UNDER FIRE

Evening Star, Issue 22990, 22 June 1938, Page 8

UNDER FIRE

PLUNKEI SYSTEM CRITIC FOOD VALUES BELOW BARE MINIMUM VERDICT OF CHILD AILMENT SPECIALIST [Per United Press Association.] WELLINGTON, June 21. “ It is the opinion of specialists throughout New Zealand that the Plunket system of feeding does not supply even the bare minimum of food values required for a baby's perfect development and health,” said Dr F, Montgomery Spencer, of Wellington, child ailment specialist, to-day, replying to Dr Martin Tweed’s defence of the Plunket system. “ I feel that Dr Tweed’s remarks cannot be allowed to go unanswered,” he said. ”He has said that malnutrition begins after the children have left the hands of the Plunket Society, and that when they start right there is no reason why they should not continue right. We maintain that they do not start right. It is physical defects which are present before the child leaves the care of the Plunket nurses that account for the prevalence of malnutrition among school children. Such accompaniments of malnutrition as rickets and dental decay have their origin, it is widely recognised, in the first 12 to 18 months of a child’s life, which is the period when it is still under Plunket supervision. “ We are not as concerned with children fed well in infancy and undernourished afterward as with those who pass through their infancy in a satisfactory state (according to Plunket standards), but which state we consider is not at all satisfactory. Dr Tweed quoted a report by Dr B. Wyn Irwin on pre-school-age children. Dr Irwin is a brilliant student and Lady King scholar, but he has never specialised in children’s diseases nor studied the subject outside New Zealand.

“ There are, however, six specialists in New Zealand, besides myself, who have made a special study of the subject, and not one of them agrees with Plunket methods. “ They are Dr S. L. Ludbrook (Auckland), Dr Elspeth Fitzgerald (Oamaru), Dr E. J. Cronin (Auckland), Dr Marie Bnchler (New Plymouth), Dr R. H. Howells (Invercargill), and Dr T. F. Corkill (Wellington). All these doctors are strongly of opinion that a change is very necessary, as no doctor who had studied child nutrition overseas in receipt years could reconcile his opinions with the Plunket system.” The position was that there was not one such specialist bn the advisory committee of the society. Or Spencer added , that nobody ha’d any desire at all to do away with the Plunket Society. Far from it. No other country possessed an organisation that so effectively reached the homes of the people or cared for so large a proportion of the children; but there was urgent need for a change in the artificial feeding system. Happily there was every Indication that such a change would be forthcoming. The advisory committee had considered the matter at “ recent meeting, and he had no doubt that it intended thoroughly to Investigate the present system of artificial feeding.

HARSH CRITICISM DEPLORED SPECIALIST'S MISLEADING VIEWS SYSTEM ALREADY UNDER REVIEW “ If the intention of Dr Montgomery Spencer’s article was immediately to disrupt the Plunket Society by discrediting it in the eyes of the large public which has looked up to it during the last 30 years, then a convincing procedure has been adopted,” said Dr r-. N Williams, joint medical adviser of the Plunket Society in Dunedin, when replying this morning to the charges against the system by the Wellington specialist. Dr Williams pointed out when referring to Dr Spencers criticism both in the Press and in the New Zealand ‘ Medical Journal ’that the impression gained by the public from these articles might be that those administering the feeding methods were deliberately and advisedly underfeeding infants. Not only was such a suggestion contrary to fact, but an examination of the many thousands of normal infante supervised by Plunket nurse# would at once nullify such a criticism go to show that good results could be achieved. REPORT BEING PREPARED. “ The publication from which the information has been derived represents the experience and opinions of one man presented to a medical audience for their judgment and criticism, said Dr Williams. “ Although it may draw attention to weaknesses in the Plunket system, it surely might have been expected that the views and intentions of the society might have been ascertained before publication of what is a condemnation of a voluntary organisation whose whole object for 30 years has been the benefit to mother and child. Had this been done it would have been found that the society is quite alive to the necessity of inquiring into its methods in the light of modern knowledge Within the last week it called together its medical advisory committee, and as a result of this meeting a report is being prepared which will be presented to the council of the society as soon as possible. It could also have been ascertained that a somewhat similar movement of wider scope is being undertaken by the Medical Research Council to inquire into the subject of nutrition as it affects the population, including infancy. In the same journal from which the subject matter of the article is derived is an editorial which is well considered and more temperate in its approach to the subject. The sincerity of the author of the criticism is not questioned, only the methods that have been adopted for making his opinions known to the public. It is easy to offer destructive criticism of a system by its failures,- and the more far-reaching

its activities the greater the oppbrtunity. That the society has been aware that there may be shortcomings is evidenced by a desire to inquire into the position, and also from the fact that from time to time it has endeavoured to bring about improvements in feeding methods. But when we consider the many thousands of successfully,' indeed, ideally, reared infants under the Plunket system through the years, there is sufficient justification for prido in a great achievement. AN UNCONSTRUCTIVE ATTACK. “ The Plunket Society, which perhaps has received more extravagant yet deserved praise than any other institution in the country, finds itself suddenly assailed on the death of its founder, as if it were responsible, not as of old, for the excellence of New Zealand children, but for every example of malnutrition to be found in the country. The term * malnutrition * may be applied to any departure from the normal—even one cartons tooth will quality. If, however, the records of an infant’s first year show norms! development, physical progress, and muscular tone, it Would seem rational to look for the causes of malnutrition after this period. _ Any unbiased observer can mention several factors operating in the pre-school and sob obi age. , Regarding the former ago the Plunket Society is doing as muob as possible with the staffs available. The school medical service is attending to the school age. More satisfactory results could be achieved in both ago groups if better, co-operation of the parents could ■ bef secured and if the necessary protective foods were -, more readily available to children who ■ are frequently deprived of them through reasons of economy or from indifference or ignorance.

REVISION OF SYSTEM. “ The public is well aware (and ha« been lately reminded) that the system under criticism was established some SO years ago by a very remarkable man, whose views on infant nutrition and requirements were then the. most advanced in the civilised world. Such a system could have been launched successfully and made universal throughout the country only by adopting _a rigid dogma which the unscientific people who had to administer it could clearly understand and insist upon. Such a system is well adapted to tha general standards, but must sometimes fail in the particular case. Its general excellence has never been in question, but a good many students of the subject in recent years have regarded its methods of infant feeding as requiring some revision. Such constructive criticism has been appreciated by tha JPlnnket Society and by those medical teen who have helped to administer the society’s work, and now that Sir Truby is no more steps have been taken to investigate the whole question, being fully persuaded that the greatest memorial that they could establish to Sir Truby King is to keep his system up to date and in line with modern thought. But Sir Truby was hardly in his grave before a series of alarmist article* began to appear in the Press, with appeals to this and that authority to institute an inquiry into a system which, it is suggested, is producing a population.’ This is surely to he deprecated. It can hardly be that a system which has been allowed to _ continue, and, moreover, has flourished for 30 years, can be so completely defective.”

AN UNTIMELY ATTACK DOMINION COUNCIL'S REPLY EXPERT OPINIONS WELCOMED “ The Plunket Society has been aware for some months of the criticism directed by Dr Spencer against one aspect of the society’s work,” comments a statement released by the executive of the Dominion Council of the Society. “ This criticism was conveyed to the executive in a letter from. Dr Spencer, who was immediately notified that a« it was a technical matter, it wdilld be dealt with in the only possible way—by reference to a Medical Committee, Dr Spencer was not satisfied with this, and proceeded to attack the society publicly through, the Press. He further knew at the time of publishing his attack, that a meeting of the Medical Advisory Committee of the society had been convened to deal with the matter, and that three of the specialists referred to by him had been co-opted in an advisory capacity. _ v “ His article gives the impression that the society is avoiding consulting expert opinion.. This he knows is not the case. The society welcomes the fullest inquiry into its work, and will be prepared at any time to make available its records of cases over « number of years. The executive regrets that Dr Spencer has consistently refused to supply confidentially sufficient particulars of specific cases cited by him to enable the society to investigate the charges he has made. Pending the receipt of the report of tha committee no further statement-can bo mide.”