Man achieves immortality largely through his children and his work. As soon as a baby is born, his health and well-being become the first concern of both his father and his 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 trying to provide ever better protection and educational and vocational opportunities for children. Sir Arthur Newsholme, England’s leading authority on public health, says: “Infant mortality is the most sensitive index of social well-being and health improvement we have. If babies were born well and well cared for, their mortality would be negligible.”
In some parts of the world the chances of a newborn child living to be one year old are no more than one in two, and in some cities of our own country in the present century about one in three children died during the first year. of life. In the registration area of the United States, 162 infants per 1,000 live births died during the first year of life; this figure 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 leading causes of infant mortality among the white population today are prenatal and natal diseases and injuries, respiratory diseases, and gastrointestinal diseases. Toxemia of pregnancy and syphilis are the main causes of preterm births. Adequate care during the pm natal period and modern hospital facilities for the care of premature babies are effective measures to reduce these deaths.
The same can be said of some of the respiratory diseases. Bronchitis, pneumonia, and other respiratory infections are serious in babies because they have little resistance against them. Therefore, all babies should be protected in every possible way from exposure to children and adults who may transmit colds or other infections. Malnutrition and deficiency diseases reduce the infant’s resistance and thus contribute to the severity of these respiratory infections.
Diarrheal or intestinal diseases occupied the first place among the causes of infant mortality for a long time and still do so in certain countries. The marked reduction that has taken place in deaths from these diseases has been due in large part 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 higher among artificially fed children than among breastfed children.
Today’s young women are physically superior to women of previous generations, and nearly all can breastfeed their babies for at least most of the usual nine-month lactation period. Breast milk is desirable not only because it is easily digested and more 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 childhood infections.
A few years ago it was discovered that a serious and often fatal blood disease of newborns was caused by a certain incompatibility of the parents’ blood. This depends on what is known as the “RH factor”. Tests can be done for this condition. If it exists, the risk to the child can be reduced by careful supervision and medical care during pregnancy.
The most important indirect causes of infant death are poverty and ignorance. Many studies have shown a direct correlation between low wage earning 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, compared to a rate of 30 per 1,000 among families with incomes of $3,000 or more, and an increase of 20 percent. in infant mortality. Mortality rate in families in which the wage earner became unemployed during the depression years.
The conditions of poverty are all adverse for the survival of the delicate life of the newborn. On the other hand, poverty, unemployment, and families larger than can possibly be supported are often the result of the same kind of ignorance and irresponsibility that contribute to a high infant mortality rate. It has also been shown that by instructing the mother in the proper care and feeding of children, it is possible to materially improve nutritional status, even if the family income is no more than a relief allowance.
The US Children’s Bureau in Washington and state and local health departments make available information bulletins, advice and, where appropriate, public health nursing service for maternal and child care, so that ignorance is no longer justified and the carelessness that has been responsible for most of the deaths of mothers and babies in the past.