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53
Dr. Newns reports on the year's work as follows:—
In November, 1936, a Toddlers' Clinic was started at Southlands for
children age 3 years. The response was sufficiently encouraging to justify
the extension of the clinics to the whole Borough. From April 1st, 1938,
a Toddlers' Clinic was held weekly at each Infant Welfare Centre. This
report covers the period from the above date to December 31st, 1938.
(The figures also include those from the Southlands Clinic which was
held throughout 1938.)
All children from the ages of 2 to 5 years were eligible to attend the
clinic, provided they were not attending school. On attaining the age
of two years, children attending the Infant Welfare Centre were transferred
to the Toddlers' Clinic. A circular was sent to the parents of all
children in the Borough on or near their second, third and fourth birthdays,
advising them to take their children to the clinic for examination.
It should be noted that nearly 20 per cent. of the children had not
previously attended an Infant Welfare Centre.
The original intention was to see the children once a year and give
them a complete medical examination. This was not entirely satisfactory
as it did not provide adequate supervision or a sufficient check
on the carrying out of advice or treatment. The children are now seen,
therefore, at three-monthly intervals. Those who are underweight are
usually seen more often. By this more frequent supervision, better
contact is kept with the parents, and defects are detected at an early
stage.
The numbers at first were small, but they gradually increased,
and are now fairly constant, the average being 12-13 per clinic. The
numbers attending All Saints Clinic are higher because of the greater
number of poorly nourished children who need more frequent supervision.
Children who are found to be ill or suffering from defects are sent
to private doctors or to local hospitals. Those with dental defects are
referred to the Borough Dentist. Tuberculosis contacts are referred
to the Tuberculosis Dispensary for investigation.
The standard of nutrition varied considerably. In the Chatham
Road and Gideon Road areas it was good, but in the Plough Road and
All Saints districts many cases of malnutrition were met with. About
5 per cent. of the total cases seen were suffering from definite malnutrition,
but there were many others who were considerably underweight.
The proportion of children with defects was high, approximately
65 per cent. Many of the defects, however, were relatively slight, e.g.,
papular urticaria, bronchitis, &c. The commonest defects were dental
ones, approximately 11 per cent. of the total. Enlarged tonsils and
adenoids were frequently met with. Many of these cases were referred to
hospital for operation. Genu Valgum was a common deformity, though
generally mild in degree. Some cases of squint and otitis media were met
with, and a few children having anaemia were discovered. No cases of
clinical tuberculosis were found.
It will be seen from the figures given that two out of three children
presented some defect. While many of these were admittedly slight,
such defects as dental caries, otitis media, enlarged tonsils and adenoids
(especially the latter), if undetected, would result in very considerable
disturbance to health. Other defects such as Genu Valgum and squint,
if detected in the early stage can be corrected, whereas if they are left
for several years are much more difficult to correct and may need
operative treatment.
The usefulness of these clinics seems therefore to be established.
They close the hitherto open gap between the Infant Welfare Centre and
the School Medical Service, and ensure that when the child reaches school
age many of the defects so often found will have been detected and
treated.