OUR BABIES.

Otago Witness, Issue 3314, 19 September 1917, Page 53

OUR BABIES.

By Hygeia. Published under the auspices of the Royal New Zealand Society for the Health of Women and Children. "It Is wiser to put up a fence at the top of a precipice than to maintain an ambulance at the bottom."

SAVING THE BABIES.

Some letters from "St. Helen's Trainees, * with reference to the recent deputation from the Central Council of the Plunket Society to the Minister of Publio Health, have appeared in one of the southern newspapers. We think our readers will be interested in the following letter from the Central Council which, while referring to the newspaper correspondence, deals broadly with the whole question. LETTER FROM CENTRAL COUNCIL. TO THE EDITOE. Sir,—The Central Council of the Plunket Society has decided, in view of the correspondence which has taken place in your columns, under the above head, to ask you to publish the following: The main facts bearing on the society's recent deputation to the Minister of Public Health, at which Mrs Truby King and Mrs Theomin acted as representatives of the Central Council, were as follow: (1) Nearly 30,000 babies are born every year in New Zealand—or say a prospective 300,000 child-immigrants to arrive in the course of the next 10 years. (2) The build, health, and fitness of these children will depend mainly on the correctness of the mother's knowledge and habits, on her health during pregnancy, and on the way in which the infants are reared throughout the first two years of life. (3) The monthly nurse is, to a very great extent, th.? arbiter of the fate of both mother and child; the destiny of the race is in the hands of the parents and nurses. Therefore, the Plunket Society is bound to leave no stone unturned to ensure the soundest and most reliable advice and teaching possible. In New Zealand the women authorised by the Government to practise as monthly nurses include, besides the St. Helens Nurses:

(a) Nurses trained at other State Maternity Hospitals in the Dominion; (b) maternity nurses bringing satisfactory certificates from training' institutions in other countries; (c) women who were practising as midwives before the passing of "The Midwives Act, 1904," and who became registered on the ground of previous practical experience. (4) The monthly nurses, drawn in this way from various sources, naturally represent very diverse views and methods. This diversity is specially marked as regards the essentials of tire-natal care, the establishment and maintenance of breast-feeding, and the best means of artificial feeding — all of which transcendency important matters have been the subject of profound investigation and radical changes and reforms in the course of recent years. Instead of confusion, we now have available simple, clear, definite knowledge. Leading authorities have arrived at consistent conclusions as to what are the most fundamental requirements for the welfare of mother and child—and incidentally, of course, what must be the groundwork of national health and efficiency in this direction. (5) To give practical effect to this accumulating knowledge regarding mothercraft, and not to leave it confined between the covers of books and periodicals on the shelves of medical specialists, simple, precise tables and figures showing normal average requirements have been drawn up and issued by the Plunket Society. These have been adopted, published, and sent out by the Government for the guidance of mother and nurse throughout the Dominion, instead of leaving them dependent on mere slipshod guesswork, or giving them recipes and figures more misleading than guesswork. While, however,, the Plunket Society has been fighting year after year for unity and consistency of teaching on the lines of what patient research and investigation have shown that Nature allows the baby in the form of its mother's milk, when both are doing well other apparently authoritative but utterly inconsistent printed instructions have been disseminated throughout the country, both from inside and outside sources —instructions which, if carried out, would hopelessly starve the baby on the one hand, or ruin its digestion on the other. We may give a single illustration. Mothers and nurses in the Dominion have actually had to choose between advice recommending for a child of one month of age an allowance of a milk mixture having the value of 7£oz of mother's milk, and on the other hand advice (apparently equally authoritative) showing the average baby at a month old as needing a mixture of which the food equivalent would be no less than 350 z of mother's milk ! Inconsistent food allowance for babies_ at one month and two months of age—taking mother's milk as the standard: One Two , month.. months. Authority A ?ioz lloz Authority B 35 oz SCoz Nature 23 oz oz The qualitative inconsistencies havo been rust as absurd, damaging, and indefensible. Thus the percentage of fat for a baby during the first week of life was set down as 1 per cent, by authority A. and as 8 per cent by authority B—the latter being actually orude butter-fat, of which the average baby cannot cope with more than 2 per cent, during the first few weeks. In mother's milk the fat is a delicate, easilyabsorbed, almost oily substance; yet Nature's average allowance throughout the nine months' nursing period is only 4 per cent. __. , Professor von Pirquet, of V umna, the leading authority in the world o.i 'Overfeeding Babies," has shown that this is one of the gravest causes of death, disease, and debility 0 in early infancy. Further, o.f all th* elements in the food of bottle-fed babies, the fat of cow's milk is the constituent most liable to disagree. The experience of the Plunket nurses shows that a large proportion of the babies brought to them are suffering from'malnutrition or indigestion induced by overfeeding in the first few weeks of life (61 The Central Councu sent Mrs Truby King and Mrs Theomin to Wellington with clear instructions to see whether some means could bo devised to bring about the consistency of teaching and advice neoesfcary in the best interests of mother and child—consistency, that is to say, with

Nature and the ascertained requirements of infancy, as explained in a simple, practical way in the Health Department's pamphlet prepared by the society. It was hoped that the necessary reform would be arrived at by merely bringing the matter before the Minister and the Chief Health Officer without publicity. Not achieving what was needed in this way (as regards bringing tho teaching of midwives up to date and making it consistent and harmonious in the directions indicated), the matter became the subject of a Parliamentary deputation, which led to the reports which have appeared in the newspapers. No attack was made or intended on the St Helens Hospitals. _ In asking the Government for the privilege of Dr King's services for all the midwives throughout the Dominion, we considered we were asking for something which ought to be as much appreciated by the maternity hospitals (State and private) as by the nurses themselves t and it is disappointing that some of those connected with the local St. Helens institution mould have proved themselves eo sadly narrow, self-sufficient, unreceptive, and utterly incapable of seeing beyond themselves m & matter in ' which the society's sole desire is to bring about tho further saving of some hundreds of lives a year, and the general safeguarding and well-being of all infants throughout the Dominion. '7. As every Plunket nurse must be in the first instance either —(1) A registered general hospital and maternity hospital nurse, or (2) a registered general hospital nurse, or (3) a registered maternity nurse; she must have had general hospital training or maternity hospital training before she took the additional throe or six months' special course at the Karitane-Harris Hospital. Therefore it is utterly absurd to say that any Plunket nurse has a narrower training and outlook than a midwife.

(8) Dr Siedeberg and your other correspondents, "The St. Helens Trainees," not having had tho Plunket training, are not in a position to estimate it 3 scope, value, or influence

For the most part the Karitane Hospital has been in charge of matrons with the double qualification of a general hospital and a maternity hospital, and after further qualifying as Plunket nurses they have entered on their teaching functions at the baby hospital. The statements of these nurses, selected in the first instance as exceptionally qualified and specially adapted for their work, have been singularly uniform, and their statements accord with the testimony of the St. Helens nurses who have qualified under them at Karitane. It will suffice to quote the following remarks made last week before the Minister of Public Health by one of the ablest of our recent matrons —a nurse who, before going in for the Plunket training, had special charge for eight months of an average of a dozen babies under 12 months of age in the children's ward at one of the best general hospitals in the Dominion. Asked as to the knowledge of the requirements of infancy displayed by nurses who came for training to the Karitane-Harris Hospital, the reply was: — —■ No nurse had any practical working knowledge of the ssimple principles or practices inculcated by the society. They had no acquaintance with the contents of the Government pamphlet or the Society's book, or the preparation of food on the formulae recommended. But, looking back, I was equally ignorant myself when I came to Karitane, and I can only sa.y that what I acquired in my three months' framing there and since has been an amazing revelation to me of my lack of qualifications for advising and helping mothers at the time when I started with the society. Asked the further question, "Have you any feeling that the Karitane training has narrowed or confined the outlook—as specialising may do —to one system to the exclusion of others?" the reply was as follows: No, absolutely the reverse. Nothing hais more broadened my mind or outlook. I have never been associated with' anything in which so much liberality of thinking and acquiring knowledge from every source, and adopting it on rational lines, was so much encouraged, as in connection with the society. As sufficient comment on the reflection made by your correspondent as to the society's work and Dr Truby King, we may say that he has just received a cablegram from Home, asking him to go to London, placing the Marlborough School of Mothercraft at his disposal, telling him to name a salary, and bring a nurse from New Zealand. —I am, etc., Amy Care, President Council Royal N.Z. Society for the Health of Women and Children. HEALTH OF WOMEN AND CHILDREN. The monthly meeting of the society was held in the Plunket Rooms on Friday, Mrs King in the chair. Dr Truby King gave a short address to the committee on the supreme importance of ensuring proper harmony and consistency of advice to mothers regarding the care of themselves and of their children. He drew special attention to the remarkably little deviation from her laws and requirements that Nature allowed in such matters as the feeding of the young. Ho said that, while considerable latitude was permissible in the case ot adults, every item of departure from what Nature had laid down and as the ideal food for a baby was made at the baby's expense and to the detriment of the future man or woman.

Both, in the form and quantity of food and in the times and manner of feeding the normal course should bo adhered to as closely as possible. Where early artificial feeding- had to be resorted to tins broad principle specially obtained —the nearer the food could be made to approximate the mother's milk the better. It was a. great pity that mothers ever had to fall back on cow's milk in the early months, and. where this was the case, the duty to humanise" the milk (that is, properly modify it to suit the human baby) should scarcely need much further demonstration and proof in New Zealand. He hoped that the lazy, irrational custom of falling back on patent food and condensed milk, which prevailed in the past, would soon bo completely eradicated. The matron of the Karitane-Harris Hospital reported as follows: —Admitted, 4 ; dis-" charged—mothers 2, babies 8 $ greatest number in residence at one time—mothers 3, babies 16. Of the four cases admitted during the month three came from Dunedin and one from Waimate. All babies discharged were making good progress. Gifts were acknowledged during the month from Mesdamea Oarr, Theomin, Mathieaoa,

Hill, Thomson, Misses Cook, Pinckncy, and .Nurse Girvan.

Nurses in training during August: Flunket nurses, 7; Karitane nurses, 11. All the babies are making satisfactory progress. The Plunket nurses reported as follows: New cases (babies only), 40; babies solely breast fed, 69. The month of August was a busy one. Cough.* and colds have been very prevalent. The epidemics has been of an unusual and ( infectious type, but not as severe as during the previous month. Mr S. Carr and Mrs J. C. M'George were appointed representatives of the Plunket iSociey on the Hospital Helpers' Association.

A resolution was passed expressing the society's pleasure at the appreciation shown by the authorities of the Marlborough School of Mothercraft in cabling to Dr Truby King and asking him to go to London to 6tart work there on New Zealand lines and to select a Plunket nurse from the dominion to act as matron of the institution placed at his disposal. The committee, though loth to part with Dr King's services for even a short period, decided to send a note to the Minister asking that, if possible, Dr King might bo spared for this national and patriotic service. The hon. treasurer reported the maintenance for the month £36 7s sd, also the receipt of a number of subscriptions and donations. SAVING THE BABIES. OFFER TO DR TRUBY KING. (From Our Own Correspondent.) WELLINGTON, September 13. Reference to the offer made to Dr Truby King to proceed to London in connection with the Marlborough School of Mothercraft was made in the House of Representatives to-day by the Hon. R, H. Rhodes. Surely, ho said, this was a great tribute to the work Dr King had done in this country in connection with the saving of babies. He asked the Minister of Public Health if he had decided to let Dr King go to England. The Hon. G. W. Russell stated that Dr King had arrived in Wellington a day or two before for the purpose of discussing the matter. Dr King had no desire permanently to dissociate himself from New Zealand or to sever his connection with the Seacliff Mental Hospital. He hoped if he could be spared for 12 or 18 months—probably the latter period —to be able to put the Plunket Society work on a firm basis in England At the end of 18 months he would return to New Zealand and resume his work at Seacliff and also carry on the work of the Plunket Society. The Minister said he had asked Dr King to submit details of the proposals in his mind in order that they might be placed before the Cabinet for consideration. In the meantime Dr King had obtained leave from Seacliff for three weeks in order to undertake a campaign in Christchurch, Wellington, and Auckland for the saving of child life, particularly in the training of midwives, nurses, etc.