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general denial to the babe of its natural food, etc., the wonder is, not that so many infants die, but
that so many survive the age of infancy—often only to die, from one cause or another, before
attaining the age of five years. It may be asked, how can this sacrifice of life be prevented or
diminished? So many children, born weakly or prematurely, hold to life by such a slender thread,
that infantile mortality must needs be high, always. But that there are many preventable deaths
admits of no doubt, and I am persuaded that the remedies for the evil must be sought in improved
homes, better training of girls to fit them for their duties as wives and mothers; and, if mothers
cannot be induced to suckle their babes, in a purer milk supply. Probably, for the present, at least,
the means last named is the more easy to be attained, and pre-eminently by the institution of
"Municipal Milk Depots for the supply of sterilized and humanised milk." When this system of
infant feeding shall have become general, we may look for a reduction in mortality from diarrhoea,
and other causes, amongst the children brought up by hand, who furnish by far the larger proportion
of the victims. But, so far, the Local Government Board have not sanctioned provision of these
establishments. Dairymen have taken no steps to supply the want as regards the poor (to whom
the mortality is practically confined), and are understood to be unfriendly to the adoption of the
system by public health authorities. "Municipal milk "has been provided, in London, in one borough
only—that of Battersea; and the Council, though surcharged, are continuing the good work. The
sterilized milk is sent out in stoppered bottles, each of which contains the exact dose required
for a meal; the bottle is not opened until it is wanted, and what milk is not consumed at the time
is not given to the infant.
WOMEN HEALTH VISITORS.
In May, 1900 (No. 5 report), I recommended the late Vestry to appoint women as Health
Visitors to perform duties analagous to those devolving upon this class of officers at Manchester,
Salford, Birmingham, etc., and which were set out in the annual report for that year (page 52),
The Sanitary Committee reported sympathetically on the proposal as one "deserving of the careful
attention of sanitary authorities," though they felt it "undesirable that any new office should be
created" at that "period of the Vestry's waning existence." Nevertheless, at the meeting of the
Vestry, on 18th July, there was a strong expression of opinion that action should be taken forthwith.
Ultimately, however, a motion to that effect was negatived.
Consideration of the facts with regard to infantile mortality in the borough, as set out in
other parts of this report, led me to revive the subject in the first monthly report for the current
year, in connexion with a report of the lady inspectors on infantile diarrhœal mortality in 1903.*
My report having been referred to the Public Health Committee, I submitted a further note on
the subject, showing that the excessive mortality was confined to three of the wards in North
Kensington; viz., St. Charles, Golborne, and Norland. In these wards, which have a population of
72,300, the deaths under one year were 366, compared with 144 in the other six wards (Pembridge,
in North Kensington, Holland, Earl's Court, Queen's Gate, Redcliffe, and Brompton, in South
Kensington), having a population of 105,700: or, to put it in another way, the deaths under one year
in the three wards were in the proportion of 167 to every 1,000 births registered, compared with 98
per 1,000 in the other six wards. The only satisfactory feature in the case is the high birth-rate in
the three wards, which in 1903 was 30.4 per 1,000 of the population (compared with 13.0 in the
remaining wards). The births were 2,194, and more numerous by 1,828 than the deaths under one
year, whilst the births in the other six wards were only 1,371, and only 1,227 more than the deaths
under one year. The disparity would have been far greater had the general death-rate been equal;
but the death-rate in the three wards was 18.8 per 1,000, compared with 10.9 in the other six wards.
The most unsatisfactory feature in the case is that in the southern division of the borough (population
86,230) the births exceeded the deaths by 64 only, having been more than the deaths in Redcliffe ward
by 99 only, and fewer than the deaths, by 25, in the remaining wards (Holland, Earl's Court, Queen's
Gate and Brompton). The growth of population by natural increase, was, in fact, practically confined
to St. Charles, Golborne and Norland Wards. I venture to think that an effort should be made to
save some of the excessive waste of infant life in these three wards, as by the suggested appointment
of Women Health Visitors, one of whose duties it would be to visit mothers as soon as practicable
after the birth of children, to advise them with respect to the proper feeding, and, generally, as to the
up-bringing of their offspring.
The Public Health Committee, after consideration of the subject (February 23rd), thought it
desirable to refer it, and my reports, to the Housing sub-Committee for consideration, and there the
matter rests for the present.
* Vide page 44.