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" The commonest method of artificial feeding employed was 'condensed'
milk which was adopted by 18 per cent, of the mothers, but ordinary milk (with the
inevitable barley water) came in a very good second (14 per cent.). Cheapness and
convenience seemed to be chiefly responsible for the choice of these foods. Indeed
as far as choice of modes of feeding was concerned the humiliating fact emerged from
my enquiries that in not a dozen cases was the method adopted due to any deference
to the views of the medical profession. The inexperienced mother seems to follow
the advice of friends or relatives. The experienced tell one that 'it was how they
had brought up all their children.' Dried milk and malted cereal foods were little
used, contrary to my expectations. Only about 6 per cent, of the mothers had used
dried milk, and a negligible number (5 in all) had used malted cereals. Probably
expense is the deterring factor. The enormous advertising costs of firms dealing in
these foods must be paid for by families in the higher social planes.
" With regard to the physical condition of the children the following criteria
were adopted (i) the general physicial efficiency and development of the children,
(ii) the presence or absence of obvious signs of rickets, (iii) dental defects.
" General physical efficiency.—Regarding anaemia, debility, stunted growth and
persistent history of' ailing ' as evidence of physical subnormality, a disappointingly
high percentage of the children (17 to 27 per cent, in the various feeding groups) had
to be classified as subnormal.
" Ordinary cows' milk and condensed milk seem to give the worst results (26 per
cent, and 27 per cent, subnormal). Properly weaned breast fed children showed the
lowest percentage of subnormal cases but even here it amounted to 17 per cent.
Prolonged breast feeding gives only slightly increased percentages of subnormal
children (20 per cent.) but the greatest number of children showing sign of rickets
was found in this group. It is only in properly breast fed children that the proportion
of children found to be above the average, (namely 18 per cent.) exceeds the
proportion of children falling below the average. The hope of gradual racial improvement
or at any rate of maintenance of the present standard depends on the extent to
which mothers can be persuaded to rear their infants in a normal physiological way,
and at present the proportion of mothers doing this only seems to be about one-fifth of
the total. In the groups in which the suckling period was prolonged or the children
were fed on condensed milk, 14 per cent, of the children showed definite signs of
rickets ; 11 per cent, of children reared on dried milk showed evidence of rickets,
but the numbers in this group are perhaps too small for deductions to be of value.
In a few cases only were the deformities produced at all severe.

Junior
technical
schools.
Arising out of the consideration of His Majesty's inspector's report for
1928, the question of the extent of postural defect and its causation in the London
junior technical schools for boys was referred to me. In a preliminary report made
by me in December, 1928, I pointed out that the results of medical inspection did
not show any greater incidence of deformity in boys in trade and technical schools