MILK IN ITS RELATION TO INFANT FEEDING 597 



What are the reasons for the lowered infant mortality in some 

 countries compared to that of others, and what steps should be 

 taken to reduce infant mortality to a minimum? A survey of 

 the various statistics brings out some of the most important 

 forces operating in both the cause and prevention of infant mor- 

 tality. 



1. Climate. — There is no doubt that the climatic conditions 

 of various countries affect in a great degree the mortality rate of 

 the infant population. The very low infant mortahty of New 

 Zealand may, we believe, be attributed primarily to its excellent 

 climate and only secondarily to its efficient system of infant wel- 

 fare. 



2. Nationality. — It has been found that nationality plays a 

 role in infant mortality. In the report of the Health Department 

 of the city of New York a statistical survey is given of the mor- 

 tality of the children of different races under five years of age. 

 The report shows that the lowest rate occurs among children of 

 Russian, Austro-Hungarian, and Swedish parents. On the. other 

 hand, a high mortality prevails among the children of English, 

 German, Irish, and Itahan parents. The highest death-rates 

 from congenital diseases are foimd among American, Irish, and 

 German infants. The rate for respiratory diseases among Italian 

 children is double and triple that of the children of all other 

 nationalities. Emphasis is laid on the fact that in many respects 

 native stock seems less sturdy than foreign stock of recent acquisi- 

 tion. The children of native parents, for instance, furnish the 

 highest mortahty rate due to malformations (47 per 10,000), to 

 marasmus (222 per 10,000), and to tuberculosis (21 per 10,000). 



That race exerts an influence on infant mortality there is no 

 question. It is a well-known fact that mortality among colored 

 children is three times that of white children. 



3. Study of Infant Feeding. — One of the greatest factors in 

 the reduction of infant mortality has been our growing knowledge 

 of the principles and methods of infant feeding. The medical 

 world now universally recognizes breast milk as the ideal food for 

 infants. Every physician is aware of the fact that to reduce 

 infant mortality it is necessary that as many mothers as possible 

 be urged to nurse their babies. In many hospitals a system of 

 wet nurses has been instituted where mothers who have a super- 

 abundance of milk are employed by the hospital for the purpose 

 of supplying breast milk to very sick babies. By this means many 

 babies have been saved who could not otherwise have been saved. 

 Not only in regard to breast feeding but in regard to artificial 

 feeding also has the medical world learned a great deal within the 

 last few years. Many so-called "truths" of infant feeding have 



