DR. H. L. K. SHAW'S PAPER 133 



is misleading and unfair. Infant mortality as gener- 

 ally accepted is the number of deaths under one year 

 of age to one thousand living births. This definition 

 is not applicable to institutions where the death-rate 

 is computed by the ratio between the number of 

 deaths and the number of infants admitted or under 

 treatment. There is a further source of error in some 

 reports, where the babies who survive more than one 

 year are included each year in the total on which the 

 mortality rate is reckoned, while the deaths are 

 counted but once. 



After considerable correspondence and study of 

 institutional reports, the fact is undeniable that the 

 statistics on the subject of infant mortality in institu- 

 tions in the United States are extremely unsatis- 

 factory. There is no uniformity in the published 

 statistics and one cannot make any comparisons that 

 are worthy of consideration. 



Many of the infants brought to infant asylums or 

 hospitals are in poor and feeble physical condition, 

 and while many of the deaths no doubt are prevent- 

 able, still a large proportion of them are inevitable. 



A closer analysis of the institutions for infants in 

 New York State shows that they can be divided into 

 two distinct types one an asylum which only pro- 

 vides hospital care for such babies as may be ill ; the 

 other an infants' hospital, established and maintained 

 for the sole purpose of treating sick babies and 

 discharging them when well. The first type of 

 institution has been in existence for centuries and 

 the mortality in them has always been high. The 

 foundling, the illegitimate, the deserted, and the 

 orphan baby form the majority of the inmates, and it 

 is in the strict sense of the word "an asylum." The 

 second type is the modern institution and is a babies' 

 hospital. It is not a home for the homeless and 

 deserted baby, but a hospital for those in actual need 

 of medical or surgical treatment. 



