Reduction of Infant Mortality Due to Respiratory Diseases

1\IA'l'ER"'l'l'Y AKD IK!•'ANCY WtmK

iutemal and extPrnal examinations :mll measurPml'nts arc m:ule :1t the flrst visit. If the women have not nwde :1rrang~•nwnts for tkliv<'ry they are arh·isell to have a physieian. If thP,v eaunut afford this, anangcmeHts for their care are made in hospitals or for 1leli,·ery at home 111Hlcr the l':Jl'l' of an ont·patintt lvi•w-in senire. This prenat:Jl \York S slowly; ol!l,,· alwut 1,01!0 lll'\\; c:tses Jl<:r .1~ea•· hnn• bPen rP;;istere,J at tl1P eouf,•rP!ll'l'S iu tilt• tlll'l'<' ye:Jl's of their ,•xistl'lltl', :!ltiiiJUgh ('lii<·agn l1ns some liO,OOU births :llmnally. For postnatal l'nutnl'ts the eity is diYided i11to 1 liS fh•l•l 1listJ·ids in <'neh of ll'hil'lt :1 llPpnrtnll'nt of henlth HHrse is nssignc<'!' <'t'llt of its l'aS<'S from the 1

Training Personnel for County Health Departments, Dr. :B1 dix J. TT lldPl'\VOOd,

.ra~kSOJl, :.\Ii~-;:-;issippi.

Utltil n•ecHtly, training nn<] t•xperit'lll'l' in livi~ion of t!Je 1~(J(·kl'feli<•J' }'oundatioll ln1s assisted thP Al:ihama l-;(ate Department of Health in mnintaining a training station in Covington Count,v, Alabama (now tak<'n on•r b.v tht• l-;t:~tt• Boanl of HL'altb). Th1• l'llllSI'lJUl'Ut supply of traim'
Reduction of Infant Mortality Due to Respiratory Diseas,es, Dr. Jio,Yard Child,., CarpentPr, Philatlt>lphia, PPlmsylvania. RPspiratory disl'ases as a ~roup arc S<'C'llllll o11ly to tht• n:Jtal :nul prcu:~tal group of diseases as a rnnsc of infant mortalit,v, anil their rate has riseu :ui ]ll'l' ecnt in the rwriod Hl2::!·l!l~li. 'l'ltt• death• l'L']I(Jl'(e
284

THE AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY

as, for example, influenza-bacillus pneumonia, pneumococcus Type I, II, III, IV pneumonia, or streptococcus pneumonia, would be more helpful for prevention and treatment. It is regrettable that public health officials have not sufficiently stressed the transmissibility of pneumonia. Isolation is advisable not only to protect the other members of the household but also to prevent them from becoming carriers and thus spreading the disease. Hemolytic streptococci, which are the most frequent and important bacteria producing infection in the respiratory tract of infants, are found more frequently in the throats of children who have tonsils than in those whose tonsils have been removed. A first item of education in prevention of respiratory diseases is the danger of too hot and too dry air in the home. A temperature of 65° F. with a humidity of GO per cent will give fair safety from respiratory diseases, whereas a temperature of 73o with a relative humidity of 25 per cent will seem less warm and com-fortable and will have a bad effect on the mucous membranes. The second most important item is the danger of overclothing the infant indoors-a practice cs pecially common among the poor. The occurrence in nelvborn infants of pneumonia-often incorrectly diagnosed as atelectasis-is an important reason for protecting them from sudden lowering of their temperatures. The delivery room should be warm and the infant should not be taken out of it nor bathed for at least four hours (or a longer period if the temperature is not yet normal). A suction apparatus should be at hand to remove secretions from the throat (instead of the common method of wiping out with a finger). Nurses having respiratory affections should not care for the new· born.

Reduction of Maternal and Infant Mortality in Rural Districts Reduction of maternal and infant mortality in rural districts, as shown by comparison of the rates during cooperation under the :tnaternity and infancy act (1922-1926) with those for a comparable period immediately preceding cooperation (excluding 1918, when the influenza epidemic may have influenced the rate) was discussed by 11 representatives from states which have been in the United States birth-registration area long enough for comparable figures to be available from the United States Bureau of the Census; which also have cooperated from the beginning· or nearly the beginning of operation of the aet; and in which the greatest reductions in rural maternal and infant mortality appear to have taken place. licaurtion oJ Jiurai Maternal Mortattty.-Dr. '1'. B. Beatty, State Heaith Com· missioner of Utah, discussed the reduction of 35.9 per cent in Utah; Dr. J. H. Mason Knox, Jr., director of the Maryland Bureau of Child Hygiene, the reduction of 26.1 per cent in Maryland; Dr. Lillian R. Smith, director of the Michigan Bureau of Child Hygim1e and Public Health Nursing, the reduction of 24.9 per cent in Michigan; Dr. Ada E. Schweitzer, director of the Indiana Division of Infant and Child Hygiene, the reduction of 23.9 per cent in Indiana; Dr. E. C. Hartley, director of the Minnesota Division of Child Hygiene, the reduction of 21 per cent in Minnesota; Dr. J. A. Frank, acting director of the Ohio Division of Child Hygiene, the reduction of 19.9 per cent in Ohio; Dr. Mary Riggs Noble, director of the Preschool Division of the Pennsylvania Bureau of Child Health, the reduction of 1 6.fi per cent in Pennsylvania; Dr. Emily Gardiner, assistant director of the Virginia Bureau of Child Welfare, the reduction of 10.9 per cent in Virginia; Dr. Elizabeth M. Gardiner, director of the maternity, infancy, and child hygiene in