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mortality was invariably between 150 and 200 per 1,000 births,
and when a town reached the 100 per 1,000 it rejoiced. We have
now reached the figure of 50 per 1,000 births, and it is natural
to enquire what are the factors which have been instrumental in
this reduction of the infantile mortality.
Many factors have been in operation, but I think it is fair
to claim that one of the most important of these is the infant
care scheme which is now a part and parcel of every public health
department in the country. The development of Infant Welfare
Scheme.s has be.en a gradual one— the appointment of health
visitors, the passage of the Notification of Births Act, the establishment
of Child Welfare Clinics, and Pre-natal Clinics, the provision
of Maternity Beds, etc. All these activities have had
immense educative effects upon the mothers, and if I were to
single out one of these, I should place the establishment of breast
feeding as one of the most important. At the beginning of this
century it was seriously suggested that mothers were losing the
power to secrete milk, as so few of them naturally fed their babies,
but the experience gained in infant welfare work, has shown that
it is a very rare phenomenon for a woman to be unable to nurse
her own baby. If a woman is capable of performing the difficult
task of bringing a living baby into this world she has it within
her power to keep it alive afterwards with nutriment from her
breast. It is admitted that the occasional unsuitability of the
mother's milk for the infant is not a unique phenomenon, for the
same phenomenon is sometimes witnessed in the animal world.
The precise biological explanation of these case.s has not been
forthcoming, and in any individual case nothing more can be said
than that there is some incompatibility between the nutrient
properties of the milk of the individual mother and the nutritive
requirements of the child in question.
It is possible that the occurence of such a case in the past
has determined the doctor in his advice to wean in other cases
without enquiry into all the circumstance.s and using every
endeavour to avoid unnecessary weaning. Women are too prone
to believe on insufficient grounds that they cannot nurse their
babies, and they are often aided and abetted in their belief usually
by ignorant friends and relatives but sometimes by doctors and
nurses who should know better.
The present-day baby is not easy to rear, breast milk or no
breast milk. The trouble commences during the establishment
of the milk flow, and difficulties are often experienced later in
maintaining the activity of the mammary glands. We frequently
hear the. remark that the milk "went away" as soon as the mother
got up after the confinement. It is true and has been proved
experimentally that there may be a diminution in the amount of
milk secreted immediately following the resumption of household
duties. One of the most important conditions of breast feeding