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have been made to train centre doctors and health visitors to select children for reference
to the school child guidance units, and lectures in mental health have been provided.
A survey was instituted in one of the health divisions in 1952, to gauge the extent to
which a psychiatric service for young children is necessary.
Reference is made in the section on mental health (page 112) to the provision of
special child welfare services for backward children.
Care of premature infants
When premature infants are nursed at home, with a midwife in attendance, steps are
taken to ensure that the midwife, in addition to her normal care of mother and baby,
has adequate time to devote to the infant by relieving her of other work. The supervisors
of midwives visit all premature infants to give advice, including recommendations for
supply of any special equipment needed. Twenty-seven sets of special equipment
(divided into five packs, i.e., cot pack, scales, clothing pack, nursing pack, feeding pack)
are provided (three for each of the nine health divisions). Small deposits are made for the
loan of the packs and these are refunded in full when the equipment is returned in good
order, subject to fair wear and tear. Nine of the sets are placed at strategic points throughout
the County, mainly at district nursing association premises or at welfare centres with
a resident caretaker. These particular sets are available at week-ends and public holidays
for collection and delivery by the ambulance service to any home requiring equipment
immediately. There is not a great demand for the special equipment, except in health
division 4. The number of times sets, or part sets, were supplied to homes was as follows :
(Part year) 1948 1949 1950 1951 1952
Nil 23 92 74 52
Special transport facilities for premature infants who have to be removed to hospital
are operated. Specially heated cots and supplies of oxygen are carried in the ambulances
and were used on 43 occasions in 1952.
Before the Council assumed responsibility for the welfare services, the Shoreditch
Borough Council had organised a special service for premature infants, including the
appointment of a trained health visitor as a premature baby visitor, who devoted the
whole of her time to the care of premature infants in that borough and to a breast feeding
clinic. The Council felt that continuity of home visiting was essential if the health visitor
was to be accepted as the friend and counsellor of the family. It is undesirable that when
a premature infant is born, the health visitor who normally visits the home should be
replaced by another officer who is unknown to the mother. Moreover, as the present
syllabus of training of health visitors includes advice on the care of premature infants, it
is considered that no additional training, except for a refresher course from time to time,
is necessary. The aim has been to ensure that all health visitors have the necessary knowledge
to advise on the care of premature infants and that these children are given priority
in visiting. The special visiting arrangements in health division 4 were therefore gradually
discontinued. There is, however, a special premature baby clinic held at one of the welfare
centres in Shoreditch, at which each infant is able to receive a thorough medical examination
at the age of 4, 8 and 12 months.
As far as is known, the following hospitals have special units or cots for the reception
of premature infants—Hammersmith, King's College, University College and British
Hospital for Mothers and Babies, Woolwich. Other hospitals are able to take them into
cots attached to the maternity units. There is a close Liaison between hospital almoners
and the Council's health visitors to ensure immediate follow-up on discharge from
hospital.
Premature
babies born
at home
During 1952, 449 infants weighing 5½ lbs. or less were born on the district to 404
mothers; 276 of these infants were between 5 lbs. and 5½ lbs. in weight and by the dates
were of at least 38 weeks gestation and showed no clinical signs of prematurity. There
were 46 twin pregnancies. In 50 instances the mothers were small in stature themselves or
had had small babies previously.