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The prevention of infantile mortality
~y, igo~
The Prevention of Infant, Mortality
667
THE PREVENTION OF INFANTILE MORTALITY. A CONFERENCE on the prevention of infantile mortality and the welfare of nursing mothers and suckling infants was held on June 5th at the St. Paneras Town Hall. Dr. R. M. Beaten, Chairman of the Public Health Committee of that borough, presided. Sir Lauder Brunton wrote advocating that pure ~esh milk should be used rather than boiled or sterilized milk for infants' food. The resolutions set out below were adopted :--
A.--Mothers. 1. That it is desirable that every encouragement should be given to prospective mothers to seek advice as to the management of their health, so that they may endow their offspring with good constitutions and prepare themselves to suckle their infants when born. 2. That it is desirable that all ef[or~s should be exhausted upon improving the health of suckling mothers before devoting attention solely to their infants.
B.--Breast-Feeding o[ Infants. 1. That it is desirable that births should be registered within five days of their occurrence, as is required in the case Of deaths by the Births and Deaths Registration Acts, and be not delayed for six weeks and longer as now by law permitted: 2. That it is desirable that the municipal authority should obtain weekly returns of births from the registrars. 3. That it is desirable that the municipal authority should send to the addresses of all mothers, furnished in the weekly returns, cards or leaflets of advice, laying greatest stress on the improvement of ante-na~al conditions, on the preparation for and maintenance of breast-feeding of infants during the first nine months of life, and strongly advising mothers not to wean their infant~ prematurely except upon medical advice. 4. That it is desirable that women inspectors should be appointed with a view to the prevention of infantile mortality by selecting from the weekly returns suitable cases amongst the poor for inquiry, affording general information in the hygiene of nursing, and directing the necessitous poor where to apply for such advice and assistance as may be urgently required in order to maintain breast-feeding. 5. That it is desirable that medical practitioners, midwives, and nurses, the staffs of hospitals and dispensaries, and the religious, charitable, and social organizations should co-operate with the municipal authority in endeavouring to encourage breast-feeding, and to diminish the infantile mortality. 6. That it is desirable that any suggestions or arrangements made by medieM practitioners or by the medical charities for the purpose of advising nursing mothers with a view to preventing infantile mortality, should be communicated to the mtmicipal authority in order that they may be made known through the women inspectors. 7. That it is desirable that the information should be spread broadcast that breast-feeding is the most economical, easy, and safe mode of feeding infants under nine months of ago, with a view to reducing the number of hand-fed sucklings to the smallest proportion possible. 47
6~
The Prever~tion of Infant Mortality [~u~ ~ r ~ C.--Premature Weaning.
t.--That it is undesirable that a suckling mother should be separated from her infant, or the infant from the mother, except for reasons of ill-health and under medical advice. 2. That it is desirable that when a woman inspector has reason to believe that a suckling mother is in a necessitous condition and unprovided with sufficient food to enable her to maintain her own strength and suckle her infant as well, she should endeavour to prevent weaning by reporting the case to the charitable organization most appropriate to deal with the circumstances. 3. That it is desirable that when a woman inspector finds that a suckling mother has insufficient nourishment, due to the husband being out of work, she should report the case to the labour bureau. 4. That it is desirable that mothers should be urged not to wean their infants until the ninth month of age except upon medical advice. 5. That it is desirable that mothers should be warned that the hand feeding of infants is expensive, troublesome, and unsatisfactory, risky at all times, and in summer dangerous and often fatal. 6. That with a view not to encourage premature weaning, it is desirable that milk for the hand feeding of infants provided privately or publicly by milk depSts at or below cost should be distributed upon the orders of medical practitioners. The following resolution being opposed by some of those present was withdrawn : That it is desirable that a suckling mother, if obliged to work at a trade, should work at home as an outworker, rather than in a workplace away from home which may necessitate weaning, and that to facilitate the fetching and returning of work materials by outworkers, rapid and cheap means of transit radiating from business centres are necessary.
D.--Hand Feeding ot Infants. 1. That, having reduced the number of sucklings required to be hand fed to the smallest proportion possible, means should be devised for providing suitable milk for the remainder. 2. That it is undesirable to encourage the use of unclean, stale, or Jecomposing milk by pasteurizing or sterilizing it for the use of hand-fed infants who unlortunately cannot be fed with clean, fresh milk directly from the breast. 3. That it is desirable that cows' milk intended for hand-fed infants should be milked, transported, and distributed under special precautions. 4. That the special precautions required in the production of cows' milk for infants should include not only care in the selection, testing, and feeding of the cows, but also care in their pasturing, sheltering, and tending ; not only extreme cleanliness in milking, but also rigid aseptic precautions, accompanied by immediate refrigeration, maintained during transport, and by prompt, dispatch, so that the number of micro-organisms and the lactic acid in the milk may be reduced to a minimum at the time of delivery instead of the hundreds of thousands and millions of organisms and excess of lactic acid now to be found in so-called fresh milk. 5. That in order to prevent the pollution of infants' milk in distribution and in the home, it is desirable that it should be protected in stoppered bottles ready for feeding, and not be transferred to other bottles. 6. That on account of the facilities that hand-feeding affords for the over-feeding and under-feeding of infants, due to want of knowledge, especially amongst the poor, it is desirable that the quantity and quality oI milk required for each feed at the particular age should be distributed
July, 19~]
Vagrancy attd I~-tious Disease
in a separate stoppered bottle, and that each basket or crate of bottles for use should be accompanied by instructions as to the frequency and manner of feeding. 7. That the provision of cows' milk produced under aseptic conditions, accompanied by ex~eme cleanliness, refrigeration and dispatch, so diluted and enriched and put u p i n stoppered bottles in such quantities, to be administered at specified intervals suitable for suckling infants, should be regarded not only as ordinary foodi but i n the nature of medical assistance, 8. That for the special protection of hand-fed infants it is desirable that Municipal Authorities should not only ascertain the quality of milk intended for infants by ct~emical analysis, and receive from the public analyst a statement of the percentage composition of each sample of milk submitted, as to fat, solids not fat, and total solids, and the absence of chemical preservatives, but also by bacteriological examination, and receive from the bacteriologist a statement in regard to each sample of milk submitted as to the number of micro-organisms per cubic centimetre and the proportion of lactic acid per cent., these being the best existing test~ of cleanliness and freshness of the milk.
VAGRANCY AND THE SPREAD OF INFECTIOUS DISEASE. THE Conference held in November last at Spring Gardens appointed a Committee consisting of representatives of County Councils, ~ounty Borough Councils, and Metropolitan Authorities to give practical effect to ~he resolutions adopted by the Conference. The Committee forwarded the resolutions adopted by the Conference to the various Associations of Local Authorities, and resolutions endorsing the majority of the decisions Of the Conference have been received from the Associations of Municipal Corporations and of Metropolitan Borough Councils, and the Association Of Poor Law Unions of England and Wales. The County Councils' Association has referred the resolutions to the various County Councils, but no decision has as yet been arrived at by the Associatiom On Thursday, June 22nd, a Deputation consisting of the Committee of the Conference and representatives from the Association of Poor Law Unions was received by the President of the Local Government Board at the House of Commons. The Deputation was introduced by Sir Walter Plummet, M.P. Alderman Dr. Newton, of Newcastle-upon-Tyne, submitted the resolutions adopted by the Conference and those adopted by the Associations already mentioned. He urged that legislation to give effect to the views of the Conference should be promoted at an early date. The Mayor of Wandsworth (the Rev. J. H. Anderson) spoke on behalf of the Metropolitan Authorities, and Dr. G. Millson Rhodes on behalf of the County Councils. At the conclusion of the latter's remarks, Mr. Balfour, who gave the Deputation a most sympathetic reception, invited all those present to express their views on the question.
The Prevention of Infant, Mortality
667
THE PREVENTION OF INFANTILE MORTALITY. A CONFERENCE on the prevention of infantile mortality and the welfare of nursing mothers and suckling infants was held on June 5th at the St. Paneras Town Hall. Dr. R. M. Beaten, Chairman of the Public Health Committee of that borough, presided. Sir Lauder Brunton wrote advocating that pure ~esh milk should be used rather than boiled or sterilized milk for infants' food. The resolutions set out below were adopted :--
A.--Mothers. 1. That it is desirable that every encouragement should be given to prospective mothers to seek advice as to the management of their health, so that they may endow their offspring with good constitutions and prepare themselves to suckle their infants when born. 2. That it is desirable that all ef[or~s should be exhausted upon improving the health of suckling mothers before devoting attention solely to their infants.
B.--Breast-Feeding o[ Infants. 1. That it is desirable that births should be registered within five days of their occurrence, as is required in the case Of deaths by the Births and Deaths Registration Acts, and be not delayed for six weeks and longer as now by law permitted: 2. That it is desirable that the municipal authority should obtain weekly returns of births from the registrars. 3. That it is desirable that the municipal authority should send to the addresses of all mothers, furnished in the weekly returns, cards or leaflets of advice, laying greatest stress on the improvement of ante-na~al conditions, on the preparation for and maintenance of breast-feeding of infants during the first nine months of life, and strongly advising mothers not to wean their infant~ prematurely except upon medical advice. 4. That it is desirable that women inspectors should be appointed with a view to the prevention of infantile mortality by selecting from the weekly returns suitable cases amongst the poor for inquiry, affording general information in the hygiene of nursing, and directing the necessitous poor where to apply for such advice and assistance as may be urgently required in order to maintain breast-feeding. 5. That it is desirable that medical practitioners, midwives, and nurses, the staffs of hospitals and dispensaries, and the religious, charitable, and social organizations should co-operate with the municipal authority in endeavouring to encourage breast-feeding, and to diminish the infantile mortality. 6. That it is desirable that any suggestions or arrangements made by medieM practitioners or by the medical charities for the purpose of advising nursing mothers with a view to preventing infantile mortality, should be communicated to the mtmicipal authority in order that they may be made known through the women inspectors. 7. That it is desirable that the information should be spread broadcast that breast-feeding is the most economical, easy, and safe mode of feeding infants under nine months of ago, with a view to reducing the number of hand-fed sucklings to the smallest proportion possible. 47
6~
The Prever~tion of Infant Mortality [~u~ ~ r ~ C.--Premature Weaning.
t.--That it is undesirable that a suckling mother should be separated from her infant, or the infant from the mother, except for reasons of ill-health and under medical advice. 2. That it is desirable that when a woman inspector has reason to believe that a suckling mother is in a necessitous condition and unprovided with sufficient food to enable her to maintain her own strength and suckle her infant as well, she should endeavour to prevent weaning by reporting the case to the charitable organization most appropriate to deal with the circumstances. 3. That it is desirable that when a woman inspector finds that a suckling mother has insufficient nourishment, due to the husband being out of work, she should report the case to the labour bureau. 4. That it is desirable that mothers should be urged not to wean their infants until the ninth month of age except upon medical advice. 5. That it is desirable that mothers should be warned that the hand feeding of infants is expensive, troublesome, and unsatisfactory, risky at all times, and in summer dangerous and often fatal. 6. That with a view not to encourage premature weaning, it is desirable that milk for the hand feeding of infants provided privately or publicly by milk depSts at or below cost should be distributed upon the orders of medical practitioners. The following resolution being opposed by some of those present was withdrawn : That it is desirable that a suckling mother, if obliged to work at a trade, should work at home as an outworker, rather than in a workplace away from home which may necessitate weaning, and that to facilitate the fetching and returning of work materials by outworkers, rapid and cheap means of transit radiating from business centres are necessary.
D.--Hand Feeding ot Infants. 1. That, having reduced the number of sucklings required to be hand fed to the smallest proportion possible, means should be devised for providing suitable milk for the remainder. 2. That it is undesirable to encourage the use of unclean, stale, or Jecomposing milk by pasteurizing or sterilizing it for the use of hand-fed infants who unlortunately cannot be fed with clean, fresh milk directly from the breast. 3. That it is desirable that cows' milk intended for hand-fed infants should be milked, transported, and distributed under special precautions. 4. That the special precautions required in the production of cows' milk for infants should include not only care in the selection, testing, and feeding of the cows, but also care in their pasturing, sheltering, and tending ; not only extreme cleanliness in milking, but also rigid aseptic precautions, accompanied by immediate refrigeration, maintained during transport, and by prompt, dispatch, so that the number of micro-organisms and the lactic acid in the milk may be reduced to a minimum at the time of delivery instead of the hundreds of thousands and millions of organisms and excess of lactic acid now to be found in so-called fresh milk. 5. That in order to prevent the pollution of infants' milk in distribution and in the home, it is desirable that it should be protected in stoppered bottles ready for feeding, and not be transferred to other bottles. 6. That on account of the facilities that hand-feeding affords for the over-feeding and under-feeding of infants, due to want of knowledge, especially amongst the poor, it is desirable that the quantity and quality oI milk required for each feed at the particular age should be distributed
July, 19~]
Vagrancy attd I~-tious Disease
in a separate stoppered bottle, and that each basket or crate of bottles for use should be accompanied by instructions as to the frequency and manner of feeding. 7. That the provision of cows' milk produced under aseptic conditions, accompanied by ex~eme cleanliness, refrigeration and dispatch, so diluted and enriched and put u p i n stoppered bottles in such quantities, to be administered at specified intervals suitable for suckling infants, should be regarded not only as ordinary foodi but i n the nature of medical assistance, 8. That for the special protection of hand-fed infants it is desirable that Municipal Authorities should not only ascertain the quality of milk intended for infants by ct~emical analysis, and receive from the public analyst a statement of the percentage composition of each sample of milk submitted, as to fat, solids not fat, and total solids, and the absence of chemical preservatives, but also by bacteriological examination, and receive from the bacteriologist a statement in regard to each sample of milk submitted as to the number of micro-organisms per cubic centimetre and the proportion of lactic acid per cent., these being the best existing test~ of cleanliness and freshness of the milk.
VAGRANCY AND THE SPREAD OF INFECTIOUS DISEASE. THE Conference held in November last at Spring Gardens appointed a Committee consisting of representatives of County Councils, ~ounty Borough Councils, and Metropolitan Authorities to give practical effect to ~he resolutions adopted by the Conference. The Committee forwarded the resolutions adopted by the Conference to the various Associations of Local Authorities, and resolutions endorsing the majority of the decisions Of the Conference have been received from the Associations of Municipal Corporations and of Metropolitan Borough Councils, and the Association Of Poor Law Unions of England and Wales. The County Councils' Association has referred the resolutions to the various County Councils, but no decision has as yet been arrived at by the Associatiom On Thursday, June 22nd, a Deputation consisting of the Committee of the Conference and representatives from the Association of Poor Law Unions was received by the President of the Local Government Board at the House of Commons. The Deputation was introduced by Sir Walter Plummet, M.P. Alderman Dr. Newton, of Newcastle-upon-Tyne, submitted the resolutions adopted by the Conference and those adopted by the Associations already mentioned. He urged that legislation to give effect to the views of the Conference should be promoted at an early date. The Mayor of Wandsworth (the Rev. J. H. Anderson) spoke on behalf of the Metropolitan Authorities, and Dr. G. Millson Rhodes on behalf of the County Councils. At the conclusion of the latter's remarks, Mr. Balfour, who gave the Deputation a most sympathetic reception, invited all those present to express their views on the question.