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Ordinary Food Stuffs.—After seven months the infant will receive some of the ordinary foodstuffs used by the
family, and the considerations advanced above as to the way in which this food is lacking would apply here also.
In this connection it should be mentioned that instruction of the mother by means of leaflets, such as those
of the London Public Medical Service which deal with breast feeding and feeding after seven months, has been
found to give good results.
Maternal Care.
In 23 per cent, of cases this was "poor," in 21 per cent. "fairly good." The comparatively low percentage
of good mothers must be a factor in causing the illness and death of these infants. This rather confirms what is
found in general practice—that the chief factor in producing a robust child is maternal care. When a good mother
has in addition the advantage of sound advice on child management, the results are very good.
The following is quoted from "Better Health," for June, 1930:—
"The children from our poorer quarters would appear to be ill-nourished and unsuitably fed. . . . There
can be little doubt that part of this is due to improvidence on the part of the parents, part to parental laziness,
cooking being too much trouble. In some cases it is, of course, the result of unavoidable poverty.—Dr. Austin
Priestman, Folkestone."
Foster-Care.
The scanty figures would suggest either that very few Kensington infants were looked after except by their
parents, or that the standard of foster-care in the borough was high, and that deaths, therefore, were few.
Possibly in some future investigation this point may be cleared up.
Size of Family.
The figures in Table I seem to show that size of family by itself has little bad effect on the health of the
children. This corresponds to the conclusions come to on this point in Dr. Corry Mann's report alreadj' referred
to. The Committee feel that the death-rate in small families is higher than it should be.
Proximity of Open Spaces.
This appears to have little influence on the death-rate ; this was the finding also in Dr. Corry Mann's report.
But it must be kept in mind that as few of these families have gardens, an open space is a necessity, and in
only 83 of the 187 cases was this easily available.
Cleanliness of Streets.
The Committee are satisfied with the steps taken by the Borough Council to cleanse the streets, and do not
wish to suggest that these are in any way inadequate. But a great deal of filth is deposited on the pavements
and streets which could otherwise be disposed of. In certain streets the washings of butchers', fishmongers',
and some grocers' shops run slowly over the pavements to reach the gutter, where they lie in pools till evening.
On the other hand bakers, confectioners, and other grocers appear to be able to secure a (presumably) equal
degree of cleanliness in their shops and to dispose of the washing water by waste-pipes inside their premises.
On Mondays the general messy condition of the streets is added to by the ostentatious washing of the furniture
of the butchers' shops, partly on the pavement, partly in the roadway.
There are several ways in which these conditions may adversely affect the health of the community. In the
first place, actual decaying material may be conveyed into the houses. Also there is the general depressing
effect of such conditions. Then from an educative point of view it seems wrong that school children should come
to consider such a state of affairs as normal.
That the ordinary citizen should share the responsibility for keeping the streets clean by preventing them from
becoming dirty is the suggestion conveyed by the receptacles fixed to lamp-posts, etc., in this and other boroughs.
The Committee feel that an extension of this principle is urgently required in the case of those responsible for the
state of affairs mentioned in the preceding paragraphs.
The Committee feel that this Report suffers because there has been no opportunity of comparing
the figures with similar figures from other areas or with those for normal children in this area.
The Committee suggests, however, that a similar investigation, carried out not only in Kensington, but over
the same period in the adjacent Boroughs of Paddington and Hammersmith, might produce extremely helpful
data which would either confirm or contradict the findings of the present Report. As these three boroughs are
the area covered by the Kensington Division of the B.M.A., possibly such an investigation might be carried out
under the auspices of this Division with the co-operation of the Medical Officers of Health concerned.
In view of this possibility the Committee has appended a schedule of the more detailed information which,
in the light of the experience gained by the present investigation, they think should be obtained regarding each
infant mortality case, before it is classified as A. B or C.
SCHEDULE OF INFORMATION,
Housing No. of rooms.
Individuals per room.
Water supply and sanitation.
Self-contained or tenement.
Income Total income.
Income less rent.
Income per head.
Maternal Employment Ante-natal.
Post-natal.