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and therefore doctors and midwives have been asked to record on birth notification cards all baby weights
of 5½ lbs. or less. Special equipment, including draught-proof cots, hot water bottles, special feeding bottles,
thermometers, etc., is readily available at the request of doctor or midwife for use in cases of premature birth.
Home Help Service.—The demand for this service continued to grow. It is difficult to assess
if any change in general social conditions is contributing to this increasing demand but it is certain that
as the service in the hands of a capable organiser improves in quality and reliability its assistance is being
sought more and more by the public and by midwives, doctors, welfare officers, children's officers, chest
clinics and hospitals. Up to 4th July, 1948, assistance was given to 312 households (67 maternity, 245 other)
as compared with 344 households in 1947 and 148 households in 1946.
According to the circumstances of the household a charge was made for the services of the home help.
Care of Illegitimate Children.—Efforts were continued to contact the mothers before the birth
of the child with a view to securing satisfactory arrangements for ante-natal care, confinement and for the
mother and child after the lying-in period. In this work contact is maintained with moral welfare workers,
hospital almoners and other interested parties. The majority of the confinements take place in hospital.
In some cases accommodation has to be found for the mother before confinement and/or for the mother
and baby after the confinement and to this end the Council arranged through Middlesex County Council

Adoption of Children.—The Adoption of Children (Regulation) Act, 1939, is designed to ensure
that, as far as is practicable, the adoption of any infant shall be carried out in the manner most beneficial
to the child and to prevent the trading in young children by a third party whose sole object is to make
money by the traffic in young lives. Adoption Societies have to be registered, must not practise for gain,
and all their activities are subject to scrutiny. Under Section 7 of the Act it is the duty of any person
(other than the child's parent or guardian), who participates in arrangements for the placing of a child
for adoption, to notify in writing the welfare authority of the area in which the child is to be placed. This
requirement should be borne in mind by doctors, midwives, hospital almoners, clergymen, matrons of
nursing homes, etc., whose advice or assistance may be sought in placing a child for adoption.
Close contact was maintained with Court Officers dealing with applications for Adoption Orders
and every request for information or assistance from Adoption Societies received attention. Up to 4th
July the Health Visitors made 48 visits in connection with the adoption of children.
Child Life Protection.—The Health Visitors undertook the duties of Child Life Protection Visitors.
The number of foster children on the register at 4th July, 1948, was 35, and during the year 152 visits of
inspection were made. No proceedings were taken against a foster-mother, but in several cases attention
was drawn to the need for improvement in the condition or furnishing of the premises or in the care of
the child.
Day Nurseries.—The four day nurseries with accommodation for 189 children continued in operation
during the year, and the charge was maintained at 1/- per child per day. The attendance of children
on Saturdays was poor, and only Nantly House Nursery opened regularly on Saturdays. The average
attendance of children was 174 (Monday to Friday) and 13 (Saturday). The demand for accommodation
continued and there was always a waiting list at each nursery. Admission generally was restricted to
children of mothers in employment, but social circumstances were also considered and priority was given
in the cases of children of separated or deserted wives, widows, unmarried mothers, married women whose
husbands are frequently ill and unable to work full time and other cases of children in need of special care
by reason of domestic or social conditions.
No excessive incidence of infectious disease was noted among the children attending the day nurseries.
Shortage of staff was less than in previous years, but the educational care in the nurseries is still
unsatisfactory owing to the shortage of trained nursery teachers and wardens. So far no explanation
has been found for the relatively high rate of sickness absence in the day nursery staff.
Residential Nurseries.—No residential nursery is maintained by the Council. When residential
accommodation has to be found for young children because of the admission to hospital of the mother
the Council undertook financial responsibility for the maintenance of the children in a short-stay residential
nursery, provided by Middlesex County Council. The number of children admitted under this scheme up
to 4th July was 5 and, according to their circumstances, a proportion of the cost was charged to the parents.