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9
The above being the assigned causes of death, it will be convenient to consider first the
apparent effect of want of breast milk, artificial feeding, the employment of mothers and other
factors which might affect the health of infants adversely.
Artificial Feeding—Out of the total infant population it may be assumed that a very large
proportion is at the outset breast fed, and inquiries have in fact shown that out of 527 children
born in and surviving to the end of the year 1911, 97 per cent. were being fed on the breast alone
at the age of 10-20 days. Between the ages of three weeks and three months, the proportion of
breast-fed children is reduced to 87 per cent., whilst the following tabulated summary of the Health
Visitors returns shows that out of 719 children who were born in 1911 and survived to the end of
the year, 68 per cent, were still being fed on the breast alone at the age of 6 months.

From the above Table it will be seen that the history of infants who died affords a striking
contrast to the history of the feeding of those who survived. In the infant population the number
of breast-fed children steadily diminishes with each month of life, and for this reason it may be
fairly assumed that the proportion of infants who are still at the breast at the mean age of 6 months,
either represents accurately the proportion so fed among infants aged 2 days to 9 months, or tends to
understate their numbers. On this assumption, if artificial feeding exercised no influence on a
child's chances of survival or death, only 32 per cent. of those who died during the year between the
ages of 2 days and 9 months would have been artificially fed before their fatal illness, whereas, as a
matter of fact, the proportion of the artificially fed amounted to no less than 64 per cent. of the
children dying at the ages mentioned. Of the children dying from summer diarrhoea, only 11 per
cent, were fed on breast milk alone, and even when the deaths from diarrhoea are excluded, more
than 50 per cent, of the children dying from all other causes are still derived from the class of the
artificially fed, as compared with the very much lower proportion of 32 per cent. in the same class
among those who survived.
Evidently then artificial feeding carries with it an element of danger to life in the homes of
the poor, but the recognition of this elementary fact is very far from justifying the additional
conclusion that the whole or even the greater part of the blame for the deaths which occur should