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INFANT MORTALITY.
There were 11 deaths of infants; that is to say, children
under one year of age. This gives an infant mortality rate of
11.73, the lowest ever recorded for the district. Analysis of the
causes of these deaths as listed below emphasize once more the
fact that infant mortality today has its root and origin in obstetrics.
It will be seen that once more all except one of the infant deaths
are neo-natal deaths; that is, occurring in the first month of
life. With the exception of a death at three months of age all
the others died within five days of birth. Four of the 10 neonatal
deaths were due to prematurity, two to birth injuries, two
to developmental defects, one to haemolitic disease of the newborn,
and one to broncho-pneumonia, so that six of these deaths,
or 60% must ultimately be regarded as preventable deaths in the
sense that improved obstetric skill, including ante-natal care,
might have prevented them. The improvement in ante-natal
care sufficient to prevent those deaths due to developmental
defects can only come about as our knowledge of the aetiology of
the conditions expands.
The dieticians, with the knowledge they have gained of the
principles of adequate nutrition, the knowledge which has been
put over to the public by the Public Health staff of this country,
have removed almost entirely pelvic deformities as a cause of
obstructed labour, the discoveries of the Sulpha drugs and of the
antibiotics Penicillin and its allied preparations have removed the
risk of sepsis, the other of the two dreaded sequelae of childbirth,
so that a revolution has taken place in our attitude to childbirth.
The idea that a mother in labour is in any way in jeopardy of her
own life is becoming a thing of the past. It is now time that
the infant was put in the same secure position. The Public
Health Service is proud of the fact that by the improvement of
environment and improvement in infant management the infant
mortality has fallen from 130 per thousand to about 30 per
thousand in the past 30 years. But this reduction has taken
place largely in the ages over one month; there has not been anything
like the same reduction in the neo-natal group.