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In 1945 the infant mortality rate was 50.7 per 1,000 live
births as compared with 45.9 in 1944/46.8 in 1943 and 72.1 in 1942.
The percentage of the total infant deaths occurring in babies under
the age of 4 weeks was 64 as compared with 65 in 1944, 49 in 1943 and
58 in 1942. The chief causes of infant deaths during the year were
prematurity (18), congenital defects (17), gastro-enteritis (11),
pneumonia and bronchitis (7), otitis media (6) and other infections (9
Prematurity and congenital defects form the hard core of infant
mortality and the variation from year to year in the infant mortality
rate is largely due to the extent to which babies have escaped or
survived infection. During 1933-1939 the infant mortality rate in the
Borough varied between 40 and 50 but during 1940-1945 the variations
have ranged from 45.9 to 72.1 and the increase has been due almost
wholly to deaths from infections. The chief environmental condition
contributing to the spread of infections is overcrowding. The need
for constant care and vigilance to protect young babies against
infection is illustrated by the following account of a small outbreak:
Early in September the conies of death certificates received
from, the Registrar revealed that two babies, aged 1 week and 3 weeks,
had died in hospital from umbilical sepsis. Birth notifications
showed that these children were born in a local nursing home. A vision
to the home disclosed that there had been admitted to hospital with th
same condition another baby who died later. There was no evidence of
puerperal infection so the care of the babies and the dressing of the
cord stump were investigated. No gross error of technique was
revealed but the opportunity was taken to impress upon the staff the
importance of guarding young babies against infection and suggestions
were made as to how a more rigid asepsis might be maintained. Throat
and nose swabs were taken from all the nursing home staff. Next day
a fourth case of umbilical sepsis occurred and was admitted to hospita
The swabs revealed that two members of the staff were carrying streptc
coccus haemolyticus and one carrying streptococcus haemolyticus and
staphylococcus aureus and as all three had been working in the nursery
they were suspended from duty. -No further case of umbilical sepsis
occurred and the home remained free of puerperal infection. Contact
was then made with the two hospitals concerned in regard to their
bacteriological findings. The first two babies were moribund on
admission and died within a few hours so no bacteriological investigation
was carried out. In the other two babies a haemolytic strepto
coccus and a staphylococcus aureus were recovered from both. The
streptococcus was not typed. Further swabs were taken from the
carriers with a view to typing the streptococcus but no growth was
obtained. Three consecutive negative swabs having been obtained from
the two carriers of streptococcus they were returned to duty after a
suspension lasting 15 days. In the third carrier staphylococcus
aureus continued to be found and 7 weeks elapsed before three consecutive
negative swabs permitted her return to duty.
Slight prematurity may be missed and the baby's chance of
survival lessened by failure to apply appropriate treatment Immediately
It has been agreed that, for practical purposes, all babies weighing
5½ lbs. or less should be treated as premature and special cots
equipped for the nursing of premature babies are available free on load
Any doctor or midwife can get delivery of such a cot at any time on
application to the ambulance station. The birth weights of 1,305 (88
of the 1,478 children, born to the Borough in 1945, were ascertained
and of these 77 (5.9%) were 5½ lbs. or less. The average birth weigh
of the 18 babies who died from prematurity was 3.2 lbs.
The maternal mortality rate was 2.0 per 1,000 (live and
still) births as compered with 1.9 in 1944, 0.6 in 1943 and 2.8 in 194
The still birth rate per 1,000 total births was 26 as compared with
22 in 1944, 26 in 1943 and 32 in 1942.
The incidence of infectious disease has been low during the
year. Scarlet fever continued to be mild and caused no deaths. A
small outbreak of dysentery (sonne) occurred at a day nursery: 22
children and 1 staff were attacked, all recovered and the nursery was
free of Infection at the end of six weeks. The number of notificatic
2.