Man achieves immortality largely through his children and his work. As soon as an infant has been born, its health and welfare become the first concern of both its father and its mother. This is one of the points of difference between man and most of the lower animals; and as culture and civilization advance, we find mankind attempting to provide better and better protection and educational and vocational opportunities for children. Sir Arthur Newsholme, leading English authority on public health, states: “Infant mortality is the most sensitive index of social welfare and of sanitary improvement which we possess. If babies were well-born and well cared for, their mortality would be negligible.”
In some sections of the world the chances are not more than one in two that a newborn child will live to reach its first birthday, and in some cities of our own country within the present century approximately one child out of three died during the first year of life. In the registration area of the United States 162 infants per 1,000 born alive died during the first year of life this number had been reduced to 64.6; the corresponding rates for several other countries were as follows: Chile, 234; India, 178; Ceylon, 175; Italy 125; Japan, 124; Germany, 96.4; France, 96; England, Scotland, and Wales, 63; Sweden, 58; Norway, 55; Switzerland, 51; and New Zealand, 35.
The major causes of infant mortality among the white population at the present time are prenatal and natal diseases and injuries, respiratory diseases, and gastrointestinal diseases. The toxemia of pregnancy and syphilis are the primary causes of premature births. Adequate care during the pm natal period and modern hospital facilities for the care of premature infants are effective measures in reducing these deaths.
The same may be said concerning some of the respiratory diseases. Bronchitis, pneumonia, and other respiratory infections are serious in infants because they have little resistance against them. Hence, all infants should be safeguarded in every possible way from exposure to children and adults who may transmit colds or other infections to them. Malnutrition and the deficiency diseases lower the infant’s resistance and so contribute to the seriousness of these respiratory infections.
The diarrhea or intestinal diseases long occupied first place among the causes of infant mortality and still do so in certain countries. The marked reduction in the deaths from these diseases which has taken place has been due largely to sanitation and improved methods of infant feeding. Breast milk is the ideal food for a baby. Studies have shown that the death rate from intestinal diseases is three to ten times as high among artificially fed as among breast-fed children.
The young Women of today are physically superior to the women of previous generations and almost all of them are able to nurse their babies for at least the major part of the usual nursing period of nine months. Breast milk is desirable not only because it is easily digested and is most nutritious for the child, but also because it offers protection against diarrhea and intestinal diseases and increases resistance against measles, scarlet fever, and other common infections of infancy.
A few years ago a serious and frequently fatal blood disease of newborn infants was found to be caused by a certain incompatibility of the parent’s blood. This is dependent upon what is known as the “RH factor.” Tests can be made for this condition. If it exists, the risk to the child can be reduced by careful medical supervision and care during pregnancy.
The more important indirect causes of infant death are poverty and ignorance. Many studies have shown a direct correlation between low income of the wage earner and high infant mortality. One of these studies reports 168 infant deaths per 1,000 live births among families with an annual income of $500 or less as compared to a rate of 30 per 1,000 among families with incomes of $3,000 or more, and an increase of 20 per cent in the infant death rate in families of which the wage earner became unemployed during the depression years.
The conditions of poverty are all adverse to the survival of the delicate life of the newborn infant. On the other hand, poverty, unemployment, and larger families than can possibly be supported are frequently the result of the same sort of ignorance and irresponsibility which contribute to a high infant death rate. It has also been shown that, by instruction of the mother concerning the proper care and feeding of infants, it is possible materially to improve nutritional status, even though the family’s income is no more than relief allowance.
The US Children’s Bureau in Washington and the state and local health departments make available bulletins of information, advice, and, if necessary, public health nursing service for maternal and infant care, so that there is no longer any justification for the ignorance and neglect which has been responsible for most of the deaths of mothers and infants in the past.