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country are healthy at birth. Among the causes of this high mortality in children
during the first year of life are:—
(a) Want of breast milk.
(b) Want of a pure supply of milk in cases in which artificial feeding must
be resorted to.
(c) Breathing foul air.
(d) Insufficient warmth.
(e) Want of cleanliness and sleep.
Among the contributory factors are:—
Improper housing conditions.
Poverty.
Condition of work.
Drink.
Ante-natal conditions.
There has been a marked decrease in the infantile mortality during the last
20 years or so in each district in the Borough, but nowhere so marked, perhaps
as in the Limehouse district, where it was above 200 per 1,000 births in the two
quinquennial periods, 1895-1899 and 1900-1904.

For a few years previous to 1911, the marked decrease in infantile mortality
was probably due to such favourable conditions as cool and wet summers which we
experienced. These conditions, however, cannot be held responsible for the gradual
decline during the last 22 years. It must be due to improved sanitary conditions
and an awakening to the fact that innumerable and unnecessary deaths were
occurring from year to year.
In a part of the Limehouse district where the Health Visitor first commenced,
as already stated, there is a larger number of females working in factories than in
any other part of the. Borough. The mothers, soon after confinement, return to
work, and leave the baby in the custody of one of their other children, which renders
hand-feeding inevitable. Human milk is the best food, and no other milk can be
made into a perfect food for infants. In infant feeding nature is superior to art,
and the artificial food should approximate as closely as possible to this ideal.