MILK AND ITS RELATION TO THE PUBLIC HEALTH 611 



which will be wholesome after heating. The general practice of 

 heating milk, which has now become a custom among the tenement 

 population of New York, is undoubtedly a large factor in the lessened 

 infant mortality during the hot months. 



"8. Of the methods of feeding now in vogue, that by milk from 

 central distributing stations unquestionably possesses the most 

 advantages, in that it secures some constant oversight of the child 

 and, since it furnishes the milk in such a form that it leaves the 

 mother least to do, it gives her the smallest opportunity of going 

 wrong. This method of feeding is one which deserves to be much 

 more extensively employed and might, in the absence of private philan- 

 thropy, wisely be undertaken by municipalities and continued for 

 the four months from May 15 to September 15. 



"9. The use, for infants, of milk delivered in sealed bottles, should 

 be encouraged whenever this is possible, and its advantage duly 

 explained. Only the purest milk should be taken raw, especially in 

 summer. 



"10. Since what is needed most is intelligent care, all possible means 

 should be employed to educate mothers and those caring for infants, 

 in proper methods. This, it is believed, can most effectively be done 

 by the visits of properly qualified trained nurses or women physicians 

 to the homes, supplemented by the use of printed directions. 



"11. Bad surroundings, though contributing to bad results in feeding, 

 are not the chief factors. It is not, therefore, merely by better housing 

 of the poor in large cities that we will see a great reduction in infant 

 mortality. 



"12. While it is true that even in tenements the results with the best 

 bottle feeding are nearly as good as average breast feeding, it is also 

 true that most of the bottle feeding is at present very badly done; 

 so that, as a rule, the immense superiority of breast feeding obtains. 

 This should, therefore, be encouraged by every means and not dis- 

 continued without good and sufficient reasons. The time and money 

 required for artificial feeding, if expended by the tenement mother to 

 secure better food and more rest for herself, would often enable her 

 to continue nursing with advantage to her child. 



"13. The injurious effects of table food to infants under a year old, 

 and of fruits to all infants and young children in cities, in hot 

 weather, should be much more generally appreciated." 



These observations do not correlate the incidence of diarrhea with 

 specific microorganisms, but they do furnish strong presumptive 



