PUBLIC SCHOOL EDUCATION FOR THE PRE VENTION OF INFANT MORTALITY Friday, October 20, 1916, 2.30-4.30 p. m. COMMITTEE CHAIRMAN PROF. ABBY L. MARLATT. Director of Home Economics, University of Wisconsin, Madison SECRETARY DR. DOROTHY REED MENDENHALL, Special Lecturer on Child Welfare Work, Extension Service, University of Wisconsin, Madison DR. ALICE BLOOD, Director of Course in Home Economics, Simmons College, Boston MISS MATHILDE KRUEGER, Chairman, State Committee of Examiners of Registered Nurses, Neenah, Wis. MISS BESS M. ROWE, Leader of Extension Work in Home Economics, University of Minnesota Topic: The Educational Possibilities in Cooperation between Public and Private Hospital Service and Public School Education, in High Schools, Vocational Schools, College and University Extension Work Chairman's Report on College Work Work of Extension Departments in Educating the Mother along the Lines of Prenatal Care The Relation of Baby Clinic Work to the Classes in Dietetics in College Courses Visiting Baby Clinics and Hospital Experience as an Aid to the Extension Worker PUBLIC SCHOOL EDUCATION FOR THE PREVENTION OF INFANT MORTALITY Chairman's Report on College Work ABBY L. MARLATT, University of Wisconsin, Madison The subject, as you know, at this session, is the possibility of affiliation with hospital work in connection with public school education. In our previous sessions in the meetings of the association, we have dealt with the possibility in the high school of courses which will equip the girl for her future work. At this session we hope to present co-operation of hospitals and the trained nursing forces with college and extension work. A good deal of this cooperative work has been done, some organized and some rather desultory. In the eastern cities there are organizations of "Little Mothers Clubs," which are affiliated with the school, though not necessarily a part of public school education. The young woman has been educated along almost every line except the fundamental one which will be her main problem in her life. It is stated that 85 per cent of the women marry, and that they go into this work with a more or less imperfect understanding of the situation. Those that have listened to the discussion at our sessions this week will remember that practically every speaker made the statement that after all the fundamental thing is the education of the parents (they didn't say parents-most of them, I am sorry to say, said "mothers"). If this education is to be given there must be a revolution in the teaching of young women so that they may meet the world problems of eugenics and nurture with at least an understanding and open mind. Ignorance can no longer be mistaken for innocence, but must be recognized as criminal in its final effect. Studies of population in regard to birth and death rates as a measure of the education of a race and the resultant standards in marriage, divorce, housing conditions, food habits and general hygiene are part of every liberal college course. Technical knowledge of preventive measures is not so often insisted upon-legislation alone never reforms-action based on knowledge of ways and means must follow and be automatic in the lives of each citizen before reformation is possible. In the reduction of the infant mortality rate the most potent factor has been shown to be prenatal care based on scientific knowledge acquired before the need arises. In what way and through what avenues may this knowledge be given? In this conference on the study and prevention of infant mortality no line of work which does not reckon with the future mother can ever succeed. She is the source and in her education the public and private schools must provide those courses which will make it possible to eliminate the frightful loss of life during the first month after birthfully one-half of the infant mortality occurring during this first month. The subject matter must cover not only personal hygiene, feeding, clothing, housing, care of the sick, but courses in child care, in which through talks, texts, demonstration, and actual practice such child care may be made fundamentally practical. In previous reports there have been outlined such courses for high schools and vocational schools. As far as united action is concerned, there are very few of the colleges that at all approach the subject. Most of these institutions are giving these courses under the name of home economics rather than child welfare work. This is due to the fact that home economics work is the easiest field where this teaching can be introduced. It can be given in connection with the study of foods, clothing and personal hygiene. In all of these the utilization of the hospital staff and hospital equipment has been suggested. In these courses the hospital staff of trained physicians give lectures which cover the following subjects: Infant feeding; infant diseases; prenatal care; normal development of the child; breast feeding; artificial feeding; and demonstration by the hospital dietitian and superintendent of nurses on laboratory technique of milk modification; on bathing the baby; on clothing for the baby. This cooperation with the best city and private hospitals has been through classes assembling at the hospitals for the lectures and in the smaller groups for the demonstrations. This work is supplemented by lectures and laboratory work in the college courses in dietetics and home nursing. It gives a basis on which future study may build and through the familiarity with the hospital staff and equipment removes the dread of the unknown and may lead to more nearly intelligent social service work, and sane and wholesome teaching to the girl in the high school who is so dependent for her standards on the teacher with whom she comes in contact. That this constructive work in teaching child care through use of the hospital as a laboratory has originated in those institutions where home economics courses are well developed is not surprising, as these courses are built around the conserving of all that is best in the home and making it recognized as the important factor in the national life. What has been done at Simmons College, Boston, is quite characteristic of the work. Dr. Alice S. Blood, who is a member of the committee, has given a short outline of the work at Simmons this year. "The course consisted of four lectures and four demonstrations given at the Infants Hospital-a lecture on prenatal care by Dr. Emmons, a lecture on the normal development of the child by Dr. Dunn, a lecture on breast feeding and one on modified milk feeding by Dr. Howell, two demonstrations on milk modification by Miss Wilson, a demonstration on bathing the baby and one on clothing the baby by Miss Gregg. The lectures were given to a group of sixty students. For demonstrations the class was divided into small groups, but the work was entirely demonstrational. We are going to do work next year on much the same plan, but it will be a part of a course in home nursing and child care-the work in home nursing being given under Miss Johnson, at the Peter Bent Brigham Hospital. We are extending our work this year in the direction of a course in home nursing and bedside care given at the Peter Bent Brigham Hospital. The work is being given by the assistant superintendent of nurses. With reference to the work at the University of Minnesota, Prof. Josephine T. Berry, Chief of the Division of Home Economics, says: "We haven't any very satisfactory relation with the hospital of the University of Minnesota, due to the fact that the work of the dietitian there is limited to preparation of food for the wards and the staff, offering very little private tray work. The hospital also is so crowded that they cannot give up any space to pupil dietitians. "Dr. Sedgwick, of the Department of Pediatrics, gives five or six lectures and demonstrations as a part of our course in dietitics. He treats the topics of infant feeding and infant's diseases. "The City Hospital, of Minneapolis, has just instituted a course for pupil dietitians. It is their plan to have all of the time four pupil dietitians and to have each one there for a period of four months. Through this we expect to be able to give our students experience which will lead pretty directly to employment as hospital dietitians." In nearly all those colleges where home economics is taught, courses in dietitics have been given as prerequisite studies. The study in baby clinics has not been so common. The moving of the class over to the hospital for lectures and demonstration work is a move in the right direction. We must have clinics in which to teach our young women if we are going to put this relation of home economics to the work of the school and district nurse on the basis that it ought to be. In the University of Wisconsin, where the home economics department has been in the College of Agriculture for seven years, there has been a close cooperation with the Madison General Hospital, the students going to the hospital for demonstration work in all the phases of nursing that seems advisable for them to know, special lectures and demonstrations being given on the baby, the clothing and bathing, etc. The biological courses that precede this are courses in embryology, and courses on the development of the child before birth and during adolescence. We are to discuss today-the possibility of cooperation with the day nursery, the visiting housekeeper, and the visiting nurse. The mutual aid between the home economic department and the nursing profession is the hope of the future if we are to reduce the high rate of infant mortality. "Every day in the year an average of 142 babies is born in Wisconsin. The deaths among children under one year of age average fifteen per day. This gives a death rate for children under one year of age of 105 for each 1,000 children born, while the average annual death rate for the entire population, including persons of all ages, does not exceed 12 per 1,000." Wisconsin is well provided with vocational schools. There is an opportunity for close affiliation work, so that the final death rate |