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It is generally recognised that catarrhal diseases, both respiratory and intestinal, are more
prone to occur and most likely to prove fatal in infants whose diet is faulty and nutrition poor.
It is the constant endeavour of the council's medical officers and health visitors to improve the
nutritional condition of these children by advice on feeding, hygiene, proper clothing and fresh air.
A comprehensive report on rickets in Kensington children was submitted to the council in July by
the assistant medical officers who conduct the infant welfare sessions. In this report the
importance of instruction regarding the essential elements of diet for children was stressed and the
value of codliver oil in the prevention of rickets emphasised. Codliver oil and its equivalent
preparations are granted free of charge by the council in necessitous cases.
The number of individual children attending the Kensington infant welfare centres for
supervision has increased from 4,985 in 1937 to 5,497 in 1938. Twenty infant consultation sessions
are held each week by the council's whole.time medical officers who have special experience in the
feeding and care of infants and toddlers ; regular home visiting is carried out by the health visitors.
Milk and codliver oil are provided free by the council for children of necessitous parents. Massage
and artificial sunlight treatment are available within close reach of the children's homes. The
baby hospital and a children's hospital are situated in the borough. Convalescent homes are
available for delicate children.
The health services provided by the council are adequate and comprehensive. An important
difficulty in the reduction of the infant death rate lies in the migrant character of many very poor
people who come to live in the north of the borough. The large number of tenement rooms available
in the neighbourhood attracts families with insufficient means to rent a small house or flat ; their
poverty causes them constantly to move their lodging and makes it difficult for the council's officers
to exert a lasting educational influence.
Maternal Mortality.
There were five deaths resulting from pregnancy and childbirth among Kensington women
during 1938, which gives a maternal mortality rate for the borough of 2.2 per 1,000. The rate
for England and Wales was 2.97.
Three of the Kensington deaths occurred among the well.to.do class, two of them following
operation for Caesarean section. The death rate is again much higher in above.standard cases than
among the class for which provision is made by the council's services. The maternal death.rates
in the two classes are about 10 per 1,000 and 1.1 per 1,000 respectively.
There were only two deaths of women belonging to the class who normally seek attention at
welfare centres ; one was a case of haemorrhage occurring in a booked hospital case, where the
hospital authorities had been responsible for pre.natal supervision ; and the other, although referred
to Kensington, occurred in Durham where the patient had stayed with her mother during her
pregnancy. It will be seen that in neither of these cases could the maternal death have been
prevented by the council's services.
Record attendances were made at the council's pre.natal clinics during the year, and careful
routine supervision continued to prove its value by the discovery of cases where it was necessary
to arrange for special obstetric care during the confinement. In some of these cases the woman
was unaware of pre.existent heart disease ; in others there was unsuspected pelvic contraction ;
in a third class of case a high blood pressure without other symptons was a warning that prompt
treatment was necessary in order to prevent the onset of toxaemia. Admission to hospital was
arranged whenever it seemed desirable for the safety of the mother, and all these women made
good recoveries.
Routine Wasserman and Kahn tests carried out in the clinics show a percentage of 1.6 positive
cases during 1938 (15 out of 928 tests performed) compared with 1.8 per cent. in 1937 and 2.2 per
cent. in 1936.
An advantage resulting from the earlier attendance of women at the pre.natal clinics is that
this test can be carried out in the early months of the pregnancy when, if found positive, treatment
of the mother is almost certain to save the child from being born with a congenital syphilitic
infection. The kind co.operation and assistance of the special departments of the West London
hospital and St. Mary's hospital has ensured that this treatment of the mother is given with the least
possible inconvenience and the greatest consideration for her feelings.