Book captures fight to save children from fatal illnesses
The COVID-19 pandemic has revived public discussion about vaccines. In her book, “A Good Time to Be Born: How Science and Public Health Gave Children a Future,” pediatrician Dr. Perri Klass examines the historic strides in public health and medical science that led to the development of vaccines, as well as antibiotics, which allow today’s parents the blissful expectation that their children will thrive and survive them. Just 100 years ago, parents lived with the routine dreaded possibility that at least one, if not more, of their children would die in infancy or childhood.
Stillbirths, birth traumas, neonatal tetanus, smallpox, typhoid, contaminated milk, pertussis (whooping cough), diphtheria, tuberculosis, scarlet fever, meningitis, polio, wound infections and more contributed to high death rates of infants and children in previous centuries. Although many of these deadly disorders were exacerbated by poverty, crowding and inferior hygienic conditions, Dr. Klass documents that the wealthy also lost children to these ailments.
The author juxtaposes the publicly acknowledged grief surrounding the deaths of white children to the brutal conditions faced by enslaved mothers and their children. Although many white children’s deaths do not appear in official records, the offspring of enslaved women were carefully accounted for because they were property. Dr. Klass cites the work of economist Richard Steckel, who studied the data kept by slave owners. In scrutinizing these records, Steckel concluded that the mortality rates of enslaved infants and children were twice what was found in the U.S. population of that time.
According to estimates, up to 30% of infants died before reaching the age of 1 in some U.S. cities in 1900. Addressing this challenge required the collection of accurate data. Without infant and child mortality statistics, it was impossible to craft effective responses. Trailblazers such as Dr. S. Josephine Baker and Dr. Esther Pohl Lovejoy worked diligently to study and treat babies and young children and recorded their interventions, thus establishing mothers, infants and children as a key focus of public health.
Births were generally not officially registered in the United States until well into the 20th century, which impeded collection of infant and child mortality data. The fight against child labor, the campaign for compulsory public education and mounting public health efforts devoted to reducing infant and child mortality all merged into legislation that mandated birth registrations.
The end of the 19th century and the early decades of the 20th century brought microbiological understanding of infectious diseases. Medicine was now poised on the exciting precipice of effective prevention and treatment. Dr. Klass details the heartbreak of Dr. Mary
Putnam Jacobi and Dr. Abraham Jacobi, the power couple of the emerging specialty of pediatrics who lost their 7-year-old son to diphtheria in 1883. By 1895, diphtheria antitoxin was in production, reducing the number of children lost to this vicious disease that blocked their throats and choked them to death.
In 1921, a vaccine against diphtheria was formulated that was superior to the antitoxin. The post-World War II era saw the licensing of a vaccine that protected against diphtheria, pertussis (whooping cough) and tetanus. Dr. Klass notes that baby boomers were the first generation to benefit from this vaccine, followed by the dramatic development of the polio vaccine that ended frightening polio outbreaks. More vaccines against other childhood diseases followed.
Dr. Klass points to continuing racial inequalities in infant and maternal mortality. Certain groups still do not share equally in the stunning bounty of progress produced by scientific medical advances and public health innovations. Programs such as Healthy Start, Nurse Family Partnership and WIC (Special Supplemental Nutrition Program for Women, Infant and Children) have made contributions to addressing disparities, but they are not mentioned in this book.
Nonetheless, Dr. Klass has done an extraordinary job of telling the poignant stories of parents, some poor and some affluent, who faced the devastating loss of young lives and the powerful stories of relentless medical pioneers and public health trailblazers who battled preventable infant and child deaths. She is a gifted writer who has produced history that reads like a novel.