Established on March 3rd 1939, during the regime of Benito Mussolini. This medal was used as a form of public recognition for mothers who bore 5 children, with a single bow added to the ribbon for every extra child she had. There are no signs of any extra fastening of bows, so I take it this Mother had 5 children.This is a thick alloy medal and much lighter than it looks. The casting is very attractive and the design with Mother and Children is beautiful.