STUDIES ON INFANT MORTALITY. 



159 



Table XIII. — Showing per cent of total infant mortality lohich occurs in breast- 

 fed and artificially fed infants in different cities. 



City. 



Breast- 

 fed. 



Artificially 

 fed. 





Per cent. 

 9 

 17 

 73.74 



Per cent. 

 91 

 83 

 26.26 









Tugendreich " states that in 64 families with 38S breast-fed children there 

 had been 77 deaths, a mortality of 19.8 per cent. On the other hand, he found 

 that 33 families with 229 bottle-fed children had 99 deaths, a mortality of 43.2 

 per cent. Twenty-four of the 64 families with 109 exclusively breast-fed children 

 escaped without a single death, while not one of the 33 families with bottle-fed 

 children escaped without the loss of at least one child. In other countries the 

 mortality among breast-fed infants is very low. 



In Germany, France, or the United States a breast-fed infant means 

 a healthy infant in 90 per cent of the cases, because the mothers in those 

 countries are usually healthy and well nourished. In the Philippines 

 the mortality is greatest among breast-fed children, possibly because of 

 the poor quality of the mother's milk. The latter is probably deleterious 

 by reason of what it lacks rather than because of any harmful constituent. 

 The average Filipino mother is in poor physical condition, many of 

 them are beriberic and subsist upon a diet favorable to beriberi. It 

 seems probable that there is an intimate relation between beriberi of 

 infants and a mother's milk poor in quality and lacking certain necessary 

 elements which are not included in the mother's dietarjr. At first glance 

 it might seem advisable to supplant breast feeding by artificial, but under 

 existing conditions this would be a blunder. The children saved from 

 beriberi would be sacrificed to enteric diseases. That small part of our 

 infant population which is artificially fed furnishes 65 per cent of the 

 deaths from enteric diseases, and the breast-fed, much the larger part of 

 the population, furnishes but 35 per cent of the infant mortality from 

 this cause; so that even in Manila, breast-feeding of infants exerts a 

 deterrent influence upon the mortality from gastrointestinal diseases. A 

 possible solution of the problem lies in improving the quality of the 

 mother's milk and encouraging the continuance of the custom of breast- 

 feeding so general among the Filipino poor. The improvement of the 

 physical condition of the Filipino mother and of the quality of her milk 

 is an economic question. Her condition is the result of poverty and 

 therefore insufficient and unsuitable food, especially during the periods 

 of pregnancy and lactation. 



"Arch. f. Kinderheilk. (1908), 48, 390. 



