Читать книгу Governing Bodies - Rachel Louise Moran - Страница 9

CHAPTER 1

The Advisory State World War I Made: Scientific Nutrition and Scientific Mothering

Dr. Wilbur Olin Atwater was best known for his calorimeter tests—dietary experiments in which he kept graduate students in sealed chambers while they burned up energy performing various tasks. He then measured the energy they exerted with an aim of understanding the physiology of calorie expenditure. Atwater ultimately dispensed dietary advice based loosely on these findings. In an 1888 treatise on nutrition science, this man sometimes described as the “father of American nutrition” expressed a paternalistic concern over women’s food-shopping habits. “The good wife and mother does not understand about protein and potential energy,” he wrote. Nor did she understand “the connection between the nutritive value of food and the price she pays for it.” Atwater believed that improving American diets required his scientific approach. Once this nutrition science spread, once it was available to doctors, public health workers, and settlement house professionals, Atwater argued, it would become the new American way of nutrition.¹ Atwater’s research was the vehicle through which concerns over American strength, vigor, and vitality began to receive direct federal research attention and funding. This federal attention, well positioned amid Progressive Era attention to health and better living through science, marked the growth of the modern advisory state.

Economic, racial, and national divisions produced anxiety in late nineteenth-century America, especially for the middle to upper classes. The Plessy v. Ferguson case codified racial segregation. European immigrants worked twelve-hour days in dirty, dangerous northern factories.² In response to a society that seemed out of control—and poised to erupt at any moment—a number of Americans sought to reorganize the nation in ways that promised to reestablish order.³ Against big banks and big railroads, against monopolies and trusts, against rampant political corruption, a middle class sought to respond to these end-of-century social problems through expertise and scientific management.⁴ Food reformers most famously embraced pure food and drug standards and meat inspections in this era.⁵ In fact, reformers interested in dietary management positioned themselves as central to this larger Progressive agenda.⁶

Wilbur Atwater and his Progressive-minded supporters pushed for food reform that went far beyond safer foodstuffs for the middle classes. Instead, they argued that scientific nutrition could help immigrants Americanize, ease the problems of the working poor, and prepare the nation for continued industrial progress. This approach reverberated loudly for Progressives. Nutrition education promised a “sound and economical basis” for human health.⁷ Atwater, for instance, referred to dietary plans as the “pecuniary economy” of food.⁸ Women—wives, mothers, and household managers—stood at the forefront of everyday American decisions about nutrition. Progressive nutritionists, through the wives and mothers of laborers in particular, held the key to industrial progress by using home economics to literally strengthen the nation’s men. Through scientific nutrition, activists like Atwater and his supporters hoped the workingman’s wife might improve American physique. In the process, Atwater, home economists, and the later federal agencies who sought to assess these women’s progress, all suggested that women had the responsibility of ensuring male labor power through educated consumer choice. The Progressive nutrition agenda included this understanding of familial responsibility for a manageable and malleable human body, alongside the belief that such responsibility required scientific education and training rather than intuition or tradition. Proper discipline would make an ideal citizen inside and out. Less-than-ideal bodies, by extension, must be the product of ignorance or bad choices.

The emphasis on advising women on nutrition, and then expecting their compliance, played a key role in shaping women’s Progressive reform work. Then the emerging public health work of middle-class female reformers fueled a 1910s and 1920s effort to improve a new generation of workers by focusing on children’s bodies. The Children’s Bureau’s voluntary networks reshaped the public discourse around child health and physique through height-weight measurements, maternal education, and conferences and other events. These women’s adaptations of scientific nutrition and public health measures offered a subtler approach than contemporaneous eugenics efforts. They placed responsibility for children’s health—typically quantified as appropriate weight and height—on mothers rather than genetic inheritance. The reform projects also avoided most controversy by emphasizing maternal approaches to distinguish themselves from medical projects, and by relying heavily on the use of quantification and standards that promised an objective approach to health concerns.

Calorie counts and dietary studies in the 1890s and 1900s, and child weighing and measuring efforts in the 1910s and 1920s, all offered neatly scientific, quantified methods of addressing otherwise overwhelming social problems. Notably, it was at the height of the Great War when American male strength seemed most embattled, that federal nutrition experts moved from the laboratory setting into the health clinic setting. World War I provided an opportunity for reformers to expand federal advisory state body projects. The advisory state of American physique was built in late nineteenth-century nutrition research, and then deployed in World War I–era child health programs. The World War I and post–World War I state enlisted women’s labor and allegiance without apparent federal overreach to construct a narrative of individual responsibility around food choices being beneficial to the civic whole.

Wilbur Atwater and Scientific Nutrition

Chemist Wilbur Atwater, inspired by a few years of study abroad, pursued federal funding for his research on which U.S. agricultural feeds were most effective.⁹ Federal government money for nutrition research was new, but money for agricultural research dated back to land grant institutions and the Morrill Acts of 1862, making the transition possible. In the early 1870s, he helped found the first federally funded Agricultural Experiment Station in the country in Middletown, Connecticut.¹⁰ Then, in 1877, an opportunity from the United States Commission of Fisheries pushed the professor’s study from the food composition of animal feed to the food composition of animals themselves. For the next three years, Atwater and his students analyzed fish that might be part of a typical American diet. These “human feed” studies made his name. The study shifted Atwater’s interest in the composition of animal feed toward work on the composition of food eaten by humans. After determining the amount of crude protein, ash, and carbohydrates in each of these fish, Atwater began to direct experiments on a diversity of human-consumed foods. By 1879 he had analyzed the composition of 1,300 foods.¹¹ Following the influence of human nutrition studies across the Atlantic, Atwater also became absorbed in research on calories. European calorie studies emerged from projects that attempted to understand the human body, especially to understand how it compared to other machines. As American and European physiologists of the late nineteenth and early twentieth century began to analogize the human body to a machine, a system of interlocking parts, they also came to understand the body as something improvable. Like other technologies of the moment, a human-machine could be assessed and managed piece by piece.¹² As German and French chemists tried to rationalize the human body in the late nineteenth century, they conceived of it as a study of labor input and output. The laboring body was a machine, and food calories provided an authoritative, quantitative, way of evaluating human physiology. Research in the late 1850s and through the 1860s tried to understand calorie-use in terms of the heat produced by the laboring body, just as well as its energy output, evaluating how the human body stood up to the laws of thermodynamics. American research only caught up to European nutrition research through Atwater, who built the first domestic respiration calorimeter in 1896.¹³ The device measured research subjects’ intake of food and output of heat. At the core of this research was the project of evaluating the body through laboratory means, assessing input and output, and imagining an ideal management of the human body under carefully calculated rules.¹⁴

For Atwater, understanding consumption through a unit like the calorie offered a way of making sense of how food composition related to energy and physique. It offered a simplifying language.¹⁵ Atwater contributed the concept of Atwater Units—now usually called macronutrient ratios—to the study of calories. The general idea of Atwater Units was that one gram of fat contained nine calories, one gram of protein contained four calories, and one gram of carbohydrates contained four calories. This idea, still central to contemporary nutrition, allowed Atwater to use the research subjects and studies available not only to understand laboring men’s basic caloric needs, but also how the composition of foods affected laborers’ energy and strength. It allowed scientists to “rationalize quality.”¹⁶ It was one substantial step beyond simply counting calories to decide what foods one should consume for optimal energy.

Atwater’s ideas were developed in a moment when the quantification of wellness was the gold standard. He also contributed to that moment. Atwater believed that the working-class “good wife and mother” needed a translated and simplified version of this emerging gospel of scientific nutrition. In the years leading up to the development of the calorimeter, he was primarily concerned about the poorest American families, with a special interest in the families of factory workers and laborers. It was working men who needed the most calories and protein to get through the workday, according to Atwater’s research on how the body-as-machine used its fuel. Yet it was, Atwater explained, “the poor man’s food that is the worst cooked and served at home.”¹⁷ Atwater argued that women’s faulty understanding of nutrition was part of the reason American laborers had tight food budgets, and that their reeducation was necessary for progress.

The chemist explained that the poorest women often insisted on purchasing the most expensive groceries, presumably because they believed that a high cost indicated high value. Atwater recounted the complaints of a butcher who observed that working-class women chose expensive tenderloin over cheaper round or sirloin cuts of beef. While the tenderloin was pricier, the butcher insisted that the sirloin would do just as good a job of feeding a family. The butcher complained specifically about one seamstress who indignantly asked, “Do you suppose because I don’t come here in my carriage I don’t want just as good meat as rich folks have?”¹⁸

Choosing food based on taste, pride, or misinformation, Atwater thought, was an epidemic in America.¹⁹ He dismissed the complexity and labor involved in navigating the marketplace.²⁰ Women, especially immigrant women, were widely understood as poor consumers by the new consumer sciences. Progressives often characterized the female consumer as emotional and easy to persuade or trick.²¹ Supposedly, the dawn of a new nutrition would replace the irrational behavior of women with rational consumer behavior. Atwater’s pecuniary economy of food never considered female labor, and he implicitly calculated working-class women’s time and effort as zero cost. Any unwillingness to put in the labor was evidence that these women were poor consumers and homemakers.

Meanwhile, Atwater’s food plans mostly ignored women’s own nutritional needs. Atwater used “a man at moderate muscular work” as a physiological norm, the basis of his nutrition math.²² Then Atwater determined the nutritional needs of that laboring man’s family through rough estimates. A thirteen-year-old boy counted as 80 percent of “a man at moderate muscular work.” A twelve-year-old girl was considered 60 percent of “a man at moderate muscular work.”²³ This data on caloric needs and macronutrient needs (how much protein, fat, and carbohydrate each man needed) became the basis of new food plans designed for the poor and working class. Atwater and the emerging field of home economics calculated the entire family’s nutritional needs based on their fractional relationship to an employed and able-bodied patriarch.

Ellen Swallow Richards, the “mother of American home economics,” and Democratic politician Edward Atkinson had no qualms about these calculations. Instead, they extensively promoted the practical application of Atwater’s research, especially the development of family food plans.²⁴ Atwater himself lost interest in research applications over time, but Progressive reformers continued to make use of his work.²⁵ Scientific nutrition offered the pleasing promise of rational actors and utopian results: if precise amounts of calories and nutrients might be cheaply and efficiently parceled out, everyone could be well-fed, everyone could work hard, and there would be no waste in the process. It was a Progressive Era reformer’s dream. Atkinson imagined that this approach to nutrition would teach working-class Americans to embrace cheaper meats, soups, stews, and flours, which they supposedly avoided out of “false pride of show.”²⁶ Scientific nutrition seemed an essential tool for social management. Richards wrote that “it is … not too much to say that women are the stumbling blocks in the way of higher industrial, social, and ethical progress.”²⁷ She believed guidance on calories and macronutrients would help them toward that progress. Atwater’s nutrition science had the potential to help women take the so-called rational costs of food to heart, to transform the supposedly superstitious immigrant into the imagined rational American consumer. It also had the potential to hold workers and their families responsible for their own poverty at an intimate, even biological level.

Atwater’s first major Department of Agriculture publication, the 1894 booklet called Foods: Nutritive Value and Cost, was critical in developing a quantification of nutrition useful to practitioners and laboratory researchers. The body was like a steam engine, Atwater wrote, except the body’s fuel was food.²⁸ There were many ways to adequately fuel the human body, then, and with careful management that body could be fueled on the cheap. In the 1902 revision, Atwater explicitly took women to task for not managing food budgets appropriately. Too often women obtain food by overpaying at the market, he wrote, “rather than by skillful cooking and tasteful serving at home.”²⁹ Around this time, Atwater also released tables on the chemical composition of foods, which remained the primary government publication on food composition for decades after his death.³⁰ In the subsequent years, the Department of Agriculture received requests for food composition charts from sources as diverse as U.S. senators, Better Baby Contests, the U.S. Army, and Cosmopolitan Magazine.³¹ These were the first federal publications on human nutrition designed for public readership.³²

Atwater’s vision of a rationally managed, scientific society fit well with the Progressive impulse. His food economy provided more efficient ways of feeding poor Americans. More importantly, it offered stern advice and persuasive instruction for poor women. Educating married women about scientific nutrition could mean more vigorous male workers. It might also mean that these men and their families could be kept vigorous without an increase in wages. As with much Progressive thought, scientific nutrition offered solutions to social problems without disrupting existing power structures.

From Department of Agriculture home economists to private settlement houses, American nutritional input was increasingly manageable. This became more important as the United States entered World War I. In the war context, this nutrition management transformed from reform work with some federal funding to the actual advisory work of the federal government. As this work became more centralized and larger in scale, it also instigated a shift toward conflating the input of nutrition with the apparent product of that input—the size and shape of the citizen body. Atwater’s research helped build the quantitative apparatus of the weight-oriented advisory state. In World War I, the labor of mothers and teachers would mainstream that apparatus.

Mother’s Work and Children’s Bodies

Scientific nutrition came with a political agenda. By focusing on quantified food composition, Atwater pushed the idea of nutritional equivalency. This meant that cheap cuts of meat could be nutritionally equivalent to more expensive ones, and stale bread just as full of needed calories and carbohydrates as bread fresh from the oven. As a result, the onus of nutritional health was firmly on the private realm. Wages did not need to be raised; food prices did not need to be regulated: the health and efficiency of American labor was in its own wives’ and mothers’ hands. Individual responsibility, not welfare state building or labor laws, was the adjustment Atwater’s research justified.

Both Atwater’s nutrition science and his politics directly influenced prominent home economists of the Progressive Era, members of the “dominion in reform” at the time. Early home economics activists, like Ellen Richards, worked directly with Atwater. Another generation, including prominent nutritionist Caroline Hunt, learned nutrition science by working under him. Other nutritionists, including his daughter Helen Atwater, based assumptions of their own research and writing on the senior Atwater’s publications.³³

The dominion of female reform, often discussed in the Progressive Era, included women’s hands-on reform work, as historians have established, as well as the unrecognized work of the advisory state. Women doing this work sometimes moved from nongovernmental positions into the growing state apparatus of the early twentieth century. Home economists funneled into local and national government with the 1915 founding of the federal Office of Home Economics.³⁴ There, they worked toward changing American nutrition habits. Around the same time (1912), women entered the new federal Children’s Bureau. Influenced by nutrition science—but also not bound by it—women of the Children’s Bureau sought ways to optimize child health through promoting hands-on, proactive mothering.

Employees of the Children’s Bureau shared the general concerns of Atwater, Atkinson, and Richards. They all sought Progressive reforms and had overlapping networks. The Children’s Bureau emerged from the Settlement House Movement. Atwater had conducted studies on the children of Hull House, the same settlement house where Children’s Bureau Chief Julia Lathrop had started out. In this era of maternalist activism, a women’s reform network allowed middle-class women into politics so long as they centered their efforts on gender-specific reforms like those affecting children.³⁵ Progressive Era women, acting as mothers of society, carved a niche for themselves first in voluntary work, eventually catapulting themselves into local, state, and federal government through efforts like the Children’s Bureau.

All parties worked within a Progressive Era framework of chemistry and social science, of expertise for a higher good, and of a belief in managing and controlling the country through quantification. The Children’s Bureau embraced quantification as a means for improving the body, as other Progressives had done. Nutrition science supplied a language to bring the citizen body into the realm of policy, a language that made the individual body’s weight and size manageable on a larger scale. Instead of calories, though, the Children’s Bureau would champion height and weight measurement as the path to a stronger nation.³⁶

At its 1912 creation, the Children’s Bureau was charged with very specific tasks. It was to investigate and report on child health and welfare. Its staff was to collect statistics, perform studies, and publish their findings. The bureau would gain moderate authority in the area of child labor by the late 1910s. In the terrain of children’s health and bodies, however, it only encouraged women to undertake its health proposals. The Children’s Bureau was not supposed to involve itself in the medical aspects of health, including anything that had to do with disease or illness. That was the fiercely guarded territory of the growing American Medical Association and the U.S. Public Health Service. Barred from the world of disease, illness, and medicine, the bureau’s campaigns relied on the quantitative language of height and weight as a stand-in for health.

Julia Lathrop and the Children’s Bureau focused on the women’s space of government–advisory state work. The bureau used the voluntary labor of mothers, teachers, and nurses across the country in its health measures.³⁷ They maintained influence with strict limits as to which aspects of human health and wellness were within the bureau’s jurisdiction. The bureau addressed this problem through the adoption of height-weight tables. In turning the ambiguous concept of health into quantified, definitive, and expert height-weight tables, the bureau both broadened the scope of what concerns it could legitimately address and made it easier for nonexperts to voluntarily do the work of the bureau.

The Children’s Bureau’s advisory health projects were pioneering state interventions into the health and bodies of Americans. The bureau built networks of volunteers and reshaped the public discourse around child health and physique. It used maternal education, the voluntary labor of women, and Atwater-esque quantification of the body for events like child health conferences, Baby Week, and Children’s Year. As Grace Abbott, Lathrop’s successor at the bureau, later explained, they “furnished the facts on which action was frequently based.”³⁸ With advertising and some cajoling, the bureau convinced middle-class mothers to show up at bureau events. Participation in such events was, of course, not a legal obligation, but it was a gendered social obligation. As such, participating in child health conferences and events became the women’s work of government.

Julia Lathrop, the settlement house and juvenile justice reformer turned bureau chief, wanted to understand the ills facing American children. At the turn of the century, these were many. The 1910 census revealed that over 150,000 American infants died each year. Lathrop believed the census number, which left out many immigrant and poor urban citizens, was a severe undercount of the infant mortality problem. She estimated that 300,000 American infants and toddlers died every year.³⁹ More disturbing was that half of these deaths might have been avoided with modest child hygiene measures. For reformers like Lathrop, such measures included what they viewed as proper child nutrition, breastfeeding, cleanliness, and visits to physicians. According to Lathrop, child mortality rates could be solved “with methods which are in the reach of every community.”⁴⁰ The women of the Children’s Bureau, most of whom had come to government by way of reform work, focused on urban immigrants living in broken-down tenements and rural women raising children in poverty. The bureau became especially focused on the health of these children.⁴¹

The bureau’s staff presented their ideas for improving child development to mothers and teachers with the expectation that these caregivers would opt to follow through on their suggestions. The bureau relied on the efforts of existing voluntary and professional networks of women, and attempted to shape local groups’ and individual women’s child health practices. The bureau itself could not require that this research, or any of the bureau’s goals for child health and hygiene, be implemented. Instead, it succeeded in getting women’s groups, teachers, and other local groups to fund and disseminate advisory policy. Using these tools of the advisory state—child health conferences, Baby Week, and the Children’s Year—the bureau reached hundreds of thousands of American families in the 1910s and early 1920s.⁴²

Quantification in the Advisory State

As the bureau set out to reach women, it needed otherwise untrained women to become authoritative figures on health and wellness in their local communities. It was necessary to do this quickly, and to do it convincingly. This would require a shortcut of some sort, since the bureau was in no position to send the thousands of women who would lead local community health projects to medical school. The bureau also needed a way to raise the credibility and authority of this army of (mainly) nonexpert women who would do the bureau’s work of managing child health in cities and towns around the nation. These nonexpert women might seem suspect in a country increasingly obsessed with professionalism and expertise.⁴³ Finally, the bureau had to address health issues without upsetting territorial groups like the American Medical Association and the Public Health Service. All understood the woman-run Children’s Bureau as a gendered helping agency, not a medical one.⁴⁴ Whenever the bureau crossed over the line and became too hands-on or was otherwise a threat to more established health and medical organizations, these organizations became vocal critics of the bureau.

Not unlike Atwater’s hope that calorie charts could simplify human nutrition, the Children’s Bureau came to rely on measuring children as a way of simplifying discussions of child health. Height-weight tables became a favorite tool of the bureau. The use of tables greatly simplified the idea of health for both the bureau designing health programs and those who were charged with implementing them. Charts suggested expertise and authority, but were still lay tools that did not encroach on medical territory.

The advisory projects of the Children’s Bureau were enabled through the broad use of quantification and the promotion of physical standards. Height-weight tables were designed to allow a quick evaluation of physique based on the ratio of one’s height to one’s weight. Some described them as “slide rules” of nutrition.⁴⁵ Dr. Thomas Wood’s height-weight tables provide an example of how these charts worked. The chart includes one axis for heights and another for boys’ ages. In the Wood chart, a mother might evaluate her 64-inch (5′ 4″) boy. On the left, she locates the 64-inch mark. She drags her finger horizontally across the chart, stopping her finger when it is below the boy’s age. If her boy is thirteen years old, then, he might weigh 115 pounds. That would be average. Some list average height and weight, others list so-called ideal height and weight combinations. In the early twentieth century the average and ideal statistics were often handled the same way. When a mother or teacher compared a child’s weight with its height using one of these tables, she generally hoped to find that the child was of average build. If the mother in the example just given found that her boy weighed more or less than the 115-pound average, then she would know he was above or below the average. In another decade, height-weight charts would begin replacing the single number (the 115 pounds) with a range of weights one might aim for. The charts of the 1910s and 1920s, however, were built on the understanding that a single number could indicate what all boys or girls of a certain age should weigh.⁴⁶

With this knowledge, clear quantitative evidence that her son was too small (or, less frequently in these decades, too large), a mother could remedy the situation. With a tape measure in one hand and the Thomas Wood chart in the other, the mother was now responsible both for the boy’s present physique and for improving it. This was the power of height-weight tables. They were simple columns of numbers that induced action by the women using them. The numbers looked objective and authoritative. The average weight allowed for each height and age left no room for error. It produced two categories of people: those with average or normal physique and those with above or below average—now defined as abnormal—physique. Although the average weight was not statistically correlated with ideal health, in practical use the average weight was used as the ideal weight on charts of the 1910s and 1920s.⁴⁷

The Children’s Bureau used these tables both to assess and to promote child health. The bureau adopted tables that were a mixture of Thomas Wood’s and those of another child health researcher, Bird T. Baldwin.⁴⁸ Baldwin’s tables focused on children under six years of age, while Wood’s focused on children and teens between six and adulthood. The Children’s Bureau adopted the unified Baldwin-Wood tables through the 1910s. The bureau would go on to use these tables in its publications and as promotion for its child health events. For the bureau, charts provided a simple way of assessing health. If a child was two or more pounds below the average weight for his or her age or height, bureau employees wrote, it “should be a warning that the child’s nutrition is not normal.”⁴⁹

Height-weight tables simplified the complex subject of child health down to a series of numbers. But this was not what the tables were originally meant to do. The first chart that might be called a height-weight table was designed by Lambert Adolphe Jacques Quetelet in 1836. Quetelet, a Belgian mathematician, developed a Body Mass Index or Quetelet Index. His index, though, was not meant to assess individual health but rather to assess the weight of entire populations and to determine averages. It was a sociological tool, not a medical one.⁵⁰

When the Children’s Bureau conflated height and weight ratios with health, it solved some of its child health problems and created others. By the early 1920s, for example, statistician Louis Dublin wrote that immigrant children’s bodies did not conform to the same standards as white, native-born children. When public health workers measured Italian immigrant children to assess their health, he explained, they marked many of the children as healthy when they were in fact malnourished. Along the same lines, other researchers concluded that “the fact that an individual child weighs less or more than the average is not conclusive proof that he is undernourished or overnourished.”⁵¹ In a 1924 article bluntly titled “The Use and Abuse of Age-Height-Weight Tables as Indexes of Health and Nutrition,” table cocreator Bird T. Baldwin argued that height-weight tables were “frequently inaccurate in themselves” and egregiously inaccurate in the hands of novice measurers.⁵² He still supported the use of his own Baldwin-Wood tables, but decried the use of other tables and what he called the “inaccurate measurements” taken by laywomen, nurses, and nutritionists alike. While Baldwin’s condemnation of female-led public health work fits into the consolidation of medical authority happening at this moment, more surprising critics of the tables also spoke out. Suspicions even emerged from the Children’s Bureau itself, an agency whose public health identity was tightly linked with its dissemination of the charts. The bureau promoted height-weight tables even though few of its employees believed that the tables identified all the health issues they were meant to identify.⁵³ The charts were political tools that produced the idea of the healthy modern child as much as they assessed it.

Bureau promotions not only popularized weighing, but also constructed the practice as an unusually intimate advisory state activity. Weighing in and of itself did not require medical expertise, but it did take equipment. Anyone could weigh themselves or someone else with little education. In the 1910s and early 1920s, public health and medical specialists owned the proper scales, which might be borrowed for child health contests. Women’s clubs interested in weighing and measuring children often teamed up with public health officials as a way of accessing scales and charts. By the late 1920s, however, it was much easier to find both of these technologies. Retailers began marketing home scales as early as 1913, but these remained too pricy for most.⁵⁴ Scales constituted a more reasonable purchase for a school, though, and school nurses weighed children a few times each year.⁵⁵ Most mothers could also be taught the basic graphic literacy required to read height-weight tables and figure out if the weight they calculated was too high, too low, or about right. With this number in hand, a mother or teacher could pick up a nutrition book to fix the problem herself. Or she might go to a clinic or physician, especially if it was a young child who was not measuring up. The bureau inserted these charts into nearly every infant and child care pamphlet it published. Tables were not meant to be flawless; they were meant to draw women in.

Height-weight tables truly came to the forefront in the mid-1910s, when women’s groups around the country had begun projects linking child weight, aesthetics, and health. Through baby health contests and other child health pageants, these groups hoped to draw attention to the importance of baby health as a step toward improving infant mortality rates.⁵⁶ Rural girls’ and women’s groups took the lead on such contests, at this moment when an increase of funding to groups like 4-H helped facilitate the growth of sex-segregated agricultural programming.⁵⁷ Mothers brought in their babies (and sometimes older children), and judges evaluated and ranked the youth. Ultimately, they named and honored the healthiest child and his or her mother.⁵⁸ In Louisiana, in 1908, the state fair included a Scientific Baby Contest.⁵⁹ In Iowa, in 1911, the Iowa Congress of Mothers put together a Better Babies Contest for their state’s fair. The women added entertainment and prizes to their event, vastly increasing its appeal. This chapter of the Congress of Mothers—taking a little inspiration from popular livestock contests already at state fairs—sought to make child pageants that had some health reform programming built in.⁶⁰ The fairs already had some of the necessary accoutrements for weighing commodities. These better baby contests channeled a romanticized idea of the ruddy, rural child to a nation increasingly grappling with urban malnutrition and child labor in factories.⁶¹ In this space, though, judges scored children from zero to a hundred points with this milk-fed and sunshine-grown health ideal in mind.⁶²

The judges declared the children with the most points to be the healthiest, a term that blended racial, moral, and physical factors. Those children won ribbons. The American Medical Association’s public health section cosponsored some child health contests, lending an air of professional legitimacy to events otherwise surrounded by prize pigs and pies.⁶³ In some cases, the contests included measures to more broadly improve child health, such as presentations and displays from public health nurses and clubwomen. Even when the contests did not have a specific health improvement section, they still had pedagogical intentions. Ranking infants and children in an ostensibly objective fashion required score cards. Score cards varied from event to event, but most employed similar conventions. Cards asked for the age, height (or length, for infants), and weight of the child. This was nonnegotiable. Other categories, ranging from plumpness to symmetry, might be included depending on the interests of the local groups running the contests.

Eugenicists shaped some of the first contests.⁶⁴ Like the Children’s Bureau, positive eugenicists—those who encouraged the reproduction of the supposedly fit—often relied on educational measures mixed with strong social pressure to share their message. The eugenics movement was not unified in its methods. While some eugenicists did not believe educational methods would ever truly weed out the unfit, instead pursuing legislation and force, others relied on these measures.⁶⁵ Most of the better baby contests, intertwined with eugenic aims, were racially segregated.⁶⁶ Still, black middle-class women’s concern about high rates of black infant mortality kept many of them engaged in the better baby contests.⁶⁷ The Children’s Bureau was not especially eugenic, but it sought to translate the energy around these projects to their own ends.

There was plenty of energy to work with. Following the Iowa fair, clubwomen and public health workers in Colorado, Louisiana, Oregon, Washington, and New York developed their own competitions. In the years that followed, the competitions expanded still more, “sweeping the whole country,” in the words of one reporter.⁶⁸ Some groups offered cash prizes, others only ribbons, local media attention, and, of course, maternal bragging rights. More important from the point of view of the reformers involved, the contests also included instructions on proper baby feeding and nutrition, an assessment of the child for obvious signs of illness or malnutrition, and lessons in what the clubwomen deemed proper hygiene. Discussions of what the contests accomplished slipped easily between eugenic and noneugenic language. The Illinois Medical Association justified the contests as a response to the “deterioration of the American stock.”⁶⁹ While many eugenics groups focused on reproduction and the elimination of the unfit through genetic means, baby contests were centered on improvement of the unfit. As the decade went on, contest organizers embraced the language of health over the explicitly eugenic language of stock. This is a critical distinction. After eugenics fell out of national favor, the language of improved health allowed subtle projects around fitness to carry on with little controversy.

The Children’s Bureau and the voluntary groups organizing baby and child contests shared the goal of assessing child health through physique, but the contests themselves frustrated the bureau leadership.⁷⁰ Julia Lathrop thought the contests were sometimes disorganized or loud and dirty, and lacked standardization.⁷¹ She also did not approve of the prizes distributed at these contests. Commodifying child health with cash prizes seemed crass and unprofessional. It made the contests carnivalesque, and detracted from the serious health purposes Lathrop envisioned for the events. Even more to the point, an emphasis on rankings and prizes created an environment that encouraged a large attendance of mothers with already healthy children. Why would a mother bring her thin, sickly child to the contest when she knew the child did not have a shot at the $100 pot? Instead, the bureau wanted mothers of the thinnest, sickliest children to show up at child health events.⁷² Based on the early work of figures like Ellen Swallow Richards, the Children’s Bureau insisted their goals were backed by “euthenics” rather than “eugenics.” Lathrop and the bureau were not alone in their insistence. Some medical professionals completely disavowed the contests, like the editor of the American Journal of Diseases of Children who said “lining up these human infants as if they were pigs or calves is exceedingly repulsive.”⁷³

Lathrop could not afford to dismiss voluntary energy around child health, though, so she set out to reform the contests. The middle-class bureau attributed thin children to well-meaning but ignorant mothering. Ignorant mothering could presumably be fixed by introducing these women to scientific motherhood. The bureau needed to create audiences of mothers interested in its child hygiene advice. The baby and child contest model had two things going for it that the bureau needed. First, the contest model attracted publicity and excitement. More importantly, the contests were run by a decentralized set of (mainly) voluntary agencies across the country. These were urban as well as rural women’s clubs, public health groups, and teachers. They received some support from a variety of national organizations, including the American Medical Association’s public health section, local and state government agencies, and the magazine Woman’s Home Companion. The contests had created an informal infrastructure around child health and aesthetics, a way of reaching millions of women across the nation and influencing their ideas on child hygiene without spending much money or expending other resources.

Assessment and Advice

In 1916 the bureau tried to mobilize its informal network of female labor. These women, they imagined, would accept the bureau’s child health conferences as the scientific alternative to baby contests. To this end, the bureau instituted a national Baby Week. The event consisted of nurses and volunteers examining hundreds if not thousands of babies in one busy week. The labor was dispersed. Local women examined local babies. The campaign included events in New York City, Pittsburgh, and Chicago, as well as in small towns and cities across the country. The number of children weighed, measured, recorded, and assessed was more than anyone had set out to assess before. One New York City reporter insisted that “Baby Week has done to New York’s attitude toward babies what a large, active firecracker placed under the chair of a dozing grandfather might be expected to do.”⁷⁴ Attaching the stamp of federal approval to these local events helped publicize them, and granted them political authority. Baby Week did not include the prizes and awards that Lathrop had deemed crass, which reduced the entertainment value of the events, but actually increased their credibility as scientific events. Baby Week events were held in around 4,700 communities.⁷⁵

The bureau’s Baby Week succeeded because of its combination of federal authority and quantification. Height-weight forms and measuring instructions offered an aura of scientific legitimacy to the project. They also made it simple for any laywoman to become an expert on child weight. While other height-weight materials and instruction existed at the time, the insistence that Baby Week was a project for the national good placed it in a different category. Historians have studied the power of the federal government to persuade—but not technically force—female citizens to comply with federal projects in roughly this period. By the time the United States entered World War I in 1917, there were programs to brutally repress and prosecute radicals, dissidents, and certain immigrants. There was also aggressive propaganda work like that of the Committee on Public Information (CPI), which made the Children’s Bureau’s requests for citizen action seem familiar and, by comparison, quite moderate.⁷⁶ CPI projects included campaigns encouraging women to do everything from monitoring their block for communists to buying war bonds. Not planting that victory garden might get a woman a sneer from her neighbor, but it was not likely to get her a police visit. Compliance was all about the responsibilities of good citizenship—and a little dose of guilt. In the end, though, huge numbers of Americans voluntarily grimaced through meatless Mondays and sent their kids out to collect scrap metal. It was both a responsibility of citizenship and a point of pride. Baby Week carried a similar mandate.

Baby Week was a way of encouraging women’s voluntary groups around the country to put on child health conferences by suggesting one week would be set aside around the nation for such events. The bureau further encouraged women’s groups by drumming up media attention for the events, and preparing more printed materials for groups that wanted them. During Baby Week, women’s groups around the nation put on conferences using height-weight tables, and employed advisory technologies to assess children’s height (or length), age, and weight. The intersection of these measurements marked the child as underweight, overweight, or acceptable in weight. These weight ratings could then be translated into health ratings: the child was read as healthy if it met the average and unhealthy if it fell short.⁷⁷

The introduction of the 1916 and 1917 Baby Weeks encouraged mothers to take these child health ratings to heart. Through brochures and pamphlets especially, mothers were to embrace the new scientific nutrition daily, not just during the designated week. The bureau’s printed materials reiterated the ideas of Baby Week, especially the idea that mothers did not innately know best.⁷⁸ They needed to learn, and they needed to embrace the new science of child health. The health of the nation, they understood, depended on it.

The Children’s Bureau’s 1914 Infant Care and 1915 Prenatal Care were designed specifically for mothers, social workers, and teachers. Infant Care would become one of the agency’s most popular publications. The booklet advised women on such topics as ventilating the nursery, registering their infant’s birth, and, of course, provided extensive details on weighing and measuring infants. Various iterations of the popular booklet remained in print for decades.⁷⁹ American mothers and women’s groups hungrily consumed the federal pamphlets. According to Lathrop, the agency sent out over 100,000 copies of both Infant Care and Prenatal Care in their first year of publication. Most of the bureau pamphlets were sent in response to individual letters directly requesting either a pamphlet or advice related to pamphlet topics.⁸⁰ Many of the pamphlets and height-weight tables were available for free, or for just a few cents. Advice literature was exploding in popularity at the time, and women were open to experts.⁸¹ For women with minimal resources and a genuine concern about how to keep their children healthy, this might be the best advice available. Pamphlets were often given to women directly, such as when they were leaving a Children’s Bureau–approved baby conference (or even one of the more legitimately educational children’s health contests of the period). Other women heard about the pamphlets from friends, neighbors, or public health workers, and then wrote to the bureau requesting copies.

Lathrop described the tone of Infant Care as “addressed to the average mother of this country.”⁸² Its voice, according to one reviewer, was “simple enough to be understood by uneducated women and yet not so simple as to seem condescending to the educated.” The maternal voice was in part meant to comfort any mother reading the pamphlet, but that was not its only aim. The maternal voice also allowed the bureau to claim it was not going beyond the bounds of what it was allowed to do. Although Lathrop was proud that the booklet was based on health literature and discussions with nurses and doctors, she also noted explicitly that with Infant Care “there is no purpose to invade the field of the medical or nursing professions.”⁸³ The booklet would by nature be advisory—all advice literature is. The bureau added an extra caveat to its booklet, though, with the explicit insistence that it was not a threat to other health organizations.

Baby Week was an ideal venue for disseminating publications like Infant Care. Baby conference score cards had begun the process of arming non-experts with tools of scientific assessment. Mothers, teachers, and nurses (in practice experts, but grouped with nonexperts since their skills were rarely taken seriously) could read a scale or ruler and fill in the blanks on a score card. The charts allowed supposed nonexperts to authoritatively do the work of experts in a simple, standardized, fashion. Lathrop thought that this quantification—the use of child contest methods alongside the more scientific-seeming advice a` la Infant Care—was an efficient way of reaching as many mothers and teachers as possible.⁸⁴

Still, Julia Lathrop struggled with getting her child health agenda in the hands of everyday women. She wrote about how “even many of the best educated fathers and mothers … have never read a statistical table, and never will.”⁸⁵ Getting these parents to take statistical tables home and integrate them into their regular child health routine was critical to the maintenance of a height-weight program. Lathrop also wrote that, while she filled the Baby Week pamphlets with “facts about the dangers which beset American babies,” she knew that parents would “successfully evade” them. Great success required a larger campaign, Lathrop knew, and that campaign would also need more active advising by the bureau.

The Great War and the Children’s Year

During the first U.S. Baby Week, Europe became engulfed in a war both enormous and—for most Americans—distant. By the second Baby Week, in June of 1917, the Great War was no longer so distant.⁸⁶ Although the scheduled work of the Children’s Bureau, including Baby Week, went forward, the U.S. entrance into the European war changed the bureau’s aims. While funds for domestic programs were scarce, American state building increased. It also intensified the discourse around women’s voluntary sacrifices and contributions. The new emphasis on women planting victory gardens, preparing wheatless and meatless meals, and rationing their shopping elevated the idea of voluntary action. It fit well with Children’s Bureau politics. Here was an unusual moment, in which the rapidly expanding federal government kept pushing into private spaces, including the intimate space of the family meal. As propagandists like the Committee on Public Information pushed these voluntary actions as responsibilities of patriotic motherhood, though, such requests fit well with middle-class American women’s existing relationship to the state. This seemingly paradoxical obligatory-volunteerism enlisted women’s labor and allegiance without apparent federal overreach. It also helped construct a narrative of individual responsibility around food choices being beneficial to the civic whole.⁸⁷

The need for so-called responsible food choices was not only the result of limited butter and sugar. As the Great War progressed, so grew an American anxiety over men too malnourished to fight. The medical statistics collected during men’s draft examinations suggested a great deal of physical unfitness. In World War II, many more extensive height-weight and physical examination guidelines made for detailed health concerns, concerns that began even before Selective Service examinations did. In World War I, though, these examinations were more holistic than the specific quantified health data to come.⁸⁸

The Children’s Bureau then promoted an even louder call to improve child health. This was not simply to be for the sake of individual children (as baby contests often portrayed themselves) but for the good of the entire nation. It was a compelling opportunity for middle-and working-class women to demonstrate their patriotism in a gender appropriate manner.

Julia Lathrop declared that 1919 would be the Children’s Year. This was a year-long campaign to promote child health. To create such a large and sustained campaign, the bureau enlisted the voluntary labor of swaths of Americans in order to promote child welfare and hygiene. The bureau’s Children’s Year campaign explicitly targeted “not only mothers and fathers, teachers, physicians, infant-welfare nurses, and other social workers who have to do with children, but men and women experienced in organization,and young people with leisure and good will.”⁸⁹ All could be used in improving child health. Lathrop explained that the goal of the Children’s Year was to save the lives of 100,000 children under the age of five, children who might otherwise die of preventable causes. Lathrop won support for this campaign based on the public claim that nearly 30 percent of World War I rejections owed to the long-term effects of childhood diseases or neglect.⁹⁰ With this incentive, an impressive list of local-level public health and hygiene measures came out of the bureau’s Children’s Year. In California, local participation sparked action to create seventeen permanent county health centers and positions for dozens of public health nurses and dental hygienists. Additionally, the state established a division of child hygiene with a $20,000 budget under the state’s Department of Health.⁹¹ The bureau argued that there was a similar outcome in every state, although this was an exaggeration. Still, following the Children’s Year, twenty-one states created child hygiene divisions (nine states had already had such divisions). The bureau’s voluntary, minimally funded, and decentralized program had more or less succeeded. Where the bureau had no power to build clinics or install teams of dental hygienists, it still managed to accomplish some of its goals during the Children’s Year.

The bureau framed the project from the start as a project that would rely on voluntary agencies and women’s cooperation. The bureau had no financial resources to offer to local events, but promised local communities that the events would be inexpensive and worthwhile. Free instruction from the bureau would be implemented through generous workers and volunteers. The Children’s Year was a more ambitious campaign than either the 1916 or 1917 Baby Week, and over the course of the year it won greater participation, enthusiasm, and support than had previously been received. The first major event was a “nationwide Weighing and Measuring Test of young children.” According to the bureau’s publications, the support would come from a number of sources. In larger cities, the bureau would lean on city officials, city health departments and their child hygiene or child welfare divisions, women’s organizations, school boards and teaching staff, and churches. They went so far as to optimistically anticipate that the mayors of some municipalities would get involved. Civic organizations were also enlisted. From infant welfare societies to the remaining settlement houses to the Camp Fire Girls and the Boy Scouts, charities could be of great use. While the actual workers involved with rounding up and measuring children were expected to be female, the bureau believed that men’s organizations might get involved with promotions and financial backing. The bureau asked fraternal orders, labor unions, and chambers of commerce all to stand behind the weighing campaign. Many provided publicity and financial support. Once support for Children’s Year was established in each locality, the bureau also provided instruction on how the groups should organize themselves. The bureau suggested local conferences be divided into publicity, finance, and enrollment committees. Another committee would focus exclusively on procuring the scientific equipment needed for measuring.⁹² The bureau managed the Children’s Year with a vision of truly shaping each event according to bureau expectations.

Figure 1. Poster from the Children’s Year campaign, which sought to improve child health through child health conferences and the promotion of weighing and measuring children. Committee on Public Information, Division of Pictorial Publicity, Library of Congress Prints and Photographs Division, Washington, DC.

As part of the Children’s Year, the bureau became an even more enthusiastic proponent of child measurement and standards. The mostly female volunteers at the events were instructed to draw heavily on the bureau’s Baby Week and child health conference pamphlets for guidance. It issued pages of special instructions for the Children’s Year weighing program. Children were to be weighed and measured with very specific equipment. The bureau promised that “the equipment essential for the test is simple.” This included a standard scale, a platform scale, a measuring rod, a good supply of tape measures, a 45-inch-long table covered in quilts, oilcloths, cotton sheets, paper towels, and a few other supplies.⁹³

The instructions for actually performing the weighing and measuring were even more complicated. They required their own separate Children’s Bureau pamphlet: Wash your hands. Undress children and wrap them in a thin towel. Take off their shoes. Hold a book or small box horizontally on top of the child’s head when measuring his or her height (assuming a more scientific scale was unavailable). Lay babies down, completely relaxed with no bent joints, and measure their length with enamel bookends. There was even a science to filling in measuring cards. Examiners needed to use fractions rather than decimals, and round ages to the nearest birthday.⁹⁴ The women who participated in this work would ideally be aided by local physicians or nurses who gave of their time freely. Only a physician was allowed, for instance, to mark a child as “healthy and free from serious defect” or to provide recommendations to mothers in writing.⁹⁵ Most of the examiners, however, would be middle-class women active in the community. These women, the bureau advised, ought to “rehearse the procedure of weighing and measuring” before being released on the babies.⁹⁶

After the actual weighing, the measurers had extensive instruction on how to record the data. The available height-weight tables represented a large number of average children, bureau pamphlets explained. Despite bureau apprehensions, local women conducting the measuring were told to treat the measurements as scientific fact. When actual children deviated from the average child weights on the tables by just two pounds, they were marked as abnormal. When the women found these divergences from the norm, even the mere two-pound ones, they were to advise parents to bring the child to a physician. In the bureau’s plans for events of meticulous measurement and careful assessment, the bureau reiterated the importance of expertise. On the one hand, giving laywomen weight tables and putting them in a position to take charge of child health—both that of their own children and of the community at large—empowered these women. On the other hand, the growing insistence on experts undermined that empowerment. As the bureau further sold the importance of expert-validated quantitative child health, mothers increasingly accepted the bureau’s message: it was their responsibility to assess and measure their child, and that was something the bureau could help them with. It was also now their responsibility to take the child for a true expert measurement and assessment. This was not something the advisory bureau could do for them.

The acceptance of the first part, the idea that women needed to take charge of their children’s health through scientific means, can be seen through their participation in the Children’s Year measuring test. As part of the bureau’s promotion of the mass quantification event, it prepared a short film called Our Children. The film was produced as part of the Children’s Year, but the Children’s Bureau hoped it would have an impact beyond the one-year affair. Our Children began with the idea that children needed to be weighed as a response to the high American child mortality rates. Club women in the film were spurred to action simply by reading a newspaper article in which the Children’s Bureau called for women to weigh their children. Clearly, the bureau believed itself to be so influential that a mere call to pay attention to a problem would lead to voluntary support. In the film, though, simply weighing children was not enough. Weighing needed to be careful, to be scientific.⁹⁷

Without a home scale, the women in the film first tried to weigh a baby by sticking him on the scale attached to the back of a passing ice truck. The infant was not interested in this, however. He cried and screamed, and wriggled so much that the women were unable to get an accurate weight reading. The women then took the child to the grocery store for a produce-scale weighing. The results were not much better. Older children kept falling off the grocery scale.⁹⁸ This was no scientific motherhood. Finally, a group of clubwomen decided to invite experts from the bureau itself to come and assess local children. As might be expected in this propaganda for health quantification, only this expert guidance allows the women to successfully weigh their children. The pictured bureau and their nurses were adept at handling children, even more than their mothers seemed to be. They came equipped with scales designed especially for babies and children, and were meant to produce meaningful numbers. Only a numerical assessment of the child could provide the modern measure of health that the bureau valued. In time, these would become the measures that most women valued.

All this weighing was explicitly intended to measure and improve the health of children around the nation. It also served another purpose. The conferences would allow the bureau to create its own height-weight dataset on American child health. The bureau figured that collecting the weights and measurements of about 200,000 children would allow them to create new height-weight charts that would assess a larger number of children, and a more ethnically and regionally diverse set of children. One of the bureau’s major complaints with baby contests had been the lack of consistent, accurate standards for assessing children.⁹⁹ With this new 1919 dataset, the bureau would have standardized numbers for future events.¹⁰⁰ To prepare this dataset, local conference organizers were asked to write in to the Children’s Bureau for official child scoring cards before holding a conference. The measurement cards used in any weighing situation were meant to be torn in half. One half of the card would be given to mothers to remind them of where their child fit into the average, and where he or she ought to fit. If a child was deemed underweight for his or her height, the local women who put on the event were also advised to keep a permanent record of that child’s measurement for themselves.¹⁰¹ Mothers also were given a more detailed physician’s assessment of their child. The other half of the simple measuring card was to be mailed to the bureau for its own records.¹⁰² Using the half-cards, bureau statisticians developed a set of height-weight charts divided by race (black and white only) and gender.

Figure 2. Still from the 1919 Children’s Bureau film Our Children. The film encouraged mothers to embrace the scientific weighing and measuring of their children’s bodies by illustrating the limitations of less-than-scientific attempts. Here, two women try to measure a baby on the scale of a passing ice truck. The baby squirms and they move on to find a more precise scale. Records of the Children’s Bureau, 1908–1969, Motion Pictures, National Archives at College Park, College Park, MD.

Figure 3. The Children’s Bureau included this sample of a child’s health record in a series of pamphlets designed to prepare clubwomen to hold child health conferences as a part of Children’s Year. This was an attempt to standardize the conference experience and the definitions of child health, as well as allow the Children’s Bureau to collect data. Children’s Year Pamphlet No. 2, Part 3, Bureau Publication No. 38 (Washington, DC: Government Printing Office, 1918), 7.

The newly created bureau height-weight tables replaced most of their predecessors, becoming the gold standard for child measuring, which in turn was the gold standard for child health. By the late 1920s and early 1930s, Americans moved most child health concerns from the community to the physician’s office. The bureau could not stop this, nor did it want to.¹⁰³ It kept a toehold in child health, though, by setting the terms on which experts would discuss child health in the immediate future.

During the Children’s Year, which ran April 1918–April 1919, the Great War ended. The Children’s bureau encouraged the local women responsible for the weighing and measuring to pursue other child health measures. Once events like the Children’s Year had brought women into the world of public health work and scientific mothering, the bureau advised localities to keep women in that world through continuous events. The bureau recommended that its pamphlets on topics like prenatal care and milk safety be spread around communities. It also suggested that local women’s clubs hold lectures and meetings on the care and feeding of children. Local groups might also introduce the next generation of mothers to weight and health standards through Little Mothers’ Leagues or school programming. Above all other measures, the clubwomen who had participated in Baby Weeks and Children’s Year were encouraged to fundraise and campaign to get at least one public health nurse in their community. The nurse must focus on prenatal and young children’s health concerns, and could be supported through private fundraising or by convincing the local government to allocate funds.¹⁰⁴ In any case, the bureau made clear that women were not to lose interest in the project of scientific mothering and health. Children needed to be weighed, the bureau told them, and they needed to be weighed in a very specific manner. The continuation of that work, though, was up to local women.

The Children’s Bureau employed a variety of advisory state techniques in the 1910s and early 1920s. The primary strategy of the agency was a reliance on voluntary networks, especially those run by women sympathetic to the bureau’s cause and accustomed to being called upon to do the family labor of government. Middle-class clubwomen read child health conference brochures, organized baby weeks in 1916 and 1917, and rose to the challenge of running a series of Children’s Year events. Through quantification and standardization, through little score cards and straightforward scales, these women likely internalized the values of scientific motherhood. In the process of accepting these values, they accepted that a careful measurement of height and weight could be a stand-in for child health. Height and weight measurements that fell within the normal range were evidence that a mother was living up to the expectations of scientific motherhood. If a child was above or below the normal range, perhaps there was something wrong with that child. More to the point, perhaps there was something wrong with that mother. At that point, it might become a public issue. It might also become a professional medical issue, an issue for the growing field of pediatrics.¹⁰⁵

Projects like the 1919 Children’s Year helped the bureau gain support for its child health/child weight efforts. Soon after the bureau published the results of its Children’s Year, the 1921 Sheppard-Towner Maternity and Infancy Protection Act passed Congress.¹⁰⁶ With it, communities found help getting the public health nurse the bureau told them to get, running the health lectures they had been asked to run, and making child weighing and measuring a regular affair. While the Sheppard-Towner Act suggested a new direction in child health matters, and a more involved and directive Children’s Bureau, the short-lived program might be better understood as an anomaly in the primarily advisory work of the bureau. Pamphlets, quantification, and, above all, women’s voluntary labor made the work of the Children’s Bureau possible.

At the same moment the Children’s Bureau was popularizing height-weight charts as a way of accessing information about children’s health, they were also putting the charts in the hands of mothers and teachers. Height-weight charts then became popular ways for those women to measure themselves. Versions of such tables, claiming to offer medical insight, circulated in the life insurance business. They circulated in popular women’s magazines. By the early 1930s, such tables would increasingly be used to assess adult men when they came in contact with the state. In the interwar years, the majority of which did not have an active draft, the men who ended up in intimate contact with the state were commonly low-income men. As the Great Depression expanded men’s participation in social welfare programs, the physique of these men was analyzed according to the quantitative norms popularized in the 1910s and 1920s. The quantification that made these height-weight tests possible would now allow for the measurement of masses of young American men. Advisory techniques continued to guide the approach of state entities toward physique, but the specific demographics of those participating in this social welfare program also recast the boundaries of the advisory.