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Why Infant Care Is Important for Both Parents

Friday, September 15th, 2017

Man achieves immortality largely through his children and his work. As soon as an infant has been born, its health and welfare become the first concern of both its father and its mother. This is one of the points of difference between man and most of the lower animals; and as culture and civilization advance, we find mankind attempting to provide better and better protection and educational and vocational opportunities for children. Sir Arthur Newsholme, leading English authority on public health, states: “Infant mortality is the most sensitive index of social welfare and of sanitary improvement which we possess. If babies were well-born and well cared for, their mortality would be negligible.”

In some sections of the world the chances are not more than one in two that a newborn child will live to reach its first birthday, and in some cities of our own country within the present century approximately one child out of three died during the first year of life. In the registration area of the United States 162 infants per 1,000 born alive died during the first year of life this number had been reduced to 64.6; the corresponding rates for several other countries were as follows: Chile, 234; India, 178; Ceylon, 175; Italy 125; Japan, 124; Germany, 96.4; France, 96; England, Scotland, and Wales, 63; Sweden, 58; Norway, 55; Switzerland, 51; and New Zealand, 35.

The major causes of infant mortality among the white population at the present time are prenatal and natal diseases and injuries, respiratory diseases, and gastrointestinal diseases. The toxemia of pregnancy and syphilis are the primary causes of premature births. Adequate care during the pm natal period and modern hospital facilities for the care of premature infants are effective measures in reducing these deaths.

The same may be said concerning some of the respiratory diseases. Bronchitis, pneumonia, and other respiratory infections are serious in infants because they have little resistance against them. Hence, all infants should be safeguarded in every possible way from exposure to children and adults who may transmit colds or other infections to them. Malnutrition and the deficiency diseases lower the infant’s resistance and so contribute to the seriousness of these respiratory infections.

The diarrhea or intestinal diseases long occupied first place among the causes of infant mortality and still do so in certain countries. The marked reduction in the deaths from these diseases which has taken place has been due largely to sanitation and improved methods of infant feeding. Breast milk is the ideal food for a baby. Studies have shown that the death rate from intestinal diseases is three to ten times as high among artificially fed as among breast-fed children.

The young Women of today are physically superior to the women of previous generations and almost all of them are able to nurse their babies for at least the major part of the usual nursing period of nine months. Breast milk is desirable not only because it is easily digested and is most nutritious for the child, but also because it offers protection against diarrhea and intestinal diseases and increases resistance against measles, scarlet fever, and other common infections of infancy.

A few years ago a serious and frequently fatal blood disease of newborn infants was found to be caused by a certain incompatibility of the parent’s blood. This is dependent upon what is known as the “RH factor.” Tests can be made for this condition. If it exists, the risk to the child can be reduced by careful medical supervision and care during pregnancy.

The more important indirect causes of infant death are poverty and ignorance. Many studies have shown a direct correlation between low income of the wage earner and high infant mortality. One of these studies reports 168 infant deaths per 1,000 live births among families with an annual income of $500 or less as compared to a rate of 30 per 1,000 among families with incomes of $3,000 or more, and an increase of 20 per cent in the infant death rate in families of which the wage earner became unemployed during the depression years.

The conditions of poverty are all adverse to the survival of the delicate life of the newborn infant. On the other hand, poverty, unemployment, and larger families than can possibly be supported are frequently the result of the same sort of ignorance and irresponsibility which contribute to a high infant death rate. It has also been shown that, by instruction of the mother concerning the proper care and feeding of infants, it is possible materially to improve nutritional status, even though the family’s income is no more than relief allowance.

The US Children’s Bureau in Washington and the state and local health departments make available bulletins of information, advice, and, if necessary, public health nursing service for maternal and infant care, so that there is no longer any justification for the ignorance and neglect which has been responsible for most of the deaths of mothers and infants in the past.

How a Letter to an Editor Written in 1980 Fueled Prescription Opioid Crisis in US

Friday, September 15th, 2017

A 1980 letter, published in the New England Journal of Medicine, is believed to have given wings to the current prescription opioid crisis in America. The letter summarized the study conducted to determine the risks of narcotic addiction. The researchers examined 39,946 patients, of whom 11,882 were subjected to a brief narcotic intervention. It was observed that there were only four cases wherein patients with no prior history had developed addiction.

The drugs in question were meperidine, Percodan, and hydromorphone. Authors Jane Porter and Hershel Jick from Boston Collaborative Drug Surveillance Program of Boston University Medical Center, said, “We conclude that despite widespread use of narcotic drugs in hospitals, the development of addiction is rare in medical patients with no history of addiction.”

Unfortunately, the entire purpose of the study was taken out of context and was used to fuel the myth that opioids are safe without any risk of addiction. Pharmaceutical companies and drug makers have cited the content of the letter numerous times (a recent study indicates that it has been cited more than 600 times) to market their products. Some have even gone to the extent of pointing out that opioids are perfectly safe in outpatient settings, a point that has been countered by one of the authors.

In a note to the Associated Press, Jick explained that since the study was conducted in hospital settings and looked only at patients who had received opioids for short duration therefore, it “has no bearing on long-term outpatient use.”

Pain used as excuse to prescribe opioids

More than 52,000 drug overdosing mortalities were reported in 2015 with 63 percent deaths attributed to opioids. Overdosing proved to be more fatal than automobile accidents (more than 38,000 mortalities) and gun violence (36,000 mortalities) during the year. The 2015 numbers even surpassed the mortality rates when the dreaded HIV/AIDS was at its peak and 43,000 people reportedly lost their lives to it. The Centers for Disease Control and Prevention (CDC) estimates that 91 Americans succumb to opioid overdose every day.

Pharmaceutical companies have taken it upon themselves to promote drugs such as OxyContin and Percocet for chronic pain despite suggestions by researchers that opioid painkillers aren’t fully effective and have serious side effects. It is also interesting to note that ever since Purdue Pharma introduced OxyContin in the 1990s, there has been a surge in the way prescription drugs have been doled out. As more Americans suffer from pain, these companies have tapped the opportunity to persuade health care professionals to prescribe more opioids. As a result, many physicians end up overprescribing and risking their patients’ lives.

Mortified by how the pharmaceutical companies unscrupulously used the content of the letter to serve their own ends, Jick said, “I’m essentially mortified that that letter to the editor was used as an excuse to do what these drug companies did. They used this letter to spread the word that these drugs were not very addictive.”

Controlling prescription drug misuse

Pain is a relative concept and it is open to interpretation. In the absence of any biological measure, physicians prescribe medication based on what they deem fit and how an individual responds to questions. Even if opioids are prescribed to treat pain, doctors should closely monitor the doses, trace the patient’s history of drug use and inform them about harmful effects of long-term use. Leftover opioids at home should be discarded before they get into the hands of a child and causes mayhem. Self-medication through prescription drugs should be strictly avoided as it may lead to physical and mental health complications.