Nutrition and mortality in infancy and early childhood: past and present relationships

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Abstract
1) In England (and other affluent countries) the infant mortality rate has greatly decreased during the last 60 years. During the same period the rate in the age group of 1 to 2 years has become almost negligible. In 1906 the causes for the high infantile rates in England were examined by George Newman, who showed that these were specially characteristic of industrial urban areas. Among the important recorded causes of death were “diarrhoea and enteritis“ and “atrophy and debility.” Breast feeding offered better chances of survival than “hand-feeding.” The hand-feeding (artificial) methods of the day were disastrous because the foods given were unsatisfactory both in quantity and quality, and often carried infection. Newman believed that faulty feeding was the most important cause of infant mortality. 2) The factors adversely influencing infant and child health in England 60 years ago were in many respects similar to those operating in the developing countries today. In other words, something like the complex of faulty diet and infection now called protein-calorie malnutrition was of key importance in the child health picture. Similarities can be found in mortality patterns, epidemiology, disease, and feeding practices. 3) Experience in the affluent countries has shown that this complex can be rapidly eliminated by efficient health services, rising standards of living, and hygienic artificial feeding. Greater reliance on breast feeding has played no part in its disappearance. The most promising method of attacking PCM in the developing countries is to promote the production and use of cheap feeding mixtures, based on plant foods that fulfill the infant’s needs for calories, protein, and other nutrients.

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