OUR BABIES.

King Country Chronicle, Volume VIII, Issue 662, 22 April 1914, Page 3

OUR BABIES.

Published under the auspices of the Society for the Health of Women and Children.

" It is wiser to put up a fence at the top of a precipice than to maintain an ambulance at the bottom."

INSTITUTIONALISM AND THE BABY. Last week I dealt with the grievous effects of undue warmth and stuffiness and lack of ventilation in 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 tho curse of European baby hospital?, and accounts for their high death rate. The 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 change from warm, stuffy roums to cold air and draughts, especially if there is also carelessness aa to clothing." In a German book published last year by Dr Ludwig Meyer, of Berlin, it is shown that in the early part of last century the infantile death rate in foundling 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 better even in the 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 insitutions, and the slow progress and feeble vitality of the inmates, strike with astonishment anyone who has seen what csn 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 are so much lower than they have grown accustomed to and regarded as inevitable. In the Karitane Baby Hospital the death rate has averaged only 10 per cent, for the last three years, and it would cprtainly ba less than. 5 per cent, but for the fact that such a large proportion of practically hopeless premature babies and uthers are sent in in a moribund condition, and die within a day or two of admission. If a baby is capahle of surviving a week after coming under care, we find death a rare event. It is interesting to contrast this with Institutionalism in other countries. Infantile Institutionalism means the prejudicial effects on babies which have been found to obtain where foundlings and others are brought together in large numbers for rearing artificially in institutions which are not necessarily hospitals. So far as the fate of the children is concerned, it is impossible to draw any hard-and-fast distinction between Institutionalism and Hospitalism. But. the fact that foundling homes most of the babies may be received in perfectly good health makes the high death rate of such institutions even more inexcusable than the high infantile mortality of hospitals. One can say with entire confidence that the infantile mortality certainly ought not to exceed 5 to 10 per cent, in any ordinary institution for the care of babie3 where, say, threefourths are 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 haj obtained, and still obtains, almost everywhere as to the fate of babies entrusted to the guardianship of institution? 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 their 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 the 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 the investigations of 'a Committee set up to inquire into the "Mortality in Institutions for Infants." A large endowment for this purpose was left by a wealhty American named Russell Sage, and the findings of the Committee not only produced a profound impression, but led to revolutionary changes in the care of children who could not be reared .by their mothers.

The reports were 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 the figures were supplied by the institutions themselves, it will readily be inferred that in vo case would they be more unfavourable than the actual facts warranted. On the other hand, it is noted that, some of the institutions tended to show less than their normal death rates owing to the practice of boarding-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 imther,' and their 3eaths are not reported." The following is a broad summary of the statistics for the 22 institutions reported on: —Total number of infants under two years of age received in the 22 institutions, 56,451; number of deaths reported, 22,743; ration of deaths per cent., 40.3. ANALYSIS OF DEATH RATES. Average for the six best institutions, under 30 per cent.; for six institutions, between 30 and 40 per cent.; for three institutions, between 40 and 50 per cent.; average for three institutions, between 50 and 60 per cent.; for two institutions, between 60 and 70 per cent.; for the two worst institutions, above 70 per cent.

Commenting on these figures, the

report said that though it is a common imprsssion that the death rates in institutions hod been greatly diminished in recent years, the actual statistics made it apparent at the latest death rates were only 4 par cent, lower than the average for the seritß of preceding years. The point of view of some of those who are in charge of these Ameican Baby Institutions is illustrated by the following facts:—l. In the printed report of a prominent home for the care of infants occurs the following statement. After referring to a change of practice, whereby nursing infants were boarded out in private families instead of being kept together in the institutions, the report was:—"The mortality has been reduced from about 100 per cent, to about 34 per cent. A later report of the same institution shows a further reduction to less than 20 per cent."

2. The physician in charge of an institution where the practice of boarding-out children in family homes has prevailed during recent years, says: "During my period of observation, covering more than a year, every motherless infant under the age of one year admitted to the institution died before reaching the age of two years." The superintendent of an asylum for infants sent the following report:—"l send you the infant statistic required. Dating tbe past 20 years the death rat 9 among the children two years and under was 75 per cent."