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136
deceptive, and that the difficulties encountered later are not at that
stage expected to arise. In about half our cases a forecast of success
has been contradicted within a few weeks.
For this reason it would be of the greatest assistance to the mothers,
as well as of benefit to the babies, if those in charge of the lying-in period
would advise their patients that despite a promising beginning difficulties
in breast-feeding are quite likely to be encountered later, but that with
a little help and supervision they can usually be overcome. This is
particularly needed in the case of first confinements. If a confident
forecast that feeding is securely established has been conveyed, the health
visitor has often great difficulty in persuading a woman that she should
have the point confirmed by attending the clinic.
As would be expected the amount of improvement which can be
effected in cases where the yield of milk is declining, becomes less as the
interval after delivery lengthens. Up to the end of the fourth week
a few days attendance is usually sufficient, after that it has to be longer.
Success is then less likely, not only because the degree of involution is
greater, but also because the necessary visits are often more than the
women can manage if their homes are situated any distance away.
184 women were referred to the department during the year, or
roughly a sixth of the number delivered in the area. Had they been
seen at the clinics early enough it is probable that twice the number
could have been helped that were in fact helped either to improve or
safeguard their powers of breast-feeding.
The rest of the work in this department is the treatment of minor
ailments such as conjunctivitis, otitis media, eczema and impetigo.
Lactation Cases.
Women referred 184
Average attendance 6.5
Total attendances 1,228
Treatment Cases.
Women 44
Attendances 152
Children 409
Attendances 2,809