

DR. L. E. LA FETRA'S PAPER 237 



by the end of the third year. This is bad enough, for 

 even an old man of 84 years has a better chance of 

 living another week than has the newly born infant. 

 But if we should add to these deaths the 5 per cent, 

 stillborn, and the more than 20 per cent, of preg- 

 nancies that result in miscarriages, the figures of infant 

 loss are simply astounding. 



Instruction in infant hygiene will save babies' 

 lives by lessening infant deaths. 



A second reason for special education in infant 

 hygiene is that the public needs and demands 

 physicians who are well instructed in the care of 

 babies. 



In this connection must be mentioned the need of 

 nurses trained in infant hygiene. There is an immense 

 and growing demand for such nurses. A wave of 

 interest in social welfare work is now spreading over 

 the whole civilized world, and now in the United 

 States almost every small town has its social service 

 bureau with one or more district nurses. The principal 

 work of the nurses relates to childbirth and infancy, 

 including the diseases of childhood. The weakest 

 link in this chain of philanthropy is the dearth of 

 women sufficiently experienced in infant feeding and 

 hygiene. Facilities must be provided for educating 

 such women, and physicians must give this instruction. 



What are the topics that should be included in 

 such a course ? An answer to this question may 

 perhaps best be reached by first enumerating the 

 problems to be attacked. We have, first, an enormous 

 mortality before the normal time of birth, due to 

 miscarriages, prematurity and stillbirths. An investi- 

 gation made in Philadelphia showed that in 1911 

 there were 39,9/5 babies born; of these 2,131, or 

 about 5 per cent., were stillborn. There were also 

 559 premature births in which the baby died, and 

 there were during the same year 10,666 miscarriages. 

 This means 13,000 dead among about 50,000 



