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12
In the early months of the year, a severe epidemic of whooping cough spread throughout
London and this was responsible for the deaths of 21 children under the age of one year in Kensington,
as compared with two deaths in the preceding year.
The increase in the number of deaths from enteritis gives cause for anxiety, especially in
view of the fact that the Council for the past six years have taken very energetic measures in an
attempt to reduce the high death rate from this disease. Zymotic enteritis in children under five
years of age is compulsorily notifiable in the borough and the Council have introduced a scheme
for the treatment of this condition. This scheme includes the employment of the services of
Dr. Ronald Carter during the months of June, July, August and September, and attention is
drawn to his report on page 71.

From the above table, it will be seen that the deaths cannot entirely be attributed to summer
diarrhoea, for they were fairly evenly distributed throughout the year. There is no doubt that
improper or irregular feeding, lack of knowledge on mothercraft, and poverty, are factors largely
responsible for these deaths from enteritis. Of the 47 deaths from enteritis of infants under the
age of one year, only 22 of the cases were notified; this is explained by the fact that the doctors
were probably satisfied that the patients were not suffering from the zymotic variety of this
disease.
On investigating the 213 infant deaths, it was found that 68 were of children under the age
of one month; fifty-four died in the first week of life, six in the second week and the remaining
eight in the third and fourth weeks. The Council's health visitors, except in special circumstances,
do not pay their first visit to the infant until fourteen days after the birth, as up to that time the
midwife and doctor have been in regular attendance; therefore, welfare visits to the home after
the birth can have but little influence in reducing the number of deaths in the early days of life.
In order to reduce the number of deaths in early life, more attention must be paid to ante-natal
supervision.
In only eighteen instances out of the sixty-eight infant deaths mentioned above, had the
mother attended an ante-natal clinic before the birth of the child.

It has been mentioned to me by persons interested in child welfare that the increasing number
of deaths from premature birth may to some extent be attributed to attempts made by mothers
to cut short their pregnancy by artificial means. With a view to investigating this suggestion,
I have interviewed a number of lady doctors and nurses and find that the majority have formed
the impression that attempts to produce miscarriage are increasing in number, but I have been
quite unable to secure any definite evidence in this direction.
Many factors may contribute to premature birth, but there is no doubt that if an improvement
is to be effected mothers must receive adequate advice and care during pregnancy.
Every effort has been made to provide adequate ante-natal supervision for Kensington women
and it is disappointing to find that, in the investigations made by the Public Health Department
into infantile mortality, the fact is established that only a small proportion of the mothers whose
babies have died received ante-natal care. This statement alone is sufficient to warrant more
attention being directed to ante-natal work.