64 DISCUSSION 



the frequency of applications for wet nurses called for some public 

 register in each community, containing the names and addresses of 

 available wet nurses, so that when people desire to obtain a wet 

 nurse for a child, they would know where to go. You who have had 

 experience trying to find wet nurses for children will know the diffi- 

 culty of finding one, and Dr. Skinner's suggestion seemed to me to 

 be one of considerable value. 



A speaker reported that such an institution for wet nurses has been 

 in existence in Boston for about a year. There are nine or ten wet 

 nurses registered and never more than one or two left on the regis- 

 ter at a time. The baby always goes with the mother ; the mother 

 is not allowed to go out without the baby. So far it has been very 

 successful. 



Mr. Walter Kruesi, Director Milk and Baby Hygiene Associaton, 

 Boston: The Boston Floating Hospital during the last summer in- 

 stituted a system of collecting maternal milk from mothers who had 

 more than sufficient for their own child and who are glad to give it 

 to the children of the Floating Hospital. Names of nursing mothers 

 were obtained from the Lying-in Hospital, District Visiting Nurses 

 and physicians. Those who were willing to give or sell milk were 

 exained by a physician, their milk was tested, their own baby ex- 

 amined and weighed and kept under observation. Their own child 

 was not allowed to suffer in any degree and several babies on the 

 hospital ship received the only nourishment they could take. They 

 collected from two to four quarts per day. The Floating Hospital 

 offered fifty cents a quart for the milk, and sent a graduate nurse 

 to collect it. She carried a refrigerator and an exchange supply of 

 sterile bottles. Many of the mothers contributed it and would take 

 no money for it; they were glad to send it to any child who needed it. 



Mr. Robert W. Bruere, New York: Mr. Chairman, I beg leave to 

 make a statement and to ask a question. The experience of the 

 New York Association for Improving the Condition of the Poor 

 and of the New York Milk Committee show that low wages, insuffi- 

 cient family budgets, account for a considerable percentage of our 

 preventable infant mortality. Last year at New Haven, I reported 

 the striking results of the Association's Caroline Rest experiment, 

 the object of which was to ascertain what the effect on the infant 

 death rate would be if working mothers were protected against 

 economic pressure and given simple hygienic instruction before the 

 birth of their children. During the first year, in 135 families where 

 the mother was visited, instructed, and protected from economic pres- 

 sure after the child had fallen sick, there were 22 infant deaths, or 

 a mortality of 17 per cent.; in 202 families of precisely the same social 

 status, where the mother was guarded against want and taught in 

 advance of the coming of the new life, there were only 9 infant 

 deaths, or a mortality of 4.9 per cent. A similar reduction in the 

 death rate in the whole of New York City would mean an annual 

 saving of approximately 12,000 infants. This result was so startling 

 that the Association took pains to emphasize its tentative charac- 

 ter. At the end of the second year 789 cases were available f9r study. 

 In 300 of these the nurses began their work after the babies were 

 born, and 40, or 13 per cent, of them died during their first year; in 

 489 cases the nurses were able to begin their aid and instruction a 

 month or more before the children came, and here the deaths during 

 the first year were 23, or 4.7 per cent.! 



Just before coming to this meeting, I had occasion to analyze the 

 budgetary information published by the New York Lying-in Hospital 



