The younger the infant, the greater the danger of death. _One-tenth of all children born die within the first month after birth_, and four times as many as during the second month.
The mortality is much larger in cities than in the country. In Dublin, during 1867, very nearly one-third of all the persons who died were under five years of age. In the same year forty-three per cent. of those who died in the eight principal towns of Scotland were children below the age of five. In Philadelphia, during the same year, forty-five per cent. of all the deaths were of children under five years of age. In New York fifty-three per cent. of the total number of deaths occur under the age of five years, and twenty-six per cent. under the age of one year.
The danger of death lessens as the period of puberty approaches. Yet, even in the last years of childhood there is a greater liability to disease and a larger proportionate loss of life than during youth or middle age.
What are the causes of this startling mortality of infant life? Why does one child out of ten die in the first month, and only three out of four live to be five years old? And what are the means of prevention?
Some of the causes which are active in producing this mortality among the little ones cannot be successfully opposed after birth. Such, for instance, are imperfect and vicious developments of internal organs existing when born. These malformations often result from inflammation while in the womb, excited by some taint of the mother's blood, or by some agitation of her nervous system. Means of prevention in those cases are therefore to be directed to the mother, in the manner indicated in treating of pregnancy. But other causes of death begin to act only after birth, and are to a greater or less extent avoidable. These are largely traceable to ignorance, negligence, and vice.
One cause of death to which infants are peculiarly liable, and which alone is said to have destroyed forty thousand children in England between the years 1686 and 1799, is being _overlain_ by the parents. For this reason, some physicians caution the mother against having the infant in bed with her while she sleeps.
The frightful waste of life caused by bringing children up by hand has been mentioned, and the importance of avoiding it when possible.