Nurses and Inspectors at the Foundling Hospital

By Lydia Clay-White Thursday 2nd May 2024
Giacomo Ceruti (1698-1767), Women Working on Pillow Lace (detail)

Soon after their admission to the Foundling Hospital, children were sent to nurses in the countryside who cared for them until they returned to the Hospital for schooling. The nurses took the Foundlings into their homes and raised them alongside their own children, essentially performing an early form of foster care. The term ‘nurse’ meant a woman who looked after another woman’s child, not a medical practitioner as the term is used today. They were supervised through regular inspections, undertaken by a network of inspectors who acted on behalf of the Hospital, reporting directly to the Governors.


The Hospital advertised for ‘nursing mothers prepared to feed and nourish unwanted babies from the Foundling Hospital’ around Surrey, Middlesex, Essex, Hertfordshire, Berkshire, and Kent. Nursing mothers were called ‘wet nurses’ because they could breast-fed the youngest babies, whilst ‘dry nurses’ cared for infants who had been weaned before admission to the Hospital. The country air was thought to be good for the children’s health, and these counties had the benefit of being close to London.

The Governors assessed nurses’ suitability and health and received references attesting to their ‘exceeding good Character’. Infants were usually placed with their nurses within a few days of admission, though sometimes a stay at the infirmary was needed to ensure the child was well enough to travel. Nurses collected their charges from London and travelled home on a ‘wagon’ (a type of stagecoach) organised by the Hospital.

Nurses were largely drawn from the rural labouring class and were usually the wives of tenant farmers and agricultural workers. Some, however, were married to parish clerks, schoolmasters, and tailors. All the nurses were either married or widowed, with young families of their own.

They were paid two shillings and sixpence a week (increased to three shillings by 1796), roughly equivalent to the income of a skilled tradesman. It was not unusual for them to foster multiple Foundlings at once, and to take on new children after their previous charges had returned to the Hospital. At a time when women’s work was largely temporary and poorly paid, nursing could offer a significant and stable salary, which could be earned whilst raising their own children. A premium of 10 shillings was awarded if the children survived infancy, and nurses were given bonuses for demonstrating ‘extraordinary care and trouble’.

In the General Reception period (1756-1760), when the Foundling Hospital had to accept every baby brought to its door, the Hospital appointed 140 new wet nurses and extended the nursing districts into Derbyshire and Yorkshire. During this period, the number of Foundlings in the care of country nurses increased from 422 in 1756 to 5,814 in 1760.

The age at which they returned to the Hospital for their education also increased. Originally, children had remained with their nurse until around the age of three. In the 1760s, children began to stay longer as the Hospital struggled to house the thousands of children admitted, despite opening six branch hospitals outside London. This extended period with their nurses led to stronger attachments and a trend of children running away from their apprenticeship to return to their nurse, as Thomas Waugh and John Coldfield did. In March 1771, the Governors sent out 250 letters requesting the return of children who had ‘run away to the places where they were nursed’.

After the 1770s, children typically stayed with their nurse until the age of five or six. If they became ill whilst living at the Foundling Hospital, however, they were often sent out to a nurse to recuperate in the clean country air, as was the case for Samuel Inman, who was recovering from whooping cough. This would be a different nurse from the woman who cared for them in infancy.

Profound relationships

Whilst the nursing system was an early form of foster care, the Hospital’s priority was to give the infants the greatest chance of survival, rather than to provide them with a familial, supportive early environment now known to be important to a person’s overall development.

For the Foundlings, these early years with the nurse was their only experience of family life and individual care. There is much evidence to suggest that this led to profound emotional attachments. In her autobiography, Hannah Brown writes of her happy childhood and the kindness of her foster parents, as well as the pain expressed by many Foundlings when they left the countryside and ‘again lost a “Mother”.’

This attachment was clearly felt by both parties as many nurses sent letters enquiring after their foster children once they returned to the Hospital, and some travelled to London to visit them. There are clear examples of foster parents who loved their Foundling ‘as tho’ he had been my own’. Sometimes, they applied to the Governors to keep the child, often with the support of local inspectors who could attest to the family’s love for the Foundling. Occasionally, the Governors agreed and apprenticed the child to their foster parents (the only legal means of adoption), as was the case with Catherine Bray. However, it was the Foundling Hospital’s duty to prepare the children for their future lives, and most requests were denied.


The inspectors were vital to the operation of the nursing system. They selected nurses from their local area, monitored the children’s care, paid the nurses’ wages, distributed Hospital clothing, supervised the children’s medical treatment, arranged funerals, and organised transport for the children’s return to the Hospital. Inspectors could be responsible for over 100 children at a time, travelling miles to visit all the nurses in their district.

The inspectors were generally well-connected local people, many of them clergymen, doctors, Hospital Governors, or members of the aristocracy. The artist William Hogarth was both a Governor and an inspector for the district of Chiswick, along with his wife Jane. A significant number of the inspectors were women – around 40% according to the inspections book for 1749-58 found in Coram’s Foundling Hospital Archive.

The Hospital inspection system was one of few examples in the 18th and 19th centuries where women and men were recognised and respected equally for the work they did. Prudence West, for example, was the inspector for Barnet and in charge of the Barnet branch hospital (1762-68). She gained a reputation for her high standard of care, and the most vulnerable Foundlings were often placed in her district. For Lady Elizabeth Marchmont, inspector for Hemel Hempstead, it may have been her own turbulent beginnings as the daughter of a bankrupt linen draper which prompted her interest in supporting the early lives of the Foundlings.

Prudence West's entry in the Inspection Book_A_FH_A_10_004_001_069

The system of inspection set an important standard of care and indicates a child-centred mentality which was highly unusual for the time. It is clear from the inspectors’ correspondence that any instances of neglect or maltreatment resulted in the child’s immediate removal from the nurse’s home. Ultimately, fewer than 5% of children were removed from their nurses, suggesting that nurses predominantly met the high standards of care expected by the inspectors and the Foundling Hospital’s Governors.

Copyright © Coram. Coram licenses the text of this article under Creative Commons Attribution-NonCommercial 4.0 (CC BY-NC).