THE MEDICAL PREVENTION OF INFANT MORTALITY 



By I,. EMMETT HOLT, M. D. 



The prevention of excessive infant mortality is a social 

 problem of the first magnitude. In comparison with it even 

 the great problem of tuberculosis takes a second place if we 

 are to estimate by the sacrifice of life involved in the two 

 cases. The latest report of the United States Government, 

 that of 1908, gives the mortality from every form of tuber- 

 culosis, in the registration area, as 78,289; whereas the deaths 

 under one year total 136,432. Certainly much more can be 

 accomplished to reduce the number of infant deaths than to 

 reduce those from tuberculosis. 



We cannot go far in our attempts at solution of this prob- 

 lem without coming up against the two great fundamental 

 causes, poverty and ignorance, to which all other causes are 

 closely related. Since poverty and ignorance can never 

 be abolished, the sacrifice of infant life will always be great. 

 We are not on this account to be discouraged in our efforts. 

 Our aim should be to make the "irreducible minimum" as 

 small as possible. Certain infant deaths are inevitable. 

 These include children born with malformations which 

 render life impossible or those so feeble that they cannot 

 support an independent existence at all, or unless the most 

 favorable conditions are furnished. Certain accidents at 

 birth it is beyond our power wholly to prevent. But these 

 inevitable deaths really form but a small proportion of the 

 total. 



No great progress is to be made unless we can influence 

 to some degree the underlying causes. The tuberculosis 

 problem of our cities is not to be solved by roof-gardens and 

 the free distribution of milk and eggs. Better housing and 

 better conditions of living are indispensable. One of the most 

 intelligent workers in New York has recently said that some of 

 them had come to the conclusion that the day of the eradi- 

 cation of tuberculosis would be brought nearer if every dol- 

 lar now spent for relief work were saved and put into the 

 construction of model tenements which could make hygienic 

 living possible. 



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