Our Own Devices: How Technology Remakes Humanity

by Edward Tenner

  If it is a truism that any security hardware can eventually be defeated by criminal ingenuity, there should be a corresponding maxim that almost anything can be made better by user experimentation. There is a benign and positive side to the unintended. Inventors also can scarcely foresee the changes in values that will give new meanings and techniques to what they have produced. Some of the most common things in everyday life reflect not only the ingenuity of the original producers but the experiences of generations, sometimes millennia, of users. When we use simple devices to move, position, extend, or protect our bodies, our techniques change both objects and bodies. And by adopting devices we do more. We change our social selves. In other species, natural selection and social selection shape the appearance of the animal. In humanity, technology helps shape identity. Our material culture changes by an unpredictable, dialectical flux of instrument and performance, weapon and tactic.

  CHAPTER TWO

  The First Technology

  Bottle-Feeding

  EVOLUTION HAS GIVEN us an enormous advantage over other animals, and a corresponding burden. We are specialized in applying techniques to our needs, and in transmitting techniques more complex than those of other organisms. While the complexity of many but not all artifacts has grown over the millennia—and we will see in the next chapter that some artifacts of “simpler” societies actually reflected skills more sophisticated than those of contemporary industrial peoples—the human capacity for complex techniques appears to have been present from the outset.

  Just as techniques (including the hardware now customarily called technology) were essential from the origin of our species, so they are present in human life from birth. Of course, there are prenatal techniques, too—not only the variety of practices followed by prospective parents but also technologies for assisting in conception and diagnosing and monitoring conditions of the fetus. Like other techniques, these probably will have unforeseen consequences for the shaping of the human body. Genetic manipulation may ultimately reduce the frequency, at least in certain populations, of genes responsible for certain birth defects. It may also promote other genes that are culturally held desirable, governing body type, appearance, and intelligence test scores. Neither most advocates nor most opponents of these techniques have fully thought out the implications of calling them “engineering.” Civil engineers—as Henry Petroski has argued in a series of books—advance through mistakes and even disasters, but misdesigned people cannot be rebuilt as failed bridges, collapsed tunnels, and failing roads may be. At the very least, in vitro fertilization may actually help increase the incidence of infertility, as we have seen that genetic testing can inadvertently spread genes for hereditary diseases while preventing their expression in a given family. Over the coming century, for an increasing number of couples, parenthood might require medical assistance. Already one in six American couples receives some kind of fertility treatment. It is easy to imagine that this proportion might increase.1

  As common as prenatal tests have become in industrial societies, they have a small effect on the human body compared with those of an older form of intervention in our development: bottle-feeding. For the majority of people in the developed world, infant formula and its physical apparatus of bottles and nipples is the first technology. And its effects, if usually subtle, are lasting.

  THE SKILL TO BE NATURAL, THE WILL TO BE ARTIFICIAL

  Human nursing is different from the lactation of other mammals, even of other primates, because (as part of the price of our hyperdeveloped brains) the human infant is uniquely dependent. Other primate infants are born as vigorous little individuals who know how to look out for themselves. They need no help in finding and latching on to the mother’s nipple. Other primate mothers do have infant care skills to learn, and second infants are easier for them, but by the time they are ready to nurse they have learned what they need, and the infant does the rest. By contrast, the human infant needs its mother’s body not just for nourishment and shelter but for immunological protection; it has been called an “external fetus.”2

  Once more, human performance requires technique, as breast-feeding advocates are the first to acknowledge. Being a baby can be hard work. While sucking is a reflex, an infant must use sixty-three different nerves to suck, swallow, and breathe, according to lactation specialists, and about one in ten has some difficulty. Maternal behavior, too, has to be learned. New mothers are not innately prepared for many contingencies: insufficient or excessive breast milk, cracked nipples, and a great variety of infant behaviors. In the words of an African infant nutrition activist: “We make the mistake of believing breast-feeding is natural, an intuitive thing. But it’s a learned behavior passed on from generation to generation. In the old days, the older women would sit there and encourage and tell you to do this and that—it was part of education.” Now breast-feeding advocacy organizations and lactation consultants have taken the place of grandmothers.3

  Humanity has a long history of feeding arrangements for mothers unable or unwilling to nurse their own children. Of course, the great majority of mothers did so, if only because there was no available alternative. In Greece and Rome the affluent often employed wet nurses, free as well as slave. Wet nursing was a thriving profession in the Middle Ages, a specialty of whole districts like the Casentino and Valdarno valleys in Italy, whence young married women and their husbands traveled to the Florence fairs to advertise their skills in verse. Wet nursing remained the rule for most Europeans who could afford it well into the eighteenth century. But religious and medical authorities were turning against it. The Catholic church vigorously promoted maternal breast-feeding not only to assure infant health but, modern historians have argued, to limit women’s growing cultural and political influence. And the authors of the Encyclopédie, the multivolume summary of the eighteenth-century Enlightenment, advocated maternal nursing as a duty that they also hoped would reduce the public influence of women. Late-eighteenth- and early-nineteenth-century medical writers all over Europe extolled the natural benefits of lactation for mothers and infants and warned of the dangers to bodily mechanisms from frustrating the natural flow of milk. And romanticism continued what religion and rationalism had begun: the women of the American antebellum South were among history’s most fervent believers in maternal suckling, on the grounds of natural duty, despite what became the postbellum cliché of the slave wet nurse.4

  Bottle-feeding did not begin in the nineteenth century. There is a long history in many societies of feeding infants animal milk or cereals. The practice was most common in cold regions with abundant and relatively easily preserved animal milk, but it was not confined to them. Feeding vessels for infants have been found at sites as much as six thousand years old, and the Romans used artificial nipples. In late medieval and early modern Europe, feeding technology was the norm in areas of Scandinavia, southern Germany, northern Italy, Austria, Switzerland, and Russia. The historian Valerie Fildes has found evidence of centuries-old debates on artificial feeding and breast-feeding. In Upper Bavaria, peers denounced a woman born in northern Germany as swinish and filthy for attempting to nurse her own baby. Their aversion appears to have no local environmental basis; the reasons for it are unclear. And the physician of Louis XV of France reported no ill effects on the health of Muscovites and Icelanders from their custom of letting the smallest babies suck on tubes placed in containers of milk or whey. A twentieth-century demographer has confirmed the effects of artificial feeding, in Bavaria at least. After a higher rate of infant mortality in the first year in districts where artificial feeding was usual, there was a far lower rate in the next four years of childhood, possibly because the surviving one-year-olds had developed resistance to organisms in their diet. Artificially fed children also remained with their parents, avoiding the medical problems associated elsewhere with wet nurses.5

  The industrial revolution, then, did not introduce the feeding bottle. Whether to absorb milk surpluses or (consciously or unconsciously)
to control family size through higher infant mortality, many earlier communities used crude expedients. But they were the exception. The nineteenth and twentieth centuries brought three changes that ultimately made many and sometimes most infants in Europe and North America dependent on artificial food: new devices for milk delivery; new scientific and medical attempts to equal the quality of breast milk; and the rise of national and international dairy food markets. These turned out to have serious unintended consequences for both infants and their mothers.

  THE TINKERER IN THE NURSERY

  None of the feeding devices for infants before the nineteenth century had a chance of becoming a technological and cultural icon. Many of the problems were functional: the vessels must have been difficult to keep clean. Some were technical: there was no satisfactory artificial nipple. (When infants were not presented directly with the neck of a ceramic, pewter, or tin vessel, or with a cow’s horn punctured at the tip, they were given a piece of stitched parchment with a bit of sponge inside. Nipples were also made of wool, chamois leather, linen, and even alcohol-preserved cows’ udders. The preferred material for nipples in early-nineteenth-century America was silver, not simply for display but for chemical stability.) But the greatest problem was economic. Feeding devices had to be hand produced at great expense. Since elite families often employed wet nurses, the market for feeding technology had to be limited. Still, inventors began to patent new styles of feeding bottle. The first in America was the Lacteal of Charles Winship in 1841, shaped like a human breast, contoured to fit on the mother, and claimed to persuade the baby that the milk was hers (“a useful deception,” in the inventor’s words). But the delivery system was literally a technological bottleneck: the child was to suck on a sponge-stuffed deerskin teat.6

  Four years later, the real revolution in infant feeding began. Elijah Pratt of New York, using Charles Goodyear’s new vulcanization process, patented the first rubber nipple. A series of patents followed, becoming a wave in the late 1860s and early 1870s—a sign of the market’s growth. These devices in turn helped make possible more successful containers; one of these, the o’Donnel bottle patented in Great Britain in 1851, was popular in the United States between the Civil War and the 1890s. It featured a flasklike bottle with a long rubber tube that had a nipple on the end. The tube was prone to bacterial contamination. A British alternative design of the 1860s, called the Mamma, had a feeding end modeled, probably of rubber, from a human breast and secured to the glass body, shaped vaguely like a whale, with an elastic band. Toward the end of the century, other models appeared that could be strung over an infant’s cot for overnight feeding on demand or deposited on its chest with small legs.7

  While the U.S. Patent Office had recognized a minimum of 230 feeding bottles by 1945, by the 1920s most had taken the form they have today: wide-mouthed containers—originally, they were made of glass— simplified for sterilization and topped by rubber nipples. (The hygienic movement and wide acceptance of the germ theory did not eliminate other variations, including figural novelties shaped like shoes, turtles, and rabbits.) Early in the past century, rubber formulations were developed that avoided the cleaning problems, stiffness, and offensive taste and odor of the nineteenth-century product. Meanwhile, an automatic glassblowing machine invented by Michael J. Owens of Toledo, Ohio, and beginning commercial operation in 1903 was, by 1920, able to produce nearly 13,000 bottles daily, significantly reducing their cost—and also assisting distribution of bottled milk. (Even in the 1880s and 1890s, bottle production was only semiautomatic, and the lip had to be added by hand.) In 1919 the Corning Glass Works patented Pyrex, a heat-resistant glass that had grown out of its work with railroad signal lights; Pyrex nursing bottles appeared in 1922. Sterilizable, wide-mouthed bottles enhanced the hygienic aura of artificial feeding and remained the familiar standard until after World War II. Pediatricians and hospitals welcomed disposable, formula-filled bottles like the plastic Mead Johnson Beniflex of 1962 and later glass models, which replaced the unpopular and sometimes careless hospital formula technicians. Following early experiments with built-in thermometers, some plastic bottles for home use now change color to reflect the temperature of their contents.8

  Before the twentieth century, hand-blown, narrow-mouthed bottles and long tubes were hygienic nightmares. The flattened Turtle was also called the Murder Bottle. Courtesy of Corning Museum of Glass, Corning, N.Y., left to right: nursing bottle, “Cerity & Morrel Feeder,” after 1880 (58.4.16. United States. Colorless glass with an aquamarine tint; mold-blown), gift of Mrs. Thomas Wilmot; nursing bottle, “Tyrian Nurser,” 1890–1910 (62.4.43. United States, Andover, Mass., Tyler Rubber Company. Colorless glass, cork, wood, brush, metal; mold-blown, assembled), gift of Mr. and Mrs. Paul Perrot; nursing bottle, 1870–1910 (66.4.53. United States. Colorless glass; mold-blown), gift of Arthur A. Houghton, Jr.; nursing bottle, patented 1890 (57.4.19. United States, New York, N.Y., McKinnon & Co. Colorless glass, metal, paper; mold-blown), gift of Hugh L. Kline.

  And a tradition of kitchen-table innovation endures. Advances in molding have recently permitted at least one variant recognized by a major cultural institution: in 1988, the Museum of Modern Art design collection added a plastic nursing bottle called the änsa, produced by an Oklahoma couple with no professional child development or design experience, shaped like a long doughnut for better infant gripping. Admiring as he was, the inventors’ own pediatrician still had a concern: that babies would like the änsa so much their parents would let them go to bed with it. While there has apparently been no independent health evaluation of this design, the doctor was wary because bottles in general have an unfortunate effect on infants’ feeding, for taking nourishment is also a technique. When a child sucks its mother’s breast, it “latches on,” taking the nipple into the mouth, clamping down with its jaws on the areola, and obtaining milk by inducing peristalsis with its tongue. In this process, the nipple can stretch to twice or three times its usual length, and the milk shoots from fifteen to thirty pores throughout the infant’s mouth.9

  Rubber, plastic, and silicone nipples function differently, with consequences for the infant’s technique. When presented with a bottle, the jaws need not engage the nipple. Negative pressure alone transports the milk. The artificial nipple is more efficient; the baby has less work to do. For this very reason, unfortunately, once an infant begins to feed from a bottle, even soon after birth or as a supplement to breast-feeding, the new style of feeding is not easily abandoned. The infant has lost its innate tendency to open wide when feeding, expects to have a nipple solidly in its mouth, is used to a free flow of milk, and pushes its tongue forward: all behaviors that will frustrate its experience of breast-feeding. With reduced sucking, the mother’s breasts will become engorged, reducing her milk production and making it more likely that the infant will continue to be bottle-fed. Infant feeding specialists call this effect nipple confusion or triple nipple syndrome. Breast-feeding and child welfare advocates are thus especially alarmed by hospital programs promoting formula-feeding for newborns and presenting mothers with free starter kits. An American hospital innovation of the 1970s, disposable sterile plastic bottles of formula for newborns, saved preparation time and improved quality but did nothing to overcome criticism. And advocates are concerned about “mixed feeding,” the alternation of breast milk and formula.10

  (Paradoxically, lactation consultants recommend a technological solution for nipple confusion and other feeding problems that combines ideas from earlier feeding vessels: placement on the mother’s body and use of a long tube. The Supplemental Nursing System [SNS] is a plastic bottle filled with the mother’s own expressed milk or formula, channeled through a tube that runs along the breast and is held in place with nonirritating tape. The tube is so narrow and flexible that the infant maintains or develops a normal breast-feeding technique and the mother’s nipple receives the stimulation that assists lactation. A valve in the bottle releases the milk only when the infant begins to suck. Fo
r bottle-feeding infants, manufacturers also offer “physiologic” nipples that encourage natural tongue technique.)11

  Besides the initial mechanical problems of bottle-feeding, there are consequences for the baby’s mouth. Inexperienced parents may put children to bed with nursing bottles and let milk or juice build up around the teeth, causing decay. Bottle-fed children also have a higher rate of malocclusions. According to one study from 1981, 36.4 percent of children breast-fed not at all or for less than three months had occlusal anomalies, while 24.2 percent of children breast-fed for more than six months did— an increase of risk by 50 percent. A 1987 paper reported an 84 percent higher risk of malocclusion among children breast-fed three months or less or not at all, and the authors estimated that 44 percent of malocclusions among the children in the study were due to brief or nonexistent breast-feeding. One medical writer on breast-feeding believes that the pistonlike motion of the tongue in bottle-feeding—it has a rolling action in breast-feeding—may be responsible.12

  CHEMISTRY TAKES COMMAND

  The mechanical risks of the bottle are still small compared to its possible nutritional consequences. Pediatric researchers and nutritionists are fond of repeating that infant formula as a substitute for human breast milk is “the largest in vivo experiment without a control series.”13