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The Nursling

By Pierre Budin, Professor of Obstetrics, University of Paris; Director of the Clinique Tarnier; Member of the Academy of Medicine, Paris, France. Authorized translation by William J. Maloney, M.B., Ch. B., 1907.

Appendix IX

Results Obtained at the Consultation for Nurslings of the Clinique Tarnier During the Months of June, July, August, and September 1899

Synopsis of a Paper by Dr. Pierre Planchon, which appeared in the "Obstetrique" of January 1900

After a few introductory remarks Dr. Planchon proceeds: "Now let us consider what happened, during summer 1899, at the Consultation for Nurslings of the Clinique Tarnier:--

"The consultation then comprised 65 infants, of whom

"40 were being exclusively breast-fed;

"3 had been breast-fed until their mothers could no longer supply their wants, and were on mixed feeding;

"22 were on artificial feeding, of whom 9 had been weaned in due course after passing through the stages of breast and mixed feeding, 10 had been on mixed feeding from both, and 3 had been reared solely on animal milk.

"Consequently 40 infants were breast-fed, 22 received all the milk their mothers could secrete, and 3 had never had any but sterilised cows' milk. Therefore--

"61.5 per cent. were nourished exclusively by their mothers.

"33.7 per cent. utilised all the milk their mothers could produce.

"4.6 per cent. were upon artificial feeding from birth.

"I have carefully collected the details of all gastro-intestinal troubles which occurred in these nurslings during the summer of 1899."

Dr. Planchon enters into a minute study of each case, and then continues as follows: There were 14 cases of diarrhoea among these 65 infants; 10 were slight and 4 were serious; there were no deaths. The morbidity was thus 21 per cent., and the mortality zero. In all but one case we traced the cause of the gastro-intestinal symptoms; in 5 they arose from "teething"; in 1 from menstruation in the nurse; and in 7 from faulty feeding, due to mothers disobeying our instructions.

What were the results obtained during the same period at the three crèches in Paris, where sterilised milk is used under proper supervision? As is seen on the following table they had a morbidity of 7.4 per cent. among 121 infants, and a mortality of zero.

Crèche

Doctor

Total of Infants

Simple Enteritis

Cholera Infantum

Deaths

Fénelon, Charles

Dr. Bouquet

42

5

0

0

Rue Gauthey

Dr. Gauchas

22

2

1

0

Sainte Philomène

Dr. Belluze

57

1

0

0

Total

121

8

1

0

In the town of Paris during these four months 2840 infants under one year died; 1470 of them succumbed to diarrhoea. The deaths from gastro-enteritis were thus 51.7 per cent. of the total infantile mortality; 139 of them -- 4.9 per cent. -- occurred among breast-fed babies, and 1331 - 46.8 per cent. -- among bottle-fed.

Month

Number of Week

Total Deaths from 0-1 Year

Deaths from Gastroenteritis

Mean Temperature
Degrees C.

Percentage of the Total Infantile Death-Rate due to Diarrhoea
Per Cent.

Breast

Bottle

Total

June

22

128

9

21

30

15.10

23.4

23

149

5

43

48

18.22

32.2

24

114

7

31

38

15.29

33.3

25

103

5

28

33

16.79

32.0

26

111

7

36

43

18.17

38.8

July

27

114

3

51

54

16.65

47.4

28

169

13

66

79

20.30

46.5

29

237

10

149

159

22.38

67.5

30

206

7

117

124

19.08

60.2

Aug.

31

256

16

158

174

23.57

68.0

32

231

7

84

91

19.55

39.5

33

215

12

131

143

20.98

60.5

34

210

9

128

137

19.86

65.2

35

175

6

88

94

19.23

53.8

Sept.

36

135

10

67

77

19.80

57.0

37

104

3

55

58

14.50

53.6

38

105

6

46

52

14.46

49.4

39

78

4

32

36

12.98

46.2

Total

2840

139

1331

1470

Fig. 125. Mortality from gastro-enteritis in Paris during the year 1899. In red, mortality among bottle-fed infants; in black, mortality among breast-fed infants.


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