A.—4a.

The following table compares averages in Western Samoa with averages in New Zealand and the United States :—

Averages for New Zealand are taken from charts in Sir F. Truby King's " Feeding and Care of Baby." Averages in Western Samoa were compiled from 274 to 357 cases in the Apia-Falefa district. The figures for the United States are composite of figures compiled by Holt from several hundred hospital and private cases in New York, several thousand cases compiled from twenty-three States by the American Medical Association, the Life Extension Institute, and. Better Babies Bureau of the Woman's Home Companion. Improper Feeding. At the age of six months the Samoan mother begins to wean her baby. Cow's milk is not available in Western Samoa ; dried milks and patent baby-foods for the average mother are unobtainable ; so the mother turns to native foods as substitutes. Boiled green bananas, baked taro, and ripe bananas are masticated by the mother, then fed to the baby. The marked change in the diet is forced upon the child before its digestive organs are used to the new way of feeding. Without proper substitutes for the mother's milk weaning-time is especially perilous in Western Samoa. The evils of improper feeding at this period of the baby's life are reflected in the vital statistics and in the average weights of the babies as worked out in the clinics. Malnutrition during this period has caused Samoan babies to average from 1 lb. to 4 lb. under weight as compared with European babies, whereas during the first six months the records show that they are from \ lb. to 1 lb. over weight. By far the largest number of infants die at this period. In 1924 and 1925 the percentages of deaths at ages under two years were as follows : —

Red Cross Supplies. During the year 1926 a shipment of dried milk for child-welfare work was received from the New Zealand Red Cross. Four cases were allotted to the Apia-Falefa district, and the worst cases of malnutrition were placed on the prepared food after all efforts to find other supplies of food failed. In at least a dozen cases it is believed that the prepared food has saved the babies so far. These babies are now gaining weight. Probably all would have died if food had not been given by the New Zealand Red Cross. In order to do the utmost good the prepared food is issued only to the most deserving cases under strict supervision. An adequate supply should be on hand to carry the infant through until stich time as it can live on other foods. There is little object in saving a baby's life for two or three months and then withdrawing its Red Cross food before it can live on the native foods. Native Foods. One of the greatest problems is the finding of proper native foods for the infant. The Samoans in the past have not owned milch-cows. Among the substitutes for milk during weaning, baked and boiled papaya, soft jelly-like meat of young coconuts, arrowroot with coconut-cream, rice-water, and boiled rice with coconut-cream are recommended. Later on eggs, fish, and scraped taro and yams, well baked or boiled, are used.

20

| New Zealand J United States j Western Samoa 8 e- Average. j Average. , Average. Ib. oz. lb. oz. lb. oz. lb. oz. One week .. .. .. •• 7 0 68 to 78 7 10-6 One month .. .. .. • • 8 12 7 13 to 8 13 9 2-4 Two months .. .. .. .. 10 8 8 9 to 10 9 10 15*3 Three months .. .. .. .. 12 8 12 0 13 5-5 Six months .. .. .. .. 16 0 16 0 17 2-2 Nine months .. .. .. .. 18 0 17 8 to 20 0 18 14 - 0 Twelve months .. .. . . .. 20 0 20 8 to 22 0 19 10-3 Eighteen months.. .. .. .. •• 21 2-0 Twenty-four months .. .. .. • • 26 8 to 27 8 23 7-1 I

1924. 1925. 1926. Aitr I I I ® ' | Per Cent. | Per Cent. j Per Cent. Number. | of Total Number. | of Total Number, i of Total Deaths. I Deaths. ! Deaths. Under 1 week .. .. . . 34 4-44 50 5-63 31 4-29 From 1 week to 1 month .. 25 3-26 36 4-20 22 3-04 From 1 month to 3 months .. 28 3-66 51 5-95 14 1-92 From 3 months to 6 months .. 44 5-74 100 11-67 37 5-12 From 6 months to 12 months .. 164 21-41 142 16-57 104 14-39 From 1 year to 2 years .. .. 99 12-93 97 11-32 93 12-86 394 51-44 476 55-34 301 41-63 I