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enough to the experienced observer. Imminent danger of death,
and illness acute enough to require the doctor, they understand;
all conditions short of this they would class as healthy, or to use
a favourite term, "wiry." Many hundreds of pallid, rickety,
children have been pointed out to me by proudly complacent
mothers as "wiry." One of the first things to be aimed at in
practical work is the implanting in the mother's mind of some
standard of what constitutes a healthy vigorous state.
"Extreme poverty has obviously an adverse influence on infantlife.
Its effect on nursing-mothers is not easily estimated, but it
seems probable that the mental anxiety consequent upon extreme
poverty, as much as the actual underfeeding of the mother inhibits
the supply of breast-milk.
"Wilful neglect is rare, and apart from alcoholism, probably
non-existent.
"Coming to details of practical preventive work, the points
upon which one concentrates attention are the feeding, clothing,
and surroundings of the child. With regard to the last point
(the surroundings), a visit with respect to the baby is always,
where necessary, made the occasion for giving some instruction
in the hygiene of the home generally.
"With regard to feeding, every effort is made to encourage
breast-feeding, but this means more than merely pointing out the
advantages of breast-milk over artificial food; it means being on
the alert for, and preventing in time, those errors in the management
of the breast-fed infant which if persisted in, lead to weaning
in the belief that the milk "does not suit," or supplementing
an abundant supply of breast-milk with artificial food in the
belief that the milk "does not satisfy." The commonest error in
breast-feeding is over-feeding: the breast-fed child is far more
frequently over-fed than the hand-fed child; the trouble incident
to preparing the food for the latter acting as a deterrent. The
commonest answer to "How often do you feed your baby?" is