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(1) That improved sanitation [i.e., hygiene of place) had brought
down the death-rate of persons over one year of age, but had failed to
bring down the death-rate of infants under one.
(2) That deteriorating maternal hygiene (i.e., hygiene of person) had
counteracted the effect of improving sanitation (i.e., hygiene of place) upon
the death-rate of infants under one.
(3) That the infantile mortality had increased in the earlier days,
weeks and months of life, and diminished in the later period of the first
year.
(4) That the increased earlier mortality of infants was caused—firstly
by immaturity, due to pre-natal conditions, especially the health of the
mother during expectancy; secondly by post-natal conditions, especially
the faulty feeding of the infant by the mother, and in a lesser degree the
deficiency of clothing and warmth provided by the parents for the child.
(5) That the greatest mortality of infants was from diseases of the
alimentary system during the summer months, a lesser mortality frc.m
respiratory diseases during the winter months, and a marked mortality
from immaturity or want of vitality all the year round.
(6) That enquiries everywhere into the deaths of infants showed that
the mortality of the hand-fed was 10, 29, 30 or more fold than that of
the breast-fed.
Therefore, it was concluded that the main remedies required were briefly—
(a) The improvement of the health of the expectant mother;
(b) The maintenance of the health of the suckling mother ;
(c) The avoidance of premature weaning of the infant from the breast,
especially during the summer months; and
(d) the protection of the infant from cold, especially during the
winter months.
In 1904 in St. Pancras we commenced, through our Health Visitors, to base
our action upon these indications. In the new leaflet we issued we purposely
omitted any instructions as to hand feeding, and referred all mothers to
medical practitioners in order to prevent them from failing in health, and
prematurely weaning their infants from the breast, and, in any case, to submit
themselves and their infants to periodical medical consultation and advice. In
the summer of 1905 a Conference of London Representatives was held in St.
Pancras Town Hall. A brief account of this Conference was given in a paper
"On teaching the hygiene of the expectant and suckling mother" by the
Medical Officer of Health, and published in the Proceedings of the National
Conference on Infantile Mortality held at Caxton Hall in the summer of 1906.
We preached breast-feeding in season and out of season until we were regarded
as unreasonable, but the infant mortality during the warm summer of 1906,
when compared with that of 1901 and 1905, fully justified our persistent
attitude. During that warm dry summer quarter of 1906 the infantile mortality
of England and Wales rose 21 per thousand, that of the 76 great towns,