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HE second year of the war for the United States, opening April 6, is to be devoted to saving the lives of babies, according to plans of the Federal Children's Bureau. A year's campaign to reduce the heavy infant mortality is planned, under the direction of the Children's Bureau and of the Women's Committee of the Council of National Defense. It will be carried into the states through the women's committees of the various state defense councils.

The co-operation of the Division of Child Hygiene of the Ohio State Department of Health in this pro gram as broadly outlined is assured, as the Federal plan coincides in most respects with work already begun in Ohio. The Federal program will be knit up thoroughly with the state program in Ohio through the fact that Dr. Frances M. Hollingshead, director of the Division of Child Hygiene of the State Department of Health, is also chairman of child hygiene, health and recreation of the women's committee of the Council of National Defense, which is to act as the Federal agent in the state.

Half Baby Deaths Preventable

The first aim of the nation-wide campaign will be to obtain public protection for maternity and infancy. Public health authorities

agree that one-half the annual total of 300,000 deaths of children under five years old is preventable. They also consider that the larger proportion of the 15,000 mothers who died last year in bringing their children into the world died needlessly.

To save a certain definite proportion of these lives, with a definite quota, based on population, assigned to each state, is the underlying object of the "Children's Drive." It is believed that 100.000 deaths can be prevented this year, despite war's depletions in the ranks of physicians and nurses. Ohio's quota has been set at 4,510. which represents a reduction of about one-third in the state's baby deaths.

Methods Outlined

The methods to be followed will be those whose efficacy has been demonstrated in child welfare work in this and other countries. Briefly stated, these are as follows:

3. Children's conferences where well babies can be taken periodically to be weighed and examined, and clinics where sick children may be given medical advice.

4. Organization of state and city bureaus or divisions of child hygiene.

5. Guarding of the milk supply, that every child may have his quota of clean, pure milk.

6. An income making possible decent living standards.

Some Machinery Ready Here

In Ohio, of course, and in a few other states, state work in child hygiene is already organized. In this state more or less of the machinery outlined in the preceding statement of methods is already provided as a part of the state's public health equipment, except in the case of the sixth method listed.

The first step in the "Children's Drive" will be a nation-wide weighing and measuring of children of pre-school age, designed to provide in a simple way data indicating the general physical condition of this group of children. No such extensive work among pre-school schildren has ever been done, and the widespread test will provide. valuable data which is unavailable now. Tests to be made will be very simple, so that they may be applied by the parent if it is not practicable to take the child to an examining station.

The Record Cards

Record cards will be arranged in duplicate so that one-half may be retained by the parent and the other filed as a record from which statistics will be tabulated at the conclusion of the tests. The record card will show physical stand

ards for children of given ages. and any marked divergence from this standard will serve as a warning to the parent that the child may need medical consideration.

Weighing and measuring the nation's babies will begin on April 6, and it is the intention of the Wash

ington bureau that it be completed throughout the country by June 6. It is suggested that, if a Baby Week celebration is desired this year, it be held during the last six days of this period from June 1 to 6. Such celebrations as are held, the Children's Bureau recommends, should emphasize the need for public health nurses and for protection of young infants against the dangers of summer heat.

What England Did

"One of the most remarkable developments of the war," declared a recent statement of the Children's Bureau, "a victory not heralded on front pages, yet which in time to come will be noted by all students of human welfare, is the saving of infant life in England during the second year of the war. The report of the chief medical officer of the Local Government Board, Sir Arthur Newsholme, published in 1917, shows for one sanitary district after another throughout England and Wales the number of babies who died before the war, those who died the first year of the war and the deaths for the second year of the war, 1916.

"It is startling to turn over the pages of this report and to see that the general social confusion of the first year of the war resulted in a large increase in the number of babies who died. But in the second year of the war, when the Local Government Board was enabled to grant financial aid to the

various sanitary districts and to secure co-operation in its policy of health visitors for every mother and baby, of health centers for consultation, of hospital care for sick mothers and babies, the rate went down not only far below the rate for the year before, but far below the rate previous to the war.

An Unparalleled Record "This record of lifesaving in the midst of the strain of war, by means so simple and so at coinmand, is, we believe, entirely without parallel.

"Although the United States now lacks the machinery for such Federal aid as England was enabled to grant to local work, it has power enough locally to make a very creditable showing, and, it may be

hoped, to pave the way for such governmental provision as will enable the United States to show the even greater salvage which its unexhausted condition makes possible.

"Again, why should the United States, especially the newer rural states, be satisfied with a less favorable infant mortality rate than that which New Zealand can show? The New Zealand rate has steadily gone down, notwithstanding the war, and it is now almost precisely half the rate for the registration area of the United States; that is, in New Zealand one baby in twenty dies, while in the United States one baby in ten dies. The most favorable state rate in the registration area is 70, that of Minnesota. Why should Minnesota not enter the race with New Zealand?"

could do was to appeal to the State Department of Health.

Department Anxious to Aid The State Department of Health is anxious to help this village or any other civil division in Ohio which needs help. It will send a man to this village just as soon as possible to organize some sort of local machinery to take care of the situation.

The Division of Communicable Diseases of the State Department of Health has available the director and his assistant, both physicians. Another assistant is provided by existing appropriations but after four months' diligent search no one even approximately qualified to do the work can be found who is willing to accept the place at the salary of $1500 per annum provided by law. Upon these two physicians, therefore, falls the duty of answering calls such as that represented by the telegram quoted above.

There are in the State of Ohio 2,141 primary health districts. Of these not more than twenty pay sufficient salary to command the whole time of a well trained and competent man. Not more than 150, at the outside, have health officers who are even approximately efficient. In practically 2,000 of the health districts of the state conditions are little if any better than those referred to above. In these 2,000 districts the appearance of any serious situation results in an immediate breakdown of the local health machinery and a call on the state for assistance. To meet these calls the state has provided the force of three physicians.

Health Officer's Real Function

The smallpox situation only accentuates a condition long existent

and crying for relief. In any community smallpox should be the least of the problems of the health officer. By intelligent and active work it can readily be controlled. The other communicable diseases, typhoid fever, diphtheria, scarlet fever, measles and whooping cough should receive a considerable part of his time, but even these are not the major part of his work. The work of a good health officer should be directed to preventing things before they happen, to building up the general sanitation of the community and the general health of the people so that he will not need to devote much time to the control of cases of disease which actually do occur. That this can be done has been amply demontrated.

Health protection in any true sense is not available to a large part of the population of Ohio. It cannot be made available by appointing the village marshal as health officer at a salary of $4 per year. It cannot be made available by the present State Department of Health, with an appropriation of little more than two cents per capita for the state. It can be had only by the formation of health districts sufficiently large to provide for the services of a competent health officer at a reasonable salary and providing back of the local organization a state organization sufficiently extensive to supervise the health administration of 5,000,ooo people.

The autumn months, when people are spending much time outdoors, are known as healthful ones. Not until winter, when windows go down and people shut themselves indoors, it has been observed, do colds and grip become prevalent.

I. Save fuel by avoiding the heating of rooms not used and by heating halls, stairways and similar parts of the building at a much less degree than the occupied quarters.

2. Save health by avoiding overheating (undoubtedly more colds and sickness are due to this than to underheating) and by avoiding the "temperature shocks" which take place in going from one extreme to another, as from zero weather out-of-doors to 70 degrees indoors. In this latter case moderately heated halls, etc., make the transition gradual and less likely to cause sickness.

3. Save fuel by avoiding heating of bedrooms except where occupied by the aged or the sick. Heated bedrooms are not needed for healthy adults, children or infants. Provide enough covers.

4. Save health by getting, at night, the invigorating properties of cool, fresh atmosphere, even though you may spend all of the day out-of-doors.

5. Save fuel and get more heat by seeing that the ordinary gasgrates and gas-plates burn only with a colorless or bluish flame, not a yellow carbon flame. Usually, adjusting the air mixer as by lifting the gas distributor an inch or so higher above the nozzle in the case of grates of ordinary type, will suffice.

6. Save fuel, in case of furnace heating, by taking air out of the basement, passing it through the furnace, then through the house. back to the basement. This is because it is not so expensive to heat.

partially warm air as to take the straight cold outside air.

7. Do not fear sickness from the use of air just described since in practically all ordinary homies there is more than enough in-leakage of fresh air and out-leakage of contaminated air to prevent sick

ness.

8. Save fuel in stoves or furnaces by use of small pieces of coal, or even dust, well moistened and placed to one side, or even below, the fire already present.

9. Save health and promote cleanliness by avoiding soot and smoke coming in windows and doors. This can be done by using fuel as just described.

IO. Save heat in a room where possible by using two heating units placed at opposite sides of the room. Thus, a gas-grate on one side and the furnace register on the other can be operated together much more economically than either one alone in the maintenance of a comfortable temperature.

II. Save health by having the heat as uniform as possible in a room. "Cold on one side and hot on the other" promotes sickness.

12. Save fuel by the use of overhead gas-plates, some types of which on the market are very efficient and furnish some light as well. Use only those types which are guaranteed to combust the gas completely.

13. Save health in quarters which cannot be kept warm by dressing more warmly.

14. Save heat by pulling down window shades, particularly at