OUR BABIES.

Dominion, Volume 7, Issue 2132, 25 April 1914, Page 11

OUR BABIES.

fßi High A.l

Published under the auspices of tie Society for the Health of 'Women and Children. "It li wirar to put up a. fence at the top ot a prooipice than to maintain an a.mbulanoj at tho bottom."

INSTITUTIONALISE AND THE BABY, Iu my last notes I dealt with the grievous effects of undue warmth and stuffiness and' lack of, ventilation iu European hospitals for babies, and showed how this brought about a condition,, known as Hospitalism, which is entirely absent from the Society's Baby .Hospital at Dunedin. Our article concluded: "Hospitalism is the curso of European Baby Hospitals, and accounts for their high death-rate. Tho reason why we have no Hospitalism at the Karitane Hospital is the fact that we are not afraid of pure, -cold air, but dread warm, muggy air. . Of course, the worst of all things is careless chango from warm, stujfy rooms to cold air and draughts, especially if there is also carelessness as to clothing." • In a German book published last year by Dr. Ludwig Moyer, of Berlin, it is shown that in the early part of last century the infantile death-rate in found- j ling hospitals often reached 50 per cent., and, sometimes almost every baby died in spite,of'there being a real desire to keep them alive. Until quite recently things were not much bettor even in tho costly and extravagant baby wards and baby-hospitals established in the great cities of Germany and Austria. Even now the high death-rates in these institutions, and the slow progress and feeble .vitality of the inmates, strike with astonishment anyone who has seen what can be brought about by simple, rational, care and hygiene. The authorities of European baby hospitals still think comparatively ''little of an infantile death-rate of 20 '.or 30 per cent., because'such figures arc so much lower than they had grown accustomed to and regarded as inevitable. i In the Karitane Baby Hospital the deati-ratei has averaged only 10 per cent, for the last three years, and it would certainly be less than 5 per cent, but for the fact that such a large proportion. of practically hopeless premature babies and others are sent in in a moribund condition, and die within a day or two of admission. If a baby is capablo of surviving a week after coming under care, we find death' a rare event. It is interesting to contrast this with institutioiialism in other countries. By infantile institutionalising I mean the prejudicial effects on babies which have keen found to obtain where foundlings and others aro brought together in large numbers for rearing artificially in institutions which are not necessarily hospitals. So far as tho fato of.tho children is concerned, it is impossible to draw any liard*ancl-fast distinction between institutionalism and hospitalism. But the fact that in foundling homes most of tho babies may bo received in perfectly good health makes the high death-rato of such institutions even more inexcusable than tho high infantile mortality of hospitals. One can say with entire confidence that tho infant mortality certainly ought not to exceed 5 to 10 por cent, in any ordinary institution for-the care of babies, where, say, three-fourths arc admitted healthy and only one-fourth suffering from malnutrition or actual sickness. How, then, can the civilised world justify itself in regard to the callous indifference which has obtained, and still obtains, almost everywhere as to the fate of babies entrusted to the guardianship of institutions? In our time no country in the world—not even Australasia —has been exempt from institutions where the baby, death : rate has averaged from 30 to 40 per cent, of those admitted, and there have been plenty of instances in the world in which the death rate has risen to double these figures—only a fifth to a sixth of tho inmates surviving.

AMERICAN FIGURES. In the transactions of the American Association for the study and prevention of infantile mortality for 1910 there is published a preliminary account of tho investigations of a committee set up to inquire into the , "Mortality in Institutions for Infants." A largo endowment for this purposo was left by a wealthy American named Russell Sage, and • the findings of the committee not only produced a profound impression, but led to revolutionary changes in the oaro of children who could not be reared by their mothers. The 1 reports wero drawn up less than five years ago, and were based on published statistics and information received directly from 22 institutions, most of them covering a series of years'. Seeing that tho figures wero supplied by the institutions themselves, it will readily be inferred that in no case would they bo more unfavourable than the actual facts warranted. On the other hand, it is noted that tome of-the institutions tended to show less than their normal death rates owing to tho practico of boarcHng-out delicate children in private families, while "in other cases it was found that moribund infants were returned to their mothers, and in such cases they appear as "returned to mother," and their deaths are not reported." ' Tho following is a broad summary of the statistics for tho 22 institutions reported on: — Total number of infants : under two years of ago'received in tho 22 institutions 56,541 Number of deaths reported 22,743 Ratio of deaths per cent 40.3

ANALYSIS OF DEATH-RATES. Number of ■ Death-rate on Institutions. ' Admission. Average for the (i best institutions Under 30 p.c. Averago for 6 institutions Between 30 & .40 p.c. A vera"tfor ■ „ 3 institutions Between 40 & 50 p.c, Average for 3 institutions Between oO & 60 p.c. Average for ■2 institutions Between 60 &.70 p.c, Average for 2 worst institutions Above 70 p.o.

Commenting on these figures, the report said that'though it is a common impression that tho death-rates in institutions had been greatly diminjshed in recent years, tho actual statistics made it apparent that tho latest deathrates wero only 4 per cent, lowor than tho average for the series of preceding J' 031 " 8 - . ~ c The point of view of some of those who aro in charge of these (American baby institutions is illustrated by tho following facts:— (1) In tho printed report of a prominent homo for the care of infants occurs tho following statement. After referring to a change of practice, whoreby nursing , infants were boarded out in private families instead of being kept together in the institutions, the report says: "Tho mortality has been reduced from about 100 por cent, to about 34 per cent. A later report of the same institution shows a further reduction to less than 20 per cent." (2) Tho physician in charge of an. institution where tho practice of boardingout children in family homes has prevailed during recent years, says: "During my period of observation, covering more than a year, every motherless infant under tho ago of one year admitted to tho institution died before reaching the ago. of two years." (3) The superintendent of an asylum for infants sent tho following report:— "I send you tho infant statistics required. During tho past 20 years the death-rate among tho children two years and under was 75 per ccut."