THE INSTITUTIONAL CARE OF INFANTS The infant that is doomed to institutional care has very poor prospects in life. The majority are illegitimates and hence are unwelcome. While the mortality in institutions is high even with the best of care and the employment of wet nurses, while without wet nurses it may reach ioo per cent.
The following factors are principally responsible for this appalling mortality: (I) The institutions are usually over crowded, so that respiratory infections run like wild fire; (2) There is a lack of sufficient fresh air; (3) Respiratory infections, whose dissemination is favored by overcrowding and defective ventilation, and lastly, (4) The lack of mothering. Babies thrive best, other things being equal, where they receive a great deal of individual, personal attention. They seem to require encouragement and coaxing over the period of their adaption to extra-uterine life.
The following conditions will largely reduce the mortality among this class of infants. Every effort should be made to induce the mother to keep her child. Its chances of survival
are enormously improved, even though it is later placed in an institution. Institutions for the care of infants are usually privately conducted and commonly known as "Baby Farms" or boarding houses. These should be placed under the control and supervision of health authorities, so that abuses in their conduct may be eliminated. For this purpose their licensure is necessary. A practice that is preferable to the employment of boarding houses is that of boarding the babies in private families with wet nursing. This enables the infant to receive the necessary individual attention. Infant hospitals should be only for those acutely sick and should not partake of the character of boarding houses. As soon as possible the child should be returned home. Every hospital which cares for infants should be provided with wet nurses. Wassermann tests should be made on both infant and nurse to prevent the transfer of luetic virus in either direction.