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55
INFANTILE MORTALITY.
No subject connected with the health interests of the community has received more attention
than this during the last few years. Several of the Metropolitan Borough Councils have shown
their desire to safeguard infant life by appointing Lady Sanitary Inspectors, some of whom are
partially occupied, as Health Visitors, in advising poor women, as soon as practicable aften-their
confinement, with regard to the feeding, and the care, generally, of their babies And recently
the Local Government Board have manifested their interest in the question by requiring the Metropolitan
Medical Officers of Health to include in their annual reports a new table of the stated
causes of deaths of infants under one year of age. This table (set out at page (56) is of great
interest, and when the returns shall have been summarised for the whole of London, the information
cannot fail to be of much value. I have supplied a further table, showing the number of
deaths, in the several calendar months, from the diseases named in the Board's table, to which
I have added (in italics) a few other diseases, which, in the official table are included under
the .eading " other causes."
Of the 498 deaths, under one year, in 1905, the quarterly numbers were 142, 105, 148 and
10-3. March and August were specially fatal to infant life; 136 deaths (59 and 77 in the two
months respectively) having been registered. Diarrhoeal diseases head the list, being the causes
of 90 deaths; but it is interesting to note that, although nearly a third of the deaths from
all causes occurred within the first four weeks of life, there was not one death at that ageperiod
from diarrhoea—a fact explicable by the general practice among poor women of suckling
their babies during the puerperal month when they are detained in their homes. Prematurity was
accountable for 72 deaths; 64 of them within four weeks of birth, and 47 in the first week.
Atrophy, debility, marasmus—terms often synonymous with tuberculosis, and usually connoting
improper feeding and want of maternal care, were the causes of 60 deaths—23 of them in
the first four weeks. To tuberculous diseases 23 deaths were attributed, to bronchitis 43, and
to pneumonia 57. Three babies only were " overlayed," but 13 perished from other forms of
"accidental" violence, as suffocation, want of attention at birth, etc. The illegitimate births
during the year were 157 = 4.54 per cent. on total births; the deaths of illegitimate children 69 =
14 per cent. on all deaths under one year, and 44 per cent. on the births registered as illegitimate.
Inquests were held in 23 cases.
This question of infantile mortality has received much of my attention during the last
few years, especially since 1902, when, with the approval of the Public Health Committee, a
special enquiry was made by the Lady Inspectors, the results of which were set out in the annual
report for that year (page 60). The particulars exhibited were; the number of deaths, of male
and female infants, in the several wards, in each of the first four weeks of life, and in each
subsequent month under one year of age; the causes of death, the position in life of the male
parent, and in illegitimate cases, the status of the mother — the particulars thus corresponding
pretty closely with those required by the table now prescribed for use by the Local Government
Board.
Table.