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mothers are able to purchase dried milk, Virol, cod liver oil, etc.,
at cost price, Miss Lister having most kindly undertaken charge
of this department. The babies are weighed by the nurses, and
afterwards seen by me in the Consulting Room. In nearly every
case the mother requires teaching with regard to feeding. Irregular
meal times, too frequent feeds especially, account for a
fair pro-portion of " ill nourished1 " babies. Until otherwise
taught, night feeding is almost universal, and two-hourly feeds
are far too frequent. Regulation of the infants' diet is often
all that is required to give it a fair start and a fighting chance
to survive the first year, when life is in great jeopardy. Every
effort is made to encourage breast feeding, and when necessary,
to supplement natural feeding by properly diluted cows' milk or
dried milk, in order to avoid weaning. Test meals by careful
weighings are carried out at the second attendance. The arrangement
for Dental treatment of expectant and nursing mothers will
influence considerably the question of breast feeding and the
development of the children attending the Clinics. Whilst cases
of severe Rickets are in a minority, a number of children suffer
from Rickets to a certain extent. These cases improve after
instruction with regard to hygiene and diet, and the facilities for
obtaining cod liver oil at cost price.
A fair number of cases have been referred to local doctors
or hospitals for operative treatment, and a case of persistent
" vomiting " or rumination—a very rare condition—was successfully
treated at Great Ormond Street Hospital.
We have found the mothers most appreciative and anxious
to learn. I consider the work done in connection with encouraging
breast feeding very important. Careful instruction is necessary
to make the mother realise the part played by the baby in
stimulating milk secretion by vigorous sucking, and to make her
understand the importance of three-hour feed's from the first to
ensure that the baby will be sufficiently hungry to take the breast
properly. She is also informed on the question of mid-day rest
and sleeping undisturbed at night, and told of the most suitable