View report page

46
maintain the necessary standard of individual attention.
Every mother and child is a distinct and individual problem
needing patient personal observation and treatment. It is
well known that one morning's test feed is not an accurate
method of estimating the efficiency of the breast milk supply.
It is better to keep the mother and child at the Centre for a
whole day and by taking the average of several feeds, reach a
more satisfactory conclusion. A second objection to the one
clinic weekly is that too long an interval elapses between each,
during which time bottle feeding may be substituted by the
mother. It is hoped that an afternoon session held halfway
through the week may help to overcome both of these difficulties.
The number of mothers who refuse to breast feed is rather
higher than last year, indicating the urgent necessity for continued
and widespread teaching as to the importance and the
many mutual advantages of breast feeding. It may be that
the very success of artificially fed infants militates against
breast feeding in the minds of some of these mothers. No
outstanding factor of pressure of financial circumstances, poor
physical condition either of child or mother can be found in
this group, but it is noteworthy that many of these mothers
had never breast fed any child, although as far as we can tell
the milk supply was adequate in every case. A mental attitude,
either lack of self-confidence or a fixed idea as to its impossibility
seems a possible explanation. It is among such mothers that
increased careful work may produce results which are worth
while.
Breast milk failed in about the same number of mothers
as last year, and it is interesting to note that neither poor
physical condition nor unsatisfactory home conditions was the
primary cause. The Worried mother heads the list and if the
badly managed infants be added to this number, it will be seen
that over half the cases of failure of breast milk in our series
are due to a mental attitude rather than a physical defect.
To attempt to assess the true value of the work done in
this clinic, records have been kept of all infants at the sixmonthly
visit by the Health Visitors. It is sad to record that
the number of our breast-fed babies was down by 20 per cent.
and the infants weaned were four times the number that they
were on discharge from the clinic. It should be remembered
that every case attending this clinic is one in which the
continuance of breast feeding was very doubtful at their first
attendance, so the results are not quite as discouraging as they
appear. They are, however, indications of the need for continued
and increased effort to improve them.