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made, as a rule, by one of these nurses, and a Child Welfare Exhibit held in the community when the survey had been completed. The survey was undertaken with a view to ascertaining what special feature of child welfare work was most needed in the community. Whether, for example, the infant death rate in a particular community was high owing to a faulty system of birth registration, or whether it was due to a poor milk supply as a source of artificial food for infant consumption. The complexity of population was investigated, as to its racial composition, its degree of illiteracy, poverty and ignorance. The general status of the people as to housing conditions, insanitation and drainage was also inquired into, as a basis for arriving at a decision as to the section of the community where welfare work was most urgently needed. This acted as a stimulus to more child welfare work in the community, such as " Clean-up Week”, support of a visiting trained nurse, establishment of an infant welfare station or a milk station, and the organization of “Little Mothers " leagues. In addition to this the nurses were instrumental in disseminating in the homes and through talks to mothers' clubs, etc., practical education along the lines of baby hygiene and prenatal care. They have also been very helpful in their talks to mothers on the sanitation of the home, the care and feeding of the baby, and in matters relating to domestic economy.

Literature

The demand for infant welfare literature of all kinds, published by the Department, has largely increased. Approximately 250,000 child welfare leaflets and pamphlets have i been vlistributed. Literature of this kind coming into the hands of those who are likely to be interested in it, might in itself be regarded as an educational feature of much value, a sort of correspondence school for those who can not secure this education in any other way. Requests for literature were received not only from within the State, but from many other parts of the country. The Department has had many of its publications for public distribution, printed in Polish, Hungarian and Italian. The value of literature of this class distributed among the foreign-born of these nationalities is unquestionably large. That these people are coming more and more to appreciate the educational advantage which is offered to them in this way is evidenced by the increasing demand that a larger variety of health literature be printed in their native tongue. The Division is constantly adding new literature to its stock.

The little baby leaflets issued by the Department are also increasing in demand. Their titles, which follow, indicate their subject matter :

Before the Baby comes.
The New-born Baby.
The Food of the Baby.
Avoid Infection.
Care of Milk in the Home.
From the Bottle to Table Food.
The Summer Care of Babies.

In addition to the above, more than one hundred thousand copies of the booklet entitled “ Your Baby, How to Keep It Well”, and much other literature in the form of bulletins, circular letters, etc., have been sent out during the year. During the first week of May a State Child Welfare Day was observed; this is a feature of child welfare work of annual occurrence. Letters were sent to clergymen, women's clubs, and other organizations, explaining the object of Child Welfare Day and urging their cooperation to make the day a success. The response was hearty and cordial and the results very satisfactory.

Motion pictures and slides Lantern slide and motion picture exhibits, illustrating various phases of child welfare work were given at thirty-nine different places as follows: Altmar, Forestville, Johnstown, Brockport, Niagara Falls, Alfred, Wallkill, Whitehall, Lacona, Silver Creek, Sherman, Tyrone, Amsterdam, Millerton, Fredonia, Lima, Utica, Rome, Carthage, Glens Falls, Cohocton, Buffalo, Fultonville, Middleburg, Schenectady, Kingston, Delanson, Doigeville, Sauquoit, Poland, Hermon, Poughkeepsie, Edwards, Port Washington, Warwick, Albany, Middle Granville, Brooklyn and Milton.

Lectures

Therever practicable the lecture platform has been utilized to aid the spread of health information along the line of child hygiene.

The Director gave the following special addresses during the year.

“Relationship Between the State Department of Health and Rural Communities”, before the Rural Studies Class, Cornell University

Annual address before the Babies Clinics Association at Grand Rapids, Michigan.

"Milk and Morbidity”, before the Health Officers of St. Lawrence and Jefferson counties.

Address to the graduating class of the “Little Mothers” leagues in Amsterdam.

An address on “ Infant Welfare Work in New York State” was given at Lockport. Addresses were also given to the Rotary Club of Albany, St. Agnes School of Albany, Methodist Conference at Burnt Hills and the Rotary Club of Binghamton.

The Acting Director gave the following special addresses:

“The Necessity for a Tuberculosis Hospital in Washington County," delivered at the Community Club at Whitehall and before the Washington County Medical Society at Hudson Falls.

“ Infant Mortality”, an address given at the Women's Hospital Association at Batavia.

A number of addresses on “ Food and Its Relation to Health given in Schenectady and Amsterdam.

A talk before the Twentieth Century Club of Cincinnatus on “ Child Hygiene," and another on “Food and its Relation to IIealth”.

A lecture on “Adult Mortality” given before the faculty and advanced students of the State Normal School and ParentTeachers Association at Fredonia.

Correspondence In reply to inquiries regarding the work of this Division and relating to various matters pertaining to child welfare, approximately 2,000 letters were sent out. This correspondence covered a wide range of subjects relating to child welfare, including advice on prenatal and aftercare of the baby, the hygiene of infancy, baby feeding, the kind and amount of baby food, of exercise, of clothing; infant welfare stations, milk stations, the duties of a visiting trained nurse, educational work for child welfare, summer camps for babies, baby welfare exhibits, and milk pasteurization, etc.

Little mothers' leagues The work of “Little Mothers ” leagues has been continued. This organization aims to educate girls twelve to sixteen years of age in the practical management of the smaller children at home. The mother of a large family finds her time fully occupied with the many problems of the home, and outside help being unavailable owing to economic conditions in the home, the work of caring for the baby and children of preschool age is given to the “ Little Mother". The league teaches her how to care for the baby's feeding, clothing, eyes, ears, nose and mouth; what things are harmful to the baby; what things are helpful; under her mother's supervision she prepares the baby's bath, food and bed and looks to its general well being. The course of lessons, ten in number, is given along practical lines by a competent trained nurse. An examination is held at the end of the course and the members of each league are awarded a certificate of membership which has been duly signed by the Commissioner of Education and the Commissioner of Health. New leagues were established at Port Washington, Saranac Lake, Silver Creek, Wappingers Falls, Alfred, Herkimer, Hillburn, Locust Valley, and two at White Plains. The new leagues which have been organized during the year have a total membership of four hundred and eighty-six.

Infant welfare stations

During the year infant welfare stations have been established in Lackawanna, Dunkirk, Niagara Falls, Westbury and Medina. Seventy-one infant welfare stations were in operation in different cities and towns during the whole or part of the year. During the year reports have been received from the following stations: Dunkirk, Peekskill, White Plains, Tarrytown, Glen Cove, Herkimer, Lackawanna, Solvay, Elmira, Binghamton (2 stations), Albany (2 stations), Little Falls, North Tonawanda, Auburn, Batavia, Buffalo (13 stations), Olean, Poughkeepsie (2 stations), Schenectady (2 stations), Tonawanda, Watertown, Yonkers (4 stations), Jamestown (2 stations).

Recommendations

The close of each succeeding year brings home more forcibly the thought that after all the best way to reduce the infant death rate is by educational measures.

Public interest .must be more fully aroused to the need of educating the thousands of young women who approach motherhood wholly unprepared to protect their own health, which is also the health of the coming child.

The public itself must be aroused to the dangers to the community which may lurk in an unpasteurized milk supply. Such milk may contain disease germs fatal to the infant, the child, the adult and the aged.

There is also need for a stricter supervision of the health and hygiene of the child of pre-school age. Much has been said and written concerning the welfare of the mother and the infant, but the public has received scant education with reference to the needs and training of the child of pre-school age. This the Division of Child hygiene hopes to remedy in the year 1918. Respectfully submitted,

H. F. SENFTNER,

Acting Director February 1, 1918

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