INFANT-WELFARE STATIONS.

The establishments included under infant-welfare stations may be described under four headings: (1) Infant-welfare stations, which do not dispense milk but to which mothers may bring their babies for examination by doctors or nurses and which send nurses into the homes to instruct mothers in the care of the baby, home modification of milk, etc. (2) Milk stations, where a good quality of milk is dispensed, either free or at the prevailing price, for the use of mothers who are unable to nurse their babies. Other activities usually correspond with those of the infant-welfare station. (3) Feeding clinics, established by certain hospitals. It is to be noted that hospital clinics for sick babies are not included. (4) Health centers, which carry on educational work in a prescribed neighborhood and which deal with health and other problems affecting not only the baby but the entire family.

Number of cities represented. The total number of cities represented in the reports received from agencies maintaining infant-welfare or milk stations is 142; the number of agencies, 205. Of the cities 53, with 93 agencies, are situated in the Middle Atlantic division, 33 of the cities and 53 of the agencies being in New York State. The New England division is represented by 29 cities and 34 agencies, with 14 cities and 17 agencies in Massachusetts, and the East North Central division by 27 cities and 36 agencies, with 10 cities and 13 agencies in Ohio.

Number of stations. Reports were received from 205 agencies, maintaining 539 infant-welfare stations in 142 cities of 10,000 population and over. Of these stations only 397 were reported as operated in the winter. According to the inquiry the Middle Atlantic is far ahead of other divisions in the total number of stations maintained (252), and, as shown in Table V, in the number of stations reported by municipal agencies or by municipal in cooperation with private agencies (134) and by private agencies (118). Even if the stations maintained in New York City are eliminated, the statements still give the first place to the Middle Atlantic division.

Milk dispensed. Replies received from the 205 agencies maintaining infant-welfare stations in 142 cities indicate that milk is dispensed by slightly more than one-half (110) of the agencies. Of these agencies 49 dispense both whole and modified milk, 60 whole milk only, and 1 modified milk only. In the stations of 95 agencies no milk is dispensed.

Nurses attached to stations.-Nurses who work with infantwelfare stations as headquarters, giving all or a portion of their time, number 866 in summer but only 604 in winter. Of the nurses employed in summer nearly one-half (404) are employed in stations

maintained by cities or by cities in cooperation with private agencies. The work is concentrated in the Middle Atlantic division with 380 nurses, of whom 256 are in New York State, including 165 in New York City.

INSTRUCTION BY NURSES NOT CONNECTED WITH INFANT-WELFARE STATIONS.

The figures in the preceding paragraph taken by themselves do not present a complete statement of infant-welfare nursing work. To obtain this it is necessary to add the nurses who are not connected with the work of a station but who visit mothers in their own homes and instruct them in the care of babies, in the modification of milk, etc. The figures shown in the tables for the number of nurses who give a portion of their time to such work are doubtless too small. At the present time a complete report would probably include workers in nearly every visiting-nurse association in the country. No attempt was made to carry on an exhaustive inquiry to bring out this information. The bureau addressed only those agencies which there was some reason to believe specialized in infant-welfare work.1 Agencies reporting nurses not connected with infant-welfare or milk stations doing educational work among mothers in their own homes were found in 198 cities. This number should not be added to the cities reporting stations in order to get the total number of cities having infant-welfare work, because many cities have both classes of work. The total number of cities reported as carrying on infant-welfare work, by municipal or private agency, either through stations or through nurses not connected with stations who visit mothers in their homes, is 287.

Of these nurses not connected with stations, 466 are reported as giving their entire time in summer to infant-welfare work, but only 122 as giving their entire time in winter. In addition, 460 visiting nurses, according to the table, do a certain amount of educational work in summer among mothers as a distinct branch of their routine, and 491 do similar work in winter. Thus altogether 926 infantwelfare nurses are employed in summer and 613 in winter. That the number of part-time nurses is greater in winter than in summer is accounted for by the fact that many nurses are attached to stations operated only during the summer. In winter their work may be described under the other heading, and this of course swells the total for the winter part-time nurses.

1 See p. 7.

PRENATAL WORK.

1

The term "prenatal work" as used in this report refers to the care and instruction of prospective mothers in the hygiene of pregnancy by doctors and nurses attached to infant-welfare stations and obstetrical clinics and by nurses not attached to stations who visit mothers in their own homes. In collecting the information presented no attempt was made to address all hospitals and obstetrical clinics; the inquiry included only those institutions to which reference was made in the original sources of information.1

Cities and agencies reporting. The number of cities reporting prenatal work as carried on by departments of health or by private agencies is 186. All sections of the country are represented. The Middle Atlantic division shows 52 cities reporting prenatal work, 23 of them being in New York State; the New England division reports 43, with 25 in Massachusetts; the East North Central division, 40; the West North Central, 18; and each of the other divisions less. than 15.

Of the 286 agencies reporting this work, 114 are in the Middle Atlantic division, 57 in the East North Central, 51 in New England, 23 in the West North Central, and less than 20 in each of the other divisions.

Nurses. According to the table, 45 nurses give their entire time to prenatal work, 13 being employed by boards of health. Among the States, New York reports 14, Massachusetts 10. Although comparatively few nurses give their entire time to prenatal work, the fact that 893 give a portion of their time to this work is significant and indicates a growing disposition to include systematic prenatal work as a feature of the activities of the stations and of the agencies sending nurses into the homes.

Obstetrical clinics. In some cases an obstetrical clinic employs nurses to do prenatal work; in others, agencies carrying on prenatal work establish clinics for the medical care of pregnant women; in others, again, such agencies work in cooperation with clinics. Of the 286 agencies reporting prenatal work by nurses, 59 report that they support obstetrical clinics.

LITTLE MOTHERS' LEAGUES OR CLASSES FOR INSTRUCTING YOUNG GIRLS IN INFANT HYGIENE.

Under this title are included classes in infant hygiene for girls of school age either as a feature of the school curriculum or as an activity carried on outside school hours by the health authorities or by some private agency. In response to this inquiry 44 cities of 10,000 population and over reported that classes for Little Mothers had been. organized by municipal agencies. The information is presented in Table III.

TABLE III-Little Mothers' Leagues or classes for instructing young girls in infant hygiene, conducted by municipal agencies in cities having a population in 1910 of 10,000 and over, 1915.

[Sign (X) signifies that some work is being done in the field indicated.]

1 Details not supplied.

* Details not supplied; cooperates with Topeka Public Health Nursing Assn.

Details not supplied; cooperates with Holyoke Infant Hygiene Assn.

Number not supplied.

Details not supplied; cooperates with Children's Relief and General Welfare Society.
Approximately.

? Details not supplied; cooperates with Olean Visiting Nurse Assn.

• Cooperates with Milk Committee.

Cooperates with Babies' Dispensary and Hospital.

TABLE III.-Little Mothers' Leagues or classes for instructing young girls in infant hygiene, conducted by municipal agencies in cities having a population in 1910 of 10,000 and over, 1915-Continued.

[Sign (X) signifies that some work is being done in the field indicated.]

2 Details not supplied; cooperates with King's Daughters Visiting Nurse Assn.
Details not supplied; cooperates with Associated Charities of La Crosse.

The number of young girls instructed annually is given as 48,475. Chicago reports 4,000 of these; New York, 17,638; Philadelphia, 9,906; Pittsburgh, 3,000; Milwaukee, 5,242. In 12 cities a distinctive badge is supplied, either free or for a small sum, to the girls in these classes or clubs.

In addition, the following private agencies reported some work under the heading of Little Mothers' Leagues or classes:

1 Affiliated with American Red Cross Town and Country Nursing Service.