View report page

143
ROYAL COLLEGE OF ST. KATHARINE, POPLAR.
Report of the Medical Officer.
March, 1928.
Work at an Infant Welfare Centre is mainly a matter of watching
and safeguarding the progress of healthy babies. The chief problems
which surround such progress are those of feeding, management and family
circumstances. At any point one or all of these may exert enough influence
to deflect the baby from the path of normal health. As a rule, the combination
of careful observation and examination at the Clinics, with
the Health Visitor's knowledge of the mother's skill and the home
conditions, is enough to control the average case.
For one reason or another, however, not every child does manifest
that immediate and satisfactory progress that one would like to record
from the start of its attendance. Where there is evidence to believe
the food supply is ample, a few weeks delay to allow the necessary
adjustments to be made is of no great consequence. But there may be
doubt on this point. And if the physician allows his doubt to be felt,
the mother is likely to be much alarmed. Her anxiety may be well
founded, for the condition of the child may suggest a failure to thrive.
Time then becomes an important consideration, especially where the
maintenance or reinforcement of lactation is an integral point of the
problem. A mistake in the advice or in its interpretation involves a
week's loss of time. The next visit reveals an accentuation of the symptoms,
and a decline in the baby's weight may well decide the mother to seek
advice elsewhere.
It is especially likely to occur in the instances where only a few
simple directions can be grasped at a time; yet the physician knows
that multiple faults of feeding, management and housing are present
and all need correction. In another group all clues to the cause of the
child's failure may be of the faintest kind, with little to show which
should be followed. A week or two on the wrong trail can then be
disastrous. An ailing child has already changed to one seriously sick.
The mother has to be told her baby is not suitable to attend a "Welfare
Centre'' ; that it needs instead medical supervision at home or transference
to a hospital.
Review of the early years' work shows far too many case sheets
where attendance ceased after one or two visits to the Clinics, suggesting