearing to be related to the degree of excitement (46). Masters and Johnson (47) noted that nursing mothers, as a group, were interested in as rapid a return to active intercourse with their husbands as possible. Sears et al. (36) found mothers who breast fed were also significantly more tolerant of sexual matters such as masturbation and social sex play in their children.

PSYCHOLOGIC

DIFFERENCES

997

More

general

attitudes

toward

men

may

also be related ing. The feeling fying time in

to acceptance of breast feedthat men have a more satislife is more often voiced by

sion The
siveness

and in other situations may traditional belief concerning

of the feral mammal in

show more. the aggresdefending

feeding than by feed. This statistically significant attitude relationship was initially found in postpartum mothers by Newton (48) and later reported in nulliparous expectant women by Adams (32). Personality and adjustment. The mothers
personality lifes situations and her may general vary with adjustment her choice to of

women women

preferring wishing

artificial to breast

her offspring was recently measured in laboratory mice. The lactating mice showed increased defense of the nest as compared with other groups (39). However, the lactating female is also reported to be less aggressive toward members of her own species. Lactating hamsters were markedly less likely to attack and eat pups presented to them than nonlactating hamsters (52). A recent study (29) on
lactating rats found that it was significantly

infant feeding. A recent study (49) on 60 mothers followed from the time of birth of their firstborn until the baby was 6 months old found that significantly less neuroticism
was breast cant of time manifested feed. inverse breast In by addition, feeding relationship mothers there who was and chose a signifito

more
rats,

difficult
using

to
electric

induce
shock

them
to

to fight
stimulate

other
fight-

ing.

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Social
is sensitive social

variations.
to even American milieu.

Breast
minor and

feeding
variations British

behavior
in studies the

between
continued

the

length
the ex-

tent of the mothers neuroticism. Another recent report (50) from England indicates that significantly more mothers who practiced artificial feeding were smokers, as compared with mothers who breast fed their infants. Earlier psychological work concentrated on mothers plans to breast feed rather than mothers (32) choosing nancy They turbed test, choosing with actual behavior in this area. Adams

(10) have usually found high social status favors breast feeding, but this does not appear to be true in Brussels and Paris (53). Those of the very lowest social groups, like those of the highest, are sometimes reported to have higher breast feeding rates than the middle groups, but this is not always true (10). The relationship is extremely complex, so that all that can be said with assurance
is that breast feeding patterns are often linked

found
to

in
bottle

her

interviews
feed responded more

that

women to pregdisgroup (51),

significantly eight with breast feed. found one

dependency.

also showed behavior on as compared to

significantly
items item Brown for

more
of the et the al.

Blackey

to social class, but the way in which they are linked depends on the location and the period of history when the data were collected. In addition, small variations in social environment may make marked differences in
breast feeding behavior. For instance, a na-

working
lower ference

with
social that

women
classes, crossed

from

the

higher

and
dif-

a personality

class lines. Both

clinic

and private patients showed significant differences in the Fc response on the Rorschach the

mean that feed placed more importance on the exchange of affection with other people than the mothers choosing to bottle feed. Newton (48) found that women who expressed negative feelings toward breast feeding also tended to express them about birth, and did in fact, if they were primiparae,
mothers choosing to breast have under longer some labors.

test.

This

may

be

interpreted

to

United States survey done in 1966 (54) revealed that only 49 and 50% of the babies in Utah and Oregon were reported to be totally bottle fed when they were discharged from the hospital, whereas in Vermont and Rhode Island the percentage was 86 and 88%.
Infant differences

tional

The psychological differences between breast and artificially fed infants will be discussed in relation to initial experience, assuagement of hunger, mother-baby interaction, oral gratification and oral sensation,
learning adjustment. and The activity, and personality

In infrahuman

situations,
circumstances

lactating
show less

females aggres-

and
prac-

type of breast

feeding

998

NEWTON

ticed, whether token to be an important

as it is for the mother. Initial experience.

or unrestricted, variable for

appears the

down.
feels

infant,

tural

Under these circumstances, heavy and ready for sucking. studies suggest that typically
which unrestricted crying in infants

her breast Cross-culin socieis

The initial feeding experience of the totally artificially fed infant may be smooth and easy. Even when his sucking reflex is somewhat inhibited by medication given the mother during labor (8, 9), the rubber nipple delivers milk with little
effort on his part. The initial nursing of un-

ties in practiced,

breast feeding is not tolerated

restricted breast feeding usually occurs easily if the babys sucking reflex has not been inhibited by maternal medication in labor. Those permitted to nurse soon after birth took significantly less time getting breast feeding started and lost significantly less weight than those whose first feeding was delayed 24 hr or longer (55). Token breast feeding frequently involves struggles to get the baby to suck, during which he cries at the breast while the distraught mother repeatedly tries to get him to take hold. Grasping the overdistended breast pushes the babys upper lip against his nose, thus shutting off the air supply and teaching him to fight the breast (56). Assuagement of hunger. Breast and bottle feeding involve different patterns of assuagement of hunger needs, which may be acute during the early weeks of rapid growth. The artificially fed baby born to middle-class parents is usually sure of a dependable formula feeding sufficient in quantity and of the same composition time and time again. Inherent

even for a few minutes (2). Token breast feeding, on the other hand, may result in frustrating irregularity in food supply. One measured characteristic of the mother who ends up as an unsuccessful breast feeder is greater variation of milk obtamed from the breast from one feeding to another (23). Sometimes the milk may come
gushing out choking the baby when his reflex

mother
times is

has
when

a vigorous
she and is tense, only

let-down,
her approximately

and
ejection

at other

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inhibited,

one-

half
breast assuage

the milk
Mother-infant feeding hunger,

in the breast
interaction. the but breast also

is available
is used, to assuage not

(23).
only all types to

In unrestricted

of discomforts and fears. It matters upsets the infant, any distress signals swered by mouth-nipple contact

not what are anand body

contact older,
the move

with his mother. his whole body can

situation. the and with the rhythm feeding mother His with

As the be seen
toes and

baby gets to react to

feet may

nursing

of sucking.

In
sucking along

unrestricted

breast
are as one

feeding,
regularly united

comfort
presented total ex-

perience. dividualized
els this would

This
has

may tend attachment.

been studied

to foster a strong On infrahuman

by and fed subjecting

in1evrat

in the

feeding

process

is either

the

need

to

pups
they mother, given

to a rotation
be cared the next them that

of mothers
for day had a substitute just been

(57).
by

One
their

day
own was from

wait while the bottle is warmed or the experience of inbibing cold formula. The artificially fed baby born in poverty rather than in affluence may experience real hunger or radical changes of food if the family consumes the usual food supplies. The
unrestricted breast-fed baby, born in pov-

mother removed

her own pups. With died, and those that

less weight than pups

this treatment lived gained

erty, on the other hand, may not experience the same type of deprivation, as severely undernourished women in times of famine

mothering. The pups showed significantly after stress.

more pups significantly that had no changes in with rotating mothers increased emotionality

often manage to feed their babies well (J. K. Harfouche, unpublished observations). The unrestricted breast fed baby, whether
born in poverty or affluence, has warm milk available within seconds. His mother also may have a physical urge to suckle him once his hunger noises have triggered her milk let-

In token breast feeding and bottle feeding, nourishment and comfort sucking are often split and experienced away from the mother. A pacifier detached from any human being may be sucked. More often the sucking turns inward toward a thumb or finger. The token breast ally sees feeding her or function bottle feeding as holding mother the baby usufor

PSYCHOLOGIC

DIFFERENCES

999

feeding sucks holding from ing. own becomes is his the As

purposes. thumb a baby breast the even baby holding less or while in

Holding pacifier he gets unrestricted older the likely. baby

a baby is not

while as likely

he as

comfort sucking breast feedand can during in older the his hold feeding solitude baby his

gets

bottle, a frequent

Sucking for

experience

not

breast
at close

fed
able

in an unrestricted
to manage

manner.
own sucking

He

becomes needs behavior cially

The breast-fed infant appears to develop more interest in sucking. Neonates were tested on a standard sucking test for 10 days. Breast-fed infants showed significantly longer sucking responses from the 4th day onward (61). The differences in sucking techniques may result in babies emitting different types of noises. Applebaum (personal communication) has tape-recorded these early nursing
songs which occur toward the end appear of feed-

a time when growing may indicate acute needs to the mother.

attachment to be espe-

ing
soft,

time

when

the

baby

is relaxed.

These
to be

contented

vocalizations

feeding does not always assure a comfortable relationship with the mother. Kulka et al. (58) analyzed motion pictures of 1 2 babies nursed under experimental conditions on were resulting both with EKG baby and and EMG mother. recordings Some taken mothers

Breast

quite different rubber nipple able to make.

to the spontaneous

from the sound a baby in his mouth appears The nursing songs are
noises sometimes

with a to be similar

Downloaded from ajcn.nutrition.org by guest on April 10, 2014

made

able

electrical
mothers tions. One

environment with slow heart rates and little recorded activity of muscles, whereas other
held their mother babies held the in awkward posi-

to forget

their

during coitus. There is also a difference in regard to anal experience. Breast milk stools are always soft. Sometimes they are passed several times a day but other times they may accumulate for several days before a large
passage which is still soft. Cows milk stools

two
bys

fingers,
head and

another
a third

did so that

not

babys support
her

neck the
fingers

by bainto

pressed

the

were produced. These infants and mothers had high EMGs. On the infrahuman level, when four rhesus monkeys grew up bottle fed and
away mal from maternal a mother, behavior they when developed they abnorthemselves

babys

skin

indentations

possibly resulting in anus and/or straining. Activity and learning. The breast and artificially fed infants may develop different activity levels by the 3rd and 4th day of life.

are often quite more stretching

solid, of the

At this age the breast

stronger arousal reaction

fed showed
to being

significantly
awakened

became

mothers.

Two
fairly closer by

of

the

mothers

did

eventually permit their apparently were (59). Oral accompanied gratification

frequent maternal more and anal

nursing, but relations violent abuse

sensations.

for anthropometric examination (62). In another study (61), there was found to be slightly but significantly more general body activity in the breast-fed infants by the 6th day. This propensity toward activity may also be shown in an early age of learning to walk.

Analysis
indicates tween breast sion

of
only breast feeding

the

details
superficial

of

sucking
resemblance

motions
be(60). The a compres-

An

early

American

study

(63)

on a popula-

and bottle sucking infant sucks with

action
He backward back

of his lips,
thrusts into his as the the

gums, nipple
posterior

and
first

cheek
forward

musand

cles.
then pulled

tongue

and

areola
oral

are

cavity.

The rubber nipple requires a tugging response, flanging the lips into a large 0 and relaxing the cheek muscles. The large rubber nipple interferes with the action of the tongue which moves forward to control
the flow of milk into the esophagus.

tion in which breast feeding for over one year still was prevalent reported a difference of almost 2 months between age of walking of the artificially fed and breast fed. Almost 20 years later in Great Britain (64), a study using a national sample found a correlation between duration of breast feeding and age of learning to walk, which did not disappear
when babies of working mothers, overweight

and
when

underweight
different

babies
weight

were
groups

excluded,
of babies

and
were

considered weaning

separately. The average date from the breast in this population

of

1000

NEWTON

was
walking

about
dates

months.
of breast

The
and

differences
bottle fed

in
in-

fants were much smaller study, although significant. Hoefer and Hardy (63)
382 Joliet, illinois,

than

the

earlier

intensively
in

studied
an era

schoolchildren

when
breast 18 %

39.9%

of them

experienced

exclusive

feeding for one year or longer and only were breast fed less than one month.

lated to the amount of social learning required (68). Marked differences exist in the duration of nursing in aquatic mammals. The mysticetes are simple grazers of the sea, whereas the odontocetes exhibit a complex social structure, cooperation in herding schools of fish, and a sophisticated navigational training. The mysticetes nurse 7 to 10.5 months, whereas the odontocetes nurse

The Stanford achievement test, Pintner terson performance scale (a nonverbal and the revised Binet-Simon intelligence
were
scores

Pattest), test

18 to 25 months.
Personality and adjustment. A number of researchers over four decades have studied the statistical association between breast feeding in infancy and later personality and adjustment.

given.
in relation

The

groups
to their

were those exclusively months. Of the breast

with the highest age on all these tests breast fed 4 to 9 fed, 4.9% had IQs of

1 30 or above,

whereas

none

of the artificially

fed received ratings this high. There was a definite dip in scores for those who remained exclusively on the breast beyond 9 months of age. Paralleling increased death rates for infants not permitted other foods besides breast milk in the latter part of the 1st year
(7), the children fed exclusively by breast

Three extensive studies based on children nursed at a time when some unrestricted breast feeding still occurred indicate that the relation of breast feeding to adjustment may depend on the behavior of the mother and the vulnerability of the infant, if weaning comes early after a breast feeding attachment has developed.

Downloaded from ajcn.nutrition.org by guest on April 10, 2014

after

9 months finding
that

had

scores on learning

lower ability
may

than

the

In 1946, (69) reported

lyn
were

Maslow on their

and Szilagyi-Kessler work with 416 Brook-

artificially

fed (63).

A recent
(65) indicates crucial than

in rats
be more

weaning

age

believed. Male rats were weaned at 15, 16, 17, 25, and 30 days of postnatal life. Rate of elaboration of conditioned reflexes at 8 months and stability

previously

of memory

traces

at 1 2 months

were

stud-

ied. The 30-day weaned conditioned reflexes more firmer memory traces than

group elaborated quickly and had any of the other groups. Those weaned as late as day 25 resembled the 15-day old weanlings more than the 30-day old weanlings. Biochemical work is beginning to give an indication of why learning and feeding may

College students, most of whose mothers foreign born. One hundred fifty-six students were breast fed 9 months or longer and only 42 were totally bottle fed. A curvilinear relationship was found. Those with the lowest security scores were breast fed around six to nine months. The most secure, as measured by a security test, were those breast fed more than I year, and those breast fed 3 months or less, or not at all. The researchers pointed out that there
were shame many in the statements mother who indicating could not guilt breast or

be

related.

Extensive

research

from

many

laboratories tionship

cumulatively indicates between malnutrition and

the relabrain de-

feed her infant. We may expect, therefore, that such mothers would often attempt to make it up to the child. A recent infrahuman study (70) tends to confirm this interpretation. Mice whose offspring have been exposed or earpunched were observed to give
three fants to that four times as much care to the in-

velopment
cystine may

(66).
be

The
an

most
essential

recent
amino

finding
acid

that
for

had

been study
some

stressed by

than

to the conand Hamil

the
cystine brain

immature

human

may

be

pertinent,

as

trol
In (71),

group.
another involving Childers breast

may be physiology.

particularly Cystine

important in is high in human

milk and low in cows milk (67). From biological sources comes tion that the duration of lactation

the suggesmay be re-

feeding long enough to be considered unrestricted, an analysis was made of 467 cases from a neuropsychiatric clinic, of whom 137 were breast

PSYCHOLOGIC

DIFFERENCES

1001

fed 1 1 to 24 months or longer. Undesirable behavioral manifestations were generally greatest for those weaned between the 1st and 6th month of infancy. The group haying fewest problems were those nursed 11 months or more. The dip in desirable characteristics of those who received some breast feeding, but

breast which
quantity,

feeding breast
since

was present, or feeding remains

no mention

in studies in an unknown
of how

is made

no long-term
some
seems

experience,
to
that

may

be related
experience.

in
It

way
likely

the
the

weaning
close

psychophysiologi-

cal interaction involved in lactation may develop strong attachments in the baby exelusively breast fed for some months, which may result in considerable emotional upset at breast denial, especially if the baby was

much and what kind of breast feeding was received. A recent review of the extensive literature by Caldwell (73), as well as a recent paper by Davis and Ruiz (74), indicated the relationship appears to be ambiguous. Both desirable and undesirable correlates of breast feeding have been reported, along with other extensive studies that found no evidence of association.

Perhaps
total feeding

if more

emphasis

were

placed

on

too

young

to handle

other

foods

easily

and

well and if the weaning was sudden. A more recent study on maternal separation behavior noted that about the time the baby was 3 months old American mothers breast feeding their babies were particularly likely to feel oppressed. Abrupt and impulsive weanings took place (72). Another notable study (35) involving 94 individuals who were infants in the late 1920s was a statistical one in the 1960s, using the excellent early records. Thirty-one of them experienced unsupplemented breast feeding for 5 months or more, but the population also contained the token breast fed and the artificially fed. The median age

experience, rather than on the mechanical duration of breast feeding, more comprehensible relationships would be found. Newton (75) in an exploratory study divided her breast feeding groups into a vanety of experience groups: never, abortive, supplemented, and successful.

Downloaded from ajcn.nutrition.org by guest on April 10, 2014

The
long ing,

supplemented
periods showed

group,

who

experienced
bottle feedbehavior.

of both breast and the least desirable

Weaning

from

the

bottle

reactions

occurred

when

unsupplemented

breast

feeding

stopped

was 1 month for the boys and 2 months for the girls. Differences in breast feeding experience were related to behavior but no clear direction was found. Heinstein (35) in summarizing his statistical analysis states, there were no apparent overall advantages in behavioral adjustment associated with either breast or formula feeding as such. However, in breaking down the data further, it was found that Girls with a warm mother did much better with breast feeding rather than
.

most frequently in those who had considerable experience with breast feeding. Unfortunately, each experience group was too small to be meaningfully studied for significant probabilities, but the possibility still exists that studies taking into account long-term cxposure to unstable milk supplies, the pains and stress of early token feeding, the hazards of sudden weaning, and the confusion of breast and bottle sucking requiring different techniques, may yield more comprehensible
results.

The

possibility

should

also be kept

in mind

that a distressed breast feeding mother may convey her stress to the baby more cornpletely than the artificial feeding mother, as they are still physiologically interrelated. Levine and Thoman (76) found that stressing lactating mother rats at different periods
in lactation significantly raised the plasma

with cold

formula mother

feeding, showed less

whereas disturbances

girls

with

mula fed rather than breast fed. relations were not found in boys
all breast Most feeding ulations feeding studies and in later which experience on only was

Similar whose
less.

if forcoroverbreast

the

relation
were token done or

of
on

behavior

pop-

short-term

corticosterone levels of the pups at weaning and in adulthood; offspring of mothers stressed 3 days postpartum showed poorer avoidance learning. Unfortunately, little work has been done at the human level on the relation of breast feeding experience to later reproductive behavior. One might expect that the first re-

1002

NEWTON

productive interpersonal act (breast feeding) might influence reproductive actions in adulthood. In rats, when sucking was limited to one long feeding per day, beginning at 7 days, the rat pups thus subjected to sucking limitation and mother deprivation showed

cultural,

experimental,

In token
come breast

breast

feeding,

and statistical studies. these differences beas so much less In addition,

muted to some extent feeding is experienced.

added of an
early sucking
chological

altered retrieving behavior, sexual and food hoarding patterns in

(77).

behavior, adulthood animal

that

complications such as the experience unstable breast milk supply, sudden weaning due to cultural pressures, and
problems
impact

may
of

make
token

the
breast

overall
feed

psyvan-

A great
has does verified influence

deal
over

of work
and

on the
over again

level
early

able. References
1.

experience, way, and one stage

same (78). breast

including
later

feeding
behavior

experience,
in a long-term

that experience of development

which is potent may not have

at the

Bowuw, Hogarth,

vol.

J. Attachment 1, 1969.

and

Loss.

London:

2.

effect at another period of development However, just as in the case of human feeding experience, the relationships

found
or even

in infrahuman
seemingly

research
contradictory

are

(59,

complex 77, 79,

strains

80) or both, in different

needs to be

and ways
done

influence different (81). Much more

on every level to

work
unravel

MEAD, M., AND N. NEWTON. Cultural patterning in perinatal behavior. In: Childbearing: its Social and Psychological Aspects, edited by S. A. Richardson and A. F. Guttmacher. Baltimore: Williams & Wilkins, 1967, p. 142-144. 3. SOUTHWORTH, T. S. Maternal feeding. In: Practice of Pediatrics, edited by W. L. Carr. Philadelphia: Lea, 1906, p. 89. 4. W.u..ER, H. K. Reflex governing the outflow

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of milk from

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Lance:

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the many Summary There between

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6.

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