The Editor: Why the Babies Die 



63 



a generally higher economic status than 

 other foreign horn, and gainful employ- 

 ment of the mother was found to a less 

 extent among them. Their high death 

 rate may be accounted for in part by 

 their large families and the prevalence of 

 artificial feeding. 



Large Families. — In general the later- 

 born children have a greater tendency to 

 a high infant mortality rate than those 

 earlier born. Large families were found 

 chiefly among the French Canadians 

 and among the lower economic groups of 

 other nationalities. The mortality rate 

 among all babies ninth and later in order 

 of birth is considerably higher than the 

 rates for those earlier born in either of 

 these groups with unfavorable rates. 



Artificial Feeding. — Artificial feeding 

 was accompanied by a higher infant 

 mortality rate than breast feeding. 

 Feeding methods reflect standards and 

 customs and the opportunity of the 

 mother to care for the baby. Artificial 

 feeding was practiced most extensively 

 by mothers gainfully employed away 

 from home; by native mothers in the 

 lowest economic class ; and by the French 

 Canadians. In each of these groups 

 other conditions coincident to a high 

 infant mortality rate are also present. 

 In the highest economic group, where 

 the food is more likely to be prepared 

 in accordance with instructions of 

 physicians and where other unfavorable 

 conditions tending to produce a high 

 rate are absent, the rates for breast-fed 

 and artificially fed babies are both low, 

 with a slight difference in favor of the 

 breast-fed bab}". 



DANGER OF :\IISINTERPRETATION 



What is the moral? Obviously, that 

 if bad housing and insanitary environ- 

 ment are improved, if the wage earners 

 are paid more, if the employment of 

 mothers is eliminated, if the large 

 families are obviated by birth control, a 

 considerable decrease in the infant mor- 

 tality is to be expected. The authors 

 of the bulletin take care not to make 

 such statements, but it would be diffi- 

 cult to read the bulletin without coming 



to those conclusions; and as the infant 

 mortality movement is firmly committed 

 to such conclusions already, it is certain 

 that this bulletin will be used as a con- 

 firmation of the generally accepted doc- 

 trine that improvement of environ- 

 mental conditions is the great panacea 

 for infant mortality. 



Such being the case, the publication 

 of this bulletin by the Children's Bureau 

 must be regarded as unfortunate, for 

 many of the conclusions that will be 

 drawn from it are fallacious and dan- 

 gerous. 



A slight knowledge of sound scientific 

 method and of the data of eugenics is 

 sufficient to cause one to discount very 

 heavily this study of the infant mortality 

 of Manchester. The citation of a single 

 piece of evidence will serve to indicate 

 the correct interpretation. 



It is suggested (more frequently, it is 

 clamorously asserted) that bad environ- 

 mental conditions are the main cause o} 

 high infant mortality. Suppose, then, 

 that infant mortality be investigated 

 under good environmental conditions. 

 The royal families of Europe offer an 

 excellent field for this study. Here, it 

 will probably be admitted, the environ- 

 ment is as good as knowledge and wealth 

 can make it. A child might conceivably 

 die there from bottle-feeding, but cer- 

 tainly not from bad housing, employ- 

 ment of mother, inadequate wages of 

 father, or lack of care. What is the 

 death-rate in this caste' 



The actual figures of infant mortality 

 are not available, but A. Ploetz^ com- 

 piled the figures for child mortality 

 (first five years of life), which are equally 

 instructive. Classifying the deaths of 

 3,210 children, he correlated them with 

 the age of death of the child's father. 

 Table I shows the result. 



INFLUENCE OF HEREDITY 



It is evident that there are wide dif- 

 ferences in the amount of child mor- 

 tality. It is evident that there can be 

 no differences in the environment which 

 would account for these differences in 

 the death-rate. It is evident that they 



2 Ploetz, A. Lebensdauer der Eltern und Kindersterblichkeit. 

 Gesellschafts-Biologic, vi (1909), pp. .33-43. 



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