170 CERTIFIED MILK. 



Milk dispensaries. In France, the decreasing birth rate first 

 stimulated an interest in agencies for decreasing the death rate 

 of infants. One form of institution called consultation de 

 noiirrisons ' ' is attached to maternity hospitals. Children born 

 in the hospital are kept under medical supervision for two years. 

 They are brought to the hospital once a week, weighed, and 

 medical advice is given the mother. A slightly different sort 

 of institution, goutte de lait (milk dispensary), furnishes milk 

 to the poor in general. 



In the work of milk dispensaries the aim is to decrease infant 

 mortality among the poor by remedying methods of care and 

 feeding. Breast feeding is urged, but when this is impossible, 

 a pure supply of milk is provided. When the circumstances 

 demand, the milk is modified to meet the requirements of the 

 individual infant. Instruction in the proper hygienic care of 

 infants is recognized as quite as" important as pure food. This 

 is accomplished most effectively by oral instruction, supple- 

 mented by educational pamphlets. 



Milk dispensaries are maintained in about twenty cities in 

 the United States. In ten of these, the milk is pasteurized at 

 various temperatures. In six cases certified milk is used and 

 in the others milk from good sources. In general the milk 

 dispensaries are maintained during the summer only, but in 

 some cases they are open during the whole year. Milk dis- 

 pensaries are maintained as charities. Nathan Straus of New 

 York is particularly active in this form of philanthrophy. Out 

 of the twenty cities in which there are milk depots, only four 

 of them are maintained at the expense and under the super- 

 vision of the health department. 



There are so many factors involved that it is impossible to 

 place a valuation upon the influence of the clean milk alone, 

 even though the work of milk dispensaries is an important 

 factor in reducing infant mortality (9, 10). 



Rochester, N. Y., milk dispensaries . Dr. Goler, the Health 

 Officer of Rochester, N. Y., has established milk depots under 

 the control of the health department. A contract is made for 

 the product of a dairy during two months' in the summer. 

 A temporary laboratory is established at the farm and em- 



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