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it by a rubber teat which is supplied at cost price. The number of feeds given daily varies from 9
for young infants to 6 for older ones. The mother must call daily for the milk, and on Saturdays get
a double supply.
The staff required consists of a manageress and a couple of assistants, and a man to spend about
half a day attending to the boiler, &c., during the time of sterilizing and washing the bottles.
As to the benefits derived from the depots, the Medical Officers of Health for Battersea and Lambeth
are absolutely convinced of their utility, for in spite of the fact that the large majority of infants
coming to the depot are actually ill or below par, the infantile mortality among them varies from
one-third to one-half of the mortality among a similar population in the Borough not using the milk.
As, however, many persons are suspicious and often justifiably so about statistics, I will quote a
paragraph from the latest report of the Medical Officer of Health for Lambeth, Dr. Priestly.
" The most conclusive proof of he value of a milk depot, in so far as the children fed are
concerned, is to be found in the medical histories of individual cases, which show again and
again that infants who appear to be seriously ill and wasting, if not moribund, as a result of
improper or irregular feeding, at the time of commencing the milk, actually recover and become
strong and healthy children.
" The educational value, too, of a milk depot must not be lost sight of."
To start a depot on a small scale the apparatus will cost about £150, and the alteration to a house
to carry on the work £200 or £300, and the net cost to the Borough about £300 per annum.
Since preparing this report I have heard that there is a municipal milk depot in Leicester in which
dried modified milk is supplied, and that its operations have been most successful, not only in preserving
infant life but as regards expense, for it is said to be carried on without any financial loss
whatever. I hope next week to have an opportunity of visiting it and shall make a further report
at an early date."
Injant Milk Depot. (Dried Milk.)
" As intimated in my previous report, I have made local inquiries in Leicester as to their experience
of the use of dried milk in their infant milk depot, and find the results, both medically and financially,
entirely satisfactory.
The County Borough of Leicester has a population of 227,000 inhabitants, a large proportion of
which consists of the working classes. Owing to the difficulty of getting suitable milk for infants
a depot on the lines of those in Battersea and Lambeth was started in July, 1906. As, however,
it soon became evident that it was a great expense, and in addition only served the position of the
inhabitants in its immediate neighbourhood, chiefly owing to the inconvenience of sending for the
milk every day, the medical officer began to experiment cautiously with dried milk in the latter end
of 1907. During the following two and a half years liquid and dried cow's milk were both used, the
latter in ever-increasing amount, until about two years ago the use of the liquid milk was finally
abandoned. In the first year of dried milk alone the net cost of the depot was £43, and in the second
year the receipts were in excess of the payments £41 3s. 7d. ; but since it is not the intention of the
borough to make money out of the depot, the surplus will be probably used to reduce the price of
milk to some of the most needy of the clientele.
Here is what Dr. Killick Millard says on their first experiment in his Annual Report for 1910 :—
"At first only infants were put on to this who were not thriving, or who were unable to retain the
humanised milk. The results in most cases were so encouraging that its use was gradually extended.
Mothers began to ask that their babies might be changed on to the dried milk, and it was practically
unknown for a mother whose baby had once been placed on dried milk to ask to go back to the
humanised. The medical men in the town also began to appreciate the virtues of dried milk, and quite
a number of infants were sent by medical men with a request that they should be placed on it.
" At first, and for a considerable time, it was thought desirable to advance cautiously, lest it should
be found that the prolonged use of the dried milk might be accompanied by certain dangers, such as
the development of infantile scurvy, supposed to be caused by the use of sterilised milk. Careful
watch was kept for any untoward symptoms, and inquiries were made as to the subsequent health
of infants several months after they had discontinued having the milk. An inquiry was also addressed
to the medical men to ascertain if they had any reason to suspect injurious effects. The inquiry
was very reassuring, for no bad results could be discovered as a set-off against the obvious immediate
good results. Indeed, I may say that we have quite come to believe, with certain eminent authorities,
that the fear of infantile scurvy or rickets from the use of dried milk is a bogie which need no longer
alarm us."
In his Annual Report for 1911, and up to the present date, the experience of the medical officer
amply confirms the statement I have quoted above. In 1907 the average number of infants receiving
the weekly supplies of milk was 102, and from that date till now its popularity has steadily increased
till now nearly 400 are using the milk. When at the depot I saw many infants at present being fed
on dried milk, and also saw some who had been fed on it some years before, and all seemed to be
thriving.
The depôt consists of an ordinary small shop in a poor part of the town. This is fitted up with
shelves and a couple of large zinc-lined receptacles where the dried milk is stored. From these it
is weighed and put into pound tins and a suitable label is affixed explaining the method of using the
milk. Three sorts of milk are supplied by the wholesale dealers, viz. : (1) " Full milk," i.e., with
all its fat, (2) three-quarter milk, and (3) half milk, each with three-quarters and half of its original
fat respectively ; a certain amount of sugar is also mixed with it. Each mother is supplied with a
small ladle, and so many fills of this are added to a certain quantity of hot water. If the infant is
under three months it gets half milk, from three to six months three-quarter milk, and from six
months upwards full milk. The milk is very digestible and as it is mixed fresh for each meal it is
impossible for it to go bad during keeping in the home. This dried milk will keep wholesome an
indefinite time, and herein lies an inestimable advantage, for one of the most fruitful causes of
infantile diarrhoea is the decomposition of ordinary milk, which inevitably takes place a few hours
after its arrival in the home especially during the summer months. In the process of drying the
milk is sterilized, and is therefore incapable of transmitting bovine tuberculosis or other infectious
diseases.