﻿INFANT FEEDING. 363 



Major E. C. Carter, formerly Commissioner of Public Health, makes 

 the following statement in his annual report for 190.3 : 



Tins excessive infant mortality is one common to all tropical countries. In 

 Manila it appears chiefly to depend upon ignorance with respect to the proper 

 care and feeding of young children and the difficulties of obtaining suitable food 

 where nursing by the mother is for any reason impracticable or the supply of 

 breast milk is insufficient. Fresh milk is almost impossible to obtain, and when 

 obtained is usually of poor quality and contaminated by improper handling. In 

 the absence of ice its preservation is practically an imposibility and no attempt is 

 made to modify its constitution so as to conform more nearly in character to 

 human breast milk. The destructive epidemics of rinderpest have also largely 

 destroyed the few milch cattle formerly in the Islands and there has been but 

 little resort to goats as a source of milk supply. The so-called Australian milk 

 is costly, its use is not general and it is not well borne by many. The employ- 

 ment of prepared infant foods is understood by but few, and their cost places 

 them beyond the reach of the poorer classes. The same applies to the use of 

 condensed milk, which is at present the most available source of supply of food 

 for- infants. When used it is frequently improperly diluted or contaminated by the 

 use of water from an impure source, giving rise to intestinal disorders and mal- 

 nutrition which are rapidly fatal. 



Major Carter in his annual report for 1904 again emphasized the 

 statements given in his report for 1903 and in addition points to the 

 invasion of the Islands by the "germ infected nursing bottle," he calls 

 attention to the use of the milk of the coconut in feeding, and he started 

 a campaign of education by distributing broadcast a bulletin on the care 

 of children, which was prepared by a committee of native physicians. 



Dr. V. G. Heiser, at present Director of the Bureau of Health, in his 

 annual report for 1906 states that as a result of this bulletin the con- 

 sumption of milk has increased by probably 500 per cent, nearly all the 

 output being used as food for infants, and he further points out that 

 notwithstanding this fact, there has been no appreciable decrease in 

 infant mortality and he considers this to be due to the improper care 

 and handling of both the milk and its containers. Dr. Heiser states 

 that probably 95 per cent of the milk used is from the carabao. 



However, even the large infant mortality, disastrous as it is, does not 

 tell us of the pernicious influences brought about by the conditions which 

 produce this mortality, upon those who escape death in infancy. A large 

 percentage additional to the 71 per cent of infants who die before the 

 end of their first year, is to be credited to those who, are left with crip- 

 pled constitutions and who later become unnecessarily susceptible to other 

 diseases. This supplementary mortality must be charged to the same 

 lack of care of the helpless ones, which makes the loss of so many infants 

 possible. 



The problem of infant mortality and infant feeding is, of course, a 

 fundamental one in all parts of the world and it is particularly so in 

 cities, but here it is even more complex than it is in other places because 

 of at least two important reasons — one, the almost complete absence of 



