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nurses were receiving no fresh milk to drink at all; and in New Orleans the study revealed that children were getting even less milk than the children of Baltimore and Washington.

National attention has been drawn to the subject of food, and especially to its relation to the nutrition of children, by the increase in the price of the essential foodstuffs such as milk. The fundamental factors in child welfare other than food are less well understood, and it is most important to secure and to popularize this essential knowledge.

In fact little headway has been made in ascertaining what are the irreducible minimum developmental requirements of a growing child. There have been, as far as we know, no intensive studies or surveys to ascertain what a child ought to have in order to be reared properly

Considering the general marked advance in the price of food, clothing, and other items in the family expenditure and the possibility that the high cost of living may endanger the health of the growing child, if economies are made in the food, clothing, and other commodities used by him, intensive and general surveys should be made at this time to ascertain the irreducible minimum requirements of a growing child, and how their attainment is being affected by high prices.

Such studies of actual living conditions require a considerable period of time. They should be made by trained investigators with the aid of nutrition experts and should be interpreted into practical terms for the use of the average mother. They must be related to actual living conditions within the household and to outside conditions such as climate, situation, size of community, available home products, and accessible markets.

The timeliness of such investigations is apparent to any one interested in child welfare, and it is apparent that these aspects of the problem must be studied if the standards indorsed by the bureau are to become effective.

Some of the obvious and immediate requirements are studies of localities where the welfare of children is markedly low, or where we are uninformed as to conditions—the areas of rural child labor; the possessions outside continental United States.

PROGRAM OF CHILDREN'S-YEAR FOLLOW UP. Throughout almost the entire country there is an obvious need of the continuance of certain activities which may be said to constitute a Children's-Year

Children's-Year follow-up program. The following measures are important:

1. Better birth registration. The year has shown afresh the value to the child of prompt public record of birth. Twenty States now keep records good enough to receive the sanction of the Census Bureau, and, hence, to be included in the birth-registration area. They are Connecticut, Indiana, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Hampshire, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Utah, Vermont, Virginia, Washington, Wisconsin. Twenty-eight States are not so recognized. They are Alabama, Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Idaho, Illinois, Iowa, Louisiana, Mississippi, Missouri, Montana, Nebraska, Nevada, New Jersey, New Mexico, North Dakota, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, West Virginia, Wyoming. Vigorous effort for one year would place all the States in the recognized list of the Census Bureau.

The Children's Bureau has prepared a simple test plan which can be used in any community in which there is a good law but where, because of nonenforcement, the State is not in the birthregistration area. In other States campaigns for adequate legislation should be waged. 2. Establishment of health stations. (a) Prenatal and infant-welfare stations for keeping mothers

and babies well and for securing proper care.? (6) Well-children stations for children of preschool age.

These are natural developments from infant-welfare stations and may be conducted with them or inde

pendently. 3. Protection of health and development of school children by weighing and measuring tests, open-air classes, nutritional clinics, and other measures.3

4. Protection of children from illiteracy and premature work by Back-to-School and Stay-in-School campaigns.*

5. Public provision for wholesome play and recreation, under trained leadership, and supervision of commercial amusements."

6. Continued study by each community of local needs and local resources, as related to the care of handicapped children, and the endeavor to bring the care of these children in line with the standards which have been found practicable in this field.

7. Study of present laws and local needs in order to effect necessary revision of existing laws and to further new legislation for the care and protection of children.?

8. Study of the standards adopted by the 1919 Child Welfare Conferences. These standards set forth the careful judgment of many experienced persons. Certain of these standards have been already attained in various communities; others are attainable by the expression of public opinion; others will require legal enactments. Study of local needs and present laws should precede, of course, any effort for new legislation.?

JULIA C. LATHROP, Chief. Hon. W. B. Wilsox,

Secretary of Labor.

1 See Bureau Publication No. 54, An Outline for a Birth Registration Test.

? For description of methods of conducting, see Bureau Publication No. 45, Children's Health Centers.

3 See Bureau Publication No. 60, Standards of Child Welfare, p. 228, “Nutrition Clinics," by Dr. William R. P. Emerson.

* See Bureau Publications Nos. 49, 50, 51, 53, 55, 56 on the Back-to-School and Stay-inSchool campaigns.

5 See Bureau Publication No. 44. Patriotic Play Week.

& See Bureau Publication No. 60, Standards of Child Welfare, Section IV, “ Children in Need of Special Care."

. See Bureau Publication No. 60, Standards of Child Welfare.








Washington, July 1, 1919. Sir: As was stated in the last annual report of the operations of the bureau, it is again indispensable, both from the point of view of what has thus far been accomplished and from the requirements for the coming year, to give due weight to the effects upon the service of the great war. This is true not only in regard to the naturalization of soldiers and sailors but also with respect to the change in the attitude of the public mind toward the subject of the naturalization of aliens in civil life. Without going into an enumeration of the various causes which produced such a change, it is sufficient to refer to the fact that, both on the part of the citizens of this country and on the part of alien residents, there has resulted from actual war conditions the conviction that a large alien population constitutes an element of insecurity to the peace and order of civil society and that it is to the interest of those alien friends who have established permanent residence here to assume the obligations and duties as well as to enjoy the privileges and protection of American institutions.

In the light of experience during these recent years of stress, it can not be denied that a public opinion has been formed that perhaps we have exceeded a safe and reasonable limit in our boasted policy of furnishing an asylum to the oppressed of other nations. This finds expression in numerous and occasionally sincere plans for the restriction of immigration, and even in proposals to condition permanent residence in the United States upon the assumption of citizenship within a reasonable time after arrival. Whatever may be the practical value, or otherwise, of such plans, the arousing of public opinion, as disclosed by numerous activities for the Americanization of the great numbers of aliens already admitted, indicates a general widespread sense among the American people that the most immediate and pressing problem is to deal effectively with the “stranger within our gates" now. Even the most superficial thinker sees now that such effective dealing is not a more or less chance conferring of certificates of naturalization. It has come to imply much more. The public realizes at last that no mere “scrap of paper," however ornamented with impressive seals, can transform an alien at heart into an American citizen, zealous and loyal under all conditions to the country of his formal adoption. The bureau had marked this point of view long before the great war began and before it had even entered the public imagination as a probable or even possible event, and under the authority of the present administration of the Department of Labor had inaugurated, with every assurance of success, its system of stimulating the common-school au

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