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when used it is because it is cheaper than the more simple boat
shaped bottle.
Infant and child mortality is one of the most complex problems,
in which hygienic, economic, moral, industrial, and even atmospheric
conditions are inter-related. It is noteworthy that, with the single
exception of 1904, there has been in each of the past 8 years a
steady decline in the rate of infant mortality. This is probably due
in some measure to a public awakening to the need of concentrating
more effort in the direction of conserving infant life, having regard
to the falling birth-rate, and the consequent seeking for and adoption
of remedial measures by public health authorities. Foremost among
these measures must be included those which have for their object
the instruction of mothers, and in some cases the rendering of practical
assistance in the rearing of offspring.
When one studies the vital statistics of the country during the
recent decennia, one cannot fail to be struck with the fact that,
although the reduction in the mean rate of infant mortality during
the 10 years 1891-1900 was only two less than in the 10 years
1861—1870, the death-rate at ages 1—5 in the more recent decade
shows an enormous reduction. It is remarkable that, whereas education
is more widely diffused and general sanitation is vastly better than
50 years ago, the reduction in the rate of infantile mortality is so slight.
It would appear that these factors have not yet succeeded in producing
such parents and surroundings as will endow and maintain
sufficient vitality to enable the survival of infants for the first year
of life, but that those who do survive the first year are now far better
able to fight against the adverse circumstances of the years 1—5.
There can be little doubt that the circumstance that the abovementioned
improved conditions are contemporaneous with some reduction
in the amount of breast-feeding by mothers is a partial explanation
of the fact alluded to, and that artificial feeding and poverty are
the chief factors in the problem, poverty connoting bad housing
accommodation, poor and often ignorant feeding and clothing, and
insanitation. A half-starved mother cannot be expected to furnish