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The high incidence of diarrhoea among hand-fed infants is a fact generally recognised. Instructive
figures are contained in a report by Dr. Howarth, of Derby, who has shown the mortality from different
causes among 8,343 infants whose history during the first year of life he recorded. The following
figures are extracted from a table contained in a paper he read in 1905 before the Derby Medical
Society:—

Further, he shows that under each other cause of mortality the rule holds good that the handfed
infants die in greater proportion than those who are first breast-fed and afterwards hand-fed, and
these again in greater proportion than those who are wholly breast-fed.
The annual reports show that throughout London, generally, sanitary authorities are devoting
increased attention to the study and prevention of infantile mortality. A conference on the subject,
under the presidency of Dr. R. M. Beaton, was held in June, 1905, at the St. Pancras Town Hall,
This conference was largely attended and resolutions were adopted which aimed at the bringing of newborn
infants under the early supervision of the health authority, with a view to securing the
better treatment and feeding of infants. In the majority of districts female inspectors are
employed in this connection, and in order to enable sanitary authorities to obtain early knowledge
of the birth of infants, the Registrar-General has authorised registrars of births, deaths and
marriages to supply them with the addresses of parents the births of whose infants have been registered.
The London County Council, moreover, in its administration of the Midwives Act, has arranged to
receive from midwives weekly the names and addresses of patients attended by them and this
information is communicated to the Medical Officers of Health concerned. The returns received from
midwives are at the rate of about 30,000 births per annum, or about a quarter of the total births. In
this way new-born infants in the poorest-class of the London population can be brought under
supervision shortly after birth.
The action taken by sanitary authorities is shown in the majority of the annual reports. The
homes of the mothers are visited, and printed and verbal advice is given. In Battersea and Lambeth
milk depots have been provided by the sanitary authorities, and in Finsbury by charitable effort,
the Medical Officer of Health being the advisor. In Holborn, the Borough Council has made
arrangements with a dairy company for the supply of suitable milk at a cost of 4d. per infant,
per day, in cases in which the Medical Officer of Health certifies that the supply is necessary.

1 For purposes of comparison deaths from Infective Endocarditis are included under this heading.
11476 c 2