DISCUSSION 87 



of the poor on whole milk modified in their homes. We have not 

 had the courage to attempt this in all cases in Baltimore, as it has 

 seemed to us that the danger of contamination was increased in pre- 

 paring milk amid the unhygienic conditions in which so many of our 

 babies live. Encouraged by Mr. Phillips' experience, however, we 

 shall increase the number of babies furnished whole milk to be modi- 

 fied in their homes. 



I should like to say a word about the local work in Baltimore, and 

 extend to you all a cordial invitation to visit our eight milk stations 

 now in operation. This year we have taken a somewhat larger grasp 

 of the whole problem and are attempting to lay additional stress 

 upon the encouragement of maternal nursing. This is possible 

 through the co-operation of the Mother's Relief Society, which for 

 many years has done excellent work in combating the evils of the 

 midwife problem. On our staff are a social worker, an obstetrician, 

 and a physician especially trained in this kind of work both in this 

 country and abroad. We are attempting to follow up all the babies 

 delivered at the Hopkins obstetrical clinic during their first year, 

 encouraging their mothers to nurse them, and giving advice when 

 needed in all matters pertaining to their care. 



The number of wet nurses available in New York referred to by 

 Dr. Hart is a revelation to me. Nursing of this kind, I know, is ex- 

 tensively done in European cities, but I did not know it was possible 

 on such a large scale in this country. 



I am particularly interested in the problem of illegitimate babies, 

 and fully believe that their salvation in a large measure depends upon 

 keeping them with their mothers. Most of them, sent to asylums or 

 bereft of home care are doomed. We all know that many of these 

 unfortunate children develop into our sturdiest wage earners. Some 

 of the brightest minds have had this shadow cast over their birth. 



Our work here is very much encouraged by what we have heard 

 this morning. We have learned a great deal and I am sure that all 

 of us in Baltimore appreciate the reports of the experiences of those 

 engaged in similar work elsewhere. 



The chairman requested that Miss Holman give a brief statement 

 in regard to inaugurating district nursing in the mountains and rural 

 communties. 



Miss Lydia C. Holman, Ledger, N. C.: Just as I entered the room 

 I was struck with this statement from a paper being read: "How long 

 through failure to organize must we allow this loss of babies?" I 

 dp not know whether we in the cities ever think of the rural commu- 

 nities or isolated communities, but I want to say that we have more 

 babies born perhaps in a year than could be recorded in five years, 

 without organization. I believe the Government undertook it and 

 found it a failure a few years ago. When you know that the neigh- 

 bor, the tanner or the soapmaker, or anyone else, man or woman, 

 often even leaving the fields, will stop and deliver a woman, you 

 know what chance the mother and baby have. When a man will de- 

 liberately in his fear and hurry dissect a baby before it is born, you 

 know what chance the woman in the mountain has. When a baby is 

 brought up, you might say, on turnips and cabbage and is often given 

 snuff and tobacco, you know what chance the baby has. Fortunately, 

 those mothers are not so cultured that they wean the baby too soon; 

 they nurse the baby too long, generally. The baby in the isolated 

 communities has no chance, and the reason I remained in the moun- 

 tains of North Carolina was because there was so little chance for 



