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80
INFANT WELFARE SERVICES.
HOME VISITING BY THE HEALTH VISITORS.
The foundation of the child welfare services is the work undertaken
by the health visitors. Their activity in the first place was the supervision
of the child under one year. This was later extended, in the one direction,
to embrace the child up to the age of five, and in the other direction, to
include the expectant mother.
Many of the deaths in the days of the high infant mortality rates
were the result of unsatisfactory environmental conditions. The health
visitor then, to be enabled adequately to advise the mother, had to visit
her in her own home. Visits were paid frequently at first, but at lengthening
intervals as the child grew. In addition to these routine visits, which
are paid as far as practicable according to a schedule, the health visitor
pays many special visits to young children. These may be because the
health visitor herself on her routine visits finds a child in need of observation,
or the medical officer at the clinic suggests it, or perhaps, because a
child is suffering from some infectious disease, such as measles or whooping
cough, or a condition such as ophthalmia neonatorum. Special enquiries
are made into cases of infant deaths, stillbirths, etc.
A run of special visits upsets the schedule of the routine visits. In
such a district as this in which the environmental conditions are usually
satisfactory, once the health visitor has satisfied herself about the suitability
of the home conditions, it is questionable whether these routine
home visits are necessary, that is, in cases where the health visitor is able
to establish contact with the mother through her attending regularly
at the infant welfare centre.
Where the mother has been attended at her confinement by one of
the Council midwives, the midwife continues the supervision of the child
up to the age of one month. It is felt that the encouragement of the
midwife at the time the mother is starting to get up and run her home,
a time when many seem temporarily to lose their milk, may result in
fewer resorting to bottle-feeding their babies at this time.
The district is divided into fifteen areas, with roughly equal populations,
each health visitor undertaking all the maternity and child welfare
duties in her section.
The following is a summary of the number of visits paid by the health
visitors during the year :
(a) To children under one year of age First visits 2,916
Total visits 8,060
(b) To children between the ages of one
and five years Total visits 13,805
In addition visits were paid to 306 cases of measles and 57 cases of
whooping cough in children under five years of age.
INFANT WELFARE CENTRES.
About half the time each health visitor devotes to maternity and
child welfare work is spent at the clinics. Those dealing with children
under five are either infant welfare centres or toddlers' clinics.