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50
information on the important question of breast-feeding, but
the most effective work has been done through the agency of
health visitors. Health-visiting has now been carried on in
Acton for over five years, and attention has been more
particularly directed towards infant rearing. The work recently
has been supplemented by other agencies. At the start, the
late date at which births were usually registered militated
against the efficiency of the visitation, but since the adoption
of the Notification of Births Act, the houses have been visited
before the mischief of weaning has been accomplished. It is
now generally recognised that the mortality amongst artificially
fed infants from diarrhoeal diseases is far higher than amongst
breast-fed ones. It is unnecessary here to enter into the various
theories regarding the causation of Summer diarrhoea, and in
what manner breast-fed infants are rendered comparatively
immune. It is sufficient to know that breast-fed infants rarely
succumb to diarrhœeal diseases. Last year only two breast-fed
infants died from diarrhoeal diseases. One of these had
Measles five months previously, and the other child died in
January.
Although dependent upon many conditions, diarrhœal
diseases in children are due to the invasion of the body by
bacteria. With regard to the mode of transmission it has been
widely held that milk is the main, if not the only, source of
infection. It is known, of course, that the milk may be contaminated
at various points, but it is significant that, though
the proportion of breast-fed infants is probably less in the
North-East and North-West Wards, no deaths under 12
months old from diarrhoeal diseases occurred in these Wards.
Thirty of the deaths occurred in the South-West Ward and
three in the South-East Ward. The milk supply of the SouthWest
Ward does not differ largely from that of the other
Wards, yet the mortality from diarrhoeal diseases was almost
entirely confined to that Ward. The explanation is, that
diarrhoeal diseases are dependent not only upon the milk supply