The Care of Children: the Influence of Medical Innovation and Medical Institutions on Infant Mortality 1750-1914

Abstract The many historical demographic studies that have been undertaken during the last 20 years have shown, in spite of the disparity of available data, that infant and child mortality fell significantly everywhere, and that the fall gathered pace after the First World War. This decline is well documented, even though in some cases it was irregular, and the initial levels, the rate of fall, and the conditions associated with the decline have differed in different countries.As is true of overall mortality, the mortality of infants and small children may be interpreted in different ways. Its decline could be seen as a consequence of the improvements of the general standard of living of the population (improved nutrition, higher standards of personal hygiene, better water supply, higher quality of foodstuffs, better housing), or it could be attributed more specifically to increases in medical knowledge and a wider diffusion of this knowledge among mothers. Since 1970 the medical explanation has been strongly criticized, particularly by Ivan Ilich and Thomas McKeown, whose arguments are well known.