CONTROL OF THE PUBLIC MILK SUPPLY 467 



exclusively and 56 were fed proprietary foods which in 17 instances means con- 

 densed milk. The large number of deaths among breast-fed children suggests 

 other factors than feeding as the cause of death. 



"6. Many children who die of bowel diseases are inherently poorly born; 

 13 of these children were premature and 41 gave a possible history of congenital 

 disease. Of the latter the parents of 14 have clear visual symptoms of tubercu- 

 losis or of gonorrhea. 



"7. A study of milk consumption in 5,731 homes with 526 babies led to the 

 conclusion that at least 60 per cent, of the babies are breast-fed, that 15 per cent, 

 are fed on cow's milk and that 10 per cent, are fed on proprietary foods. 



" The total milk consumption of the city was 90,000 qt. Of this amount about 

 3,250 qt. are retailed daily in stores, 1,950 qt. being dispensed in bottles and 1,300 

 qt. as dipped milk. The latter is very dirty food and a menace to the customers. 

 The store milk is sold where the poor live and where infant mortality is highest. 

 The city consumes about 5,500 cans of condensed milk daily. 



"8. While the study shows that about six times as many babies are nursed 

 as are fed on cow's milk and proprietary foods yet more than twice as many babies 

 of the latter class die as of the former. 



"9. The more important factors in the group of causes of the infant mortality 

 were: 



(A] Diseased or physically unfit parents. 



(J5) Dirty, disease-breeding homes. 



(C) Neglect and bad care. 



(D) Improper methods of feeding and the use of ill-suited foods. 



(E) Dirty and disease-carrying milk." 



Dr. Price, the health officer of Detroit, Mich., has recently told how 

 the infant mortality in that city was greatly reduced by attention to 

 factors quite independent of the milk supply. The first move was to 

 get the births as completely reported as possible, for the effect of this 

 may be to considerably reduce the infant mortality rate. A city with 

 an infant mortality of 200 per 1,000 births with only half the births re- 

 ported would have a death rate of 100 per 1,000 births if all of the births 

 were recorded. The next step was to proceed to actually reduce the 

 number of deaths of infants. 



The city was divided into 498 districts of six to eight blocks each and 

 the births and deaths of babies in each district was tabulated. Then 

 births were spotted in red and the deaths in black on a map of the district. 

 This work showed that each district might be placed in one of the 

 following groups : 



1. No deaths. 



2. Deaths 1 to 10 per cent, of the births. 



3. Deaths 10 to 20 per cent, of the births. 



4. Deaths 20 to 40 per cent, of the births. 



5. Deaths more than 40 per cent, of the births. 



On July 1, 1914, that is, at the beginning of the most trying season 

 for babies and in what proved to be a hard summer for babies, four of the 



