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37
In the indexes a mark is put against houses where two or more births or
deaths have occurred, so that in case there should be a suspiciously large
number at any one house, further investigations may be made.
Quarterly reports have been made as to the number of infants enquired after
and additional visits, etc., also the inquiry forms of all infants visited have
been arranged into separate quarters so that they may be referred to more
easily and details of subsequent visits added, the voluntary workers generally
passing on to me cases presenting any special difficulty, when a 2nd, 3rd, or
4th, visit may be necessary.
Voluntary Notification of Births.—As regards the voluntary notification of
births, within two days, which was in force for four months of the year (August
19th, to December loth), I have already submitted a full report of this to you.
Taking into consideration all that was able to be effected as a result of this
early notification (in the matter of sending off Advice ('ards immediately after
receiving the notification of birth, and of making personal visits before natural
feeding had been discontinued and artificial feeding begun), it is a matter of
extreme regret (having regard to the lessening of Infantile Mortality) that the
registration of all births within a few days should not be compulsory,
especially as it would bring us into contact with certain classes of nurses and
helps who require instruction in more recent methods.
Workhouse Cases.—Since August, the births that have taken place in the St.
Pancras Workhouse have been notified to the Health Department within two
days, and in each instance an Advice Card has at once been sent in an envelope
directed to the mother, and at intervals I (and sometimes one of the voluntary
visitors), have paid a visit to the Maternity Ward, and have thus had the
opportunity of seeing the mother and baby there, and of explaining the
importance of the Advice Card, so that when advisable and possible, we may
visit these infants (mainly illegitimate) in their subsequent homes.
Infant Mortality in St. Pancran.—Hitherto in St. Pancras, in the attempt to
lessen the general death-rate amongst infants, the main object has been to
strike at the root of the principal cause of high infantile mortality, viz.,
epidemic, zymotic or summer diarrhoea (occurring chiefly during July, August,
and September), by promoting throughout the whole year all possible means
for bringing about natural feeding and discouraging hand-feeding.
But in addition to this it seems that other factors need to be taken into
account.
Visiting the cases as we do, not only during the summer, but all the
year round, and examining carefully week by week, winter as well as summer,
the causes of infantile deaths in the death returns, one is constantly confronted
with the fact of the large amount of illness and high number of deaths from:—
(1) Bronchitis and Pneumonia, during the winter months.
(2) Premature Births.
And so the problem has to be seriously faced, as to how one can also strike
at the root of the causes of these, at the same time as, and hand in hand
with, the attempts to lessen "Epidemic" Diarrhœa.