September i, 1904] 



NA TURE 



425 



THE ISFASTS' MILK DEPOT. 



'T^HE annual toll of infant lives in all countries is 

 -'■ a heavy one. At the present day in most 

 civili.sed countries the problems of infantile mortality 

 have come into prominence from many causes, chiefly 

 the declining birth-rate, and although in England the 

 general death-rate has fallen from 22-6 per looo in 

 the five-yearly period 1851-5 to 17.6 in iSg6-igoo, the 

 infant mortality, that is, the death-rate of infants 

 under one year per 1000 births, has remained stationary 

 (156) in those two periods. In the great industrial 

 centres the infant mortality ranges from 168 to 182, 

 and if it could be reduced to 104, which is the average 

 of the semi-rural counties, there would be a saving of 

 40,000 lives annually. Dietetic dis- 

 eases are mainly responsible for 

 this terrible loss of life, and from 

 one-third- to one-half of the total 

 infant mortality is due to diarrhoea, 

 which is especially active in hot 

 summers. 



These conditions are chieflv 

 attributable to improper feeding, 

 and to the use of milk which 

 bacteriologically is grossly polluted. 

 These sources of danger to the 

 infant population would, of course, 

 be inoperative were breast-feeding 

 the rule, but breast-feeding seems 

 to be difficult to secure, partly from 

 the selfishness of mothers, and 

 partly from an ignorance which 

 assumes that hand-feeding can take 

 its place. It is naturallv among 

 the poor that improper feeding 

 chiefly obtains. The infant from 

 its earliest days, in lieu of its 

 natural nourishment, has tit-bits 

 from the parents' table and various 

 concoctions of cow's milk, con- 

 densed milk, and infants' foods. 

 With regard to the latter, it has 

 been remarked that if a mixture of 

 chicory with coffee is sold as pure 

 coffee the trader is liable to pro- 

 secution, but that anvone mav 

 make up any sort of mi.xture and 

 call it a perfect infants' food, and 

 the law leaves him alone ! 



There is obviously a great field 

 for specialised measures of preven- 

 tion against the dietetic diseases of 

 infants, and organisations have 

 therefore been established for the 

 supply of sterilised milk for the 

 babies of the poor, and incidcntallv 

 to teach the mothers how their 

 children should be reared, and 

 to encourage breast-feeding when- 

 ever practicable. 



Many of these infants' milk depots are now in active 

 work, both on the Continent, and in England at St. 

 Helens, Liverpool, Battersea, and other districts, and 

 their administration is summarised bv Dr. McCleary, 

 the medical officer of health for Battersea, in a useful 

 paper.' In Battersea this is as follows: — The milk 

 for Use at the depot is carefully controlled, and special 

 conditions have to be accepted by the contractor. The 

 amount of milk requisite for a single meal, and suited 

 to the age of the infant, is contained in a screw- 

 d Function • (Journal of 



Stoppered bottle ; for the youngest infants it is 

 modified by the addition of water, cream, and sugar 

 according to recognised principles. The bottles are 

 then placed in the sterilising chamber (see illustration), 

 steam is injected, and the temperature raised to 

 212° F., which is maintained for about ten minutes. 

 They are then taken out of the steriliser and 

 rapidly cooled in a cooling tank. The bottles are 

 supplied in wire baskets, each basket holding from 

 six to nine bottles, and containing a twenty-four hours'' 

 supply. The next day the basket of empty bottles is 

 returned, and a fresh supply obtained. When a child 

 is entered at the depot the mother is instructed by the 

 manageress as to the proper method of using the milk, 

 and she receives a printed leaflet of instructions. The 



1 "The Infant 

 HygUnc, iv.. No. 



Milk Dep.'.t : 

 ), July, 1904. p 



'\\% History 



3=9)- 



NO. 18 18, VOL. 70] 



Milk DepMt, B.itteri. 

 loaded trolley. 



cost varies according to age, from 2S. to 2S. gd. per 

 week . 



The method of infant feeding is a very simple matter 

 so far as the mother is concerned. When feeding 

 time arrives, all she has to do is to place a bottle, un- 

 opened, in a basin of warm water until it reaches body 

 temperature, to open the bottle, put on a rubber teat 

 supplied at the depot, and feed the baby from the 

 sterilised bottle direct. There is no need for a " feed- 

 ing bottle," which alone is a great advantage. 



The homes of the children fed on the milk are 

 visited by the lady sanitary inspectors, who endeavour 



