ber, this led to discussion of nutrition and food service. Then would come a request for help with some phase of the child-feeding problem. And after a while the whole problem would be discussed.

As time went on, more and more institutions, including schools for delinquent children, homes for unmarried mothers, group foster homes, and others, began to ask for consultant service. And by the end of the war the association was receiving more requests than the members could fulfill.

When an institution had accepted the offer of help, the consultant that went to visit it would be able to give considerable assistance even at the first visit. She could, for example, point out satisfactory, and easily obtained, substitutes for rationed foods. And she could help the institution to make the best possible use of its allotment of such foods.

Some small institutions were found to be buying food at retail because none of the staff was familiar with wholesale buying. In such cases the consultant gave advice about ways of getting in touch with wholesale dealers and about economically sized packages and units of purchase.

Another consultant service was to demonstrate how institution menus could be adjusted so that the foods would be more adequate and less costly. For example, an institution might be spending too much for meats and too little for milk, vegetables, and fruits.

Some institution workers did not realize that it is possible to stretch the sum budgeted for milk and eggs by buying evaporated milk, dried skim milk, and egg powder. Consultants were able to show institution workers. how to prepare these economical foods appetizingly.

In many institutions a consultant found that the staff had been reduced by wartime conditions, and that the remaining workers were having a hard time. In some of these the consultant was able to suggest better methods of organizing the work so that the burden was lessened and the workers did a better job.

Again and again a superintendent or a board member would ask, "What should it cost to feed the children properly?"

So that we could give an answer to

portant in getting people in institution to eat the foods they need, whether the are children or adults.

The amounts of foods suggested i the chart were based on purchases i family-size packages. And so, with th help of a Bureau food economist, w adjusted the plan so that we could figur costs from institutional-size package We then calculated the wholesale cos of a week's food, and the total gave u the answer that the institutions wer asking for.

This method of estimating the cost of adequate food for children, on the mod erate-cost plan, was tested at a boys

Seventy-three familiar foods were listed in the plan, divided into 11 groups. A chart showed what amounts of the foods in each group should be purchased weekly to supply adequate food for children of different ages.

Amounts were given separately for low-cost and for moderate-cost diets. We selected the moderate-cost plan, because it provides more variety than the low-cost one, and variety of foods is im

various foods served during a week at the camp were compared with those specified by the Bureau of Human Nutrition and Home Economics, and the camp diets were found to meet the Bureau standards for adequacy in every food group and to exceed them in some groups. Then we compared the cost estimated for a week's food with the actual cost, and the actual cost per child proved to be only 7 cents a week greater than the amount we had estimated.

When a consultant visited an institution, usually the superintendent would ask her to analyze the menus to see whether the children were getting the .right food. The consultant knew, of course, that such analysis by itself was not enough to show whether the diets were adequate. She would analyze the menus, as requested, but would also explain to the superintendent that she would need to study a record of all the foods served during a given period, say a week. This record did not take account of food wasted, but otherwise it gave a fair picture of the types and amounts of food the children were receiving.

From the record the consultant classified the food served, according to the 11 groups mentioned previously in connection with calculating costs. She then compared the amount of food in each group that was served to the children during the week with the amount specified in the plan as needed by children of their age.

The superintendent of one institution that had been doing an excellent feeding job without trained personnel expressed her gratification when the consultant gave her a favorable report on the adequacy of the children's diet.

"We have tried to feed the children properly," she said, "but we have always wondered whether they were getting the right amounts of all the various proteins, minerals, and vitamins. Now we know for sure, and we know how to check on ourselves in the future."

so that the amount of each food used every day can be written in. The last two columns are headed, "Total amount used in week" and "Total cost for week."

To get the total cost of the dairy products used in the week, add the figures in the last column.

When the costs of all the groups are added together the total is the cost of the week's food.

An educational program needed

The amount of food left on the plates, and other evidence, suggested to the consultants that there was great need for an educational program in nutrition, both for the children receiving

ing enough of the right kinds of food. The consultant service of the Maryland Dietetic Association, which was set up entirely as a wartime service, was discontinued according to plan after the war ended. But by the time the work ceased, many institutions had begun to realize that this kind of help is needed for a good feeding program. And so many nursery schools, hospitals, homes for the aged, and so forth, called on the nutritionist in the State department of health for dietary consultation that in less than a year after VJ-day the department appointed a consultant dietitian on its staff, full time, to give regular service to State institutions.

care and for the staff members. In one home for unmarried mothers many of the girls had been so used to a poor diet in their own homes that they did not care for the balanced, nutritious meals that the home provided, with milk, and a variety of vegetables and fruits.

The consultant asked the doctor who was in charge of the girls' health to join with the staff in trying to change their food habits. She also referred the staff to sources of posters, pamphlets, motion pictures, and film strips that present attractively the advantages of eat

Under the supervision of the health department's consultant dietitian, educational programs have been established in two State training schools for delinquent children and in all the State's tuberculosis sanitaria. Through motion pictures, posters, and talks, efforts are made to correct the poor eating habits of the children and others in these institutions.

In the sanatoria this educational program also includes use of a pamphlet, Eat Your Way to Health, which (Continued on page 125)

I

N ALL studies of the psychological development of the child, it has been repeatedly pointed out that the parents, and particularly the mother, play the dominant role in the evolution of his emotions, of his personality, his adjustment to his social environment; indeed, even of his intelligence. The nervous mother may be expected to have a nervous child. Insecurity and emotional imbalance in the parents are reflected in the child.

And so it follows (1) that if the mental health of the child is our concern, we must focus our attention on the mother and (2) that the most effective way to prevent personality disturbances in the child is to give him welladjusted parents.

This, I grant you, is a big order and one that presents to the pediatrician a problem that often seems beyond his control to solve.

We must, however, accept it as our concern, analyze the way in which we are actually attacking it, and evaluate our approach in order to determine whether or not the part we play is productive of the best possible results.

It is with this thought in mind that I wish to call to your attention some of the commonly accepted patterns of relationships between the physician and the mother.

Let us assume that we are considering the case of young parents faced with the responsibilities of their first baby. They have, to a greater or less degree, shaken off the domination of their own parents and taken their place as adults with a home of their own, but the young

mother feels much uncertainty and ignorance in relation to the baby. This new job is one for which she has had little preparation.

Perhaps, in spite of her feelings of uncertainty, she is determined not to lean on her own mother, from whom she has managed to liberate herself. Nevertheless, her intellectual desire for independence is in conflict with her emotional longing for support and protection in this new situation.

Mother needs self-reliance

If she is to be a mother that her child can trust, she must learn to trust herself; but her many fears, often increased by stories she has heard and articles she has read, give her no freedom to use her instinctive feelings of protectiveness, of "mothering." Instead, she often tries to bury these feelings and to follow her intellect rather than her instinct.

And how does the medical profession help her to meet her problem?

A fairly high percentage of mothersto-be receive excellent medical care during pregnancy, but they seldom are prepared for the task of motherhood in any way that concerns itself with their feelings about it. They are not given much opportunity to discuss even the practical aspects, such as where to put the baby's crib-in the cold bedroom where it can be isolated or in the hot living room in which gather family and friends. Or whether to hire a practical nurse to care for the baby for a few weeks, or a houseworker who can cook and clean. And how much it will cost

to keep the baby after he arrives.

These are all things that may influ ence the environment of the first months of a baby's life, but even more important are the emotional problems that the young mother may be trying to solve alone or with very inadequate help.

Perhaps she feels resentment of pregnancy, or fear of childbirth, or anxiety lest a baby will interfere with the father's rest and comfort and so be a source of trouble between them.

"Suppose the baby isn't perfect” is a question that often haunts the mother. Even "Suppose I find that I don't love it." Or "Suppose it's a girl, when my husband has set his heart on a boy."

The doctor who allows time for the discussion of such worries may not be able to wipe them out, but the very act of putting them into words is often healing when the listener accepts them seriously, and, without scorn or ridicule, helps the mother to face her fears in the light of reality.

Perhaps I am placing too much emphasis on a situation which is the business of the obstetrician rather than of the pediatrician. But one so often meets a young mother who brings her baby for infant care with these very fears unresolved, that this phase of the problem of preparing a well-adjusted mother to care for her baby cannot be ignored.

I must also say a word about the separation of mother and baby during the hospital stay. Certainly there are few who would argue that this is a natural state of affairs. Although not many

selves, often with a minimum of benefit to the individual or consideration of his particular needs. We build up a group of dependent mothers who feel guilty at the least infringement of the rules laid down. We enjoy our power over them while complaining about their demands for advice concerning each little circumstance that may arise, and we groan over the number of spoiled brats we have to deal with.

Gradually, I have come to see the fallacy of the pediatrician's playing the part of the strict parent. I have had my troubles, for many insecure and immature mothers desire domination and even demand it. Fathers, too, have been at times disapproving.

I have become more and more convinced that the happy and contented baby is one whose mother feels free to adjust his schedule, the amount of his food, the hours for his sleep and play,

Pediatricians, like many other people, often find satisfaction in this dominating role. They like to lecture the mother for using her own judgment and breaking some rule they have laid down. Mothers not infrequently use such a phrase as "I'm afraid you'll scold me," when they have only followed common sense in working out their problems. Certainly a mother who feels she must apologize for giving her baby more to eat when he is hungry, or picking him up and rocking him when he is unhappy, is a mother who is filled with distrust of herself and who spreads an atmosphere of insecurity about her.

Our insistence on frequent visits at which the baby is weighed and measured and a new set of rules is handed out is a way in which we satisfy our

servation of the baby's needs. With this increasing assumption of responsibility and freedom to use her own judgment, her skill and wisdom increase; and minor variations in appetite, sleeping habits, or bowel habits do not fill her with consternation.

To encourage mother

I spend more time with the mother at each visit, have a long talk with her before she leaves the hospital when that is possible, and early teach her that if she observes her baby and notices what things make him comfortable and happy, she will soon become the great authority on that baby. No one else will know so much about him, and no one else will be as skilled as she in satisfying his needs.

She is advised to allow him to take the amount of food he seems to want, at the intervals that most conveniently meet the needs of the baby and the household. She is encouraged to enjoy him and to accept the fact that babies don't cry to irritate their parents, but as their only way of expressing their feelings of hunger or loneliness or fear or frustration, so that their need is for comforting, not for punishment.

She is led from the first to respect her child as a human being, whose inner drives are to be guided but not thwarted, whose need for love is as great as his need for food and who should never

and to acquire the customs of the adults. Because of his love and his trust in them, he follows his strong imitative urge and accepts their mores.

He may show occasional healthy signs of rebellion and anger at the limits that are placed on his activities, but not many serious problems of behavior arise for the mother to cope with.

I am glad to find that most pediatricians are discouraging the mother in her attempts at early control of the baby's bowel habits. If one can assure the mother that there is no special virtue in the daily bowel movement, and that many babies are normal in every way in spite of a 2- or 3- or (as I once observed) a 5-day interval between evacuations, a great deal of unnecessary misery can be spared both mother and

the mother of his patient: He should, I believe, offer her a source of strength and reassurance, be a friend to whom she can turn to talk over her problems and whose greater experience and objectiveness will help her to see these problems in their proper light. He is the guardian of both her child's physical and emotional well-being.

She can talk to him of anything from colds to masturbation and expect understanding and sympathy, and he in his turn must avoid the short-cuts of authoritarianism. He must encourage her to acquire the full maturity of her adult role, firmly insisting that she assume the responsibility of parenthood, teaching her to believe in herself, so that her child may find strength and security in her.

Reprints available in about 4 weeks.

MUSEUMS

(Continued from page 118)

ments out of cigar and cheese boxes and other discards.

Art devotees are equally numerous, and art and music go hand in hand in the museum's program. Children paint their responses to music, or to a dance. There are young people in Toledo who have literally grown up in the museum. Directors of the program feel that the seeds of culture sown in the minds of children flower in the life of the whole community.

The day I visited one children's museum I noticed a small boy whose interest in the exhibits seemed particularly keen. His brown eyes sparkled and danced as he darted from one exhibit to another. I learned that he is deaf and dumb. The museum is his greatest source of delight, and the infinite variety of things he can see and touch make up in part for his lack of hearing and speech.

Many museums give special attention to handicapped children. The Indianapolis (Ind.) Children's Museum has materials which can be handled by blind children, with large tags labeled in braille. Convalescent children from the hospitals are often brought to the Boston Museum, and loan boxes take treasures from foreign places to students of Perkins Institution for the Blind. Retarded children receive special attention in a number of children's museums.

How about your city?

Children's museums are not confined to larger cities. The idea is spreading, and many small places are developing museums. They start in various ways and are carried out under various auspices. Jacksonville. Fla., has a live and growing children's museum which developed from a few historical objects donated by a group of public-spirited citizens. It is a humming center of activity on week ends and during holidays. Among its interests are a fix-it shop and a toymaking group. The museum cooperates closely with the schools in science instruction.

Children's museums have an international aspect which is important. Through introducing children to an