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" Influence of weather.—The hot summer was a very trying time for babies fed on cows' milk,
many homes not being provided with accommodation for keeping it cool and fresh. I have been
in rooms in which it was difficult to breathe—stuffy and unventilated, well stocked with children,
and swarming with flies, which settle freely on the lips of the unprotected baby, or perish in the
uncovered milk vessel. The plague of flies is, I believe, responsible for much of the mortality
from infantile diarrhoea.
"Cleanliness.—As regards cleanliness, the home of the mother wn» goes out to work is naturally
the most neglected : the room is generally ' cleaned up ' at night.
"Bathing.—Many mothers have a rooted objection to washing the baby when ill, and some of
the little things suffer a long and miserable convalescence from being deprived of the accustomed
tonic of a hot bath for, it may be, days or even weeks. The mothers are often surprised when I
insist upon the need of a hot bath—and stay, sometimes, to see it given. Under ordinary circumstances
the baby is sometimes washed before little or no fire; and often very early in the
morning, even in bitter cold weather, is carried out, after a hurried meal, lightly shawled, to the
caretaker, to enable the mother to get to her work-place by 8 o'clock. This practice, and the return
journey at night, may reasonably account for some of the many deaths from lung diseases.
" Ventilation.—Whenever I can, I endeavour to persuade the mother to unseal the windows
and remove the plugs of rags wedged into every crevice, and so let in some fresh air. The hot
room is too often used for drying the family washing.
"Revisiting.— I feel that the amount of my revisiting is most inadequate. I should like to be
able to revisit, at least two or three times, all infants whose mothers go to work, or who are expecting
to go to work, at the time of my call; all infants artificially fed, wholly or partially; all
infants found sick or weakly, or where a change of any sort has been suggested by me; and all
infants whose mothers have lost by death more than two babies. I should like also to revisit every
child once, at least, during the teething period. From the necessity of the case my visit to the
children, in the great majority of instances, is, as I have said, a solitary one, and is paid long before
teething begins. Experience has satisfied me that the value of the Health Visitor's work is largely
a question of her ability to keep the babies visited under more or less frequent observation."
Tables appended to the report show—
(1) Visits and re-visits in the several Wards:—St. Charles, visits 398, re-visits 214; Golborne, 664
and 259; Norland, 407 and 249; Pembridge, 168 and 70; Holland, 123 and 19; Earl's Court, 149 and 9;
Redcliffe, 90 and 10; Brompton, 42 and 9. (No information obtained in 67 cases). Total visits, 2,138;
re-visits, 842.
(2) The manner of feeding of the infants observed at the first visit: viz., breast-fed, 1,673; handfed,
201; breast-fed and hand-fed, 197; improperly hand-fed, 110. Long tube bottles seen in use in 58
instances only.
(3) The state of health of the infants at the first visit: Healthy, 1,785; weakly-born, 121; sick,
weakly, ill-nourished, 286; weakly babies hand-fed, 129; weakly babies improperly hand-fed, 51.
(4) Number of rooms occupied by families visited: One room tenements, 393; two room tenements,
1,093 ; three (or more) room tenements, 508. N o home ; mothers in maternity ward at infirmary, 77.
" Observations by the Health Visitor with respect to 250 deaths of babies under one year of
age, the causes of which were investigated.—Out of the 452 deaths of Infants under one year of
age, 250 were subjected to an investigation with a view to obtaining information regarding the
method of feeding adopted. Forty-three of the deaths were of illegitimate children; 52 of the
babies were born weakly; 55 of the mothers were constitutionally delicate, and 31 of them
physically unable to suckle their infants. Nine of the mothers were obviously of intemperate
habits : seventy-four went out to work leaving their infants to the care of relatives and young
children, and to women who ' foster-mother' as a means of livelihood, some of them being
intemperate, unreliable and ignorant.
"Of the Homes visited, 56 were single rooms, 22 of which were let ' furnished.' In some
of these I found large families; 107 were homes of two rooms ; 31 of three or more rooms. Twentyfour
homes were dirty and ill kept, and in many there were no means for keeping milk fresh and
cool in hot weather.
"Feeding.—Of the 250 infants, 57 were breast fed, only, up to the time of death : 38 were
partially breast fed ; 155 were wholly hand fed, 66 of them from the time of birth, and
44 of them improperly. Infants described as ' improperly fed' (age of child in each case fully
considered) had been given cows' milk and boiled bread; boiled bread and no milk; biscuits and
(or) some other farinaceous food; patented foods; tinned milk. Some that were suckled were
also given ' a bit of what we had ourselves.'