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plainly demonstrated that neither district nurses, settlement workers, nor visiting dietitians knew much about the foods of the foreign-born patients. Gallons of American soups, and broths were served to these people, only to be thrown out untouched. This was at a time when diet was an important element in fighting the disease. In our hospitals and dispensaries we usually find only American foods prescribed for diets. Often it has been said, "They should learn to eat American foods if they are to live here." We may not all agree with this, but at least we will agree that when a person is ill and needs a special diet, it is no time to teach him to eat new foods. It is like hitting a fellow when he is down. Our milk soups are nutritious, but so are theirs; why not learn what they are and prescribe them? The same is true of other foods.

It is much easier for the dietitian to learn the foods of the foreign born than for these people to adjust their finances to a new dietary. Often their income is insufficient to buy the foods which they know they like. Can we wonder that they hesitate to invest in food about which they are uncertain?

A Bohemian family of father, mother, and six children, who were patients at a dispensary, were living (or staying) here on an income of twelve to sixteen dollars a week. It was necessary to get milk and cereals into the diet of the children, but who, without a knowledge of Bohemian foods, dare disturb that very limited amount which could be spent for food?

Mrs. Angelo's husband is a printer, who earns seventeen dollars a week. They have seven children,

the oldest a boy of eleven. Barbara, five years old, was very bowlegged and had to have her legs broken to straighten them. Three younger children were sent to a dispensary food clinic for diet to prevent their being bowlegged. It was necessary to have not less than two and one half quarts of milk added to their food each day. The income was too small to allow this, so the man got night work to pay for the milk. This shows that they were willing to go at least halfway in changing diet habits.

The derangement of the hereditary diet often presses hard on the children. Although the immigrant mother is accustomed to breast feeding her babies, often nourishing them thus long after the usual period, early in life the child is given other food, too often from the family table. The beneficial effects of breast feeding, therefore, in reducing infant mortality, are often counteracted after the first few months of life by unwise additions to the child's diet. The unwisdom of these is often explained by the immigrant's dietary backgrounds. Much instruction for American health workers lies in this true story, told by the nurse in a certain clinic. A sick baby had been brought in for treatment. Bad diet was evidently the trouble.

"What do you give the baby?” asked the nurse through an interpreter.

"What we have ourselves," was the reply.

"But why should you do that to a little baby?" chided the nurse.

"I always did that in our own country with my other children before we came here."

"But what did you give your children in the old country that you had yourselves?"

[graphic]

IN EUROPE THE MILK SUPPLY WAS IN THE FRONT YARD

"Soup and buttermilk," answered the mother, smiling, apparently at the pleasant recollection of those days. "What do you give your child now that you have yourselves?"

"Beer and coffee."

ONE QUART

ES

IN AMERICA MILK FROM A DISTANCE MAKES NEW

REQUIREMENTS

The changed relation of the immigrant family to the milk supply is of great importance for the maternity and child-welfare worker. A nurse finds, for instance, an Italian mother giving her child no milk;

or a baby sick from impure milk; or again, youngsters of five or seven years of age getting along with no milk, or only a tiny bit of it in their diet.

In her native land this Italian woman probably went out of doors, chased the goat, milked it, and gave her child to drink. The milk was comparatively clean and too fresh to be contaminated by the growth of bacteria. Then this woman comes to America; she has to buy milk, and it seems to cost a great deal. It has been a drink to her, and its food value is not appreciated. It seems astonishing to have to pay out a large sum of money for merely something to drink, something, furthermore, which the adults of the family-particularly the man-are likely to care very little about. In other countries, like Russia and Poland, they "live on the cow." Milk usually costs nothing in cash, only labor.

From immigrants with these backgrounds it is unreasonable to expect a sufficient and wise use of milk, which must be purchased and cared for under city, or even town conditions, in the United States, unless there is built up a wholly new attitude of mind and of family habits in regard to it.

There are certain diseases prevalent among the foreign born which are connected with their change of diet. If this is corrected it may overcome the disease. In adapting diets, the conditions and dietary habits of the people in their own country, as well as their food problems here, must be considered. We shall make special reference to some diseases in which diet is a factor and which are most frequently noted by physicians, nurses, and social workers. Fortunately it is possible to make foreign recipes from our

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