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37
ROYAL COLLEGE OF ST. KATHARINE.
Report from the Senior Medical Officer, Harold Waller, M.D.
For the main part the work carried out in the district allotted
to the Royal College of St. Katharine has followed, during the past
year, the lines laid down at its inception in 1913. Experience has
naturally shown certain directions in which its value could be
strengthened, and the suggestion has been made that some account should
be given in the Medical Officer of Health's Annual Report of one particular
development which has been found useful.
The Health Visitors and Medical Officers at the Clinics are daily
concerned to promote the highest possible percentage of successful
breast-nursing of the infants. Regular inspection shows us that this
is easy to achieve in the majority; but there are many cases where, for
one reason or another, the infant does not thrive at the breast, or is
brought to be weighed because its mother fears it is not thriving. Some
of these cases offer considerable difficulty of diagnosis, and it has been
our experience that even the most careful instructions based on an
examination of mother and child sometimes fail to effect improvement.
The fact is that whereas a weekly inspection and weighing will show
that the baby is not thriving, they cannot furnish the exact reasons in
obscure cases. Some opportunity is needed to observe directly the
infants behaviour, to estimate the amount of food it receives, and to
gauge its mother's skill in management, and the effect also of its
surroundings on its progress.
To this end certain of the mothers are invited to bring their infants
for a daily inspection to Brunswick Road, where the College has a small
garden with a shelter and a room set aside for experimental feeding.
The value of being able to watch the babies and estimate the daily yield
of milk over a period of time has been so great that one almost ventures
to think it will have to become part of the necessary equipment of every
Infant Welfare Institution.
A few examples of the discoveries made will explain best both the
types of problem and the methods of investigation.
A mother complains that her infant is no longer satisfied with its
feeds, cries after nursing, and requires frequent meals. The nurse in
charge of the observation department finds that the feeding had gradually
become entirely one-sided; i.e., the baby had abandoned one breast and