The evolution of infant feeding is fascinating and includes breastfeeding, wet nursing, the feeding bottle and formula use.
The wet nurse, i.e. a woman who breastfeeds another person’s child, has been around since 2000BC.
It evolved from an alternative of need to one of choice, and was an organised profession with contracts and laws that regulated its practice.
Wet nursing continued until the feeding bottle was introduced in the 19th century and had declined markedly by the beginning of the 20th century.
There has been literature on crude feeding bottles and its cleanliness since Roman times, the Middle Ages and the Renaissance.
It was not until the Industrial Revolution that a refined, hygienic feeding bottle became available.
The feeding bottle and nipple developed in the middle of the 19th century, with glass bottles initially used, followed by plastic ones.
Until the end of the 19th century, various animal milks were the most common source of artificial infant feeding, with the most common being cow’s milk.
Many scientists attempted to formulate non-human milk to resemble human milk, with breast milk being the gold standard.
Many commercial formulas were rapidly introduced after the marketing of Liebig’s infant food in 1865.
This was the world’s first commercial, scientifically-formulated infant formula invented by German chemist Justus von Liebig.
Scientists began developing non-milk-based formulas for infants allergic to cow’s milk in the 1920s, with the first non-milk formula based on soy flour available to the public in 1929.
The aggressive marketing of formulas in most countries, particularly in developing nations, contributed to a global decline in breastfeeding.
Various studies reported the increasing trends of formula-fed infants developing atopy (allergies), diabetes mellitus and childhood obesity.
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Throughout the history of wet nursing, the feeding bottle and formula, breastfeeding has remained the medically-preferred method of infant feeding.
There is still no formula that can totally replace mother’s milk.
Benefits of breastfeeding
Breastfeeding benefits both the baby and the mother.
The benefits for the baby include:
- It is always available
- It contains needed vitamins and minerals
- It provides protection from certain infections
- It helps improve the baby’s long-term health
- It reduces the risk of sudden infant death syndrome (SIDS), childhood diabetes and leukaemia
- There is evidence it helps the baby’s digestion of solid foods.
The benefits for the mother include:
- It helps the uterus get back down to size – after childbirth, the uterus gradually gets smaller, but breastfeeding will help speed this up
- It strengthens bonding with the baby – breastfeeding facilitates the feeling of closeness and strengthens the bond between mother and baby
- It causes the release of a hormone called oxytocin that helps one feel calm and connected to the baby
- It protects maternal health, as it lowers the risks of breast and ovarian cancers, osteoporosis, diabetes and cardiovascular (heart) disease.
In monetary terms
With the current obsession of monetary measurement of human activities, it is pertinent to note that many studies have reported the enormous economic benefits of breastfeeding.
Some global studies showed economic losses of around US$300bil (RM1.23tril) globally due to lack of breastfeeding.
According to a review published in the journal Health Policy Plan in October 2024, the “costs from child cognitive losses make up the bulk of the costs of suboptimal infant feeding practices, and costs from premature maternal deaths are larger than medical costs in the identified studies”.
The 2017 Nurturing the Health and Wealth of Nations: The Investment Case for Breastfeeding report stated that: “Breastfeeding is not only an investment in improving children’s health and saving lives, but also an investment in human capital development that can benefit a country’s economy.
“Breastfeeding is one of the best investments in global health: every US$1 (RM4.09) invested in breastfeeding generates US$35 (RM143.24) in economic returns.
“In China, India, Nigeria, Mexico and Indonesia alone, inadequate breastfeeding is responsible for more than 236,000 child deaths each year; in these countries, the estimated future economic cost of mortality and cognitive losses attributed to inadequate breastfeeding are estimated to be almost US$119bil (RM487bil) per year.”
In a review of 26 articles across diverse income settings, breastfeeding-related cost savings varied widely, with global breast milk valued between US$1.4-64bil (RM5.7-262bil), while formula costs reached up to US$394.5mil (RM1.61tril) annually.
Exclusive breastfeeding saved up to US$90.9mil (RM372mil) in lifetime maternal cancer treatment costs and US$1.26-73.5mil (RM5.16-300.8mil) annually in paediatric healthcare costs.
According to a review published in the journal Discover Public Health in December 2025, three of the studies reviewed showed high economic returns on breastfeeding promotion, with up to 139% investment return.
Saving lives and money
The theme for this year’s World Breastfeeding Week (Aug 1-7, 2026) was “Breastfeeding for a Sustainable Start in Life: Strengthen What Works”.
It emphasised on tracking progress, evaluating impact and scaling proven approaches that improve breastfeeding outcomes.
The key messages from the World Health Organization (WHO), United Nations Agency for Children (Unicef) and the Global Breastfeeding Collective were: “Key interventions to protect and support breastfeeding have been proven to be effective at increasing rates of exclusive breastfeeding.
“Closing the implementation gap is critical.
“Many countries have adopted supportive policies, but insufficient financing, accountability and enforcement continue to constrain impact and slow progress.
“Investing in breastfeeding delivers exceptional value for money.
“Scaling up evidence-based health system support for breastfeeding, including facility- and community-based IYCF (infant and young child feeding) counselling and implementation of the Ten Steps to Successful Breastfeeding would generate returns of US$59 (RM241) for every US$1 (RM4.09) invested, with impacts driven largely by improvements in cognitive development, education outcomes and lifetime productivity.
“Further investment in national mass media campaigns, enforcement of the International Code of Marketing of Breast-milk Substitutes, paid maternity leave and work place support for breastfeeding would save the lives of 263,000 children and would generate US$357bil (RM1.46tril) in economic gains over the next 10 years in the 88 high burden countries studied.
“All modelled intervention packages generate benefits that substantially exceed their costs, making breastfeeding one of the most cost-effective investments in health and development.”
A simple message
The message to mothers and mothers-to-be is simple: Breastfeed your infant exclusively for the first six months of life.
Thereafter, infants should receive nutritionally adequate and safe complementary foods with continued breastfeeding up to two years of age or beyond.
There is nothing that can replace mother’s milk, which is ideal for every newborn.
The WHO’s message for policymakers is clear.
The interventions are proven; the economic returns are exceptional.
The challenge is not knowing what works – it is investing at sufficient scale.
Dr Milton Lum is a past president of the Federation of Private Medical Practitioners Associa-tions and the Malaysian Medical Association. For more information, email starhealth@thestar.com.my. The views expressed do not represent that of organisations that the writer is associated with. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
