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14
premature birth, and these and other influences have counteracted the
benefits to the infant population of the generally improved sanitary
conditions of the people, and the fruits of over a quarter of a century
of compulsory education. This excessive infant mortality is confined
to the poorer classes, and it is the result of many forces, some of which
are very complex ; but the main factors are :—the employment away
from home of those about to becomo mothers, and of those recently
confined who should be nourishing their infants, the infants being
badly cared for and ill-fed while their mothers are at work; and the
greater ignorance among women as to feeding, clothing, and managing
of infants. This maternal ignorance and neglect offend against every
law of hygiene, and is responsible for the fact that approximately one
out of every six children born fails to complete its first year of life.
If the share of this death-rate which is due to ignorance, indifference,
and neglect could be computed, it would probably amount to 50 per
cent.
Diarrhoeal diseases and deaths from defective nutrition are always
truly referred to as the chief dangers to which hand-fed children are
exposed, and this fact emphasises the argument against rearing a child
by hand except in cases of absolute necessity. The proportion of handfed
children to those who are suckled increases yearly, and everywhere
the same testimony is forthcoming that children fed naturally from the
breast have a prospect in life far in excess of those who are fed
artificially. Even under the most favourable conditions the substitution
for the infant's natural food of an artificial diet is disadvantageous,
but when we find the mother's milk is very often substituted by such
products as cheap brands of condensed milk and of artificial foods,
administered by those who have little knowledge of the infant's requirements
and none of the composition of the stuff's they are giving it, how
can we hope to avert the Nemesis of much preventable sickness and
death? But it is not only in the actual number of deaths that one sees
the evil of this state of things reflected. One has to think of the far
greater number of infants who escape death, but grow up with
constitutions permanently damaged. It is obvious that there are
two main directions in which we must seek our remedy. We must
get in touch with the mothers of to-day after the baby has made its