HASTINGS H. HART, LL. D. 63 



who would then proceed to feed the baby according to her ideas. 

 Thus, in a single day, the unfortunate infant would receive four 

 different feedings of different milk, with different modifications 

 and without any exchange of information. 



When this practice was brought to the attention of the society 

 they immediately changed their methods. The baby is now taken 

 directly from the hospital to the train. The hospital nurse pro- 

 vides a supply of the milk to which the baby is accustomed for 

 use en route, and the hospital physician furnishes a formula for 

 the guidance of the foster mother in feeding the child. Thus 

 there is only one change of food instead of three, and that change 

 is made under the advice of the physician who knows the child 

 and its needs. 



Second That there is a surprising amount of ignorance in 

 quarters where knowledge might be expected. Only a very few 

 societies have anything like an adequate history of their wards, 

 and very few have a proper medical examination on admission. 

 Nurses are often incompetent and ill paid, and babies are given 

 to foster mothers who are without instruction or training for 

 their responsible work. 



Third That physicians, nurses and superintendents are eager 

 to obtain information which will assist them in improving their 

 methods of dealing with infants, and the Society for Study and 

 Prevention of Infant Mortality has here a great opportunity. 



DISCUSSION 



Dr. Woodward: I would like to ask Dr. Baker about the record 

 of mortalities in the asylums. Has it run very high, year after year? 



Dr. S. Josephine Baker, Health Department, New York City: I 



do not know that I can answer definitely. At the present time there 

 is an investigation being conducted as to the exact conditions rela- 

 tive to the foundling asylums in New York, with particular refer- 

 ence to the mortality of the babies that are kept in the institution 

 and those that are boarded out in homes. I think the real problem 

 of the institution is not the problem of the breast-fed baby. The 

 breast-fed baby in the institution or in the home does pretty well, 

 but the real interesting feature to my mind is the fact which I can 

 not prove by statistics now, but which I know to be absolutely true 

 that the bottle-fed baby boarded out in a home has a chance for life 

 at least 50 per cent, better tjian if kept in the institution. I think the 

 question of boarding out babies in homes should be elaborated 

 more for the bottle-fed baby than for the breast-fed baby. I have 

 a chart of infant deaths in homes and institutions which is very strik- 

 ing, but owing to the fact that it is made of red and blue pins it was 

 rather impossible to send here. No one could see it without real- 

 izing that almost half of the infant mortality in the borough of 

 Manhattan of New York City is the institutional mortality. 



Dr. Woodward: I wish to ask a question more. I would like to 

 know whether any one knows of a community where there is kept an 

 official or public register of available wet nurses. Dr. Skinner, in 

 charge of the Columbia Hospital, in Washington, has suggested that 



