Making Better Babies: Public Health and Race Betterment in Indiana, 1920–1935

Abstract

In 1920, Indiana's Division of Infant and Child Hygiene inaugurated its first Better Babies Contest at the state fair. For the next 12 years, these contests were the centerpiece of a dynamic infant and maternal welfare program that took shape in Indiana during the decade of the federal Sheppard–Towner act. More than just a lively spectacle for fairgoers, these contests brought public health, “race betterment,” and animal breeding together in a unique manner.

This article describes one of the most popular expressions of public health and race betterment in rural America. It also raises questions about the intersections between hereditarian and medical conceptions of human improvement during the early 20th century, especially with respect to child breeding and rearing.

BY 8 AM ON THE MORNING OF September 3, 1929, dozens of mothers were lined up in front of the Better Babies Building at the Indiana State Fair, eagerly waiting for the doors to open.1 Since 1920, and in increasing numbers, babies from nearly every Indiana county had been weighed, measured, and tested at the state fair by physicians and psychologists affiliated with the State Board of Health's Division of Infant and Child Hygiene. During the 1920s, this division launched a multifaceted program of “child saving” and maternal education, which included radio talks, mother's classes, the screening of hygiene films, statistical reports, and consultation clinics. The Better Babies Contest, however, was by far the division's most spectacular and beloved event, drawing hundreds of young entrants and thousands of curious onlookers to the state fairgrounds during the week of Labor Day.

Each year, more and more Hoosiers—as Indianans like to refer to themselves—crowded into the Better Baby facilities. They watched nurses demonstrate infant feeding techniques, collected free pamphlets such as the Indiana Mother's Baby Book, or perused displays about nutrition and the virtues of sterilized and sparkling bathrooms and kitchens. While individual girls and boys, twins, and triplets competed for blue ribbons and cash prizes, tired mothers could find refuge at the rest tent and noncontestant children could romp in the playground or nap peacefully in the nursery. According to many physicians, the Indianapolis News, and the promotional newsletter The Hub of the Universe, the Better Babies Contest was one of Indiana's most anticipated yearly events.2

At the helm of the better babies program was Dr Ada E. Schweitzer. Over the course of little more than a decade, Schweitzer, appointed director of the newly created Division of Infant and Child Hygiene in 1919, assembled one of the most vibrant public health agencies in the nation. Immediately before she was ousted and the division was disbanded in 1933, Schweitzer counted 4 physicians, 4 nurses, and 5 assistants on her core staff.3

During her 14-year reign, Schweitzer worked sedulously to lower infant and maternal death rates and convince Indianans of the importance of scientific motherhood and child rearing. She lectured to hundreds of neighborhood and civic associations, penned voluminous articles and poems, assessed the physical condition of babies in every one of the state's 92 counties, and fastidiously managed the affairs of her industrious division. Seemingly unfazed by a taxing travel schedule, Schweitzer could frequently be found adding miles to the division's child hygiene mobile, which had been equipped with a generator to project movies and lantern slides in remote towns and villages. She was even known to take to the air in a 2-seater airplane to arrive punctually for speaking engagements.4 In part owing to Schweitzer's efforts, Indiana's infant mortality dropped by one third, from 8.2% in 1920 to 5.7% in 1930.5

In this article, I explore not only Schweitzer's better baby crusade but also the particular circumstances that gave rise to such a dynamic child welfare project in Indiana from 1919 to 1933.6 This work flourished because of the state's concern with public health and eugenics. By 1907, for example, Indiana had a pure food statute and a vital statistics act on the books and, furthermore, had passed the country's first eugenic sterilization law. In 1915, the Indiana State Board of Health was ranked sixth nationwide, in terms of effectiveness, by the American Medical Association.7

During this period many Indiana health reformers, including Schweitzer, frightened by what they perceived to be an escalating menace of the feeble-minded, joined the Indiana State Mental Hygiene Association.8 Through legal and educational means, Indiana Progressives sought to control procreation and endorsed only the birth of the “best” and healthiest babies. For many Hoosiers, born and raised as farmers, breeding superior children was just a step away from producing heartier corn, pigs, and cattle.9

The activities of the Division of Infant and Child Hygiene multiplied markedly in the 1920s owing to the resources made available by the federal Sheppard–Towner Act, passed in 1921.10 Administered by the US Children's Bureau, this act provided matching funds to states that approved “enabling legislation” and established agencies devoted to infant and maternal welfare. Schweitzer, who had preexisting ties to the Children's Bureau, astutely took advantage of the support granted by Sheppard– Towner. With Schweitzer serving as the intermediary, the convergence of state and federal infant and maternal hygiene programs proved exceptionally efficacious in Indiana.

The success of the Division of Infant and Child Hygiene was also facilitated by Indiana's demography and topography. In 1920, the state's population hovered at close to 3 million residents, 95% of whom were native-born and 97% of whom were White. The bulk of Indiana's African American and immigrant communities lived a marginalized and segregated existence in the cities of Indianapolis, Gary, and East Chicago.11 Unlike Progressive reformers in diverse, multilingual states such as New York, Illinois, and California, Schweitzer and other Indiana child savers did not need to translate their message into foreign languages or tailor their “Americanization” campaigns for Polish, Italian, or Mexican newcomers.12 Instead, the primary targets of public health and race betterment efforts in Indiana were poor and working-class Whites, especially impoverished farm dwellers living beyond the orbit of urbanization and industrialization.

Despite Indiana's unusual makeup, it has often been characterized as the quintessentially American state, a reputation most decidedly earned by the 1929 publication of Robert and Helen Lynd's Middletown: A Study in Modern American Culture, which examined the city of Muncie.13 If Middletown encapsulated the values of America as idealized in the 1920s, then tracing the emergence of its better babies movement should reveal a great deal about the largely understudied interplay between public health and race betterment in the country as a whole during the first half of the 20th century.14

THE INDIANA CHILD CREED

The Indiana Child Creed (sidebar) entered the Hoosier vernacular in 1915 when it debuted as the epigraph of the Indiana Mothers' Baby Book.15 Published by the State Board of Health, this advice manual was distributed free of charge, along with a letter of introduction, to every mother who registered her newborn with the state.16 Over the subsequent 2 decades this creed, an awkward patchwork of eugenic, public health, Protestant, and Progressive ideas, would be printed in hundreds of articles and tracts and recited resolutely by the state's health advocates. Although it is impossible to gauge how many Hoosiers absorbed or heeded the child creed, its appearance signified the inception of better baby work in Indiana. Promoted on 3 interconnected levels—local, state, and federal—child welfare programs took shape and began to coalesce in the Hoosier heartland in the late 1910s and early 1920s.

Indiana's burgeoning interest in infant hygiene reflected broader trends at the turn of the century, as reformers from coast to coast began to embrace the doctrine of “progressive maternalism.”17 According to Molly Ladd-Taylor, progressive maternalists occupied the middle ground between feminists and proponents of sentimental motherhood. Whereas the former waged a fierce battle for sex equality on the streets and in the halls of Congress, the latter saw no place for women outside the home. Progressive maternalists combined and tempered these 2 perspectives, asserting that the biological and social experience of motherhood endowed women with a heightened sense of moral duty that was beneficial to both family and nation. They politicized maternity by arguing that female citizens, who carried the well-being of future generations in their wombs, were entitled to suffrage as well as leadership roles in society and government.

This logic was employed by suffragettes who asserted that New Zealand's low infant mortality rate was a direct result of more than 20 years of female enfranchisement. One leaflet issued by the National Woman Suffrage Publishing Company, for instance, portrayed a toddler looking warily at a door that was barely ajar and swarming with deadly microbes. The accompanying caption read: “I wish my mother had a vote—to keep the germs away.”18 Linking the language of bacteriology and biology, progressive maternalists charted an agenda for the country in which national strength, better babies, and the political visibility of women went hand in hand.

On a national scale, the ethos of progressive maternalism was best exemplified by the US Children's Bureau. Established in 1912 by Progressives long committed to immigrant and infant welfare, the Children's Bureau was the first government agency directed by a woman, Julia Lathrop, who in 1921 was succeeded by Grace Abbott. Both were veterans of Chicago's Hull House, one of the first immigrant settlement homes in the United States.19 Immediately after taking charge of the Children's Bureau, Lathrop settled on the reduction of infant mortality as the agency's cardinal objective. In 1910, between 100 and 200 of every 1000 infants born in the United States perished, a figure that had been lowered discernibly since 1900 but still exceeded rates in New Zealand and a handful of European countries.20

Although the Bureau interpreted the manifold problems of children through the prism of public health and medicine, few members of its staff were physicians. The preliminary composition and outlook of the bureau were altered substantially over time, however, as doctors—many of whom were male—began to claim jurisdiction over most arenas of children's health. One of the historical ironies is that by professionalizing infant and maternal welfare and urging mothers to consult private pediatricians, the Children's Bureau enhanced the authority of doctors and bolstered the notion that private primary care was the most creditable mode of child health.21 The development of better baby work in Indiana emulated this pattern, arising in large part from a groundswell of women's volunteerism in the first decade of the 20th century but thoroughly controlled by male pediatricians by the mid 1930s. Much to her dismay, Schweitzer, a physician and a progressive maternalist, paved the way for this gendered transfer of power in the Hoosier heartland.

Just 2 years after its founding, the Children's Bureau initiated what would blossom into a fruitful relationship with the Indiana State Board of Health when it dispatched its designated exhibit expert, Dr Anne Louise Strong, to Indianapolis to preside over an upcoming child welfare display.22 Two years later, in January 1916, the Children's Bureau returned to Indiana. This time, however, the agency came for 4 months, to lay the foundations for a comprehensive infant and maternal hygiene program. During the second decade of the 20th century, the Children's Bureau rotated its field agents throughout the country to galvanize child welfare initiatives.23 To rural Indiana, it sent Florence Brown Sherbon, a Kansas physician who in the 1920s became a member of the American Eugenics Society and one of the most vocal exponents of “fitter families” contests at agricultural fairs.24 She was later joined by Mary Mills West, author of the acclaimed Children's Bureau tracts Infant Care and Prenatal Care, and Elizabeth Moore, who had helped Strong with the child welfare exhibit less than 2 years earlier.25

During the winter and spring of 1916, Sherbon, Moore, and West preached the gospel of child saving throughout Indiana. In places often inaccessible by rail or asphalt, they showed movies; handed out pamphlets; examined the eyes, ears, and mouths of children; illustrated infant feeding techniques; and dispensed scales of normal development and nutrition charts, all the while compiling birth and death statistics.26 Following on the heels of American Farm Bureau agents, who had begun canvassing the countryside at the turn of the century to further modern agriculture, Sherbon and her team used the language of crops and breeding to persuade Hoosiers to apply scientific knowledge to the procreation and bringing up of children.27 They implored farmers to shed superstition for science, vowing that if they heeded their instructions about milk sterilization, nourishment, and parturition, their sons and daughters would “grow up strong and well.”28

INDIANA CHILD CREED

Every child has the inalienable right to be born free from disease, free from deformity and with pure blood in its veins and arteries.

Every child has the inalienable right to be loved; to have its individuality respected; to be trained wisely in mind, body, and soul; to be protected from disease, from evil influences and evil persons; and to have a fair chance. In a word, to be brought up in the fear and admonition of the Lord.

That state is delinquent which does not ceaselessly strive to secure these inalienable rights to its children.

The crux of the Children's Bureau mission in Indiana, however, was the “babies' health conferences” Sherbon and her colleagues orchestrated in towns and cities such as Lagrange, Butler, Kendalville, Petersburg, and Washington. According to the informational brochure, the aim of these gatherings was to “show the physical condition of the children examined and indicate the points at which their health and vigor may be improved by the efforts of the parents.”29 Spending 4 days in each locale, bureau representatives inspected children younger than 6 years and exposed Hoosiers to films, written materials, and visual aids.30

Aside from ushering in innovative notions about child rearing, one of the topmost goals of these conferences was to expedite the continuation of better baby work in Indiana. In every town on their itinerary, Sherbon and her team scrutinized the feasibility of follow-up efforts among local women's clubs and medical groups, many of which had independently begun grassroots campaigns.

ESTABLISHING THE DIVISION OF INFANT AND CHILD HYGIENE

These activities sparked moderate interest in child hygiene but certainly did not bring about the sweeping program envisioned by the Children's Bureau. The seeds for a more far-reaching plan were planted at the babies' health conference held in conjunction with Indiana University's Extension University in Bloomington in March 1916.31 Sherbon and her colleagues were convinced that the movement would be guaranteed “a much better chance for permanent survival” if it were housed in a state division, not scattered among local groups. Hence, at that meeting they broached the possibilities for such a public health unit with John N. Hurty, director of the Indiana State Board of Health from 1896 to 1922 and an ardent eugenicist and outspoken supporter of the sterilization and marriage laws.32

Not surprisingly, given his concerns with race betterment and child saving, Hurty responded enthusiastically and, in spite of an immediate lack of funds, conveyed his willingness to submit a proposal in the next legislative cycle.33 Three years after these conversations and the Children's Bureau babies' health conferences, the Indiana State Board of Health's Division of the Child and Infant Hygiene was created and Schweitzer was appointed its director.34

Schweitzer's relationship with Hurty and the Board of Health began in 1906, when she was hired as an assistant bacteriologist at the state laboratory. Born in 1873 in the northern town of Lagrange, Schweitzer grew up on a farm where her Scottish-Irish mother and German father raised mint and purebred poultry. After attending Lima High School, she left Indiana to obtain her baccalaureate at Michigan State Normal College, returning permanently in 1902 to pursue her medical degree at Indiana Medical College.

While in school, Schweitzer conducted bacteriological studies at the state laboratory, concentrating on the prevalence and morbidity of children's epidemics such as measles, diphtheria, and typhoid.35 Inspired by ideas of progressive maternalism and Hurty's principles of racial uplift, Schweitzer soon became Indiana's leading champion of infant hygiene, and by the second decade of the 20th century she was spearheading child welfare projects. In 1916, for example, she represented the State Board of Health at the Children's Bureau conference in her hometown of Lagrange, delivering 2 talks titled “Personal Hygiene” and “Sanitation in the Home.”36

In 1918 she was elected chairwoman of the Indiana branch of the American Association for the Study and Prevention of Infant Mortality.37 That same year she authored a survey of infant mortality in Gary on special assignment for the Children's Bureau. In the fall of 1918 she traveled to the South to realize a similar investigation but soon was attending to the crisis engendered by the influenza outbreak. As she was vacating her temporary post in Georgia, Schweitzer received word of Hurty's invitation to become director of the Division of Infant and Child Hygiene.38

When the division's starting appropriation of $10 000 became available in October 1919, Schweitzer and her staff of 3—a nurse, a chauffeur, and a stenographer—swung into action.39 In a detailed letter, Hurty boasted to Lathrop about the extensive and trailblazing endeavors of Schweitzer and her underlings. Hurty explained that Schweitzer was “carrying the news into the rural regions beyond the railways” and venturing “deep into the country” to find areas that had scarcely been reached by health officials or the Indiana Mothers' Baby Book. Above all, Hurty was proud of the division's child mobile, a Dodge truck outfitted with “a Delco electric apparatus” that lit up “country school houses or churches” and activated the “stereopticon and moving picture machine.” In most towns, Schweitzer's entrance behind the wheel of the mobile—customarily adorned with flags—was a festive event always “announced by a bugle.” In town after town the routine was repeated: “Mothers are invited to bring their babies for physical examination. Advice and circulars are given to them, and then the Division moves on to the next stand, which as said, is always advertised beforehand.”40

As she launched Indiana's better baby movement, Schweitzer reenergized the mission of the Children's Bureau. Crisscrossing Indiana from county to county, Schweitzer and her corps handed out pamphlets, mounted exhibits, delivered lectures, screened films, and demonstrated techniques for nursing and preparing formula. Each month, Schweitzer personally scrutinized the health of hundreds of children—assessing their teeth, height, weight, vision, hearing, tonsils, adenoids, possible infections, defects, eating habits, hours of sleep, access to fresh air, and home surroundings.41

Schweitzer's 1920 annual report revealed that the division had convened conferences in 27 counties, examined 8000 children, and presented lectures or films in 290 towns. Continually striving for lay involvement, the division had collaborated with 476 local, 53 state, and 63 national organizations on joint projects.42 Furthermore, by 1921, many Indiana mothers, worried about the health of their babies, had sent “Dear Dr Schweitzer” letters to the division's headquarters at the State House.43

If the division grew steadily in the early 1920s, it expanded exponentially after the passage of the federal Maternity and Infancy, or Sheppard–Towner, Act. Although the Indiana State Medical Association—like its parent the American Medical Association—loudly opposed Sheppard–Towner and labeled it intrusive state medicine, Hurty's national prestige and Indiana's entrenched eugenic and public health programs guaranteed endorsement of the necessary “enabling legislation” by the state assembly.44 With a budget 3 times her original one, in 1923 Schweitzer substantially broadened and reconfigured the division. She hired additional nurses and assistants, amplified the radius of the child health conferences, founded maternal and infancy centers, augmented public nursing efforts, and realized increasingly ambitious statistical and clinical studies.45 As in similar agencies across the country, the bulk of her staff were female nonphysicians, an arrangement that provoked the ire of a vocal segment of Indiana's predominantly male medical establishment.

During this period Schweitzer initiated mothers' classes to teach pregnant women the fundamentals of prenatal and baby care.46 In addition to inculcating scientific motherhood and basic precepts of public hygiene, these courses also furnished a venue for Schweitzer to expound on the virtues of Indiana's eugenic marriage and sterilization laws, which she believed ensured the robustness of Hoosier babies.47 In 1925, 16 649 women—more than 50% of all attendees nationwide—took mothers' classes in Indiana under the aegis of the Division of Infant and Child Hygiene.48

That same year, Schweitzer wrote to the Children's Bureau, “[O]ur work is growing so fast that it is difficult to plan so far ahead.”49 By 1926, the division's operating funds had climbed to $60 000 and it counted more than 20 full-time and temporary employees.50 Moreover, according to the census, Indiana's infant mortality rates had fallen to the fourth lowest in the country, a decrease due to several intertwined factors, including the division's campaigns.51 After one decade, the division had examined the health of 77 584 children, enrolled 55 171 mothers in instructional classes, shown health films to 606 364 viewers, and reached almost half of the state's population of 3 million through the distribution of 1 216 577 pamphlets.52

Schweitzer's crusade indubitably altered attitudes about health, maternity, and childhood in Indiana. In Muncie, for example, the Lynds found that mothers were voracious readers of pamphlets and installment books on prenatal and infant care, always on the lookout for “every available resource for help in training their children.”53 Moreover, according to the Lynds, most Muncie parents readily embraced the latest pediatric advice.

Some, however, were bewildered by this avalanche of new instructional materials and were averse to renouncing tried and true practices that had been handed down from generation to generation through female relatives. Like the Children's Bureau during its 1916 tour of Indiana, since 1919 the Division of Infant and Child Hygiene had sought to persuade inhabitants of Muncie and the rest of Indiana of the imperative of the rules of scientific motherhood and child rearing. From the perspective of Schweitzer and other reformers, the integrity of Hoosier health and citizenship depended the mass adaptation of infant and maternal hygiene. As Schweitzer was fond of saying, only this would enable Indiana to become a good parent.54

THE BETTER BABIES CONTESTS

The centerpiece of Schweitzer's quest to groom Indiana into an enlightened guardian of Hoosier children were the better babies contests, inaugurated in 1920 and, until their discontinuation in 1932, one of the most popular events at the state fair. The significance of the contests was layered and complex. As manifestations of the state fair in miniature, each year the better babies contest served as a venue for Hoosiers to negotiate past and present, nostalgia and modernity.55 They acquainted Indianans with the most up-to-date opinions of child specialists, thereby reinforcing emergent pediatric norms and imbuing university-trained experts with ultimate authority over matters pertaining to the biology, physiology, and psychology of children.

The contests also commercialized this process, through advertising in and sponsorship by the Indianapolis News, by soliciting patronage from businesses such as the Hoosier Fence Company and the Weber Milk Company, and by fostering a competitive climate in which the winner received cash prizes and a trophy.56 Finally, while the contests bolstered professionalized child medicine and brand name consumerism, they simultaneously depicted babyhood as a time of innocence and purity that was under assault by 20th-century urbanization and industrialization.57

Moreover, by excluding African American children, the contests reinforced patterns of segregation in Indiana and promoted the idea that only White babies could achieve perfection and symbolize the Hoosier state.58 Schweitzer reportedly ordained the contest “a school of education in eugenics” and countenanced the use of categories that made “some allowance for familial and racial types.”59 More implicitly than overtly, she furthered Indiana's racial divisions as she strove to improve the overall health of Hoosier children and modernize rural mothers through science.

Despite their immense popularity at the state fair, better babies contests did not originate in Indiana. Adumbrated by 19th-century beauty pageants, the contests began at the Iowa State Fair in 1911 when clubwoman Mary T. Watts asked, “You are raising better cattle, better horses, and better hogs, why don't you raise better babies?”60 To judge infants like livestock, Watts and another rural reformer, Margaret Clark, devised scorecards that tallied level of physical health, anthropometric traits, and mental development. Soon thereafter, the widely read magazine Woman's Home Companion embarked on its Better Baby Campaign by sending one of its editors, Anna Steese Richardson, to Colorado to advance the contests.61 Soon they were all the rage, and by 1914, Woman's Home Companion claimed “that contests had been held in every state except West Virginia, New Hamsphire, and Utah, and that more than 100 000 children had been examined.”62

With its field workers already dispersed around the country taking part in local infant hygiene efforts, the Children's Bureau became involved in the contests as well. Lathrop, however, while supporting the educational aspect of the contests, was disturbed by the competitiveness they fostered, the commercialism they endorsed, and their glaring lack of a standardized scoring system. Thus, she arranged for the Bureau to join forces with the American Medical Association to develop a scorecard acceptable to the pediatric establishment and also began to sponsor an alternative, the children's health conferences, which contained most of the elements of the better babies contests without numerical rankings. Indeed, during Sherbon's reconnoitering of Indiana in 1916, she and her colleagues complained in several towns about crowded, confusing, and ill-managed contests that had been inspired by Woman's Home Companion.63 They hoped that the children's health conference would “successfully demonstrate a different method.”64

Given her close ties to the Children's Bureau, Schweitzer was initially reluctant to incorporate better babies contests into her division's activities. Hence in 1920, when Charles F. Kennedy, then secretary of the State Board of Agriculture, proposed that she oversee a contest at the state fair that year, she evinced skepticism. Kennedy, who had conducted a similar contest in Grand Rapids, Mich, was convinced it would be a wonderful addition to the fair.65 Schweitzer was soon swayed by Kennedy's petition and in 1920 presided over one of the fair's most crowd-pleasing features.66 Within no time, she was a fervent defender of the contests, justifying them as completely professional endeavors, guided by the firm principles of pediatrics and child psychology. Explaining her decision to avidly back the contests at the state fair, Schweitzer wrote to Dr Talafierro Clark of the US Public Health Service, “I had numerous consultations with men skilled in pediatrics and specialists” as “we needed to place the contest on as high a plane as possible, in order to free it as near as could be from objectionable features.”67

Schweitzer consistently distinguished the state fair contest from its makeshift and unregulated imitations in small rural towns and villages. Schweitzer wanted all of Indiana's baby contests to be directed solely by the division and regularly pleaded with rural reformers to erect an alternative, the baby rest tent, where toddlers would be shielded from dust, crowds, possible exploitation, and the disappointment of losing in an amateur competition.68 To meet the benchmark of professionalism, she used a scorecard based directly on the template formulated by the American Medical Association and the Children's Bureau.69

By the mid-1920s, Schweitzer was showcasing the better babies contests on the radio and in articles in the Monthly Bulletin of the ISBH and the Hub of the Universe. She contended that the value of the contests resided in the fact that they “set the best standards of health before the parents that they may compare these with the actual condition of their child.”70 For the most part, Schweitzer believed that better babies contests provided a level playing field on which infants could be judged according on their own merits.

While Schweitzer certainly viewed the contests as a facet of a more extensive race betterment project, she alleged that the “gates of heredity” were closed after the baby left the womb. It was essential to first restrict birth to only the most fit, through marriage and sterilization laws, and then create only the most desirable children through scientific child rearing and motherhood. Reflecting her particular blend of eugenics and public health, Schweitzer told one Muncie reformer, “You can not make a silk purse out of a sow's ear, neither can we make a citizen out of an idiot or any person who is not well born.”71

MAKING INDIANA A GOOD PARENT

Schweitzer frequently extolled the benefits of the contests, claiming, for example, that the lessons taught by the contests had helped to lower the percentage of underweight contestant babies from 10% in 1920 to 2% in 1929.72 To publicize this annual September event, she wrote announcements, published fact sheets, and explained scoring procedures in laborious detail.73 With each passing year, the contests became more popular among Indianans. In 1920, for example, 78 babies were examined; by 1925 this number had risen more than 10-fold, to 885, and in 1930 when 1301 young entrants were counted, enthusiasm was so overwhelming that Schweitzer opted to cap the number of entrants at 1200 the following year.74

In 1923 the Indianapolis News began to sponsor the contest, giving it a big boost; not only did the paper devote more space to articles, but it also began to print full-length pages with individual photos of hundreds of contestant babies whose mothers had sent in their registration forms by the deadline.75 In 1924 the contest grounds were enlarged when a window-paneled Better Babies Building was erected, thanks to a $10 000 donation from J. E. Oliver of Oliver Chilled Plow Works. This new edifice housed exhibits, examinations of noncontestant babies, and demonstrations.76 In 1927, the contests themselves were moved from a partition of the Woman's Building, where they had been held faithfully since 1920, to a brand-new Better Babies Contest Building. Constructed as part of the state fair's Diamond Jubilee, this building was financed by a special $5000 appropriation from the State Board of Agriculture and the legislature.77

As the contest grew under Schweitzer's commanding presence, it also became more streamlined and efficient. For the week-long event, she contracted a general pediatrician—almost always Dr James C. Carter—as well as an optometrist, an otorhinolaryngologist, and several extra nurses and orderlies. In addition, assistance was provided by the Girl and Boy Scouts, who escorted mothers from station to station.

The contest procedure was well honed. Before the event began, the registered infants were divided into groups based on age (12–24 months or 24–36 months), sex, and place of residence. Those categorized as city babies lived in places with 10 000 inhabitants or more; the others were considered rural. With their children classified, parents—usually mothers—arrived at the better babies complex at the state fair at a designated time. As the mothers entered the building they submitted their enrollment form to a female attendant, who recorded the name of the mother and child. Then the baby was whisked away to the next booth, where its overall health history was taken by a nurse.

Mental tests—distinct for each age group—followed. Psychologists observed whether the children could stand, walk, and speak; how they manipulated blocks and balls; and how they responded to questions such as “How does the doggie do?” and “Who is the baby in the mirror?”78 Mental tests completed, the babies were undressed and their clothes placed in a paper bag with an identifying number. Identically robed in flannel togas, the babies were weighed and measured. From here each baby passed from the optometrist to the general pediatrician and finally to the otorhinolaryngologist. After being weighed and measured a second time, each baby was dressed in his or her own clothing and bedecked with a bronze medal on a blue ribbon, courtesy of the Indianapolis News.

Scores were calculated along the way. From a starting score of 1000, deductions were calculated for a wide host of physical defects including unevenness of the head, scaly skin, ill deportment, delayed teething, abnormal ear size or shape, and enlarged glands. Slow reactions to the mental tests or perceived lack of muscular coordination lowered a child's score, as did deviations from the national standards for height and weight (based on age) and weight-to-height ratio. Tabulated results from the contests indicate that Schweitzer instructed her team to subtract the most infinitesimal of figures for each defect—most likely to maintain high results for every baby, thus diluting the rivalrous nature of the contests. The victor generally scored above 990; Alma Louise Strohmeyer, a 1-year-old Indianapolis girl, triumphed with 999.92813 points in 1923.79

In spite of their professed formality and orderliness, the contests were both crowded and noisy. In 1928, for example, 67 000 people streamed through the better babies complex, watching the psychological tests, spending time at the rest tent and nursery, and taking in the infant and maternal care dioramas.80 As thousands made their way through the contest rooms, babies howled as they were unclothed, squealed when prodded by the stethoscope, or cooed delightedly when given their blue ribbon.81 In 1925, the News described the chaos as a packed room filled to overflowing with the “noisy accompaniment of more than 200 child voices. The perfection of the lungs of the babies examined Monday could scarcely be doubted, and if there are not future opera singers and booming voiced orators of the group, many of the attendants and onlookers are exceedingly poor prophets.”82

While the impact of the contests is difficult to gauge, it is not unreasonable to accept Schweitzer's contention that they played a part in effectively reducing infant mortality rates and prompting mothers to safeguard against the bacterial infection of milk and food. The contests also provided a platform for the commercialization of public health as well as the incorporation of the “better baby” into advertising—a newborn icon that figured regularly in the 1920s, selling products such as condensed milk and infant formula. Schweitzer's correspondence, furthermore, reveals that not only did many Hoosiers regularly send her general inquiries about child rearing, but many mothers—of varying degrees of literacy—were concerned enough about their children's contest scores to contact the division. In 1922 one parent wrote to Schweitzer anxious to know her daughter's “failing points” and to find out “in what way she failed a perfect score.”83 That same year, Schweitzer received a letter from another set of fretful parents: “We are so anxious to know her defects and in what way she was lacking.”84

These and numerous additional letters demonstrate the extent to which Indianans from every inch of the state viewed Schweitzer as a trusted expert who could direct, or at least make recommendations about, local child-saving events. They also suggest that for those who attended the division's many conferences, workshops, and classes, the line between public health and eugenics was nebulous or nonexistent. On one hand, Schweitzer implored Hoosiers to adhere to the state's marriage laws and spoke out consistently in favor of the state's sterilization restrictions, which were based on a Mendelian understanding of hereditary transmission. On the other, she was just as beholden to the gospels of private hygiene, pure milk, vaccination programs, and clean air and sunshine. For Schweitzer and hundreds of other reformers, particularly the progressive maternalists, these multiple and seemingly paradoxical aspects of infant welfare and scientific motherhood coexisted quite comfortably on a wide continuum of race betterment.

EPILOGUE: A NEW DEAL FOR HOOSIER BABIES

In 1932 the last better babies contest was held, attracting thousands of spectators. In the early 1930s, the Depression, the resentment of Indiana's male pediatricians, and the election of new Democratic administration converged, setting the stage for the end of the Division of Infant and Child Hygiene. Intent on centralizing his New Deal plan and distancing himself from his Republican predecessors, in 1933 Governor Paul V. McNutt abruptly dismissed Schweitzer and transferred the newly named Department of Child Health and Maternal Welfare to the Indiana University School of Medicine.

Of the division's more than 20 employees, only Dr James C. Carter—the pediatrician Schweitzer hired each year to examine better babies—was retained to serve on a committee charged with designing a new blueprint for child welfare in Indiana.85 None of the female physicians or nurses who had so faithfully staffed Schweitzer's division for more than a decade were asked to join McNutt's revamped department, which emphasized clinical pediatric teaching instead of hands-on infant and maternal hygiene projects. Nonetheless, Schweitzer's legacy was felt in 1936 when McNutt oversaw the passage of legislation to receive Title V funds through the Social Security Act and partially revived the division. A Bureau of Maternal and Child Health, both federally and state financed in a manner akin to Sheppard–Towner, was founded, and a male physician closely affiliated with the Indiana State Medical Association was named its director.86

Many historians of 20th-century America conceptualize public health and eugenics as antithetical movements separated by the conceptual gulf between environment and heredity.87 Schweitzer's work in Indiana, and better babies contests across the country more generally, illustrate that race betterment was an expansive rubric with a great deal of space for overlapping ideas and practices. The Division of Infant and Child Hygiene's experiment demonstrates the active leadership of female reformers in infant and maternal welfare in the 1920s as well as the problematic racial and class implications of making babies better in Indiana.

Figure 1.

Contestants (probably winners) from the 1927 Better Babies Contest, accompanied by Division of Infant and Child Hygiene nurses. (Photo courtesy of the Indiana State Archives, Indiana Commission on Public Records.)

Figure 2.

Baby Contest Building and spectators, Indiana State Fair, 1929 (Photo courtesy of the Indiana State Archives, Indiana Commission on Public Records.)

Figure 3.

Spectators watching the various testing and measurement tables at the 1930 contest. (Photo courtesy of the Indiana State Archives, Indiana Commission on Public Records.)