- Email: [email protected]
County Borough M.O.H. Group
PUBLIC HEALTH, March, 1949
118
BREAST-FEEDING AND SOCIAL CIRCUMSTANCES tion of Accidents' suggestions for accident prevention. He thought the difficulty in this subject was to get evidence about the non-fatal B y R. M . DYKES, M.A., M.B., D.P.H., accidents which might stimulate effort in small populations where the accident death roll was not so high. Deputy Medical O~eer of Health, Borough of Luton Dr. A. S. Hebblethwaite (M.O.H., Sunderland) asked whether F e w s u b j e c t s are o f g r e a t e r i n t e r e s t to h e a l t h d e p a r t m e n t s electrical b u r n s were commoner in the U.S.A., with its bigger ratio of electrification. H e suggested that there might be a free repair t h a n i n f a n t feeding, a n d few illustrate so well t h e g u l f b e t w e e n scheme for electrical apparatus. H e asked also for information w h a t we s h o u l d like to k n o w a n d w h a t we d o k n o w . about cases of suffocation due to overcrowding, and of gas poisoning T h e r e is, h o w e v e r , n o scarcity o f p a p e r s a n d c o m m e n t a r i e s by children turning on gas taps. o n b r e a s t - f e e d i n g a n d its significance for c h i l d h e a l t h . E v e r y Dr. Boucher said that figures had been sought from the United m e d i c a l officer is f a m i l i a r w i t h the s t a t e m e n t s r e p e a t e d t i m e a n d States b u t had not yet arrived. Gas. poisoning figures had not yet again o n d i f f e r e n t aspects of t h e subject. W e are told, for been analysed. Regarding information of non-fatal accidents, he thought the hospital almoner would be found most co-operative in instance, t h a t t h e b r e a s t - f e d b a b y e n j o y s m a n y a d v a n t a g e s giving M.O.H.s the details. Regarding deaths, coroners' reports o v e r t h e b o t t l e fed, a n d t h a t b r e a s t - f e e d i n g h a s d e c l i n e d d u r i n g were now under analysis and should produce further information. t h e last 25 years. W e h a v e also b e e n told t h a t t h e b r e a s t Dr. A. A. E. Newth (S.M.O., Nottingham) asked for information f e e d i n g of b a b i e s b o r n i n h o s p i t a l is less successful t h a n t h a t about accidents arising from children climbing. H e was also in- of b a b i e s b o r n at h o m e . F e w s u c h s t a t e m e n t s , h o w e v e r , are terested in home accidents to epileptics, and he drew attention to the s o u n d l y b a s e d o n fact. O p i n i o n a n d u n s u p p o r t e d assertions juvenile suicides where expressed intentions were sometimes not are c o m m o n ; verified d a t a relatively rare. T h e s i t u a t i o n is, taken seriously but where deaths could be prevented by psychological indeed, s u c h t h a t a r e c e n t r e p o r t t w h i c h d e p l o r e d " t h e lack treatment. Dr. C. Metealfe Brown (M.O.H., Manchester C.B.) pointed out the of satisfactory statistical i n f o r m a t i o n " a b o u t b r e a s t - f e e d i n g dangers of the two-pin plug from which children could get shocks can h a v e c a u s e d little s u r p r i s e a n d m o s t of us w o u l d b e ready by inserting small objects. He made a plea for the universal pro- to a d m i t t h a t t h e s u p e r i o r i t y of b r e a s t - f e e d i n g o v e r artificial vision of three-pin plugs. He asked whether there was any way of f e e d i n g is still m a i n l y conjectural. preventing accidental death from gas escaping from fires connected T h e r e are m a n y q u e s t i o n s still to b e a n s w e r e d conclusively. with penny- or shiUing-in-the-slot gas meters. For educational W h a t is t h e p r o p o r t i o n o f m o t h e r s w h o fail to e s t a b l i s h b r e a s t purposes there was no doubt that health visitors would be the most feeding ? W h a t is t h e d u r a t i o n of b r e a s t - f e e d i n g generally ? tmportant agents by keeping their eyes open when they visited the W h a t are t h e differences in different social g r o u p s a n d family homes, and he thought also that the local B.B.C. would be of service. sizes ? W h a t are t h e reasons for failures ? H o w are the Dr. Boueher said regarding broadcasting that prevention of accidents had been mentioned in the " W o m a n ' s H o u r , " which was p h y s i q u e , t h e n u t r i t i o n a l state a n d t h e sickness experience o f extensively listened to. Regarding electrical plugs, he agreed, in i n f a n t s affected b y t h e i r feeding ? Q u e s t i o n s of this k i n d regard to the dangers of the two-pin plug, and said that it had also suggest at once t h a t t h e r e are m a n y gaps in o u r knowledge. been under consideration whether plugs need be at ground level T h e c o n t r i b u t i o n we are able to m a k e in this p a p e r is a m o d e s t at all and should not be placed higher where they were out of reach one ; a n d u n f o r t u n a t e l y o u r data are n o t generally comparable. of young children. w i t h t h o s e o f m o s t o t h e r r e c e n t surveys. T h e w e a n i n g rate Dr. Miriam Florentin (Senior A.M.O.H., West H a m C.B.) was m o n t h b y m o n t h u p to n i n e m o n t h s is rarely g i v e n in p u b l i s h e d convinced that overcrowding was the main factor in many home accidents. She thought it was a mistake in the overcrowding legis- papers, a n d m o s t of t h e g r o u p s investigated are selected, i.e., lation that babies were not reckoned in computing the n u m b e r of i n f a n t s in n u r s e r i e s a n d hospitals o r a t t e n d i n g welfare eentres. T h e p r i m a r y p u r p o s e o f t h e survey s f r o m w h i c h t h e data dwellers and children under five only reckoned as half unit. T h e chairman asked if there was any authoritative view about the for t h i s p a p e r were d r a w n was to estimate t h e a m o u n t a n d dangers of pillows for babies. H e pointed out one danger of suffoca- n a t u r e o f infantile s i c k n e s s ; i n f o r m a t i o n a b o u t feeding tion by babies getting their heads between the bars of cots and histories was, therefore, incidental. N o a t t e m p t was m a d e to thought that the distance between bars was a n important point. He investigate i n f a n t feeding i n detail, n o r to assess t h e causes of mentioned one unusual accident where a baby had been suffocated a failure to b r e a s t - f e e d at different ages. T h e h i s t o r y dealt by a plastic bib which blew over its face. Regarding loose gas taps, he mentioned a device by which a tap was self-locking and had to be o n l y w i t h t h e age i n m o n t h s a t w h i c h b r e a s t - f e e d i n g ceased completely. N e v e r t h e l e s s , we feel justified i n r e p o r t i n g o u r lifted to turn on. I n regard to the danger of a coin-in-the-slot meter, he suggested that a small pilot light on the gas fire might obviate findings because legitimacy a n d h o u s i n g c o n d i t i o n s , social class a n d f a m i l y size, w e r e all investigated, a n d it was, t h e r e this danger. Finally, in moving a hearty vote of thanks to Dr. Boucher, h e " fore, possible to relate f e e d i n g h i s t o r y to t h e s e factors. M o r e regretted the small attendance b u t said that the value of the paper over, t h e s u r v e y g r o u p (1,498) h a s t h e a d v a n t a g e o f relating and the discussion would be appreciated b y all m e m b e r s when they to all t h e b a b i e s b o r n i n 1945 in a t o w n o f t i 0 , 0 0 0 i n h a b i t a n t s , read it in the journal. a n d n o t to a selected g r o u p (for example, welfare b a b i e s or babies b o r n i n hospital). T h e m a i n f i n d i n g s are as follows : COUNTY BOROUGH M.O.H. GROUP Under the presidency of Dr. R. M. Galloway (Bolton), the County Borough M.O.H. Group will hold their Annual Meeting and Conference at "Low Wood," Windermere, from May 6th to 9th, 1949. The programme includes a talk on " The Working of the National Health Service Act, 1946," by Dr. C. Metcalfe Brown, Medical Officer of Health of Manchester, and Dr. F. Hall, County Medical Officer, Lancashire, on " Maternity and Child Welfare " by Mrs. Baker, formerly Matron, St. Mary's Hospital, Manchester, on " M e n t a l Health Service responsibilities of Part III Authorities under the Health Service Act, t946" by Dr. W. Rees Thomas, Ministry of Health, on " T h e Care of the Deaf in the Community " by Drs. A. W. G. and Irene Ewing, University of Manchester, on " The Training of Health Visitors " by Professor I. G. Davies, Leeds University, and on " Medicine--Social and Anti-Social--in West Africa " by Professor Andrew Topping, University of Manchester. The Hon. Secretary is Dr. J. Greenwood Wilson, Cardiff. An announcement by the University of London of the By~ott studentships tenable at the London School of Hygiene and Troptcal Medicine appears on p. x of this issue. Copies of the Index of Volume 61 of PUBLIC HEALTH are now available free of charge on request to the Executive Secretary.
Age of Weaning T h e s u r v e y s h o w e d t h a t f o r t h e w h o l e g r o u p (1,498 infants) t h e p e r c e n t a g e o f i n f a n t s n o l o n g e r b r e a s t fed a t different m o n t h s of age was B r e a s t - f e e d i n g n o t e s t a b l i s h e d o r lasting less t h a n 10 days . . . . . . . . . . . . . . . 20~o Off breast completely : 1 month . . . . . . . . . . . . . . . 26% 2 months . . . . . . . . . . . . . . . 35% 3 . . . . . . . . . . . . . . . . . 43% 4 . . . . . . . . . . . . . . . . . 5t% 5
. . . . . . . . . . . . . . . . .
5~%
6
. . . . . . . . . . . . . . . . .
GI%
7
. . . . . . . . . . . . . . . . .
73%
8
. . . . . . . . . . . . . . . . .
79%
9
.
.
.
.
.
.
.
.
-.
.
.
.
.
.
84%
I t will b e n o t e d t h a t a b o u t a q u a r t e r o ( ' t h e i n f a n t s were n o l o n g e r o n t h e b r e a s t at t h e age of o n e m o n t h , a n d t h a t above this age i n f a n t s were t a k e n off t h e b r e a s t at a fairly s t e a d y rate u p to t h e age o f six m o n t h s . A t t h e age o f six m o n t h s 39~to o f i n f a n t s were still b r e a s t - f e d a n d 16~o were still h a v i n g one or m o r e b r e a s t - f e e d s at t h e age of n i n e m o n t h s . T h a t is to say,
118
BREAST-FEEDING AND SOCIAL CIRCUMSTANCES tion of Accidents' suggestions for accident prevention. He thought the difficulty in this subject was to get evidence about the non-fatal B y R. M . DYKES, M.A., M.B., D.P.H., accidents which might stimulate effort in small populations where the accident death roll was not so high. Deputy Medical O~eer of Health, Borough of Luton Dr. A. S. Hebblethwaite (M.O.H., Sunderland) asked whether F e w s u b j e c t s are o f g r e a t e r i n t e r e s t to h e a l t h d e p a r t m e n t s electrical b u r n s were commoner in the U.S.A., with its bigger ratio of electrification. H e suggested that there might be a free repair t h a n i n f a n t feeding, a n d few illustrate so well t h e g u l f b e t w e e n scheme for electrical apparatus. H e asked also for information w h a t we s h o u l d like to k n o w a n d w h a t we d o k n o w . about cases of suffocation due to overcrowding, and of gas poisoning T h e r e is, h o w e v e r , n o scarcity o f p a p e r s a n d c o m m e n t a r i e s by children turning on gas taps. o n b r e a s t - f e e d i n g a n d its significance for c h i l d h e a l t h . E v e r y Dr. Boucher said that figures had been sought from the United m e d i c a l officer is f a m i l i a r w i t h the s t a t e m e n t s r e p e a t e d t i m e a n d States b u t had not yet arrived. Gas. poisoning figures had not yet again o n d i f f e r e n t aspects of t h e subject. W e are told, for been analysed. Regarding information of non-fatal accidents, he thought the hospital almoner would be found most co-operative in instance, t h a t t h e b r e a s t - f e d b a b y e n j o y s m a n y a d v a n t a g e s giving M.O.H.s the details. Regarding deaths, coroners' reports o v e r t h e b o t t l e fed, a n d t h a t b r e a s t - f e e d i n g h a s d e c l i n e d d u r i n g were now under analysis and should produce further information. t h e last 25 years. W e h a v e also b e e n told t h a t t h e b r e a s t Dr. A. A. E. Newth (S.M.O., Nottingham) asked for information f e e d i n g of b a b i e s b o r n i n h o s p i t a l is less successful t h a n t h a t about accidents arising from children climbing. H e was also in- of b a b i e s b o r n at h o m e . F e w s u c h s t a t e m e n t s , h o w e v e r , are terested in home accidents to epileptics, and he drew attention to the s o u n d l y b a s e d o n fact. O p i n i o n a n d u n s u p p o r t e d assertions juvenile suicides where expressed intentions were sometimes not are c o m m o n ; verified d a t a relatively rare. T h e s i t u a t i o n is, taken seriously but where deaths could be prevented by psychological indeed, s u c h t h a t a r e c e n t r e p o r t t w h i c h d e p l o r e d " t h e lack treatment. Dr. C. Metealfe Brown (M.O.H., Manchester C.B.) pointed out the of satisfactory statistical i n f o r m a t i o n " a b o u t b r e a s t - f e e d i n g dangers of the two-pin plug from which children could get shocks can h a v e c a u s e d little s u r p r i s e a n d m o s t of us w o u l d b e ready by inserting small objects. He made a plea for the universal pro- to a d m i t t h a t t h e s u p e r i o r i t y of b r e a s t - f e e d i n g o v e r artificial vision of three-pin plugs. He asked whether there was any way of f e e d i n g is still m a i n l y conjectural. preventing accidental death from gas escaping from fires connected T h e r e are m a n y q u e s t i o n s still to b e a n s w e r e d conclusively. with penny- or shiUing-in-the-slot gas meters. For educational W h a t is t h e p r o p o r t i o n o f m o t h e r s w h o fail to e s t a b l i s h b r e a s t purposes there was no doubt that health visitors would be the most feeding ? W h a t is t h e d u r a t i o n of b r e a s t - f e e d i n g generally ? tmportant agents by keeping their eyes open when they visited the W h a t are t h e differences in different social g r o u p s a n d family homes, and he thought also that the local B.B.C. would be of service. sizes ? W h a t are t h e reasons for failures ? H o w are the Dr. Boueher said regarding broadcasting that prevention of accidents had been mentioned in the " W o m a n ' s H o u r , " which was p h y s i q u e , t h e n u t r i t i o n a l state a n d t h e sickness experience o f extensively listened to. Regarding electrical plugs, he agreed, in i n f a n t s affected b y t h e i r feeding ? Q u e s t i o n s of this k i n d regard to the dangers of the two-pin plug, and said that it had also suggest at once t h a t t h e r e are m a n y gaps in o u r knowledge. been under consideration whether plugs need be at ground level T h e c o n t r i b u t i o n we are able to m a k e in this p a p e r is a m o d e s t at all and should not be placed higher where they were out of reach one ; a n d u n f o r t u n a t e l y o u r data are n o t generally comparable. of young children. w i t h t h o s e o f m o s t o t h e r r e c e n t surveys. T h e w e a n i n g rate Dr. Miriam Florentin (Senior A.M.O.H., West H a m C.B.) was m o n t h b y m o n t h u p to n i n e m o n t h s is rarely g i v e n in p u b l i s h e d convinced that overcrowding was the main factor in many home accidents. She thought it was a mistake in the overcrowding legis- papers, a n d m o s t of t h e g r o u p s investigated are selected, i.e., lation that babies were not reckoned in computing the n u m b e r of i n f a n t s in n u r s e r i e s a n d hospitals o r a t t e n d i n g welfare eentres. T h e p r i m a r y p u r p o s e o f t h e survey s f r o m w h i c h t h e data dwellers and children under five only reckoned as half unit. T h e chairman asked if there was any authoritative view about the for t h i s p a p e r were d r a w n was to estimate t h e a m o u n t a n d dangers of pillows for babies. H e pointed out one danger of suffoca- n a t u r e o f infantile s i c k n e s s ; i n f o r m a t i o n a b o u t feeding tion by babies getting their heads between the bars of cots and histories was, therefore, incidental. N o a t t e m p t was m a d e to thought that the distance between bars was a n important point. He investigate i n f a n t feeding i n detail, n o r to assess t h e causes of mentioned one unusual accident where a baby had been suffocated a failure to b r e a s t - f e e d at different ages. T h e h i s t o r y dealt by a plastic bib which blew over its face. Regarding loose gas taps, he mentioned a device by which a tap was self-locking and had to be o n l y w i t h t h e age i n m o n t h s a t w h i c h b r e a s t - f e e d i n g ceased completely. N e v e r t h e l e s s , we feel justified i n r e p o r t i n g o u r lifted to turn on. I n regard to the danger of a coin-in-the-slot meter, he suggested that a small pilot light on the gas fire might obviate findings because legitimacy a n d h o u s i n g c o n d i t i o n s , social class a n d f a m i l y size, w e r e all investigated, a n d it was, t h e r e this danger. Finally, in moving a hearty vote of thanks to Dr. Boucher, h e " fore, possible to relate f e e d i n g h i s t o r y to t h e s e factors. M o r e regretted the small attendance b u t said that the value of the paper over, t h e s u r v e y g r o u p (1,498) h a s t h e a d v a n t a g e o f relating and the discussion would be appreciated b y all m e m b e r s when they to all t h e b a b i e s b o r n i n 1945 in a t o w n o f t i 0 , 0 0 0 i n h a b i t a n t s , read it in the journal. a n d n o t to a selected g r o u p (for example, welfare b a b i e s or babies b o r n i n hospital). T h e m a i n f i n d i n g s are as follows : COUNTY BOROUGH M.O.H. GROUP Under the presidency of Dr. R. M. Galloway (Bolton), the County Borough M.O.H. Group will hold their Annual Meeting and Conference at "Low Wood," Windermere, from May 6th to 9th, 1949. The programme includes a talk on " The Working of the National Health Service Act, 1946," by Dr. C. Metcalfe Brown, Medical Officer of Health of Manchester, and Dr. F. Hall, County Medical Officer, Lancashire, on " Maternity and Child Welfare " by Mrs. Baker, formerly Matron, St. Mary's Hospital, Manchester, on " M e n t a l Health Service responsibilities of Part III Authorities under the Health Service Act, t946" by Dr. W. Rees Thomas, Ministry of Health, on " T h e Care of the Deaf in the Community " by Drs. A. W. G. and Irene Ewing, University of Manchester, on " The Training of Health Visitors " by Professor I. G. Davies, Leeds University, and on " Medicine--Social and Anti-Social--in West Africa " by Professor Andrew Topping, University of Manchester. The Hon. Secretary is Dr. J. Greenwood Wilson, Cardiff. An announcement by the University of London of the By~ott studentships tenable at the London School of Hygiene and Troptcal Medicine appears on p. x of this issue. Copies of the Index of Volume 61 of PUBLIC HEALTH are now available free of charge on request to the Executive Secretary.
Age of Weaning T h e s u r v e y s h o w e d t h a t f o r t h e w h o l e g r o u p (1,498 infants) t h e p e r c e n t a g e o f i n f a n t s n o l o n g e r b r e a s t fed a t different m o n t h s of age was B r e a s t - f e e d i n g n o t e s t a b l i s h e d o r lasting less t h a n 10 days . . . . . . . . . . . . . . . 20~o Off breast completely : 1 month . . . . . . . . . . . . . . . 26% 2 months . . . . . . . . . . . . . . . 35% 3 . . . . . . . . . . . . . . . . . 43% 4 . . . . . . . . . . . . . . . . . 5t% 5
. . . . . . . . . . . . . . . . .
5~%
6
. . . . . . . . . . . . . . . . .
GI%
7
. . . . . . . . . . . . . . . . .
73%
8
. . . . . . . . . . . . . . . . .
79%
9
.
.
.
.
.
.
.
.
-.
.
.
.
.
.
84%
I t will b e n o t e d t h a t a b o u t a q u a r t e r o ( ' t h e i n f a n t s were n o l o n g e r o n t h e b r e a s t at t h e age of o n e m o n t h , a n d t h a t above this age i n f a n t s were t a k e n off t h e b r e a s t at a fairly s t e a d y rate u p to t h e age o f six m o n t h s . A t t h e age o f six m o n t h s 39~to o f i n f a n t s were still b r e a s t - f e d a n d 16~o were still h a v i n g one or m o r e b r e a s t - f e e d s at t h e age of n i n e m o n t h s . T h a t is to say,