The advantages for an infant of being suckled by its mother are greater than can be accounted for by the mere fact of being suckled rather than hand-fed. This has been shown by Vitrey (De la Mortalité Infantile, Thèse de Lyon, 1907), who found from the statistics of the Hôtel-Dieu at Lyons, that infants suckled by their mothers have a mortality of only 12 per cent., but if suckled by strangers, the mortality rises to 33 per cent. It may be added that, while suckling is essential to the complete well-being of the child, it is highly desirable for the sake of the mother's health also. (Some important statistics are summarized in a paper on "Infantile Mortality" in British Medical Journal, Nov. 2, 1907), while the various aspects of suckling have been thoroughly discussed by Bollinger, "Ueber Säuglings-Sterblichkeit und die Erbliche functionelle Atrophie der menschlichen Milchdrüse" (Correspondenzblatt Deutschen Gesellschaft Anthropologie, Oct., 1899).
It appears that in Sweden, in the middle of the eighteenth century, it was a punishable offense for a woman to give her baby the bottle when she was able to suckle it. In recent years Prof. Anton von Menger, of Vienna, has argued (in his Burgerliche Recht und die Besitzlosen Klassen) that the future generation has the right to make this claim, and he proposes that every mother shall be legally bound to suckle her child unless her inability to do so has been certified by a physician. E. A. Schroeder (Das Recht in der Geschlechtlichen Ordnung, 1893, p. 346) also argued that a mother should be legally bound to suckle her infant for at least nine months, unless solid grounds could be shown to the contrary, and this demand, which seems reasonable and natural, since it is a mother's privilege as well as her duty to suckle her infant when able to do so, has been insistently made by others also. It has been supported from the legal side by Weinberg (Mutterschutz, Sept., 1907). In France the Loi Roussel forbids a woman to act as a wet-nurse until her child is seven months old, and this has had an excellent effect in lowering infantile mortality (A. Allée, Puériculture et la Loi Roussel, Thèse de Paris, 1908). In some parts of Germany manufacturers are compelled to set up a suckling-room in the factory, where mothers can give the breast to the child in the intervals of work. The control and upkeep of these rooms, with provision of doctors and nurses, is undertaken by the municipality (Sexual-Probleme, Sept., 1908, p. 573).
As things are to-day in modern industrial countries the righting of these wrongs cannot be left to Nature, that is, to the ignorant and untrained impulses of persons who live in a whirl of artificial life where the voice of instinct is drowned. The mother, we are accustomed to think, may be trusted to see to the welfare of her child, and it is unnecessary, or even "immoral," to come to her assistance. Yet there are few things, I think, more pathetic than the sight of a young Lancashire mother who works in the mills, when she has to stay at home to nurse her sick child. She is used to rise before day-break to go to the mill; she has scarcely seen her child by the light of the sun, she knows nothing of its necessities, the hands that are so skilful to catch the loom cannot soothe the child. The mother gazes down at it in vague, awkward, speechless misery. It is not a sight one can ever forget.
It is France that is taking the lead in the initiation of the scientific and practical movements for the care of the young child before and after birth, and it is in France that we may find the germs of nearly all the methods now becoming adopted for arresting infantile mortality. The village system of Villiers-le-Duc, near Dijon in the Côte d'Or, has proved a germ of this fruitful kind. Here every pregnant woman not able to secure the right conditions for her own life and that of the child she is bearing, is able to claim the assistance of the village authorities; she is entitled, without payment, to the attendance of a doctor and midwife and to one franc a day during her confinement. The measures adopted in this village have practically abolished both maternal and infantile mortality. A few years ago Dr. Samson Moore, the medical officer of health for Huddersfield, heard of this village, and Mr. Benjamin Broadbent, the Mayor of Huddersfield, visited Villiers-le-Duc. It was resolved to initiate in Huddersfield a movement for combating infant mortality. Henceforth arose what is known as the Huddersfield scheme, a scheme which has been fruitful in splendid results. The points of the Huddersfield scheme are: (1) compulsory notification of births within forty-eight hours; (2) the appointment of lady assistant medical officers of help to visit the home, inquire, advise, and assist; (3) the organized aid of voluntary lady workers in subordination to the municipal part of the scheme; (4) appeal to the medical officer of help when the baby, not being under medical care, fails to thrive. The infantile mortality of Huddersfield has been very greatly reduced by this scheme.[[16]]
The Huddersfield scheme may be said to be the origin of the English Notification of Births Act, which came into operation in 1908. This Act represents, in England, the national inauguration of a scheme for the betterment of the race, the ultimate results of which it is impossible to foresee. When this Act comes into universal action every baby of the land will be entitled—legally and not by individual caprice or philanthropic condescension—to medical attention from the day of birth, and every mother will have at hand the counsel of an educated woman in touch with the municipal authorities. There could be no greater triumph for medical science, for national efficiency, and the cause of humanity generally. Even on the lower financial plane, it is easy to see that an enormous saving of public and private money will thus be effected. The Act is adoptive, and not compulsory. This was a wise precaution, for an Act of this kind cannot be effectual unless it is carried out thoroughly by the community adopting it, and it will not be adopted until a community has clearly realized its advantages and the methods of attaining them.
An important adjunct of this organization is the School for Mothers. Such schools, which are now beginning to spring up everywhere, may be said to have their origins in the Consultations de Nourrissons (with their offshoot the Goutte de Lait), established by Professor Budin in 1892, which have spread all over France and been widely influential for good. At the Consultations infants are examined and weighed weekly, and the mothers advised and encouraged to suckle their children. The Gouttes are practically milk dispensaries where infants for whom breast-feeding is impossible are fed with milk under medical supervision. Schools for Mothers represent an enlargement of the same scheme, covering a variety of subjects which it is necessary for a mother to know. Some of the first of these schools were established at Bonn, at the Bavarian town of Weissenberg, and in Ghent. At some of the Schools for Mothers, and notably at Ghent (described by Mrs. Bertrand Russell in the Nineteenth Century, 1906), the important step has been taken of giving training to young girls from fourteen to eighteen; they receive instruction in infant anatomy and physiology, in the preparation of sterilized milk, in weighing children, in taking temperatures and making charts, in managing crêches, and after two years are able to earn a salary. In various parts of England, schools for young mothers and girls on these lines are now being established, first in London, under the auspices of Dr. F. J. Sykes, Medical Officer of Health for St. Pancreas (see, e.g., A School For Mothers, 1908, describing an establishment of this kind at Somers Town, with a preface by Sir Thomas Barlow; an account of recent attempts to improve the care of infants in London will also be found in the Lancet, Sept. 26, 1908). It may be added that some English municipalities have established depôts for supplying mothers cheaply with good milk. Such depôts are, however, likely to be more mischievous than beneficial if they promote the substitution of hand-feeding for suckling. They should never be established except in connection with Schools for Mothers, where an educational influence may be exerted, and no mother should be supplied with milk unless she presents a medical certificate showing that she is unable to nourish her child (Byers, "Medical Women and Public Health Questions," British Medical Journal, Oct. 6, 1906). It is noteworthy that in England the local authorities will shortly be empowered by law to establish Schools for Mothers.
The great benefits produced by these institutions in France, both in diminishing the infant mortality and in promoting the education of mothers and their pride and interest in their children, have been set forth in two Paris theses by G. Chaignon (Organisation des Consultations de Nourrissons à la Campagne, 1908), and Alcide Alexandre (Consultation de Nourrissons et Goutte de Lait d'Arques, 1908).
The movement is now spreading throughout Europe, and an International Union has been formed, including all the institutions specially founded for the protection of child life and the promotion of puericulture. The permanent committee is in Brussels, and a Congress of Infant Protection (Goutte de Lait) is held every two years.
It will be seen that all the movements now being set in action for the improvement of the race through the child and the child's mother, recognize the intimacy of the relation between the mother and her child and are designed to aid her, even if necessary by the exercise of some pressure, in performing her natural functions in relation to her child. To the theoretical philanthropist, eager to reform the world on paper, nothing seems simpler than to cure the present evils of child-rearing by setting up State nurseries which are at once to relieve mothers of everything connected with the production of the men of the future beyond the pleasure—if such it happens to be—of conceiving them and the trouble of bearing them, and at the same time to rear them up independently of the home, in a wholesome, economical, and scientific manner.[[17]] Nothing seems simpler, but from the fundamental psychological standpoint nothing is falser. The idea of a State which is outside the community is but a survival in another form of that antiquated notion which compelled Louis XIV to declare "L'Etat c'est moi!" A State which admits that the individuals composing it are incompetent to perform their own most sacred and intimate functions, and takes upon itself to perform them instead, attempts a task which would be undesirable, even if it were possible of achievement. It must always be remembered that a State which proposes to relieve its constituent members of their natural functions and responsibilities attempts something quite different from the State which seeks to aid its members to fulfil their own biological and social functions more adequately. A State which enables its mothers to rest when they are child-bearing is engaged in a reasonable task; a State which takes over its mothers' children is reducing philanthropy to absurdity. It is easy to realize this if we consider the inevitable course of circumstances under a system of "State-nurseries." The child would be removed from its natural mother at the earliest age, but some one has to perform the mother's duties; the substitute must therefore be properly trained for such duties; and in exercising them under favorable circumstances a maternal relationship is developed between the child and the "mother," who doubtless possesses natural maternal instincts but has no natural maternal bond to the child she is mothering. Such a relationship tends to become on both sides practically and emotionally the real relationship. We very often have opportunity of seeing how unsatisfactory such a relationship becomes. The artificial mother is deprived of a child she had begun to feel her own; the child's emotional relationships are upset, split and distorted; the real mother has the bitterness of feeling that for her child she is not the real mother. Would it not have been much better for all if the State had encouraged the vast army of women it had trained for the position of mothering other women's children, to have, instead, children of their own? The women who are incapable of mothering their own children could then be trained to refrain from bearing them.
Ellen Key (in her Century of the Child, and elsewhere) has advocated for all young women a year of compulsory "service," analogous to the compulsory military service imposed in most countries on young men. During this period the girl would be trained in rational housekeeping, in the principles of hygiene, in the care of the sick, and especially in the care of infants and all that concerns the physical and psychic development of children. The principle of this proposal has since been widely accepted. Marie von Schmid (in her Mutterdienst, 1907) goes so far as to advocate a general training of young women in such duties, carried on in a kind of enlarged and improved midwifery school. The service would last a year, and the young woman would then be for three years in the reserves, and liable to be called up for duty. There is certainly much to be said for such a proposal, considerably more than is to be said for compulsory military service. For while it is very doubtful whether a man will ever be called on to fight, most women are liable to be called on to exercise household duties or to look after children, whether for themselves or for other people.