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Child-Welfare Programs Study Outlines for the Use of Clubs and Classes Children’s Year Follow-up Series N o. 7 Bureau Publication N o . 73 U. S. Department of Labor C hildren’ s Bureau https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CONTENTS. Page. 3 Introduction_____________________________ ______________________________________ Part I.— The community and the child__ s___________________________________ 5 Part II.— Child-welfare in rural and village communities.________________ 11 Part III.— The care of the mother, the baby, and the young child________ 14-18 Program for mothers’ clubs__________ ____________ ._______________ ____ _ 14 A simpler program for mothers’ c l u b s ..._______________________________ 18 Part IV .— Detailed outlines o f single t o p ic s ...____ . . . . . . ________________ 19 -2 9 infant mortality_____ . . . __________________ ___________. . . _________________ 19 Children in industry.__________________________________ _______________ ____ 21 Recreation__________ _____ . ____ ___ _________ „______________________ ________ 25 Children in need o f special care___ _____ ______________ _______________. . . Part V.— Development and present status of inf ant-welfare work in other countries_________ _________ . . . . . . . . . _____________________ ________ ___________ 2 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 27 30 U,sr«c $13 C H IL D -W E L F A R E P R O G R A M S .1 INTRODUCTION. The Children’s Bureau is frequently asked to make suggestions regarding the programs of clubs, classes, and other organizations desiring to study the problems and methods of child-welfare work or interested in the matter o f the care of young children. In response to many inquiries and requests o f this kind, the bureau has brought together in the following pages some programs which it is hoped may be found useful. Several programs are included, in order to. meet the possible needs o f different groups. Any one of the programs may be shortened by selecting from it such topics as are most applicable to the plan of study the club is following; also, any regrouping o f the topics may be made. The introduction o f outside speakers into programs of this sort may serve to stimulate interest and attendance. Also it is true that an address from a specialist may often shed a great deal of light on some problem under discussion. Since, however, a definite course of study is being undertaken, in which the whole membership is sup posed to take part and to which each is expected to contribute, it is wiser, in many cases at least, to restrict the use of outside speakers. It is sometimes best to call an extra meeting if a person who would give much to the club becomes available. On the other hand, a whole program may be carried through by inviting outsiders to present each topic. This would be quite feasible in a large city where specialists on every subject are available. Country communities may in some cases arrange with the State university extension office to assist them in the matter of securing outsiders for occasional meetings. Since the ultimate object of studying the problems o f childhood is the betterment of the conditions for children in any given locality, and since this can be secured only through the education o f the gen eral public to desire it, publicity is a necessary adjunct to this work. This publicity may be secured through reports to local newspapers, and through the attention o f the members of the club to local matters under consideration which affect the welfare o f children. Many 1 By Mrs. Max West and Nettie McGill. m https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 3 4 CHILD-WELFARE PROGRAMS. other ways to give publicity to the work will no doubt occur to the club in the course of a year’s work. A t least one meeting should be open to the public, and as many others as may seem best. Coopera tion with other clubs, agencies, and organizations engaged in any approved form o f child-welfare work is desirable, and necessary if the best results are to be accomplished. Although the principal object o f such courses of study as these is to improve the conditions surrounding child life in the given com munity, and one o f the secondary or immediate objects is the educa tion and entertainment of a group o f people, another object may well be the creation of a zeal for scholarly research—a much-needed and essential part o f social enterprises. I f the club has the good fortune to be located near a college or university its members should have unusual advantages in assistance o f various kinds, particularly in the direction of investigations. It may be assumed that in all large cities and many smaller places there is a public library, the resources o f which are available to all the members o f the club. Traveling and package libraries are avail able sources for library material in rural sections in many States. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis PART I. THE COMMUNITY AND THE CHILD. This outline is intended for the use of clubs or groups desiring to give a whole year to the study o f the problems of community responsibility for child welfare. A s has been said, it may be used as a basis for shorter or lighter programs if desired. It provides opportunity, however, for any degree of investigation, re search, and study the members are willing to give, and for addresses from out side specialists. 1. CHILD-WELFARE WORK. a. What is meant by this term? Describe work done abroad during the war and in the United States during Children’s Year. b. Describe work done in this community during Children’s Year: Was it adequate? How might it be improved? c. Follow-up work: What is being done? What needs to be done? Who will take the responsibility o f carrying it on ? From where is the financial support to come ? d. Is the community awake to its responsibilities for the wel fare o f its children? Must a campaign o f education to this end be carried on ? How shall it be done ? READING REFERENCES. U. S. Department of Labor, Children’s B u reau : Publication No. 36. Children’s Year Leaflet No. 1, Save 100,000 Babies. a Square Deal for Children. Publication No. 38. Measuring Test. Publication No. 40. Program. Get Children’s Year Leaflet No. 2, April Weighing and Children’s Year Leaflet No. 3, Children’s Year Working Publication No. 44. Children’s Year Leaflet No. 4, Patriotic Play Publication No. 49. Children’s Year Leaflet No. 7, Back-to-School Annual Reports of the Chief of the Children’s Bureau, 1917, 1918 able for distribution, but probably can be found in a number of Week. Drive. (not avail libraries). 2. BIRTH REGISTRATION. a. What is birth registration ? Importance o f good vital sta tistics to any community. b. What is the birth-registration area? Is this State in the area ? I f not, how can it be put in ? c. What is the condition o f birth registration in this com munity? How shall we go about it to secure better registration ? d. Method o f making a simple test o f the completeness o f birth registration. 5 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 6 CHILD-WELFARE PROGRAMS. READING REFERENCES. U. S. Department of Commerce, Bureau of the Census: Birth Statistics for the Registration Area of the United States, 1915, 1916, 1917. Mortality Statistics, 1917. U. S. Department of Labor, Children’s B u reau : Publication No. 54. Miscellaneous Series No. 12, An Outline for a BirthRegistration Test. Dodger No. 3. Is Your Child’s Birth Recorded? I f Not, W hy N ot? 3, INFANT AND MATERNAL MORTALITY. a. What is meant by “ infant mortality ” and “ infant mor tality rate ” ? What is the infant mortality rate for the United States ? Compare it with that o f other countries; b. What are the chief canses o f a high infant mortality? C. What is the maternal mortality o f the United States com pared with other countries ? d. Infant and maternal mortality in this community. READING. REFERENCES. Mangold, George B . : Problems of Child Welfare. The Macmillan Company, New York City, 1914. U. S. Department o f Commerce, Bureau of the Census r Birth Statistics for the Registration Area of the United States, 1915, 1916, 1917. Mortality Statistics, 1917. U. S. Department of Labor, Children’s B ureau: Publication No. 61. Children’s Year Follow-up Series, No-. 2, Save the* Youngest; 4. COMMUNITY MEASURES TO SAVE INFANT AND MA TERNAL LIFE. a. Purpose, nature, and extent in the United States o f pre natal w ork; infant-health centers; the instructive visiting nurse; hospitals with, special reference to maternity pro visions and care of children, and clinics (a series of 10-minute papers) . b. Present status o f such work, in this community. What is needed and how may we secure it? c. Importance o f milk to the growing child. Local measures to protect milk supply— State regulations, local ordi nances, and enforcement. Report on milk supply o f com munity. (This may be given by local officials, or club members may visit loeal dairies and make reports, a method found to be very effective.) READING REFERENCES. MacNutt, J. S . : Modern Milk Problem in Sanitation, Economies and Agricul tu ra The Macmillan Company, New York City, 1917. U; S. Department o f Labor, Children’s Bureau: Publication No. 15. Miscellaneous Series, No. 5, Baby W eek Campaigns. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CHILD-WELFARE PROGRAMS. 7 Publication No. 35. Care of Children Series, No. 4, Milk, the Indispensable Food for Children, by Dorothy Reed Mendenhall, M. D. Publication No. 45. Children’s Year Leaflet No. 5, Children’s Health Centers. Publication No. 47. Children’s Year Leaflet No. 6, The Public-Health Nurse. 5. MALNUTRITION. a. Definition o f term. Prevalence of malnutrition in the United States. b. Clinics, classes for mothers, instructive work in schools, literature. (These may be short papers by a number of persons.) c. Essentials in the feeding o f young children to insure proper nutrition. d. The school lunch: Its purpose; movement in favor o f it; some results. e. How are the children o f the community being fed? Use o f milk. (School lunches. Education o f parents and teach ers in nutritional needs o f children. READING REFERENCES. Indiana University: Bulletin o f the Extension Division No. 8, Vol. IV , Feed ing Children at School, by Edna Hatfield Edmonston and Mabel Thatcher Wellman. Bloomington, Indiana, April, 1919. U. S: Department of the Interior, Bureau of Education: Bulletin 1909, No. 3. D aily Meals for School Children, by Caroline L. Hunt. 10^. U. S. Department o f Labor, Children’s B u reau : Publication No. 59, Children’s Year Follow-up Series, No. 1, W h at is Mal nutrition? by Lydia Roberts. •Publication No. 60, Conference Series, No. 1, Standards of Child W elfare— “ Nutrition Clinics,’’ pp. 2 3 8-24 4; “ The Nutrition of Adolescence,” pp. 256-261. 6. THE PROBLEM OF CHILD LABOR AND EDUCATION. a. What does the ideal school do for children? b. Has this State a good compulsory-education law? Is it enforced ? How might it be improved ? c. The local situation: Are all the children o f this community in school ? Is there a school census ? How many truant officers? Visiting teachers? Number o f local school buildings? School buildings: Number, accessibility, equipment, safety, sanitary condition, etc. Teachers: How many, how well paid, training required, needed im provement in teaching force? Educational experiments? (Vocational training, Gary system, junior high schools, etc.) d. How many children leave school for work ? Excused from school on what grounds? A t what age? Safeguards as to educational and physical requirements, hours, night work, hazardous occupations ? Any vocational guidance ? e. Report on the “ Back-to-School ” drive o f Children’s Year. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 8 .CHILD-WELFARE PROGRAMS, READING REFERENCES. Ayres, May, and others: H ealthful Schools. The Macmillan Company, New York .City, 1909. Bureau of Educational Experiments, 16 W est 8th Street, New York -City. Bul letin No. 3, 1917, Experimental Schools. Dewey, John and E v ely n : Schools .of Tomorrow. E. P. Dutton and Company, New York City, 1915. Mangold, G. B . : Problems of Child W elfare. The Macmillan Company, New York City, 1914. U. S. Department of the Interior, Bureau of Education: Bulletin 1914, No. 4. The School and the Start in Life, by Meyer Bloom field. Bulletin 1914, No. 18. The Public School System of Gary, Indiana, by W m . P. Burris. Bulletin 1915, No. 21. Sehoolbense Sanitation., by W m . A. Cook. U. S. Department of Labor, Children’s B u reau : Publication No, 51. Children’s Year Leaflet No, .9, Scholarships for Chil dren. Publication No. 53. Children’s Year Leaflet No, 10, Advising Children in their Choice of Occupation and Supervising the Working Child. Publication No. 56. Children’s Year Leaflet No. 12, The Employment-Cer tificate S y stem : A Safeguard for the Working Child. Publication No. 58. Children’s Year Leaflet No. 13., The States and Child L abor: Lists of States with certain restrictions as to ages ¡and hours. Publication No, 64. Children’s Year Follow-up Series No, 3, Every Child ia School. 7, THE PROBLEM OF RECREATION. a. What does play mean in the life o f a growing child ? E f fects on comm unity o f lack o f wholesome »recreation for young people. b. Needs o f this community for recreation. Have the schools sufficient playground space ? How many other play grounds? Are they well equipped, accessible, supervised? What facilities for indoor play and recreation are there? Neighborhood .clubs or centers, boys’ and girls'’ organiza tions ? Are there any community movements for recrea tion— sings,” plays, pageants, etc.? Are commercial amusements properly safeguarded? c. Report on the Recreation Drive of Children’s Year. READING REFERENCES. Addams, Jane : The Spirit of Youth and the City Streets. Th e Macmillan -Company, New York .City, 1909. Curtis, H . S . : The Practical Conduct of Play. The Macmillan -Company, New York .City, 1915. Johnson, G, E , : Education Through Recreation. Russell Sage Foundation, 1916. U. S . Department of the Interior, Bureau o f Education: Bulletin 1912, No. 16. The Reorganized School Playground, by Henry S. ‘Curtis. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CHILD-WELFARE PROGRAMS. 9 U. S. Department of Labor, Children’s B u reau : Publication No. 44. Children’s Year Leaflet No. 4, Patriotic Play Week. Publication No. 60. Conference Series, No. 1, Standards of Child W elfare— “ The Leisure of the Child,” pp. 5 4 -6 3 ; “ Standards for Children’s Play,” • pp. 63-66. 8. THE PROBLEM OF THE CHILD IN NEED OF SPECIAL CARE. a. Dependent and neglected children: The importance o f a living wage for heads o f families. Are mothers’ pensions given ? What relief agencies are there ? Are cruel, non supporting, and deserting parents prosecuted? What is the extent o f illegitimacy? Is father compelled to as sume any support for child born out o f wedlock? Are child-caring institutions supervised? By whom? Is en deavor made to place children in foster homes rather than in institutions? Are such homes supervised? b. Defective children: What are local facilities for education o f blind, deaf, crippled, or deformed? Are there special classes in public schools for the mentally retarded? Are feeble-minded segregated in institutions ? c. Delinquent children: Is an attempt made to consider the' child’s character and environment in relation to his offense? The role o f suitable recreation in preventing juvenile delinquency. What provisions are made for the hearing o f children’s cases in court ? Is provision made for separate detention? Is there a probation officer or staff for children’s cases? Institutional provision for de linquent children. Is the institution a last resort ? READING REFERENCES. Folks, H om er: The Care of Destitute, Neglected, and Delinquent Children. The Macmillan Company, New York City, 1902. Mangold, G. B . : Problems of Child W elfare. The Macmillan Company, New York City, 1914. U. S. Department of Labor, Children’s B ureau: Publication No. 60. Conference Series, No. 1, Standards of Child W elfare— “ The Responsibility of the State,” pp. 307-313. Publication No. 65. Dependent, Defective, and Delinquent Classes Series, No. 8, Courts in the United States Hearing Children’s Cases, by Evelina Belden. Publication No. 66. Dependent, Defective, and Delinquent Classes Series, No. 8, Illegitimacy as a Child-Welfare Problem. Part I. A brief treatment of the prevalence and significance of birth out of wedlock, the.child’s status, and the State’s responsibility for care and protection, with bibliographical material, by Emma O. Lundberg and Katherine F . Lenroot. 180207°— 20------ 2 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 10 CHILD-WELFARE PROGRAMS, 9. STANDARDS OF LIVING. a. Series o f 10-minute papers on effects upon life and health o f children, with special reference to community conditions, o f: Low wages; unemployment or seasonal employment o f fathers; employment o f mothers outside for wage, or excessive work o f mothers in irhe home. Small, crowded, ill-ventilated houses; lack o f satisfactory drainage, dirty streets, lack o f play space. Lack o f enough, or wellselected, fo o d ; lack o f medical attention. b. Account o f community (1) water supply; (2) milk supply (may be briefly referred to if already treated under Sec tion 4 ) ; (3) collection o f garbage. READING REFERENCES. Broadhurst, Jean, Ph. D . : Home and Community Hygiene. J. B. Lippincott Co., Philadelphia, 1918. Lathrop, Julia C . : Ineome and Infant Mortality. Reprinted from American Journal o f Public Health, Vol. I X , No. 4, April, 1919, pp. 270-274 (may be obtained through the Children’s Bureau). Rochester, A n n a : Infant Mortality as an Economic Problem. National Con ference of Social Work, 315 Plymouth Court, Chicago, 1919 (may be ob tained through the Children’s Bureau). U. S. Department o f Labor, Children’s B u reau : Publications Nos. 6, 9, 20, 29, 37, 52. Infant Mortality Series. Publication No. 60. Conference Series, No. 1, Standards of Child W el fare— “ Economic Basis of Child W elfare,” pp. 26-53. Annual Reports o f the Chief (not available for distribution, but probably can be found in a number of libraries). 10. STANDARDS FOR CHILD-WELFARE WORK. a. A presentation and discussion o f the minimum standards, as set forth by the Child-Welfare Conference in Washing ton, May, 1919. b. General statement o f the most apparent and pressing needs o f the community for promoting the welfare o f children, as compared with the minimum standards. c. Statement of best practical line o f effort for this club. d. Measures for child welfare pending—national; State, How this community is affected and how best to support desirable measures, READING REFERENCES. U. S. Department of Labor, Children’s Bureau: Publication No. 62. Confer ence Series, No. 2, Minimum Standards for Child W elfare Adopted by the Washington and Regional Conferences on Child W elfare, 1919. N o t e .— For bills pending in State legislatures, write to State Divisions of Child Hygiene (in 31 States). For bills pending in Federal Congress, write to U. S. Children’s Bureau. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis P A R T II. CHILD WELFARE IN RURAL AND VILLAGE . COMMUNITIES. This program is intended to develop the need for, and the possibilities of, greater knowledge of the conditions under which country children are grow ing. It was conclusively shown in the draft that bad health conditions were just as prevalent among young men from the country as from the city, and it is known that in some respects, at least, country children are worse off than, are those who have lived all their lives in cities. In order that child-welfare work may not be undertaken in the dark, it is necessary, first of all, to take at least a cursory survey of present conditions in any given community, and to gauge, as far as may be possible with the time and facilities at disposal, which of these conditions is most in need of immedi ate change. In one case it may be malnutrition, or other curable physical de fe c t; in another case, lack of schools; in another, lack of recreation; or some other remediable condition. The child-welfare section or committee o f some established club may well be the leaders in this study. By dividing the work among a number of persons, and allowing time enough, a fair picture of local conditions should not be too hard to secure. 1. CENSUS. a. Number o f children, by ages: For example, how many babies under 1 year ; how many under 5 years, etc. ? b. Parentage— foreign, native; families not speaking English. 2. MEDICAL, NURSING, AND HOSPITAL FACILITIES. a. Number o f physicians available for population: Are they accessible to all families ? b. Number o f public-health nurses. c. What are the possibilities for hospital treatment for serious cases? Distance from hospital? Facilities o f nearest hospital for caring for women’s and children’s cases ? d. What are the possibilities for the treatment o f physical defects among children: Clinics, specialists, etc.? 3. MALNUTRITION. a. Are the children all well nourished ? What number appear to be underfed or in poor health ? b. Is instruction for mothers in the selection and preparation o f proper food for children a great need ? I f so, how may it be met ? c. Is milk used freely in the diet o f young children? Com ments on the local milk situation. U https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 12 CHILD-WELFARE PROGRAMS. 4. PHYSICAL EXAMINATION. a. Have the children been weighed and measured? Have those who were found to be underweight been examined by a doctor ? b. D o the parents o f the, community need instruction in the necessity for such examination and for the removal o f curable defects? c. How could such a campaign be organized and carried on? - 5. EDUCATION. a. Number in school ?—not in school who ought to be ? b. Are there enough school buildings for all the children who ought to be in school ? A re they accessible>j are the rooms overcrowded; are they properly furnished, heated, and lighted ? c. What are the toilet facilities—sufficient, sanitary, and decent ? d. Are there playgrounds, and is there oversight o f the play hours ? e. Teachers: Are there enough? Is the pay sufficient to com mand well-trained teachers ? Are they comfortably housed ? f. Are there any medical or physical examinations given at school? Any effort to have physical defects corrected? Has the warm noon lunch been tried ? 6. RECREATION. a. What chance for play do the children o f this neighborhood have? Under any direction—clubs, classes, etc. ? b. Are the young people supplied with proper, wholesome, and pleasant recreation? Is a community house needed? 7. CHILD LABOR. a. Are any o f the children who ought to be in school at work for wages? Are young children being deprived o f time for free play by being required to work too much at home, especially on farms? b. Is anyone in the community given responsibility to look after these matters ? B. CHILDREN IN NEED OF SPECIAL CARE. a. How many children are dependent—orphaned, neglected, bom out o f wedlock? How many are defective physi cally, feeble-minded? b. General survey o f relief measures and statement of most pressing needs in this field. c. What provisions for dealing with delinquent children? Is delinquency a serious problem in the community? https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CHILD-WELFARE PROGRAMS. n 9. PREVENTION OF DISEASE. a. Does contagious disease spread through the community every season ? What are the standards o f the community in respect to prevention and control o f disease? b. Talk by health officer or physician on most apparent needs in this field. 10. PUBLIC EDUCATION. Possibility o f education o f public opinion to higher standard o f life and health by lectures, movies, literature, instruc tive visiting nurses, etc. READING REFERENCES. (For general view of rural problems.) Calpin, Charles Josiah: Rural Life. 1918. The Century Company, New York City, Cubberley, Ellwood P . : Rural Life and Education. ton, 1914. Gillette, John M .: Constructive Rural Sociology. York City, 1917. Houghton Mifflin Co., Bos Sturgis and Walton Co., New U. S. Department of the Interior, Bureau of Education: Bulletin 1914, No. 12, Rural Schoolhouses and Grounds, by Fletcher B. Dresslar. U. S. Department of Labor, Children’s Bureau: Publications Nos. 26, 38, 34, 46— Rural Child-Welfare Series, Nos. 1, 2, 3, 4. (For follow-up work.) U. S. Department of Labor, Children’s Bureau: Publications Nos. 36, 38, 40, 44, 45, 47, 49, 50, 51, 53, 55, 56, 58. Children’s Year Leaflets Nos. 1-13. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis P A E T II I. THE CARE OF THE MOTHER, THE BABY, AND THE YOUNG CHILD. PROGRAM FOR M O T H E R S’ CLUBS. Because of the technical points involved, this course should be under the di rection of a nurse or a physician, who may give those topics which are con cerned with medical matters. I f this is not possible, the club leader should select the topics from this list which may be mastered with the help of books, or use the simpler program which follows. T H E M OTHER. * 1. PRENATAL CARE. a. Meaning and importance : Importance o f skilled supervision by competent physician throughout pregnancy, especially first pregnancy. Necessity for a complete physical examination, including heart, lungs, abdomen, urine, blood pressure, and measuring the pelvis. (¡Statement of some o f the dangers avoided by such care and examination. How good care given a prospective mother makes a “ bet ter baby,” and how overwork, underfeeding, illness, and neglect at this time affect the baby adversely. b. Essentials: Simple rules for good home care during pregnancy ; diet, sleep, and rest; clothing; bathing; exercise and outdoor life ; mental habits, etc. Recognition of symptoms which may indicate the need of a doctor. 2. PREPARATIONS FOR CONFINEMENT. a. At home: Engaging doctor and nurse; arrangement for nurse’s board, etc. ; laundry work ; supplies needed ; baby’s clothing and nursery equipment. b. A t hospital : Advantages o f hospital care ; relative expense. c. Arrangements for housekeeping during mother’s incapacity. d. In village and rural communities: General discussion o f local conditions and how to improve them—hospitals, nurses, physicians; are they available? What can the poorer women o f the community expect in the way o f good care? (Special attention should be called to the fact 14 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CHILD-WELFARE PROGRAMS. 15 that medical examinations early in pregnancy are espe cially necessary in the case o f the country woman, in order to determine whether hospital or expert surgical care is likely to be needed, and, if so, to permit her time to make the arrangements.) 3. THE LYING-IN PERIOD. a. Danger o f too short a rest after childbirth; good effect upon mother and baby o f long rest. b. Medical attention needed at this time. c. Care o f breasts and nipples. d. Diet, sleep, and general care o f mother to insure future health. 4. THE NURSING MOTHER. a. Importance o f healthful life at this time; bad effects o f overwork, worry, illness. b. Daily habits to insure health and a good supply of breast m ilk; proper fo o d ; rest and sleep; exercise; diversion. TH E B A B Y . 5. CARE OF THE NEW-BORN BABY. a. b. c. d. e. Care o f eyes. Statement about dangers o f ophthalmia. Care o f cord. Bath and clothing. Feeding; sleep. Birth registration. 6. WEANING. a. Indications for weaning. b. How to wean the baby; what to feed. c. Harmfulness o f too early weaning; how mothers‘may post pone the weaning by proper daily habits which will keep up a supply o f breast milk. 7. BOTTLE FEEDING. a. Cow’s milk the best food, if a substitute for mother’s milk must be used. b. Preparation o f modified milk. (Demonstration.) c. Amount to give; feeding interval. d. Dangers and difficulties o f bottle feeding; safeguards. e. Other food. 8. FEEDING THE OLDER BABY. a. Pure milk the basis o f the diet during babyhood. b. What other foods a baby may take and when they should be added to his diet. c. Demonstration lesson in the preparation o f foods. d. Dangers o f improper feeding at this period. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 16 CBILI>-WELFARE PROGRAMS* THE B A B Y — Continued, g. CARE OF THE BABY. a. Nursery, bed, equipment. b. Teaching good habits: Regularity from the first days of life essential. c. Sleep and quiet; fresh a ir; play and exercise. d. Clothing; shoes, and care o f the feet. e. Necessity o f a daily routine; the program for a well baby. 10. REVIEW. a. General summary o f the course. b. Questions and answers. T H E YOUNG CHILD. 11. THE GROWING CHILD. a. Statement regarding the development of physical defects and illness by neglect o f the needs o f the growing child: Teeth, tonsils, adenoids, etc. b. Proper food for the growing child. Meaning o f malnu trition. Prevalence o f malnutrition. Its prevention. Its treatment. c. Health habits: Sleep, rest, play, and exercise, baths, care o f the teeth. d. The importance o f periodical medical examinations. 12. THE CHILD’S TRAINING. a. Studying the child’s nature and adopting methods o f train ing best suited to it. b. The use o f cooperation, suggestibility, the child’s pride, in training. c. Teaching obedience and self-control: The value o f clear ness, simplicity, and consistency; some common mistakes that parents make. d. Training in truth telling: Distinguishing between imagina tive or playful untruths and lying for gain; the im portance o f preventing the child from lying through fear. e. Training in sex: The importance o f teaching cleanliness; o f answering early questions truthfully; o f confidence be tween parent and child. f. Religious training: The right o f the child to religious training; the force o f example. 13. THE CHILD AT SCHOOL. a. Responsibility o f parents for sending child to school in good physical condition and keeping him so. b. Responsibility o f school in protecting against contagions. c. How best can home supplement school work I https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CHILD-WELFARE PROGRAMS. 17 14. PLAY. a. What play means in the life o f every child, and the serious results when children are deprived o f time and oppor tunity for free play, especially out o f dobrs. b. Home play: Sand boxes, teeters, and swings; blocks and dolls; games and toys. c. Equipment o f a simple playroom. d. Playing with other children a necessary part o f a child’s education. e. The importance of sympathetic direction and supervision o f play. 15. REVIEW. a. Summary statement o f study done. b. Questions and answers. 16. REPORT ON LOCAL CONDITIONS SURROUNDING YOUNG CHILDREN. a. Living conditions in the community compared with the ideal. : b. Bad conditions and how they may be remedied. READING REFERENCES. Bureau of Educational Experiments, 16 W . 8tli Street, New York C ity: Bulletin No. 8, 1918. A Catalogue of Play Equipment for Little Children. Bulletin No. 1, 1917. Playthings. Fisher, Mrs. D. C .: Mothers and Children. 1914. Henry Holt & Co., New York City, Gruenberg, Mrs. S. M .: Your Child Today and Tomorrow. Philadelphia, 1913. Holt, L. E., M. D . : Care and Feeding of Children. York City, 1918. J. B. Lippincott Co., D. Appleton & Co., New Ramsey, W . R., M. D . : Care and Feeding of Infants and Children. J. B. Lip pincott Co., Philadelphia, 1916. Scott, Miriam F in n : How to Know Your Child. Little, Brown & Co., Boston, 1915. Slemons, J. M., M. D . : The Prospective Mother. City, 1918. D. Appleton & Co., New York Terman, L. M .: Hygiene of the School Child. Houghton Mifflin Company, Boston, 1917. U. S. Department of Agriculture: Farmers’ Bulletin 712. School Lunches, by C. L. Hunt. Farmers’ Bulletin 717. Food for Young Children, by C. L. Hunt. U. S. Department of the Interior, Bureau of Education: Bulletin 1915, No. 4. The Health of School Children, by AV. H. Heck. U. S. Department of Labor, Children’s Bureau: Dodgers on Child Welfare, 1-10. Publication No. 4. M ax West. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Care of Children Series, No. 1, Prenatal Care, by Mrs. 18 CHILD-WELFARE PROGRAMS. Publication No. 8. Care of Children Series, No. 2, Infant Care, by Mrs. M ax West. Publication No. 30. Care of Children Series, No. 3, Child C a re : Part I, The Preschool Age, by M rs. M ax W est. Publication No. 35. Care o f Children. Series, No. 4, Milk, the Indispensable Food for Children, by Dorothy Iteed Mendenhall, M. D. Publication No. 59, Children’s Year Follow-up Series, No. 1, W hat is M al nutrition? by Lydia Roberts. A SIM PLER PROGRAM FOR M O T H E R S’ CLUBS. 1. CARE OF THE BABY BEFORE BIRTH. a Importance o f good care for the prospective mother from doctor, nurse, and family, to safeguard her own life and health and that o f her baby. b. Hygiene o f maternity. c. Preparations for confinement; place o f confinement. 2. CARE OF THE NEW-BORN BABY. a. Attention to eyes and cord. b. First bath and clothing. c. Breast feeding. 3. CARE OF THE BABY DURING THE FIRST YEAR. a. b. c. d. e. f. Feeding. The nursing mother : Diet and general hygiene. Bottle feeding: Modified milk; preparation. Other food. Good habits and how to teach them. The daily routine o f a normal baby. Teething and small ailments. 4. CARE OF THE BABY DURING THE SECOND YEAR. a. Feeding: Demonstrations o f methods o f preparing cereals, beef juice, and other foods. b. Clothing: Demonstration of garments. c. Fresh air and exercise. d. Sleep and rest. 5. CARE OF THE PRESCHOOL CHILD. a. b. c. d. Feeding. Training and habits. Physical care to prevent defects or to remedy them. Prime importance o f play out o f doors. 6. SUMMARY. a. Statement o f principles o f best care. b. Questions and answers. READING REFERENCES. Same as those for longer program on “ The Care of the Mother, the Baby, and the Young Child.” (See p. 17.) https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis P A R T IV . DETAILED OUTLINES OF SINGLE TOPICS. The following outlines are intended for the use of groups or individuals interested in the closer study of phases o f the problems involved in childwelfare work. Social workers, for example, may desire to study the subject of infant mortality in great detail, if in a given community the mortality is un duly high. These intensive studies may be made by a section of the club carrying on Part I of this outline. IN F A N T M O R T A L IT Y . 1. Statistical aspects. a. Definition and explanation o f terms. Infant mortality. Infant mortality rate. Vital statistics. b. Methods o f presenting figures, graphic or otherwise; c. Birth registration in the United States. Explanation o f birth-registration area; present extent. Compared with other countries. Methods o f popularizing birth registration. 2. Effects o f a high infant mortality. a. On the health o f survivors and the population in general. b. On national prosperity. 3. Extent o f infant mortality. Is it increasing or decreasing ? a. In the United States. b. In foreign countries. 4. Causes o f infant mortality. 4 a. Chief medical causes. proportion dying from these dis eases. increase or decrease within past Diseases o f early infancy 10 years. relation to health and care of mother. increase or decrease within past Gastric and intestinal 10 years. diseases relation to feeding. Respiratory diseases responsibility^ o f public-health o f Contagious diseases ficials. necessity for educating mothers. 19 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 20 CHILD-WELFARE PROGRAMS. (Presentation o f figures for Nation, State, local community, or all three, by means o f curves and graphs, might be advisable.) b. Social and economic causes. Low wages and unemployment. Work o f mother outside the home. Ignorance and illiteracy. Family disintegration. . c. Civic causes. Housing. * Sanitation. Milk supply. 5. Age at death—early weeks most fatal. 6. Prevention o f infant mortality. a. Methods employed. In cities and States in United States. In foreign countries, notably England and New Zealand. b. Principles o f prevention. .... Provision o f living wage and decent home conditions. Keeping mother and child together during infancy. Adequate prenatal and obstetrical care, and medical atten tion. Education o f mothers and fathers and community in needs o f mother and child. Civic improvement. 7. Public protection o f health o f mothers and infants. (F or detail, see Minimum 'Standards—“ Maternity,” and “ In fants and Preschool Children,” U. S. Children’s Bureau Pub lication No. 62.) 8. Infant mortality in local community. a. Are birth and death registration prompt and accurate? b. What is infant mortality rate? Find, if possible, proportion o f infant deaths due to each medical cause. c. Is infant mortality higher in certain wards or sections than in others ? d. Is there a State or local department o f child hygiene ? What steps have been taken locally to conserve infant life? e. Prepare plan for reducing infant mortality, based on Chil dren’s Bureau standards. (See Topic 7.) READING REFERENCES. American Association for Study and Prevention of Infant Mortality : Transac tions of the first to eighth meetings. 1910-1917. Dublin, L. I. : Present Status of Birth Registration in American Cities and Its Relation to the Infant Mortality Rate. 1916. Address author, Metropolitan Life Insurance Co. (Also in 1916 Transactions o f the American Association for Study and Prevention o f Infant Mortality.) https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CHILD-WELFARE PROGRAMS, 21 Hibbs, H . H ., Jr., M. D . : Infant M ortality; Its Relation to Social and Indus trial Conditions. Russell Sage Foundation, 1916. Latlirop, Julia C .: Income and Infant Mortality. Reprinted from American Journal o f Public Health, Vol. I X , No. 4. April, 1919, pp. 270-274. Mangold, G. B . : Problems of Child W elfare. The Macmillan Co., New York City, 1914. U. S. Department of Commerce, Bureau of the Census. Birth Statistics for the Registration Area of the United States, 1915,1916,1917. Mortality Statistics. U. S. Department of Labor, Bureau of Labor Statistics: Summary of the Re port on Conditions of Woman and Child W age Earners in the United States. (Infant Mortality and Its Relation to Employment o f Mothers.) U. S. Department of Labor, Children’s Bureau : Publication No. 6. Infant Mortality Series, No. 2, New Zealand Society for the Health of Women and Children. Publication No. 9. Infant Mortality Series, No. 3, Infant Mortality, Johns town, Pa., by Emma Duke. Publication No. 26. Rural Child-Welfare Series, No. 1, Maternity and Infant Care in a Rural County in Kansas, by Elizabeth Moore. Publication No. 29. Infant Mortality Series, No. 7, Infant Mortality, W aterbury, Conn., by Estelle B. Hunter. Publication No. 33. Rural Child-Welfare Series, No. 2, Rural Children in Selected Counties o f North Carolina, by Frances Sage Bradley, M. D., and Margaretta A. Williamson. Publication No. 34. Rural Child-Welfare Series, No. 3, Maternity Care and the W elfare of Young Children in a Homesteading County in Montana, by Viola I. Paradise. Publication No. 37. Infant Mortality Series, No. 8, Infant Mortality, Brock ton, Mass., by Mary V. Dempsey. Publication No. 46. Rural Child-Welfare Series, No. 4, Maternity and Infant Care in Two Rural Counties in Wisconsin, by Florence Brown Sherbon, M. D., and Elizabeth Moore. Publication No. 52. Infant Mortality Series, No. 9, Infant Mortality, Sagi naw, Mich., by Nila F. Allen. Publication No. 54. Miscellaneous Series, No. 12, An Outline for a BirthRegistration Test. Publication No. 60. Conference Series, No. 1, Standards of Child Welfare. Publication No. 61. Children’s Year Follow-up Series, No. 2, Save the Youngest. C H ILD R EN ' IN IN D U ST R Y . 1. Historical review. a. Growth o f child labor with modern industrial revolution. b. Beginnings o f legislation. England. Continental Europe. United States prior to 1860. c. Growth o f child-labor legislation in United States. d. Federal legislation in regard to child labor. United States child-labor law, 1916— declared unconstitu tional, June, 1918. United States child-labor-tax law, 1919. e. International regulation o f child labor. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 22 CHILD-WELFARE PROGRAMS. 2. Causes o f child labor. a. Poverty. b. Ignorance on part of parents, child, and general public o f the advantages o f education and the disadvantages o f premature labor. c. Attitude o f child. Distaste for school. Desire to earn money and be independent. d. Failure o f school to provide suitable and interesting training. Narrowness o f curriculum. Maladjustment to individual child. e. Demand for supply o f cheap labor. 3. Evils of child labor. a. Defective education. b. Impaired health for individual, physical deterioration for race. c. Juvenile delinquency. d. Industrial inefficiency for individual—low wages, unemploy ment, poverty. e. Economic waste—child labor an expense to industry. f. Lowering of civic standards. 4. Present extent o f child labor in United States, a. Distribution by occupations and industries. Agricultural pursuits—largest numbers o f children. Manufacturing and mechanical trades—chief child-employ ing industries. Domestic and personal service. Clerical occupations. Trade and transportation. Mercantile establishments. Offices. Street trades special dangers. Messenger service Mining—special dangers. b. Geographical distribution, by 'States and by sections. Present legal regulation o f child labor in United States. a. Federal child-labor-tax law, 1919. Industries affected. Age requirements. Hours and night work. Method o f enforcement. b. Variations among the States. As to asre. As to hours. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CHILD-WELFARE PROGRAMS. 23 5. Present' legal regulation of child labor in United States— Contd. b. Variations among the States— Continued. As to night work. As to hazardous occupations. As to educational requirements. As to physical requirements. As to exemptions. 6. Movement for vocational education, direction, and placement. a. Causes. Economic waste involved in lack o f training and unguided choice of occupation by children. Decline o f apprenticeship system. Lack o f opportunity for training under modern industrial conditions. b. Establishment of— Manual training courses and manual training high schools. Evening vocational classes. Trade and vocational schools. c. Federal aid to vocational education— Smith-Hughes or Voca tional Education Act o f 1917. d. Vocational guidance or direction, and placement. Aim. Methods. fscholarships, e. Special efforts to keep children in school [visiting teachers. 7 . Minimum standards for working children, a. Age. b. Educational. c. Physical. d. Hours o f employment. e. Types o f employment. f. Wages. g. Placement and supervision. h. Administrative. 8. Survey o f child labor. a. In State. State child-labor law—its requirements. Administration of child-labor la w -b o d y charged with en forcement. numbers. Children under 16 at work in State chief industries and oc cupations. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 24 CHILD-WELFARE PROGRAMS. 8. Survey o f child labor—Continued. b. In local community. Chief child-employing industries ^an&ers* . . and occupations opportunities for advance ment. Approximate numbers o f children under 16 employed in each occupation. Opportunities for vocational education. Amount and scope o f vocational guidance and placement work. 9. Presentation of plan for State legislative program based on local needs. READING REFERENCES. Brewer, John M ark: The Vocational Guidance Movement. Co., New York City, 1918. The Macmillan Leake, Albert H . : Industrial Education: Its' problems, methods, and dangers. Houghton Mifflin Co., Boston, 1913. Mangold, G. B . : Problems o f Child W elfare. City, 1914. The Macmillan Co., New York National Child-Labor Committee, 105 East 22nd St., New York City. Labor Bulletins (quarterly). Nearing, S co tt: The Solution o f the Child-Labor Problem. New York City, 1911. Child Moffat, Yard & Co., Ogburn, W illiam Fielding: Progress and Uniformity in Child-Labor Legisla tion. Columbia University, New York City, 1912. Taylor, F. J . : Child Labor in Your State, A Study Outline, 1917. Child-Labor Committee. Taylor, Joseph S . : A Handbook of Vocational Education. New York City, 1914. National The Macmillan Co., U. S. Department of Commerce, Bureau o f the Census: Abstract of Manufacturers, 1914. Census of Manufacturers, 1914. ” Thirteenth Census o f the United States, Volume IV, Occupations. U. S. Department of the Interior, Bureau o f Education: Bulletin 1914, No. 4. The School and the Start in Life, by Meyer Bloomfield. U. S. Department o f Labor, Bureau o f Labor Statistics: Summary of the Report on Conditions of Woman and Child W age Earners in the United States, pp. 49-60, 88-92, 119-135, 184-194, 227-284. (This report gives the early history o f child labor as well as a description of conditions found at the time of the report.) Twenty-fifth Annual Report o f the Commissioner of Labor, 1910. Education. Industrial Historical Survey o f International Actions Affecting Labor. U. S. Department o f Labor, Children’s B u reau : Publication No. 18. Industrial Series, No. 3, List of References on Child Labor. Publication No. 49. Children’s Year Leaflet No. 7, Back-to-School Drive. Publication No. 53. Children’s Year Leaflet No. 10, Advising Children in Their Choice of Occupation and Supervising the Working Child. Publication No. 56. Children’s Year Leaflet No. 12, The Employment-Cer tificate System : A safeguard for the working child. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CHILD-W ELFARE PROGRAMS. 25 Publication No. 58. Children’s Year Leaflet No. 13, The States and Child Labor : Lists o f States with certain restrictions as to ages and hours. Publication No. 60. Conference Series No. 1, Standards o f Child Welfare. Publication No. 64. Children’s Year Follow-up Series, No. 3, Every Child in School. Leaflet. Standards Applicable to Child Labor, by Helen L. Sumner. Annual Reports of the Chief o f the Children’s Bureau (not available for distribution, but probably ean be found in a number of libraries). R EC R E ATIO N . 1. Value o f play. a. Physical. b. Mental. c. Social. 2. Home and play. a. Special educational importance o f play for young children. b. Use o f work as play. c. Essentials o f play, to be o f most value to child. Sympathetic oversight. Play space in the home. Child playmates. Pets. Constructive materials and toys— encouragement to selfexpression. d. Outdoor play for young children. Supervision— duty o f parents to safeguard play. Neighborhood playgrounds for small children. Outdoor toys and apparatus (demonstration o f methods o f making home apparatus). Gardening. 3. School and play. a. Tendency to legislate in behalf o f physical education. State provisions. National— Fess-bill for physical education. National provisions for physical education in England and France. h. Tendency o f school to take over leisure time activities o f child—Gary movement an example. c. School-garden movement. d. Necessity for play space, equipment, and supervision as mini mum requirements o f every school ; appropriations from school fund for this purpose; proper amount. 4. The community and play. a. Prevalence o f commercialized recreation—dangers. b. Recognition o f civic value o f play. How play trains for citizenship. Recreation vs, juvenile delinquency— war-time experiences. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 26 CHILD-WELFARE PROGRAMS. 4. The community and play— Continued. b. Recognition of civic value of play— Continued. What some cities have done to provide wholesome recrea tion for children. Recent movement toward community recreation— li sings,” pageants, etc. c. Factors to be considered in establishing playgrounds. Number and proper distribution, according to juvenile population. Size. Distance for children o f various ages. Equipment. Leadership. Kind o f play and duration. d. Value o f play space in community, even when little or no money can be secured for equipment and directors. e. Popularization o f playground for children o f all classes. 5. Organizations fostering recreation. a. Boy and Girl Scouts. b. Camp-Fire Girls. c. Y. M. C. A. and Y. W. C. A. d. Neighborhood centers and clubs. e. Canning, pig, poultry, and other farm clubs. 6. 'Survey o f local facilities and local needs for recreation. READING REFERENCES. Curtis, H . S . : The Practical Conduct of Play. City, 1915. Macmillan & Co., New York Department o f Recreation, Russell Sage Foundation, 130 East Twenty-second . Street, New York City. Publications. Gruenberg, Mrs. S. M . : Your Child Today and Tomorrow. York City, 1913. Lippincott, New Johnson, G. E . : Education by Plays and Games. Ginn & Co., New York City, 1907. -----------Education Through Recreation. Russell Sage Foundation, 1916. Lee, Joseph: Play in Education. The Macmillan Co., New York City, 1915. Mangold, G. B . : Problems of Child W elfare. Macmillan & Co., New York City, 1914. Playground and Recreation Association o f America, 1 Madison Avenue, New York City. Publications. U. S. Department o f Labor, Children’s B u reau : Dodger No. 10. W h at Do Growing Children Need? Publication No. 30. Care of Children Series, No. 3, Child C are: Part I, The Praschool Age, by Mrs. M ax W est. Publication No. 44. Children’s Year Leaflet No. 4. Patriotic Play Week. Suggestions to Local Committees. Publication No. 60. Conference Series, No. 1, Standards of Child W elfare, pp. 54-63. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CH ILD -W ELF ARE PROGRAMS. 27 C H ILD R EN IN N EED OF SPECIAL CARE. 1. Types o f children in need o f special care. a. Dependent and neglected children. b. Defective children. c. Delinquent children. 2. Conditions tending to produce dependency, defect, and deliquency. a. Poor heredity— due to marriage o f unfit. b. Faulty environment— due to poverty, ignorance, shiftlessness, cruelty, drunkenness, immorality, etc. c. Social causes— death or illness o f one or both parents, separa tion o f parents, desertion, divorce, illegitimacy. 3. Dependent and neglected children. a. Prevention. Economic measures. Living wage. Mothers’ pensions. Workmen’s compensation laws. Relief agencies, etc. Measures to enforce parental care and responsibility. Prosecution o f cruel, deserting, and nonsupporting par ents. Requiring parental responsibility to be assumed by fathers o f children born out o f wedlock. Measures to improve social and moral welfare o f community. b. Treatment o f dependent or neglected children. Care in own home i f possible— reconstruction o f family con ditions or supplementing o f family resources. Care in foster homes. Principles governing child placing. The home versus the institution. Adoption. Institutional care. 4. Defective children. a. Physically handicapped. Types—blind, deaf, crippled, or deformed. Problem—specialized education for self-support—how to secure it for each class. b. Mentally defective. idiot. Grades o f mental defect imbecile. moron. heredity. syphilitic infection, injury at birth, severe injury, or Causes illness in early infancy, possibly alcoholism. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 28 CHILD-WELFARE PROGRAMS. 4. Defective children—Continued. b. Mentally defective—Continued. Prevention.' Enforcement o f laws preventing marriage o f the unfit. Segregation o f feeble-minded in institutions to prevent procreation. Measures to insure freedom o f prospective parents from venereal disease. Asexualization o f feeble-minded in order to prevent pro creation. Care. Provision in public schools o f special training and classes for mentally weak who could through suitable educa tion be made self-supporting. Institutional care and training for mental defectives dan gerous to community or in need o f protection. Care in own home—when it is permissible or advisable. Necessity o f educating parents, teachers, and social work ers in needs of mentally defective. 5. Delinquent children. a. Causes o f juvenile delinquency. In the child—mental and physical. In the home—broken home, unfavorable environment, lack o f parental control. In the community—limited or unsuitable recreational op portunities, low moral tone, laws not enforced. b. Prevention. Suitable home conditions. “ Cleaning up ” o f community. Eegulation o f commercialized amusements. Provision o f playgrounds, community activities, etc. Compulsory-education laws enforced. c. Juvenile courts. Aim—education rather than punishment. Types—special courts, or courts with special juvenile ses sions. Principles. Child not treated as a criminal. Hearings separate from adults. Detention separate from adults. Physical and mental examination o f children. Woman assisting judge in hearing girls’ cases. Special probation officer or staff for children’s cases. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CHILD-WELFARE PROGRAMS. 29 5. Delinquent children— Continued. d. Treatment o f delinquents. Probation under supervision in child’s own home or in foster home. Commitment to training or industrial school—last resort. 6. State responsibility^ a. State regulation, supervision, and licensing o f foster homes and institutions, and o f agencies and associations whether public or private receiving or caring for children. b. Laws in your own State for protection o f child in need o f special care, 7. Survey o f local facilities for care o f dependent, defective, and de linquent children. READING REFERENCES. Flexner, Bernard, and Baldwin, Roger N . : Juvenile Courts and Probation. The Century Co., New York, 1916. Folks, H om er: The Care of Destitute, Neglected, and Delinquent Children. The Macmillan Co., New York, 1902. Goddard, Henry H . : Feeble-Mindedness, Its Causes and Consequences. The Macmillan Co., New York, 1914. H art, H . H . : Preventive Treatment of Neglected Children. 1910, Healy, W illiam , M. D . : The Individual Delinquent. Little, Brown & Co., Boston, 1915. Mangold, George B . : Problems of Child W elfare, York, 1914. The Macmillan Co., New Massachusetts Society for Mental Hygiene, 1132 Kimball Building, Boston, Mass. Publications. National Committee for Mental Hygiene, 50 Union Square, New York City. Publications. National Conference of Social Work, 315 Plymouth Court, Chicago. ings. Proceed Slingerland, W . H . : Child Placing in Families. Russell Sage Foundation, New York, 1919. U. S. Department of Labor, Children’s B u reau : Publication No. 32. Dependent, Defective, and Delinquent Classes Series, No. 4, Juvenile Delinquency in Rural New York, by K ate Holladay Claghorn. Publication No. 42. Excerpt from Legal Series, No. 2, Illegitimacy Laws of the United States, Analysis and Index, by Ernst Freund. Publication No. 60. Standards of Child W elfare, a report of the Children’s Bureau Conferences, May and June, 1919. Section IY , Children in Need of Special Care. Publication No, 65. Dependent, Defective, and Delinquent Classes Series, No. 8, Courts in the United States Hearing Children’s Cases, by Evelina Belden. Publication No. 66. Dependent, Defective, and Delinquent Classes Series, No. 9, Illegitimacy as a Child-Welfare Problem, Part I, by Emma O. Lundberg and Katharine F. Lenroot. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis P A R T Y. DEVELOPMENT AND PRESENT STATUS OF INFANTWELFARE WORK IN OTHER COUNTRIES. The following outline is intended to present in brief form the main facts in the development of infant-welfare work in foreign countries. W hile it may be used as the basis for a more intensive study of this particular subject, its chief purpose is to provide data for comparison with work being done in this country. Some of this material may also be used for publicity purposes if the desirability and practicability of child-welfare work is to be demonstrated. I. Public protection o f mothers and babies had its beginning in Europe in the early years o f the present century through recognition, hastened by the declining birth rate, that a high infant mortality— 1. Means sickness and low state o f health in all classes o f the population. 2. Represents an economic waste. II. While certain measures are appropriate and necessary only in the country where they have been developed, certain others have proved their worth in all countries. These measures are— (1) The establishment o f inf ant-welfare centers; (2) The provision o f infant-welfare nurses. 1. The infant-welfare center. a. First established in France in 1894 it has spread to all civilized countries. b. Has tended to replace milk station (established a few years earlier) where modified milk was given or sold to mothers o f young babies, but where no regu lar medical supervision was exercised over babies. c. Expert and regular medical direction is now consid ered essential for every center, though earlier cen ters had only a nurse in charge. d. Emphasizes maternal nursing. In most continental countries mothers attending centers are given a premium in money or kind so long as they continue to nurse their babies. e. Gives physical examination and periodical weighing and measuring to baby, and expert advice to mother concerning baby’s food, clothing, and daily care. 30 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CHILD-WELFARE PROGRAMS. 31 II. Certain measures are appropriate, etc.—Continued. 1. The infant-welfare center— Continued. f. 'Some have exhibits, courses in infant care for moth ers and girls* and instruction in sewing and cook ing. This is common in England, where centers are frequently known as “ schools for mothers,” and Subsidized by board o f education. g. The most successful have visitors to visit babies in home. This phase o f work most developed in Eng land, Canada, and New Zealand, but exists also in France, Germany, Austria, and Belgium. 2. The infant-welfare nurse. a. In European countries seldom a trained nurse. In many countries often volunteer workers, but neces sity for training is rapidly being recognized—in France training schools opened in large cities; in Prussia and Saxony diploma from State training school required; in England must be two or three things—sanitary inspector, trained midwife, or trained nurse; in New Zealand special training in addition to trained nurse’s course. b. Visits well baby in home and teaches mother care o f herself and baby through personal relations thus established. III. Practically all foreign countries provide maternity benefit at child-birth. In some countries—as, for example, in England, France, and Australia—money only; in others, medical and nursing care also. 1. Benefits have tended to increase in amount and scope. % But unless combined with a system o f centers and nurses for the education o f mother in care o f herself and baby have generally been found inadequate; for instance— a. In Germany during the war there was a general de mand for centers to take over the administration o f benefits for breast feeding, because the money failed to provide better food and care for mother and child unless health o f mother was supervised. b. In Australia, where Government since 1912 has allowed $25 for each living birth, an official report in dune, 1917, strongly urges the adoption o f a gen eral scheme o f practical measures as a means o f reducing infant mortality, saying that thereby much greater benefit could be obtained from the money spent than is now being obtained under the present system. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 32 CHILD-WELFARE PROGRAMS. IH . Foreign countries provide maternity benefit, etc.— Continued. 2. System o f centers and nurses, etc.— Continued. c. In England, where it was found necessary in 1914 to supplement maternity benefits (first given in 1911) by public provision for protecting health of mothers and babies. IV . The expansion o f infant-welfare work in certain European countries offers a stimulating example, especially when it is remembered that much o f this expansion took place under war conditions. 1. Especially valuable is the experience o f England. a. In July, 1914, Parliament voted to make grants o f 50 per cent o f approved expenditure on infantwelfare work done either by voluntary agencies or public bodies. b. Year by year these grants have been enlarged until practically every aspect o f infant and maternity welfare is covered ; for instance— Salaries and expenses o f health visitors and nurses. Provision o f doctor or midwife at confinement. Maintenance o f centers. Hospital treatment for mothers at confinement and for sick infants and children up to 5. Provision of food for expectant and nursing mothers. Maternity homes for expectant mothers. Convalescent homes for nursing mothers and children under 5. Home nursing o f mother or child during illness, especially where hospital accommodations are lacking. Creches. Domestic assistance following confinement. “ Experimental work.” As a result infant-welfare centers, for example, in creased from 842 in 1916 to 1,278 in 1918 ; health visitors probably doubled in number during 1914-1918. c. In 1915 passed notification-of-births (extension) act, requiring notification o f birth within 36 hours—• enables Government to send a health visitor to mother during critical first days o f infant’s life. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CHILD-WELFARE PROGRAMS. 33 IY . Expansion of infant-welfare work, etc.— Continued. 1. Especially valuable is the experience of England— Contd. d. In 1918 passed new midwifes’ act providing- more efficient supervision o f midwives. Lengthened period o f training for midwives from three to six months. e. In 1918 passed maternity and child-welfare act, mak ing child-welfare work obligatory for all local au thorities throughout England and Wales. 2. In countries most hard pressed by the war there has been a notable increase in work for the protection o f infancy and maternity since 1914. Maternity benefits alone • have proved insufficient. a. In Franee: special emphasis has been put on care of expectant and nursing mothers—prenatal centers and mothers’ lunch rooms have increased; the law o f August, 1917, obliges employers of nursing mothers to provide nursing rooms on premises and to permit mothers time off (half an hour twice daily) to nurse their babies; “ baby weeks” and traveling exhibits have increased since 1914; and “ traveling centers ” have been inaugurated. b. In Belgium: number o f infant-welfare centers in creased during 1914-1918 from 70 to more than 700, and lunch rooms for nursing and expectant mothers reached a total o f 473 in 1918 as compared with 2 in 1914; in September, 1919, a law was passed cre ating a national Children’s Bureau and extending national aid to the extent of one-half o f approved outlay on child-welfare work. c. In Ita ly : a bill providing for national aid to infantwelfare work was introduced into the Chamber o f Deputies in 1918, and its passage was widely advo cated. Y. Comparatively new countries like Canada, Australia, and New Zealand have done successful and inspiring work. 1. Reference has already been made to Government meas ures in Australia. 2. Canada— a. Has well-organized system of infant-welfare and pre natal nursing in connection with general publichealth nursing (Yictorian Order o f Nurses), not only in large cities, but also in the most isolated rural districts. b. Is now organizing a national Children’s Bureau. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 34 CHILD-WELFARE PROGRAMS. V. New countries, etc.— Continued. 3. New Zealand— a. Markedly successful work—reduction o f infant mor tality from 89 in 1907 to 48 in 1917. b. In 1907 the Society for the Health o f Women and Children—sometimes known as Plunket Society from patronage and interest o f Lady Plunket, wife o f former Governor o f New Zealand—was founded to carry on educational work to decrease infant mortality and improve health o f the people. Government supervises and extends financial aid. ,V olunteer and public bodies cooperate, about 70 local committees in 1914 representing all kinds o f local interests. Functions mainly through visiting in f ant-wel fare nurses (Plunket nurses). Has established a unique baby hospital, provid ing accommodations not only for baby but also for his mother, with object o f insuring breast feeding whenever possible. Cottage hospitals in remote areas for mothers and babies. Makes a point o f popular education through newspapers, pamphlets, etc. VI. Experience in all countries points to several well-defined tend encies. These are: 1. Preventive care. The object o f modern child-welfare work is to insure good and intelligent care o f baby by healthy mother in own home. Care o f the expectant mother is emphasized. Development o f well child is supervised in order so to direct his feeding and care as to keep him well. 2. Extension o f work to child o f preschool age. In England—Health visiting has recently been ex tended to include systematic oversight o f children between 1 and 5 years o f age, and nursery schools have been established for children o f preschool age. In Germany— Centers intended especially for children between 1 and 5 years o f age have been opened. In France—Welfare centers and canteens for nursing mothers receive the “ ex-baby.” https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CHILD-WELFARE PROGRAMS. l V I. 35 Experience in all countries, etc.— Continued. 3. Community, State, and national responsibility for child welfare. History o f child-welfare work in almost all countries shows the development from volunteer efforts to community and municipal direction and finally na tional aid, which coordinates, standardizes, and renders financial assistance. READING REFERENCES. Carnegie United Kingdom T r u st: Report on the Physical W elfare of Mothers and Children, Yols. I, II, III, IV , C. Tinling & Co., Limited, Liverpool, 1917. U. S. Department of Labor, Children’s B u reau : Publication No. 6, Infant Mortality Series No. 2, New Zealand Society for the Health of Women and Children. ' * Publication No. 57, Legal Series No. 3, Maternity Benefit Systems in Certain Foreign Countries, by Henry J. Harris. Annual Reports of the Chief of the Children’s Bureau. (Not available for distribution but probably can be found in a number of libraries.) Infant-W elfare W ork in Europe: An account of recent experiences in Great Britain, Austria, Belgium, France, Germany, and Italy, by Nettie McGill. (In press.) WASHINGTON : GOVERNMENT PRINTING OFFICE : 1920 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis
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