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16
By far the larger proportion of deaths occur amongst hand-fed
children and illegitimates, the latter for obvious reasons seldom
receiving the care they should if they are to surmount the many risks
of babyhood. The number of deaths among illegitimates was 26, of
whom 22 were under one year of age, and are therefore included in
the preceding table, and is an infantile mortality of illegitimate
infants of 500 per thousand as compared with 114 per thousand
legitimate.
Hand-fed children have to be reared chiefly on cow's milk in
some form or another, or various substitutes for human milk, which
if of any real value are quite beyond the reach of the poorer classes
(amongst whom the mortality is highest) owing to the cost, and for
this reason they are left out of account here. Thus cow's milk is the
hand-fed babe's chief food, and this, unfortunately, is subject to
contamination in very many ways in its journey from the cow to the
infant's stomach—the filthy udders and hind-quarters of cattle, dirty
hands of the milkers, dirty receptacles and cow-sheds, milk churns
left near accumulations of manure at the farm, or close to trucks
laden with house and other refuse in the railway siding, dust from
street or yard, foul sinks, dust bins and sour feeding bottles, as well
as the other risks inside the house, such as direct contamination of
the food or milk with faecal or decomposing matter conveyed
by flies, etc.
1 have seen some dwellings (well-built and drained and with
modern sanitary appliances) in which the children were under conditions
little better than the worst housed animals, the atmosphere of
some of the rooms being almost beyond description. I have seen a
mother trying to feed an infant on raw arrowroot, and on another
occasion, when called in to see a baby a few months old, and enquiring
how it had been fed, the answer given was, "Oh, the same as
us," meaning the rest of the family.
Is it any wonder that under such circumstances there is a high
infantile mortality? The ignorance of some mothers respecting
feeding is truly surprising, and this remark is not confined solely to
the poorer classes.
As the infant death-rate is influenced to such a great extent by
the presence and amount of epidemic diarrhœa, the remedies