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MATERNITY AND CHILD WELFARE SERVICES.
Under the council's scheme of maternity and child welfare, complete arrangements are made
for the care of expectant and nursing mothers, and children up to five years of age. The scheme
includes ante-natal and post-natal clinics, infant consultation sessions, day nurseries, a maternity
home, a municipal midwife, the provision of an obstetric consultant for difficult confinements, the
provision of free dentures for necessitous expectant and nursing mothers, hospital and convalescent
treatment for mothers and infants, home nursing and home helps, arrangements for the boarding-out
of children while the mother is in hospital, facilities for the skilled nursing and treatment of cases of
puerperal sepsis, and the supply of free milk, dinners and cod liver oil to necessitous cases. During
the year, all the above schemes have been reviewed, and the procedure to be followed by the council's
officers in dealing with applications has been revised.
It is natural, in view of the high infant mortality rate in the borough that the attention of the
council has been focussed on the care of infants and children, and the maternity and child welfare
committee have given much thought in attempts to find solutions of the problem. The appointment
of an additional whole-time assistant medical officer in May, 1936, has enabled the number of sessions
to be increased at the more crowded centres, and has also made possible the institution of toddlers
sessions at three of the infant welfare centres. These toddlers sessions are an essential part of a
scheme for the more careful supervision of the pre-school child, which was put into operation in 1936.
At these special sessions the toddler receives a full medical examination, and the mother is advised
in regard to the diet, hygiene and general management of the child of this age. The difficulty of
obtaining physical without mental health is recognised and the psychological problems of the mother
and child receive careful attention. Particular care is paid to the prevention of illness and deformity,
and to obtaining prompt treatment in the early stages of any defect. The benefits of diphtheria
immunisation are constantly taught.
The council's increased grants of free milk for children up to three years of age (and in special cases
to five years), and the grant of cod liver oil or its substitute in necessitous cases have proved of much
value to the toddler, and marked improvement has been shown in many cases where the diet was
previously deficient. The question of providing cheaper milk for working-class families in the
borough has been considered, and the maternity and child welfare committee have been in consultation
with the Milk Marketing Board to discuss the possibility of the introduction of such a
scheme.
There has been an extension of convalescent home treatment during the year, and twice as
many pre-school children have been sent for convalescence from the infant welfare centres as in the
previous year. Children suffering from repeated infections of the respiratory tract and those
recovering from serious illness have received prolonged periods of convalescent treatment with the
object of permanently restoring their health ; in all cases improvement, which is sometimes astonishing
in degree, has occurred.
The advisory committee, which is composed of representatives of the voluntary committees of
the welfare institutions, have advocated the introduction of a scheme for the remission of fees for
the admission of children of necessitous parents to the day nurseries in the borough in suitable
cases. This scheme has been adopted by the council and should produce good results.
Particular care is paid by the council's medical officers to the prompt detection and treatment of
the defects which are still too frequently found in the child entering school. Cases of anaemia,
malnutrition, rickets, orthopaedic defects, dental caries, discharging ears and infected tonsils and
adenoids are constantly referred from the welfare centres to the appropriate agency for the purpose.
For children unable to afford the services of a private practitioner, the baby clinic, which serves as
the treatment centre for all the Kensington infant welfare institutions, has been of the greatest
value. Arrangements have been made for an auxiliary treatment centre to be instituted at the
Notting Dale school treatment centre at Kenley Street. The three school treatment centres in the
borough will now also be treatment centres for the toddler and there will be continuity of medical
treatment in the same premises, and in two out of the three centres by the same staff, from infancy up
to school-leaving age. There is thus adequate provision in the borough for the medical treatment
of the toddler when this is found to be necessary by the council's medical officers and health
visitors.
The importance of home visiting in the supervision of the health of both infants and pre-school
children and in ensuring that any necessary course of treatment is carried out, is recognised by the
council. For some time it has been difficult for the health visiting staff to get into contact with all
parents of children suitable for welfare attention owing to the large floating population in Kensington.
Families in necessitous circumstances are constantly moving in and out of the borough, and it is
very difficult for the existing staff of health visitors to keep these families under adequate supervision.
The council, after considering the subject, decided, in view of the recommendations in the
Minister of Health's circular 1550, to appoint two additional health visitors ; these officers commenced
their duties on the 1st April, 1937. In addition to more frequent visiting in order to
supervise the pre-school child closely, the new appointments permit of intensive visiting in the
congested areas of the northern part of the borough where health education is so vitally important.
The ante-natal work as organised in 1934 is progressing satisfactorily, and the attendances
during 1936 show an increase over the previous year. Two additional weekly ante-natal sessions
were instituted during the year, and eleven clinics are now held each week. The importance of
post-natal examination is also recognised, and the gynaecological clinic is a useful ancillary to the
service.