4. Discussion
Historically, and for centuries, human nutrition has been the only way to guarantee the health and survival of the newborn, and its failure has been one of the most important causes of death. While it is true that the research maintains that breastfeeding by wet nurses favoured the survival of royal infants, this was not the case for newborns raised by wet nurses in institutions or foundling homes, and even breastfeeding did not guarantee the survival of royal infants in all cases, as some inevitably died of infectious and contagious diseases. Therefore, it can be stated that breastfeeding, together with hygienic and sanitary conditions and access to medical resources made it possible for the royal infants breastfed by wet nurses to survive longer than those raised in lower social strata. Neonates nursed by non-royal wet nurses generally did not have the same sanitary conditions and had fewer health resources. For this reason, breastfeeding was not sufficient in these cases. Thus, the office of wet nurse was undoubtedly a guarantee of health in royalty, but it did not ensure the survival of infants, just as breastfeeding, despite its nutritional and immune components, did not guarantee the survival of children from lower social classes in that period. The subject of newborn feeding has been present in the medical treatises of great thinkers, philosophers, physicians and historians throughout the centuries. In the vast majority of cases, the approach to the subject was centred on the figure of the mother and the wet nurse, valued from the point of view of moral or religious indoctrination, considering the woman as an ignorant, hysterical or capricious being
[26][27].
The great importance given to the reasons and advice on breastfeeding that sages and scholars, since the time of Aristotle, have used to justify its convenience for both mother and child is surely to be found in the fact that many women who could afford it were unwilling or unable to breastfeed
[25]. This situation highlights the weak balance between the natural, the cultural and the social. Since the beginning of society, a difference has been established between women who breastfed their children and those who, for cultural or social class reasons, did not engage in this practice
[26]. In fact, different tests are described in the work of Oribasius of Pergamon, 4th century AD, to check the quality of the milk of wet nurses and whether they were fit to care for and feed a child belonging to the nobility
[28].
Works on wet nurses have been very prolific in records, legends and even manuscripts. Thus, in the works of great physicians of antiquity such as Soranus of Ephesus, Oribasius, Mesitheus, Etius and Galen, advice to be taken into account for wet nursemaids was extracted and was followed well into the 20th century
[29]. In fact, Abou Aly
[28] shows, through the texts of Ancient Greek physicians, the recommendations to be taken into account when choosing a good wet nurse. In this sense, Knibiehler
[30] made an important contribution with his work on the non-maids of the wealthiest classes in France during the Ancien Régime, becoming one of the basic references on the practices related to the figure of the wet nurse.
Such is the importance of this profession carried out by women that researchers such as Colmenar have shown the legislation and regulations relating to wet nurses as a measure aimed at protecting infants and the children of the upper classes, but above all to protect the heirs of noble families
[31].
However, what can be said about the role of breastfeeding in noble families, and specifically in the royal family of 16th century Spain, one of the most powerful and important royal families in history? Raising a child in the 16th century was not an easy task; infant mortality was very high, and to survive beyond the age of two or three was a real challenge. Neither princes nor kings escaped this sad reality, with Philip II standing out in this respect; he had eight legitimate children with four wives, of whom only three survived
[10][24]. This situation highlights the importance of the wet nurse for the suckling of infants, as these women could help royalty by increasing infant survival, by excluding queens and birth mothers from the suckling process, and by increasing the frequency of childbearing to expand the power of the ruling classes.
Faced with this terrible situation and given the importance of the royal heirs for the very survival of the monarchy, it was logical that care and attention should be paid to the young infants and their royal mothers. One of the aspects of greatest consideration was the choice of suitable and sufficient breeding mistresses, given the high mortality rate among infants, as has already been studied. It was also necessary to guarantee sufficient food for the infant royal children. In this regard, Cabrera
[1] provides a historical overview of the wet-nursing profession, including the auxiliary nursing carried out by the most modest women, as well as the wet nurses employed in the royal households, some of whom were immortalised by court painters together with the infants in their care. On the other hand, Del Hoyo
[32] studied the qualities required of an upper-class wet nurse and the physical and anatomical examination she had to undergo.
In the court of Philip II, wet nurses and housekeepers enjoyed a good reputation, and their social standing was so high that many were called “Doñas” and were given exquisite gifts. The most productive of them obtained certificates of nobility for their husbands and large lifetime salaries.
However, the court of Philip II established health criteria, as these women had to be healthy, beautiful and with milk—if possible, a lot of milk. Ethnic-religious prohibitions were also created, as wet nurses had to be old Christians
[33] and, in many cases, with a certificate of cleanliness of blood, which meant that they could not be Jewish or Muslim, or even descendants. Finally, there were the moral considerations, as they had to have good customs, which had to be justified directly by the church
[34].
Such was the importance of this figure at the court of Philip II that a letter sent from Madrid on 5 December 1588 by King Philip II to one of his daughters, Catherine Micaela, Duchess of Savoy, was preserved, in which the monarch was interested in the health of his three grandchildren and mentioned the mistresses of the brood: “[…] and also that my grandchildren are so well and that what Vittorio Amadeo had is past, and it is very good to give them the mistresses when necessary”
[35].
The presence of wet nurses was essential brought great benefits to these women and their families. In this sense, Borrel examines the reasons that could coexist with the economic contribution for a woman to decide to work as a wet nurse in Girona during the 17th and 18th centuries
[36].
In addition, the court encouraged queens to devote themselves to their own bodily care and to exercise other functions and obligations within the court, apart from the search for an heir. This situation led them to use the empirical medicine of the time through health, beauty and curative methods to improve their image and to avoid the epidemics of the time (influenza, smallpox) and even to remove breast milk and control bodily alterations after childbirth. The queens had to look like healthy and attractive women to a man who wanted to perpetuate his dynasty on the throne through his children
[37]. Therefore, the figure of the wet nurse is important because she substituted for the natural mother in breastfeeding, in the supervision of the child’s care and in education so that she could carry out the obligations of the court and of society, allowing queens to continue having children and thus perpetuate the lineage and the family name in power for generations.
It is important to consider that, by avoiding breastfeeding, the mother restarted the reproductive cycle as soon as possible, which favoured an increase in the number of births
[38]; despite the fact that the infants had good wet nurses and the best nurses of the time, mortality in early infancy was very high
[10][24]. In fact, the court of Philip II was not the only one that enjoyed the presence of milkmaids, as it is known that in the Cortes of the Castilian kings they were common, starting at least in the 12th century, even regulating the criteria for the selection of wet nurses in the Castilian constitutional body, in the very same Partidas. Thus, in the second partida, in the third law of chapter VII, the characteristics that these wet nurses had to have were set forth
[39].