340 MEDICAL SECTION 



It must not be forgotten that these mothers were 

 not only receiving ice for the preservation of the 

 milk, but careful instruction in the care of the baby 

 milk supply. We meanwhile found that the cost 

 of modifying milk in individual packages was be- 

 coming prohibitive (a quart of milk costing the com- 

 mittee, including all administration charges, 28 cents 

 when placed in the hands of the mother). We 

 accepted the lesson, and determined to sell at cost 

 to the mothers a quart or pint bottle of milk and 

 teach them how, to modify it in their own homes. 

 For a whole year milk was thus dispensed, the mother 

 being taught by the station nurse, first, at the station, 

 as to the general principles of modification (class-room 

 work and demonstration) ; second, by demonstration 

 in her own home ; third, by supervision in her own 

 home when it was believed she was sufficiently 

 capable to do the modifying herself. Only in rare 

 instances did it develop that a mother was so ignorant 

 or careless that it was necessary constantly to modify 

 the milk for her baby at the stations. This method 

 I want particularly to bring to your notice as best 

 fulfilling the fundamental principle involving all work 

 tending to the reduction of infant mortality namely, 

 instruction. I can conceive of localities and circum- 

 stances in which it would be better previously to 

 modify the milk for each individual. This method 

 may still be the better for milk dispensaries in connec- 

 tion with babies' hospitals to which will be gathered 

 babies convalescent from alimentary disturbances, but 

 for the general prophylactic work of milk depots 

 we must strongly urge the adoption of the home 

 modification method. That this opinion is gaining 

 ground in America is indicated by the fact that a 

 majority of the cities have changed to this method. 

 Over 80 per cent, of the work in New York City 

 is now done in this way. 



In the order of the efficiency in the reduction of 



