London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1938

[Report of the Medical Officer of Health for London County Council]

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47
Provision of meals
Dinners are provided for necessitous children attending school, and follow menus
which have been approved by the school medical officer.
Samples of meals provided are taken from time to time and submitted for
analysis by the Council's chemist, the required standard being that each complete
meal should contain 25 grammes protein and have a heat value of 750 calories.
Since the commencement of 1936 all children receiving dinners free or on partpayment
have been brought before the school doctor at the earliest opportunity,
and thereafter kept under observation by examination at 3-monthly intervals.
Children are given milk and/or oil and malt on the recommendation of the school
doctor. Those on the milk list receive two bottles (one-third pint each) of milk daily,
and they are'kept under observation by the school doctor regularly.
In addition to those shown in the following table as receiving milk free, on the
doctors' advice, there are a number recommended by the doctors to have milk,
whose parents are able to pay for it. These, too, receive two bottles daily.

The numbers of individual children on free "meals" in December in the years 1934 to 1938, inclusive, were as follows :—

Table 25

Meal19341935193619371938
Dinners5,7255,2455,5966,2517,228
Milk15,69120,30024,12028,80032,224

Some 2,000-3,000 children received cod-liver oil and malt in school on the
doctor's advice; many others obtained it in school on payment by the parents.
In view of the changing attitude and beliefs in regard to the nutritional needs of
children, and the recognition that the difficulties experienced are no longer those of
total insufficiency of nutriment, but are due rather to specific defects in home dietaries,
certain experiments are being carried out which are of great interest. Two of these
experiments are those concerned with the substitution of halibut-liver oil for cod-liver
oil and malt, and the substitution of an " Oslo " meal for the ordinary hot dinner.
Difficulties have arisen in certain schools in the provision of cod-liver oil and malt
when recommended by the school doctor. These have been due in part to the sticky
or messy nature of the mixture. Consideration has therefore been given to the provision
of a substitute which can be administered in capsule form.
Halibut-liver
oil
A thousand doses (each a desertspoonful) of cod-liver oil and malt cost 18s. Id.
The equivalent of halibut-liver oil (two capsules to a dose) would cost 18s. 4d. In
the distribution of cod-liver oil and malt to about 11,000 children women helpers are
employed for a total of about 1,150 hours a week, at an annual cost of about £2,371.
There would thus be a saving of about £2,340 if this service could be dispensed with
by the substitution of capsules for liquid oil and malt. An experimental trial of
capsules has been sanctioned at five schools.
Considerable attention has of late been directed to the method of giving school
meals to necessitous school children and others in the schools of Norway and
other northern countries. This method is generally referred to as "the Oslo breakfast."
Not only has it spread far and wide in schools of Norway and neighbouring
countries, but it has attracted the attention of dieticians in other countries and has
been favourably commented on in the bulletin of the Health Organisation of the League
of Nations ; and suggestions have been made that it should be introduced into London
schools in substitution for the present provision of hot mid-day meals.
Prior to the passing of the Education (Provision of Meals) Act, in 1906, there
existed no powers to local education authorities under which money could be expended
on the provision of food for hungry or ill-nourished children.
The " Oslo "
experiment