details of a baby's diet; but the 'greatest bugbear’ of some doctors was the
'ignorant' nurse, who, impervious to taste or smell, fed the newborn cows'
milk which was septic, had curdled or turned green, 'kept in bad places in
the hot weather', and solid foods: the baby might be given minced meat,
pies or anything that was going; it might have forced upon it something
unsuitable before its mother's milk arrived, from its first day of life.105 How
many nurses and mothers there seemed to be who simply stuffed their
children or charges and thought 'to quiet them with the bottle'.106 Even
well-educated women, Dr Clubbe asserted, gave a 2-4 month old baby 4 or 5
pints of fluid a day.107 Food or filling could be bad in two ways, Dr Ken
Herring of Shepparton, Victoria, told doctors in the New South Wales town
of Goulburn in 1900: 'It may be septically bad by being stale or sour, or
containing some deleterious element which acts as a poison,' he said, 'or it
may be mechanically bad by being indigestible.'108 All these problems were
exaggerated in the hot weather when bacteria multiplied in food and milk,
mother and baby were tired and irritable and the baby was thirsty. The result
was a baby with an upset stomach who succumbed 'in nine cases out of ten',
105G.E. Cussen, 'Infantile Gastro-Enteritis’, AMG, 20 May 1899, p.188; T.H.R. Willis, 'Pathologic Conditions in Cases of Summer Diarrhoea’, AMG, 20 May 1901, p.187 and Dr Nield, p.188; C.P.B. Clubbe made a similar remark about the 'ignorant nurse' who fed the child improper food, often septic milk, in RCDBR, vol 2, Evidence of Clubbe, 30 Nov 1903, q.4396. Also J.S.C. Elkington, The Feeding and Care of Babies, Hobart, 1906. For further details on infant feeding, see Milton Lewis, 'The Problem of Infant Feeding: The Australian Experience from the Mid-Nineteenth Century to the 1920s', Journal of the History of Medicine and Allied Sciences, vol 35, no 2, Apr 1980, pp.180-2. See also the American study by Apple,
Mothers and Medicine, esp. chap 1; and on Britain, Smith, The People's Health, pp.85-101 106Phusis, 'About Nutrition', Parents' Review, vol 5, 1895, p.269
107RCDBR, vol 2, Evidence of Clubbe, q.4430
99
according to colloquial dictum , to gastroenteritis.109
T his su p p o s itio n w as tested an d stre n g th e n e d by D r A rm stro n g 's su rv e y s. In the 18 m o n th s before the C om m ission on the Birth Rate, A rm stro n g in v estig ated the d eath s of 145 babies w ho h a d succum bed to in fan t d iarrh o e a in S ydney and fo u n d th at 138, or 95 p e r cent, h ad eaten som e artificial food. Of 60 u n d er three m onths of age w ho h ad died in 1902- 5, th e p ro p o rtio n w as 93 p er cent. H is findings tallied w ith the m uch p u b licised figures of D r A rth u r N ew sholm e in B righton, E ngland, th at of 121 babies in 1903-5 w ho h ad died of epidem ic diarrhoea, 93 p er cent were not w h o lly b reast fed .110 They h a d the fu rth er effect of h ig hlighting the p ro p o rtio n s of babies w ho died after being fed condensed m ilk, either as a su p p le m e n t or w ith artificial foods, including biscuits: 65 of 116 or 56 per cent of S ydney babies w hose deaths A rm strong investigated in 1903, and 30 per cent of N ew sholm e's sam ple of infant deaths. The association betw een in fa n t d ia rrh o e a an d artificial feed in g seem ed clear to ev ery o n e except Litchfield. H is w as a lone voice th at pronounced it w rong-headed to foist all the blam e on food.1 11 111
Lewis has concluded, reasonably, that 'the surveys ten d ed to show the connection b etw een p o o r n u tritio n and diarrhoeal co n d itio n s'.112 But poor n u tr itio n w a s itse lf d e p e n d e n t on o th e r in flu e n ce s, am o n g th em a hopelessly in ad eq u ate incom e, and cu rren t know ledge suggests, how m uch schooling the m other had received. As alw ays Litchfield's scepticism offered 109rrhe estimate is Byrne's, who added '... of every hundred bottle-fed babies at least 75 die before reaching the age of one year.' AMG, 20 Feb 1904, p.56; cf. S.W. Newmayer, Director of Child Hygiene, Philadelphia, who asserted that ten artificially fed babies died for every one breast fed, 'The Warfare Against Infant Mortality', American Academy of Political and Social Science, The Public Health Movement, Philadelphia, 1911, p.292
110RCDBR, vol 2, Evidence of Armstrong, 7 Dec 1903, q.5165A, Armstrong, 'Some Lessons',
TAMC, 1905, pp.388, 391 and AMG, 20 Oct 1905, pp.516, 518, Metropolitan Combined Sanitary Districts, Annual Report of MOH, 1903, p.15. Newsholme reported his results as 'Domestic Infection in Relation to Epidemic Diarrhoea', Journal of Hygiene, vol 6, no 2, Apr 1906, pp.139- 48
11 Litchfield, 'Summer Diarrhoea in Infants', TAMC, 1905, pp.423, 425 112Lewis, 'The Problem of Infant Feeding', p.185