H.-31

VIII

"As a result of a most careful and patient personal investigation, an inquiry extending over several years, and supplemented and checked by the experience of members of the Liverpool Medical Institution, it is found that the mortality amongst equal number of infants below three months of age fed during the three months, July to September, upon cow's milk with artificial foods as well as breast-milk is fifteen times as great as it is amongst those fed on breast-milk alone. Twenty infants out of every 1,000 below three months of age fed on breast-milk alone die from infantile diarrhoea during this season ; but no less than 300 die out of every 1,000 fed upon cow's milk and artificial foods, but who do get some breast-milk. If, however, they are fed on cow's milk and other artificial foods only, the deaths of those under three months of age during this season increases from 20 to 440 per 1,000 —a number almost incredible. " The year 1903 had the smallest death-rate ever recorded in Liverpool. The infantile mortality showed that out of every 1,000 born 159 deaths occurred during the first year of life. On the other hand, the average infantile death-rate for the previous three years was 178 per 1,000. It will be known by those most interested in this question that the most frequent causes which contribute to high infantile mortality are atrophy, diarrhoea, convulsions, and similar causes—diseases which tend to show that nutrition is interfered with." " The main reasons which appealed to the Health Committee of Liverpool Corporation in establishing these infants' humanjsed-milk depots is this enormous mortality amongst those infants wtio, from one reason and another, cannot be suckled, but require to be artificially fed. Every summer and autumn the sacrifice of life amongst this class in the great cities is deplorable. The Health Committee of the Liverpool Corporation felt that if something could Ije done to do away with the noisome and injurious contents of the feeding-bottles by substituting a food as near as possible to what Nature intended, a great step would be made towards lessening this melancholy loss of life, and we have in the humanised sterilised milk the nearest approach which it is possible to get to human milk. The cost is no greater than the ordinary food, and it is hoped to increase the facilities for obtaining it. "It is advisable that parents who apply for the humanised milk should be told how to give it, and from time to time they require to be visited in order to be sure that they are using it properly." Here is the standard used: —

City of Liverpool. — Humanised Sterilised Milk.

oz. cream, l|oz. sugar, |oz. salt, to each gallon of mixture.) Where a municipality takes up the question, (1) the children should be weighed regularly, (2) and there should be a woman inspector to visit the houses and watch the children. As has been pointed out, gastro-enteritis, diarrhoea, enteritis, gastritis, fee, are very often the resultant of the imbibition of impure or unsuitable food. In a country such as this there should be no difficulty in so arranging matters as to place milk outside the circle of contaminated or depreciated food. The reverse, 1 am sorry to say, is the case. Great care, energy, and skill is exercised in seeing that our customers oversea get none but the best butter and cheese; little, if any, is expended upon the milk consumed by our own people. In previous reports attention has been drawn to this matter. Something has been done, but until the Pure Food Bill has been placed upon the statute-book our efforts to secure that this most important article of diet shall come to the consumer in a clean and wholesome condition must fail. When one contrasts the manner in which a small country like Denmark manages such things with what obtains in New Zealand one feels ashamed. The ideal conditions would embrace some of the following: Healthy cows, sanitary byres, clean milkers, suitable dairies, proper pans, insulated cool railway carriers, expeditious delivery, storage (where necessary) in cool-chamber, and delivery to the householder in clean glass bottles. Alas ! nearly every one of these is wanting in many instances. The milking-sheds are bad: there is no cool-storage at the farmer's; the cans are often of such a form and material as

Age. Single Quantity. Dilution. Number of Bottles. Quantity of Pure Milk. 1 to 2 weeks 2 „ 8 „ 2 „ 3 months 3 „ 5 5 „ 7 „ Over 7 months Oz. 1* 3| 34 6* 7 1 to 1 1 „ 1 2 „ 1 2 „ 1 8 „ 1 3 „ 1 9 (I 9 i) 9 7 Oz. 6f 134 20f 30 36 36