Symposium: Accomplishments in Child Nutrition during the 20th Century

It is quite fitting for a symposium reviewing progress in

infant nutrition in the 20th century to start with a review

of infant mortality rates during that time period. Indeed, it

has been a truism in public health that, within limits, the

infant mortality rate of any community, large or small,

reflected its general state of health better than any other

single indicator. Although no longer valid for the wealthier

countries, it is still the norm for most countries in the

world, where the diseases that kill most babies, i.e., infec-

tions, diarrhea and pneumonia, are all enhanced by inade-

quate nutrition. Interrelation of infection and nutrition was

appreciated early, as documented persuasively in Scrim-

shaw’s classic 1975 review (1).

At the beginning of the 20th century, infant mortality was

at such heights that organized attempts to attack it began more

or less simultaneously throughout what is now called the

developed world. In the forefront was western Europe, a major

effort having come from the French, stung by the loss of the

Franco-Prussian War in 1870 and the realization that popula-

tion dynamics favored a newly united Germany. A landmark

step in the United States came when more or less isolated

efforts in many cities led to organization in 1909 of the

American Association for the Study and Prevention of Infant

Mortality, instrumental in promoting the White House Con-

ferences on Children and Youth and stimulating the establish-

ment of the Children’s Bureau.

Almost 100 years later, decline in infant mortality has

occurred worldwide, dramatically in the industrialized nations,

less so and unevenly in many population groups in those

nations and worldwide.

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