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L 5.20:45


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Children’s Health Centers

Bureau Publication No, 45

Federal Reserve Bank of St. Louis

Federal Reserve Bank of St. Louis

In the campaign to save the lives of 100,000 children during the
second year of the war it is hoped that many children’s health cen­
ters will be established, for they have proved their value in saving
children’s lives. In response to numerous requests for information
as to how to establish such centers this circular has been prepared.

The purpose of a children’s health center is “ to keep well children
well ”—to make available to all the mothers of a community knowl­
edge of the way to prevent needless sickness.
The essentials of a successful health center are a good doctor and
a good public-health nurse who understands children, a mother and
a child, and a room in which to meet. To such centers children are
brought once a week by their mothers. There they are weighed by
the nurse and a record kept of their weight and development. The
physician in attendance sees each child, advises the mother about the
feeding, and urges her to nurse her baby if possible. Through such
advice many mothers who would otherwise wean their babies con­
tinue to nurse them. I f breast feeding is impossible the doctor ad­
vises the mother about the preparation of artificial food. The doctor
and the nurse tell her of the methods by which she can keep her child
well, for example, through jthe hot summer weather. The nurse then
visits her in her home and shows her how to carry out the doctor’s
Children who are ill are not cared for at these centers but are re­
ferred for care to the family physician or to a hospital or dispensary.
Prenatal care, or the care and instruction of women before confine­
ment, is often carried on through the same centers.

The Public Health Commission of New York State in 1913 recom­
mended that “ each city with a population in excess of 10,000 and
having an industrial population should have one infant welfare sta1 Sometimes called in fan t welfare stations.
Federal Reserve Bank of St. Louis


tion. and larger cities with an industrial population should have one
such welfare station for approximately each 20,000 inhabitants.”
In industrial communities and in those having a large foreign
population children’s health centers have been especially successful.

The first step in their establishment should be to secure the co­
operation of responsible physicians and also of the local visiting
iiurse association, if such exists. In some cases an agency estab­
lishes a children’s health center and employs a nurse; in other cases
the agency establishes it and the nurse is supplied by the local visit­
ing nurse association. Associations interested in the establishment
of these centers gain much help by sending a representative to see
the work in a city where one has been in successful operation for
some time.
There is a growing tendency on the part of municipalities to under­
take the establishment of these centers, either assuming the entire
responsibility f 01 them or working in cooperation with other agencies.
Most of the principal cities of this country are looking upon their
establishment as a necessary part of the preventive work of depart­
ments of health under special divisions of child hygiene. New York
City is a notable example of the development of this work.

Attending 'physicians.—In each community the best method of
selecting a medical director and attending physicians must be de­
cided according to local conditions. The cooperation and under­
standing of the local medical society is essential. These are best
secured by making plain that the purpose of the center is to keep
well children well, not to care for those thht are ill.
Nurse—The nurse is a very important factor in the undertaking.
Her work in the homes, in helping mothers to follow the advice of
physicians, is essential. No center can be a success without a good
nurse who has had special training or experience in public-health
work with children. Information in regard to public-health nursing
is to be found in the leaflet on Follow-up Work for Children’s Y ear1
and in other bulletins which may be obtained on application to the
Children’s Bureau, United States Department of Labor, Washing­
ton, D. C. The National Organization for Public Health Nursing.
lOo Fifth Avenue, New York City, will furnish literature and advice
on this subject.
1 CMIetren’s Year Leaflet No. 2, pt. 3, p. 4.
Federal Reserve Bank of St. Louis

U. S. CfaiMron’s Bureau Publication No. 38.


Volunteers.—Volunteers who can be depended upon for regular
work can be of great assistance to the nurse at the center in receiving
mothers, filling out record sheets, and, after a little practice, in
weighing the babies.

The health center should be placed near the center of the district
in which its work is, most needed. A study of the location o ï the
infant deaths in a city (as shown on a spot map) will often deter­
mine where the need is greatest. Convenience for the mothers is a
prime necessity.
Eooms for a health center may often be obtained in schoolhouses,
rent free. These make excellent quarters if the consultation hours
can be arranged on Saturday or after school hours. I t may be estab­
lished in a schoolhouse during the summer months also. In smaller
communities free quarters may sometimes be secured in the city hall
or courthouse. In some cases it will be necessary or advisable to
rent suitable rooms.

I t is desirable to have two rooms, but if this is not possible one
room will serve, with one corner partitioned or screened off. One
room or corner of room is used for'a waiting room for the mothers;
here the babies are undressed. In the other room the babies are
weighed and the mother consults with physician and nurse.

The essential equipment is very simple, though it may be elaborated
if circumstances permit. I t consists of the following:
Standard scales for weighing babies. A platform scale, upon which is
fastened a simple tray from which a baby can not fall out, is often used
with success. A very large scoop, firmly fastened to the scales, may also
be used. Scales should be tested frequently for accuracy.
Two tables, covered with oilcloth. .
Pad for examining table, blanket, and sheet.
Chairs ; enough to accommodate the doctor, nurse, and mother.
One pail; running water, if possible; if this is not obtainable, bowl,
pitcher, and slop jar should be provided.
Wooden tongue depressers.
Paper napkins or paper towel; or, what is less expensive, tissue paper,
which may be bought by the ream and cut into the needed sizes. A fresh
piece of paper should be placed in the scales before each baby is weighed
and on the table pad before each examination.
Record cards. No standard record card for children’s health centers has
been devised. Those in use by agencies carrying on the work in the larger
cities may be studied before printing cards for local use.
Federal Reserve Bank of St. Louis


Formerly many health centers dispensed milk, but at present fat*
fewer are doing so. Where the general milk supply is a safe one, it
has been found better to advise mothers to obtain milk from the reg­
ular milk companies and to confine the work of the center to super­
vision and advice. When this method is followed and milk and ice,
free or at reduced cost, are necessary in special cases, they are ob­
tained through the local charity organization society, to whom the
family is referred.
The work of milk stations will not be taken up in this circular.

Conferences should be held at least every week on the same day and
at the same hour. If the attendance is great, more frequent consulta­
tions will be necessary. Much of the success of the center will depend
/upon setting the day and hour of the conference àt a time convenient
for the mothers.

The initial cost of equipment need not be great if the equipment is
i as simple as that described. The scales are the chief item of expense.
The cost of operation includes the following items :
Salary of nurse, which is the chief expense. The salary of a good nurse
varies between $75 and $125 per month.
Salaries of attending physicians, unless their services are given free.
Rent of rooms, if they are not obtained rent free.
Supplies (tissue paper, tongue depressors, record cards).

Leaflets and pamphlets on the care of the baby and of the mother
I are distributed at many children’s health centers. Many State and
city departments of health and certain Federal agencies will furnish
excellent literature for this purpose. A list of these is given in Baby
Week Campaigns (revised edition), which may be obtained upon ap­
plication to the Children’s Bureau.1
The bulletins in the Care of Children Series published by the Chil­
dren’s Bureau are: No. 1, Prenatal Care; No. 2, Infant Care; No. 3,
Child Care; and No. 4, Milk the Indispensable Food for Children.
1 United States Children's Bureau Publication No. 15, M iscellaneous Series No, 5, pp,
118-131. W ashington, 1917,
Federal Reserve Bank of St. Louis

Limited quantities of these publications will be furnished for dis­
tribution, or samples will be supplied together with blank forms on
which the names and addresses of those desiring bulletins should be
clearly written. When the lists are returned to the bureau, the bulle­
tins will be mailed directly to the addresses furnished.

Many public health nurses doing infant welfare work in smaller
communities and rural districts have found that central headquarters
where mothers can meet for conferences have been very successful.
Such centers have been established in several county seats in connec­
tion with rest rooms for women, and conferences are held on the days
on which it is the custom of the women from the country to come
to town for shopping. Nurses working in rural counties find that,
in addition to such a central headquarters, centers at rural schools
needed. The State department of health
throughout the
ies of Children’s Health Centers in
of one State
¿lie headquarters of a rural pubrural districts
lie-health nurse,
e furnished by a specialist
by the State dein infant welfare and cni
intervals of from
partment of health, who w
one to three months.


Federal Reserve Bank of St. Louis
Federal Reserve Bank of St. Louis