LETTER OF TRANSMITTAL.

U. S. DEPARTMENT OF LABOR,

CHILDREN'S BUREAU,

Washington, D. C., July 22, 1914.

SIR: I transmit herewith the second monograph in the Care of Children series.

This issue discusses the care of the baby to the close of the second year. It is written by Mrs. Max West, who wrote the first number of this series, entitled "Prenatal Care," and the same method has been used in its preparation—namely, exhaustive study of the standard literature on the hygiene of infancy as well as consultations with physicians, nurses, and other specialists in this field.

Like the preceding one of the series, it is addressed to the average mother of this country. There is no purpose to invade the field of the medical or nursing professions, but rather to furnish such statements regarding hygiene and normal living as every mother has a right to possess in the interest of herself and her children. It endeavors to present the accepted views of the best authorities at the present time. Footnotes indicate the chief sources.

The bureau is deeply indebted to many persons for aid, not only to those who have given generously of valuable professional time to read and criticize the manuscript, but as well to those who have advised as to materials and appliances and to those who have aided in securing the illustrations.

Respectfully submitted.

Hon. WILLIAM B. WILSON,

Secretary of Labor.

JULIA C. LATHROP, Chief.

7

INFANT CARE.

BIRTH REGISTRATION.

One of the most important services to render the newborn baby is to have his birth promptly and properly registered.

In most States the attending physician or midwife is required by law to report the birth to the proper authority, who will see that the child's name, the date of his birth, and other particulars are made a matter of public record. Birth registration may be of the greatest importance when the child is older, and parents should make sure that this duty is not neglected.1

LIVING CONDITIONS.

The house which is to be the home of children should be sunny, well ventilated, and dry. The choice is usually limited by the size of the family income, but there is, nevertheless, within this limit some range of selection. Among houses of the same rental one may be in better repair than another, or the houses on one side of the street may be sunnier than those on the other, or one house may have more space about it than another, or the plumbing, drainage, or other conveniences in one may be in a more sanitary condition than in another.

Flats and apartments do not usually afford enough freedom for growing children, although a baby may do very well in such a place until he is 2 or 3 years old, when he needs more room, both indoors and out. Tenements with dark rooms are not fit homes for children. Suburban homes, or those in the outskirts of cities or close to public parks, give to city children of the average family the best chance for proper growth and development.

In selecting a city house it is wise to consider what possibilities it has for future improvements-as, for example, whether the roof can be utilized for play space, whether there is room for a porch or bay window on any side, and whether the back yard can be made into a pleasant out-of-door living room for the family.

1 Write to the Children's Bureau, U. S. Department of Labor, Washington, D. C., for monograph on birth registration.

Those who live in smaller cities, towns, and rural communities will find it easier to provide their children with light, air, and out-of-door space. In every case the house and its surroundings should be carefully inspected. The cellar or basement should be clean and dry; if there is a well, it should be so located as to prevent the water from being poisoned by the foul drainage from stable or outhouses. Pools of stagnant water, manure heaps, piles of garbage, refuse or rubbish of any sort, or open privies are all dangerous to health and furnish breeding places for disease-carrying insects, such as flies and mosquitoes.

The health of the baby is so dependent upon sanitary surroundings that a list of Government publications relating to the hygiene of the home is given in the appendix to this pamphlet. (See Appendix.)

NURSERY.

LIGHT AND VENTILATION.

Sunshine is as necessary for the baby as for the plant, and a baby deprived of it will pine and droop just as a plant does; therefore the room in which the sun shines for the longest period of the day should be chosen for the nursery.

The room should have a constant supply of fresh air, as the baby will be much less liable to illness than when he is deprived of it. To "air" a room at intervals by opening the windows is well, but a far better plan is to have a continual stream of fresh air flowing through. To do this the windows must be opened on opposite sides of the room in order to secure a cross draft, which is always necessary to real ventilation. When the outside temperature is so extremely low that a comfortable temperature can not be maintained with the windows open, outside air should be frequently admitted by opening wide the windows on opposite sides and flushing every part of the room for a few moments. In severe weather it is a good plan to air the nursery whenever the baby is taken into another room. In all the mild months the windows should be kept constantly open night and day.

The overwhelming importance of fresh air to children is strikingly shown in a recent English report on the mortality, by different age groups, among the inhabitants of well-ventilated and ill-ventilated houses in the same towns. The families chosen were of similar income and social status.

1

The general result of this investigation was to show that in the group comprising children under 5 years of age not only were the

1 A report on Relative Mortality in Through and Back-to-Back Houses in certain Towns in the West Riding of Yorkshire, by Dr. L. W. Darra Mair, London, 1910.