At infant welfare centres infants are not infrequently seen who fail to make progress while living at home, and who yet are not ill enough to be sent to a hospital. This especially applies to cases of defective nutrition. For these cases beds in connection with centres have been found to be necessary for observation purposes and to initiate further treatment. In some instances, especially for failure of breast-feeding, it is advisable to admit the mother with the infant. On July 30, 1914, the Local Government Board sent a circular letter and a covering memorandum by their Medical Officer which may be claimed to have been the starting point of maternity and child welfare work on a larger scale, more generally distributed throughout the country, and more completely covering the whole sphere of medical and hygienic work for this purpose than had previously been envisaged. Although the country at that time might be said to be already under the shadow of war, these documents had been previously prepared, and their appearance four days before the declaration of war was a coincidence. The chief burden of the additional work to which local authorities were urged was that there should be _continuity in dealing with the whole period from before birth until the time when the child is entered upon a school register_; and the memorandum contemplated that “medical advice and, where necessary, treatment should be continuously and systematically available for expectant mothers and for children till they are entered on a school register, and that arrangements should be made for home visitation throughout this period.” It was added that “the work of home visitation is one to which the Board attach very great importance and in promoting schemes laid down in the accompanying memorandum the first step should be the appointment of an adequate staff of health visitors.” The main provisions of this memorandum are printed on page 135. The increase of work since that date may be gathered from the following table, which shows the increase each year in the number of health visitors, of child welfare centres, and of grants given on the 50 per cent. basis by the Local Government Board and the Board of Education. _Amounts of Grants (pounds sterling) in Each Financial Year to Local Authorities and Voluntary Agencies, on the Basis of 50 Per Cent. of Total Approved Local Expenditure_ Financial Year Local Government Board Board of Education 1914-15 11,488 10,830 1915-16 41,466 15,334 1916-17 67,961 19,023 1917-18 122,285 24,110 1918-19 (estimated) 209,000 44,000 These grants do not cover the entire scope of child welfare work carried out throughout the country, and their amount must not be taken as a complete indication of the extent of this work.