Mortality in infancy and early childhood in Ireland, Scotland and England and Wales 1871 to 1970.

Abstract

Mortality in infancy and early childhood in Ireland, Scotland, England, and Wales is reviewed for the 1871-1970 period. Until the beginning of the 20th century the infant mortality rate in England and Wales was high. It was higher in the urban and industrialized areas than in the rural areas, and there were substantial differences in the rates in working class and middle class families. The rates were lower among the middle class families. The cause of the high rate appears to have been a complex of factors. Sanitation and faulty feeding were the most important contributors. The infant mortality rate in Ireland was consistently lower than the rate for England and Wales until the 2nd decade of the 20th century. Scotland's rate came in between. After 1920 the infant mortality rate in England and Wales declined substantially below the Irish and Scottish rates and held this position until 1960. At this time all 3 rates have reached the level of 20 per mille and below. Breast feeding has steadily decreased in all countries until only a small proportion of mothers are breast feeding their infants. Simultaneously artificial feeding based on cow's milk has become safer, more convenient, more efficient, and is within the means of all segments of the population. Something relevant to the present situation in the developing countries can be learned from these trends and their causes. In most developing nations there is a high rate of infant and child mortality associated with protein calorie malnutrition. Experience in developed countries shows that what is particularly needed to remedy the situation is improvement in domestic sanitation, cleaner water supplies, the extension of maternity and child welfare services, and the satisfactory feeding of children.