Caring for Mentally Retarded Babies in London in 1950's

Premature infants are unremarkably found ensconced inside the walls of hospital-based Neonatal Intensive Care Units (NICU's) in both large and small hospitals. There particularly trained physicians, nurses, and an army of other wellness care personnel anticipate and see their every need. While debate continues most the limits of viability of prematurely built-in infants, those built-in afterward at least twenty-4 weeks of gestation have increasingly optimistic prognoses. This is, however, a relatively contempo development in the care of infants.

Late Nineteenth Century: Premature Infants and Incubator Shows

At the turn of the twentieth century, a baby born prematurely (earlier thirty-8 to forty weeks gestation) had dismal prospects for survival. Except for a few scattered pockets of medical interest, the noesis, expertise, and technology necessary to help these infants was not available. "Preemies" who survived more than than a 24-hour interval or two were oft labeled "weaklings" or "congenitally debilitated" implying an inherent frailty that did not bode for their future. Survival of these tiny infants depended on many factors, primary of which were the caste of prematurity and the infant's weight at nascency.

Nurses caring for newborns, Philadelphia General Hospital, 1895.French physicians introduced the closed infant incubator in the 1880s in response to governmental mandates to decrease the overall dismal French baby mortality charge per unit. (Politicians feared the lack of sufficient soldiers for futurity wars).[1] In Europe, displays of premature infants in their incubators began appearing in the tardily nineteenth century at national fairs and exhibitions. Dr. Martin Couney brought the shows to the United States in the tardily 1890s, and they continued until the 1940s.[2] The small size of the infants, their placement in a machine like to those used on farms for poultry incubation, and the encouragement of carnival style barkers stimulated the interest of the off-white-going public. [iii]

While entertaining, the incubator exhibit's identification as a side evidence and location among midway entertainment spectacles initially prevented mainstream physicians from embracing incubators as substantive progress. Their faulty design also posed serious issues. Over- or underheated incubators caused potentially fatal errors. Many physicians, relying on anecdotal rather than statistical evidence, dismissed the incubator as ineffective and even unsafe.[four] Some hospitals provided intendance for preemies using other ways of providing warmth, including open incubators and more traditional methods such as warm bricks in cradles and rooms heated to ninety degrees or more than.[5]

Early on Twentieth Century: Premature Intendance in Hospitals

In 1901, Parisian obstetrician Dr. Pierre Budin published the first major textbook on the care of preemies. Translated into English language in 1907 and available in the Us, The Nursling: The Feeding and Hygiene of Premature and Total-Term Infants became the standard for physicians, nurses, and others interested in premature babies.[6] Its basic tenets, which relied on traditional common sense, still class the basis of care today. They include maintaining warmth, providing acceptable nutrition, and preventing infection. During the early on decades of the 1900s, a few American hospitals established short-lived premature babe stations. 1, founded by Joseph DeLee, M.D., the famed obstetrician, opened in Chicago as the Lying-In Hospital. Funding problems and a lack of interest, however, acquired them to shut. During the outset two decades of the twentieth century, America'south bottomless over-all baby mortality rate overshadowed the plight of premature infants. As deaths of otherwise healthy babies decreased, withal, prematurity became a more visible problem.

By the early 1920s, premature babe care in the Us was at a crossroads. Based mainly in the dwelling prior to 1920, over the adjacent two decades, a variety of social, cultural, and technological factors combined to foster the transition from domicile-based to hospital care. As knowledge well-nigh the physiologic details of prematurity and public interest in premature infants grew, the demand for care expanded and culminated in the identification of prematurity equally a new disease or condition worthy of treatment by medical professionals. Identifying and isolating premature infants allowed physicians to focus on and specifically treat problems dissimilar from those of other infants. These methods, initially unchallenged, and which meant separation of the infants from their parents, were presented to the public as the just possible promise for saving these previously doomed babies.

Early Twentieth Century: Premature Infant Care Expands

In 1922, two events placed premature intendance permanently within the realm of physician-directed and hospital-based nurseries. One was the establishment of a premature baby station nether the management of Dr. Julius Hess at the Michael Reese Infirmary in Chicago. At Michael Reese, medical personnel separated premature infants from the "normal" newborn and pediatric populations. The infirmary hired nurses solely to care for and to develop specific procedures to aid these premature babies.[7] This was the starting time of hospital-based intensive care for premature and low-nascence-weight babies. The Infants' Aid Society of Chicago, a local women'due south philanthropic grouping endowed $85,000 to secure the station'south hereafter.

The second significant event of 1922 was the publication of the first major American textbook devoted to the care of premature infants. Julius Hess'south Premature and Congenitally Diseased Infants provided the about detailed account of hospital-based premature infant intendance available in the Usa.[8] The premature station at Michael Reese soon became the acknowledged leader in premature care. It hosted physicians and nurses from around the country eager to learn and implement the latest procedures. Thus, through Hess'south writings and willingness to teach, his ideas and practices speedily became standard treatment for all premature infants. Hess collaborated extensively with Evelyn Lundeen, R.N., the head nurse of the premature unit. Later editions of Premature and Congenitally Diseased Infants list her as co-author.[9]

During the 1920s, reports on experiences with premature infants multiplied in the professional literature. Most articles were positive, often citing impressive survival rates that discounted infants who expired during the first twenty-iv hours in the premature unit of measurement.[10]  The case of a one-and-a-one-half-pound infant surviving more two years is reported, but the general consensus remained that a birth weight of approximately two pounds represented the limit of viability in most situations.[11] The usefulness of incubators for heat received standing attention. One study concluded that the infant's body temperature should exist used to regulate the incubators' oestrus, a new idea at the time.[12]

Understanding the Complexity of Premature Care

Through ascertainment and clinical studies, physicians began to sympathise that premature infants needed individual attention and care. The improver of oxygen as a treatment for the respiratory distress prevalent in premature infants sealed the demand for an individual approach to climate control. The commercially manufactured, mechanical incubator that physicians almost universally disavowed in the mid 1910s received acceptance in a revised form in the 1930s. In March 1938, Charles Chapple, M.D. of Philadelphia submitted an application for a patent for an incubator.[13] The Chapple incubator was the predecessor of the Isolette brand of incubator that captured the market past 1950. With updates and revisions, the Isolette and its competitors, remains a fixture in NICUs today.

Prior to the establishment of NICUs in the subsequently 20th century, premature baby units, or stations, opened in many places, although many consisted of only one or ii cribs at the edges of regular newborn nurseries. Larger units opened in cities, with Chicago, Philadelphia, Boston, and New York leading the fashion. Preemies from outlying areas oft arrived in the artillery of their parents or, in a few places, via an incubator ambulance. Thus, years earlier adult intensive care units and infirmary-based emergency send systems, premature intendance was setting the standard for disquisitional care.

By focusing on the prematurely born, physicians soon began to appreciate the developmental differences between preemies and full term babies. Respiratory difficulties are directly related to the degree of prematurity. The shorter the gestational period, the more likely the baby volition experience serious breathing bug. In the 1930s, oxygen slowly gained a reputation for easing the cyanosis and asphyxia associated with prematurity. Several studies published in the professional journals indicated the benefits of its use and suggested, every bit one article concludes, "a continuous supply of oxygen seems to be of advantage in treating feeble, premature babies."[14] Physicians administered oxygen for cyanosis, respiratory embarrassment, feebleness, asphyxiation, a birth weight under 1200 grams and to "all others whom it was believed might exist benefited."[15] Before the development of the Isolette brand closed incubator, babies received oxygen through masks, plastic tents, or, later, nasal catheters. With closed incubators, the oxygen was piped in through connections in the incubator wall, providing a more than consistent menses of oxygen. Since in that location appeared to be no negative consequences of oxygen and respiratory distress, doctors could justify administering oxygen to all premature infants. Along with the individualized warmth provided by the new incubators, oxygen seemed to promise an end to the most meaning causes of morbidity and mortality.

Nurse learning to treat infants, Philadelphia General Hospital, c. 1930Public wellness officials caught up with the problem of premature infants during the 1930s. The Us Children's Bureau became a "meaning campaigner" for premature intendance during that decade, advising local efforts and providing funding. The Bureau as well supported premature-babe enquiry and a follow-upward clinic in New York City.[xvi]  Public health departments in cities and states began to devise strategies aimed at bringing the premature infant to the attention of hospitals, physicians, and nurses.

By 1940, the Children's Bureau reported that twenty-eight states, the District of Columbia, and Hawaii had community plans either in identify or set to begin to ensure that premature infants received the special care they required. Title V, part of the 1935 Social Security Act, included the provision of funds to help set these plans. Medical and nursing teaching was often part of the plans, and public health nurses and pediatricians traveled to premature centers in Boston and Chicago for in-depth training, returning to their home states to teach and advise their professional person colleagues.[17]

Meanwhile, media attention to the babe incubator shows grew slowly but steadily. In 1933, the Century of Progress Exposition opened in Chicago. The Infant Incubator Show, located on the midway, promised "living babies."[18] The public wellness section referred premature babies and local hospitals transferred them to the fair showroom. Parents brought babies to the exhibit where they received care costless of charge. Fairgoers paid admission fees to support the show.[19] Nurses from Michael Reese Hospital staffed the exhibit. [xx] Information technology is difficult to determine the benefits, if any, for the premature infants as their twenty-four hours-to-day care was probably like to that received in the hospital despite the abiding parade of people past the incubators, a exercise forbidden past most hospitals at that time.[21] The influence of this do on infection rates and thus morbidity and mortality is unknown.

The Century of Progress incubator show expanded public interest in premature infants immensely. Press coverage focused on the extremely small size of premature newborns, the special equipment required, the heroic physicians and nurses, and the fight for life by the infants themselves.[22] In May 1934, the nascency of the Dionne quintuplets in Quebec, Canada dramatically increased involvement in prematurity, specially in instances involving multiple births. The public could not become enough of the "quints," and newspapers, magazines, and early movie producers obliged. By 1940, premature babies, in one case ignored, became celebrities in their own right, requiring large amounts of professional care. Increasing the provision of premature care in hospitals meant a decline in the number of premature infants bachelor for incubator exhibits. The 1939 New York World's Fair held the last major incubator showroom.[23]

The Globe War Two Era and Across

Nurses caring for a premature infant, Philadelphia General Hospital, c. 1950The entry of the U.S. into Earth War II in 1941 postponed many public health efforts to benefit preemies, including a major programme for New York City. When the war was over, cities and states across the state renewed these efforts and the resulting plans encompassed the revision of hospital standards, transportation of premature infants to hospitals, fiscal assist, and more educational programs to train physicians and nurses.[24]

During the 1940s, premature infants treated in the most upwards-to-date nurseries could expect to lead normal healthy lives once discharged. At to the lowest degree that is what physicians promised their parents. Although some premature infants demonstrated long-term neurological bug, at the time the risk did not seem great. Other atmospheric condition lasting past the neonatal period doctors traced to prenatal influences or poor home weather.[25] Treatment alternatives increased as physicians adopted apparently successful ideas and procedures used by others. Many times these worked as the doctors hoped they would, but unexpected consequences emerged past the 1950's.

Nurse and physician examining premature babe, Philadelphia General Hospital, 1954During the 1950's, as smaller and more premature babies were saved with increasingly technological treatments and the intensive care of these infants expanded across the country, several problems surfaced. Oxygen, the miracle cure for the respiratory distress associated with prematurity, did save many lives. Nonetheless, its unregulated utilise in higher doses and for prolonged periods appeared to be detrimental to some babies. In 1942, the American Journal of Ophthalmology published an article most an apparently new condition, retrolental fibroplasia, or RLF.[26]  By 1950, this disorder of the retinal vasculature became the leading cause of blindness amid children in the U.Southward. Past 1956, it became the first acknowledged complication of the treatment of prematurity. Physicians and scientists worked zealously throughout the 1940's and early on 1950's trying to identify a cause for RLF, ruling out geography, heredity, lack of prenatal intendance, and early exposure to low-cal. They examined the medical and nursing care of the infants for any discrepancies or omissions that might have triggered RLF. They focused on newer treatments including vitamin therapy, blood transfusions, and various medicines and hormonal supplements. Physicians and others did not seriously consider oxygen in the search for a crusade of RLF until the early 1950s. A large calibration, multi-hospital report of the effects of oxygen began in 1952 and culminated in 1956 with solid bear witness pointing to it as the culprit.[27] Oxygen use was immediately curtailed throughout the earth, and rates of RLF dropped dramatically. Unfortunately, without oxygen treatment, deaths due to respiratory failure increased by 1960 even as the incidence of RLF began to ascent again. Known at present as retinopathy of prematurity (ROP), information technology continues to affect preemies today.[28] Physicians at present believe ROP has many causes. Standard screening procedures identify infants at risk early, and doctors plan treatment accordingly. Clinical studies keep to sort out the best style to foreclose the affliction and to treat it once information technology develops. Oxygen, once seen equally a panacea for all preemies, remains a major component of respiratory back up, still it is advisedly controlled and regulated according to individual needs.

Betwixt 1960 and 1990, the pace of advance in the care of premature infants accelerated dramatically. Neonatology became a medical subspecialty of pediatrics requiring a yr or more of postgraduate grooming for physicians after they served a pediatric residency. Clinical research studies of treatments became standard in the big academic wellness centers. Incubator technology connected to evolve. The wooden boxes of the 1930s gave way to clear Plexiglas models allowing direct view of the baby without disrupting the flow of heated air. Existence able to come across the baby gave parents and caregivers the ability to estimate progress and continue hope. For the smallest and sickest preemies, open warming tables allowed immediate access in emergencies while maintaining the necessary environmental temperature. Other innovations included improved venous and arterial access, meliorate antibiotics, and expanded use of imaging techniques to identify gastrointestinal, cardiac, neurological, and other abnormalities or complications quickly and accurately. Perhaps the near important innovation involved the evolution and refinement of the ability to back up and maintain the premature babe'south respiratory efforts.[29]

Prior to the 1970s most babies born more three months premature died as they lacked the ability to breathe on their own for more than than a short time. Reliable mechanical ventilators for these infants did not exist. Although ventilators had been a staple of adult intensive intendance units for several years, the applied science necessary for the physiologically different neonate did not become available and constructive until the 1970s.[30] By the mid 1980s babies born equally early on equally twenty-4 weeks gestation could survive their early on entry into the world with ventilators, warming beds, and effective medical and nursing care.

There were complications, all the same. 1 major problem was that babies born earlier thirty-ii to 30-4 weeks gestation frequently lacked sufficient levels of surfactant, a naturally occurring substance that maintains the stability of lung tissue, to proceed their lungs inflated. Early mechanical ventilators saved many lives only oft damaged the babies' lungs in the process. Bronchopulmonary dysplasia (BPD), abnormal evolution of the lung tissue, which acquired scarring of the lungs with resultant decreases in lung part, was a frequent upshot of long-term ventilation. Babies with the most serious cases of BPD required tracheotomies. Mechanical ventilation continued in some cases for several years and frequently played a office in growth and developmental delays. Bogus surfactant therapy, developed during the 1980s and widely bachelor past the early 1990s, led to a pregnant decrease in the length of fourth dimension premature infants required mechanical ventilation and eliminated the need in some. This and other new treatments led to a concomitant decrease in the frequency and severity of BPD.[31]

The introduction of objective measures to assess the newborn premature baby further refined approaches to care. Until the 1970s, preemies were identified mainly by birth weight. Both the American University of Pediatrics in 1935 and the World Wellness Associates in 1948 cited birth weights of v-and-a-half pounds or less as the definition of prematurity.[32] By the late 1960s, it was obvious this method was bereft for authentic infant cess. The gestational historic period, or the number of weeks the pregnancy lasted, was more specific but difficult to calculate in an objective manner. Then in the early 1970s, the development of a standardized scoring system provided a consistent assessment of the baby'due south prematurity.[33] Today a combination of physical and neurologic findings, the mother's estimation of gestation, and sonographic studies make up one's mind the degree of prematurity. If the mother has had amniocentesis during her pregnancy, the results of this exam may also assist make up one's mind fetal maturity.[34]

The terminal decade of the twentieth century witnessed the continued decrease in bloodshed associated with premature birth. At the same time, all the same, there was a rising in the overall number of babies born prematurely to approximately 11 percentage of all births in the late 1990s.[35] Several explanations exist for this increment. First, maternity care continued to better. Women who might have miscarried in an before era were able to give birth to a live, admitting premature, baby. At the aforementioned time, at-risk mothers such every bit those living in poverty and adolescents continued to have a lower rate of prenatal care and thus higher rates of premature births. A third and more publicized reason is the increase in multiple births (twins, triplets, etc.) every bit a result of fertility treatments.[36] In that location is a documented rise in the run a risk of prematurity in multiple births, which increases with the number of babies.[37]

The 1990s was also a time when the limits of viability for preemies, always a indicate for debate amid medical professionals, appeared to stall at almost the 20-ii to xx-fourth weeks of gestation time. For babies born at or earlier this time, parents and professionals must cull to either initiate resuscitative procedures or let the baby dice. Moreover, if resuscitative procedures are initiated, few well-defined parameters exist to help  guide parents in making decisions to either continue going or to terminate. In most cases, at that place is no articulate answer.[38]

Decision

At the beginning of the twentieth century, many people labeled babies born prematurely, weak or congenitally devitalized. Few measures existed to save them. Still, equally the century progressed the increased attending showered on all babies benefited those born premature as well. The exhibition of premature infants in incubator shows and manufactures written in newspapers and magazines presented parents, and the general public, with something previously subconscious from view. These infants, tiny, frail and under-developed yet portrayed every bit 'fighters' rather than 'weaklings,' could with the appropriate care, survive to live a normal life. The portrayal of these infants as survivors rather than victims enabled the public to respond by labeling them every bit cute, desirable and worthy of life saving care. They demanded modify and doctors, public wellness personnel and hospitals responded.

Nurse caring for a premature babe, Hospital of the Academy of Pennsylvania, 1970Individuals with an interest in premature babies responded to public interest past developing new techniques, new machines, and new facilities to care for them. When the first permanent hospital unit of measurement for premature babies opened in 1922, information technology signaled the beginning of a new era. In the 1930s, premature care expanded, and doctors establish even more than means to ensure survival of e'er smaller babies. By mid-century, premature baby care was established as a societal obligation.

Throughout the second one-half of the century, publicity about premature babies increased steadily forth with the power to care for them. In 1963 Jacqueline Kennedy, wife of President John F. Kennedy, gave birth to a son several weeks early. The baby died a few days later on birth due to hyaline membrane disease, besides known as neonatal respiratory distress syndrome. This birth and decease of an admired president'south babe brought the upshot of prematurity to the forefront of popular and professional involvement. Betwixt the mid 1960s and late 1990s, connected advancements pushed the limits of viability back so that virtually any baby born alive had a chance for survival. Multiple births continued to be more common with accounts of quintuplets, sextuplets, septuplets, and fifty-fifty octuplets receiving attention from the print and broadcast media. Success stories were common; those who died or suffered long-term complications of prematurity got lilliputian attention.

The changes in the intendance of premature infants over the course of the twentieth century while truly inspirational continue to leave room for improvement. Ethical dilemmas are inherent in matters of life and death. Even when a medical treatment or procedure goes exactly the way doctors hope information technology will, a poor outcome may result. The fact that the patients are infants and unable to give informed consent is a constant. Should the parents accept the final say in decisions about treatment? And if non them, who? Does society have responsibilities to a baby whose life is saved simply who is neurologically devastated? And if and so, what are they? Admission to expensive and all-encompassing care is a complex issue misreckoning families and professionals alike.

By the tardily 1990s, neonatal intensive care was bachelor for babies in almost every area of the state. Specialist and sub-specialist pediatricians, pediatric nurses, respiratory therapists, social workers, physical and occupational therapists, nutritionists, and a host of others responded to the needs of babies and the demands of their parents and the public. At the beginning of the twenty showtime century, research and innovation proceed to transform the lives of these babies, giving many more of them the potential for healthy, long, and possibly even notable lives.

References

[1] Karen Offen, "Depopulation, Nationalism, and Feminism in Fin-de-Siecle France," American Historical Review 89 (1984): 648–76; Richard Meckel, Save the Babies: American Public Wellness Reform and the Prevention of Infant Mortality, 1850–1929 (Baltimore: Johns Hopkins University Press, 1990), 101-102; and Jeffrey P. Baker, The Auto in the Nursery, (Baltimore: Johns Hopkins Academy Press, 1996), 45–50, 78–79, 84–85, 93–94.

[2] Baker, Machine in the Nursery, 86–106; and William A. Silverman, "Incubator-Infant Side Shows," Pediatrics 64, no. 2 (1979): 127–41.

[3] Baker, Automobile in the Nursery, 93–94.

[4] Baker, Machine in the Nursery, 152–74.

[five] Amy A. Armour, "Hints for Maternity Nurses," Trained Nurse and Hospital Review 53 (August 1914): 89–ninety; Jennings C. Litzenberg, "Long Interval Feeding of Premature Infants," American Journal of Diseases of Children 4 (1912): 391–409; N.O. Pearce, "Review of Recent Literature on the New-Born," American Journal of Diseases of Children 18, no. ane (July 1919): 51–68; and Cone, Premature Infant, 52–53.

[6] Pierre Budin, The Nursling: The Feeding and Hygiene of Premature and Full-Term Infants, Translated past William J. Malloney (London: Caxton Publishing Company, 1907).

[7] Julius H. Hess and Evelyn C. Lundeen, The Premature Babe: Medical and Nursing Intendance, 2d ed., (Philadelphia: J.B. Lippincott Co., 1949).

[8] Julius H. Hess, Premature and Congenitally Diseased Infants, (Philadelphia: Lea and Febiger, 1922), Role I, Part Ii, Chapters v, half-dozen, 7, viii, 9.

[9] Hess & Lundeen, 1949.

[ten] Lila J. Napier, "Method of Caring for Premature and Underweight Babies at the Lying-In Hospital, New York City," Bulletin of the Lying-In Hospital of the City of New York 13 (1927): 132–34; Julius H. Hess and I. McKy Chamberlain, "Premature Infants – A Report of Two Hundred and Sixty-Six Consecutive Cases," American Journal of Diseases of Children 34 (1927): 571–84.

[11] D.S. Pulford and West.J. Blevins, "Premature Infant, Nascence Weight 680 Grams, with Survival," American Periodical of Diseases of Children 36 (1928): 797–98; Aaron Capper, "The Fate and Development of the Immature and of the Premature Child," American Journal of Diseases of Children 35 (February 1928): 262–75; Hess and Chamberlain, 571–84; and Aaron Capper, "The Fate and Development of the Immature and of the Premature Kid," American Periodical of Diseases of Children, 35 (March 1928): 443–91.

[12] Napier, "Method of Caring for Premature and Underweight Babies,"; William N. Bradley, "The Intendance of the Premature Baby," Medical Journal and Record 124 (xviii August 1926): 222–25; "Simplifying the Nursing Care for Premature Babies," Trained Nurse and Hospital Review 78 (June 1927): 633; and Ralph M. Tyson and Edward F. Burt, "Continuous Temperature Records of Premature Infants," American Journal of Diseases of Children 38 (1929): 944–52.

[13] Charles Chapple Papers. MSS 2/0207–01, Series 2.2, Folder 5. Historical Collections, Higher of Physicians, Philadelphia.

[14] William P. Buffum and George F. Conde, "The Use of Oxygen in the Care of Feeble Premature Infants," Journal of Pediatrics 4 (1934): 326–30; Alexander Thousand. Burgess and Alexander M. Burgess, Jr., "A New Method of Administering Oxygen," New England Journal of Medicine 207 (1932): 1078–82. Burgess and Burgess describe pipe oxygen into a box placed over a patient's caput. They were able to attain oxygen concentrations of 40-l%. In the instance of babies, they advised placing the box completely over the baby.

[fifteen] Anne Y. Peebles, "Care of Premature Infants," American Journal of Nursing 33 (1933): 866–69; Buffum and Conde, "The Use of Oxygen in the Care of Feeble Premature Infants," 326–thirty; Daniel A. Wilcox, "A Report of Three Hundred and Thirty Premature Infants," American Journal of Diseases of Children 52 (1934): 848–62; Julius H. Hess, "Premature Infants – A Report of Sixteen Hundred and Xx-three Sequent Cases,"Illinois Medical Periodical 67 (1935): fourteen–25. Quote is from Hess, 18.

[16] Gerald Thou. Oppenheimer, "Prematurity equally a Public Health Trouble: US Policy from the 1920s to the 1960s," American Journal of Public Wellness86 (1996): 870–78.

[17] Ethel C. Dunham and Jessie M. Bierman, "The Care of the Premature Infant," Periodical of the American Journal of Medicine 115 (1940): 658–62.

[18] "A Geographical Map of the Century of Progress Exposition…faithfully executed and drawn in a carnival spirit past Tony Sarg."  The baby incubators were listed first in the list of attractions. Century of Progress drove, Department xvi, box 13, folder sixteen-197, Main Library, Special Collections, University of Illinois at Chicago. The building was captured in a picture taken from distant that showed a huge crowd around the building and flowing down the Midway.

[19] Official Guidebook, World's Fair, 1934, 109. Century of Progress collection, Section xvi, box 13, binder 16-193, UIC library.

[20] Thomas E. Cone, Jr. History of the Care and Feeding of the Premature Infant. (Boston: Fiddling, Brown and Company, 1985), 9–x, 18–21; Silverman, "Incubator-Baby Side Shows," 137. Silverman interviewed Evelyn Lundeen, the head nurse of the premature center at Michael Reese, before her death in 1963. Despite misgivings almost the carnival like atmosphere, Lundeen praised the care the infants received.

[21] Henry L. Woodward and Bernice Gardner, Obstetric Direction and Nursing (Philadelphia: F.A. Davis Company, 1942), 681; "Nursing Intendance of Newborn Infants – Excerpts from Children's Agency Publication 292, Standards and Recommendations for Hospital care of Newborn Infants, Full-Term and Premature,"; Sister Mary Pulcheria Wuellner, "Safe Nursing Care for Premature Babies," American Journal of Nursing 39 (November 1939): 1198-1202. Wuellner suggested assuasive parents to view their infants through a drinking glass sectionalization.

[22] Tiny Baby Fights to Live," New York Times (NYT), 8 December 1932; "1¾-Pound Baby At present Normal," NYT, 25 December 1933; "Infant Weighing 19 Ounces is Reported Thriving," NYT, 14 August 1934; "One-Pound Baby Dies," NYT, xv November 1934; "Gives Birth to ane½ -Pound Babe," NYT, 23 February 1935; "15-Ounce Infant Fed At present Between Meals," NYT, 9 February 1936; "Baby Weighs Pound 13 Ounces," NYT, two August 1936; "Tiny Hartford Baby Wins Fight for Life," NYT, vii Dec 1936; "I-Pound Baby Girl Fighting for Life," NYT, 13 March 1937; "28-Ounce Baby Off Whisky Diet," NYT, 27 March 1937),; "Nine-Ounce Baby Loses Bid for Life,:" NYT, 27 March 1937; "24-Ounce Baby a New Napoleon,"NYT, xv August 1937; "24-Ounce Infant is 'Gaining'," NYT, 12 September 1937; "ane-Pound, 11-Ounce Baby Lives," NYT, four April 1938; "Tiny Babe Gains Weight," NYT, 23 May, 1938; "Babe of ii¼ Pounds Survives," NYT, 17 July 1938; "21-Ounce Baby Built-in at Brooklyn Hospital," NYT, 18 June 1939; "Bellevue Staff Wins Fight for Baby'due south Life," NYT, 8 October 1940; "27-Ounce Boy Born in England," NYT, 14 August 1940; "Race to Save Babe Fails," NYT, 17 February 1937.

[23] Baker, Machine in the Plant nursery, 105.

[24] Oppenheimer, "Prematurity as a Public Health Trouble," 870–79.

[25] Hess, "Premature Infants, A Report of Sixteen Hundred and 20-three Consecutive Cases," 14-23. Hess reported in 1935 that intracranial hemorrhage was nowadays in over xl% of the infants autopsied after death in his unit. Approximately 11% of the unit of measurement'due south graduates demonstrated symptoms. Of these 69 were followed and 27 adult physical injuries related to the central nervous system. Ix of the 27 were classified as mentally retarded.

[26] T.L. Terry, "Extreme Prematurity and Fibroblastic Overgrowth of Persistent Vascular Sheath Behind Each Crystalline Lens, Preliminary Report," American Periodical of Ophthalmology 25 (1942): 203–04.

[27] T.L. Terry, "Fibroblastic Overgrowth of Persistent Tunica Vasculosa Lentis in Premature Infants, Etiologic Factors" Archives of Ophthalmology29 (1943): 54–65; Kate Campbell, "Intensive Oxygen Therapy equally a Possible Cause of Retrolental Fibroplasia: A Clinical Approach," Medical Journal of Commonwealth of australia two (1951): 48–50; V. Mary Crosse and Philip Jameson Evans, "Prevention of Retrolental Fibroplasia," Athenaeum of Ophthalmology 48 (1952): 83–87; Arnall Patz, "The Role of Oxygen in Retrolental Fibroplasia," Pediatrics nineteen (1957): 504–24; Loren P. Guy, Jonathan T. Lanman, and Joseph Dancis, "The Possibility of Total Emptying of Retrolental Fibroplasia by Oxygen Restriction," Pediatrics 17 (1956): 247–49; Leroy E. Hoeck, and Edgar De La Cruz, "Studies on the Result of High Oxygen Administration in Retrolental Fibroplasia – Nursery Observations," American Journal of Ophthalmology 35 (1952): 1248–52; 5. Everett Kinsey, "Retrolental Fibroplasia – Cooperative Study of Retrolental Fibroplasia and the Apply of Oxygen," Archives of Ophthalmology 56 (1956): 481–543. For an overview of the RLF story see William A. Silverman, Retrolental Fibroplasia: A Modern Parable, (New York: Grune and Stratton, 1980).

[28] Patz, "The Role of Oxygen in Retrolental Fibroplasia," 504–24; Mary Ellen Avery and Ella H. Oppenheimer, "Recent Increase in Bloodshed from Hyaline Membrane Disease," Journal of Pediatrics 57 (1960): 553-559; G.C. Robinson, J.East. Jan, and C. Kinnis, "Congenital Ocular Blindness in Children, 1945–1984," Archives of Pediatrics and Adolescent Medicine 141, no. 12 (December 1987): 1321–24; P.B. Campbell et al., "Incidence of Retinopathy of Prematurity in a 3rd Newborn Intensive Care Unit," Athenaeum of Ophthalmology 101, no. eleven (November 1983): 1686–88; The Committee for the Classification of Retinopathy of Prematurity, "An International Classification of Retinopathy of Prematurity," Archives of Ophthalmology 102, no. eight (August, 1984): 1130–34; D.R. Brownish et al., "Retinopathy of Prematurity. Take chances factors in a Five-Year Cohort of Critically Ill Premature Neonates," Archives of Pediatrics and Adolescent Medicine 141, no. two (February, 1987): 154–60; Walter K. Fierson et al., "Screening Exam of Premature Infants for Retinopathy of Prematurity," Pediatrics 100 (1997): 273–74; Gary C. Chocolate-brown et al., "Cost-Effectiveness of Treatment for Threshold Retinopathy of Prematurity," Pediatrics 104 (1999): 47-52.

[29] Murdina MacFarquhar Desmond, Newborn Medicine and Society: European Background and American Practise (1750–1975) (Austin, Texas: Eakin Press, 1998): 170–71, 198.

[xxx] Desmond, Newborn Medicine and Society, 209.

[31] Lynn Singer et al., "A Longitudinal Study of Developmental Effect of Infants with Bronchopulmonary Dysplasia and Very Low Birth Weight," Pediatrics 100, no. 6 (December 1997): 987–93; H.One thousand. Hennes, Thousand.B. Lee, A.A. Rimm, and D.L. Shapiro, "Surfactant Replacement Therapy in Respiratory Distress Syndrome. Meta–Assay of Clinical Trials of Single-Dose Surfactant Extracts," Athenaeum of Pediatrics and Boyish Medicine 145, no. ane (Jan 1991): 102–04; and Rachel M. Schwartz et al., "Effect of Surfactant on Morbidity, Mortality, and Resource Use in Newborn Infants Weighing 500 – 1500 k." New England Journal of Medicine 330, no. 21 (26 May 1994): 1476–80.

[32] Julius H. Hess, "A City-Broad Plan for the Reduction of Deaths Associated With and Due to Prematurity," Periodical of Pediatrics 6 (1935): 104–21; Cone, Premature Infant, 62–63. The American University of Pediatrics (AAP) passed their resolution on June seven, 1935 in New York City.

[33] Lilly M.S. Dubowitz, Victor Dubowitz, and Cissie Goldberg, "Clinical Assessment of Gestational Historic period in the Newborn Infant," Periodical of Pediatrics 77 (July 1970): one–ten.

[34] M.C. Haeusler et al., "Amniotic Fluid Insulin Testing in Gestational Diabetes: Rubber and Acceptance of Amniocentesis," American Journal of Obstetrics and Gynecology 179, no. four (1998): 917–20; M. Kucuk, "Tap Test, Milkshake Examination and Phosphatidylglycerol in the Assessment of Fetal Pulmonary Maturity," International Periodical of Gynaecology and Obstetrics 60, no. i (1998): nine–14.

[35] Joyce A. Martin et al., "Births: Final Information for 2000," National Vital Statistics Report fifty, no. 5 (12 February 2002): 15–18; Kathryn A. Sowards, "What Is the Leading Cause of Infant Bloodshed? A Note of the Interpretation of Official Statistics," American Journal of Public Wellness 89 (1999): 1752–54.

[36] Susan Schindehette, "Coming Up Roses," People Weekly, 8 Dec 1997, 54-60; Linda Kulman, "Cigars All Around," U.S. News and World Written report, 1 December 1997, 14; Michael D. Lemonick and Jeffrey Kluger, "'It's A Phenomenon,'" Fourth dimension, i December 1997, 34-39; John McCormick and Barbara Katrowizt, "The Magnificent 7," Newsweek, 1 December 1997, 58-62; Claudia Kalb, "Families: The Octuplet Question," Newsweek, 11 January 1999, 33; and "Question Time," People Weekly, 11 January 1999, 72.

[37] Due south.East. Jewell and R. Yip, "Increasing Trends in Plural Births in the U.s.," Obstetrics and Gynecology 85, no. 2 (1995): 229–32; Diane Holditch-Davis, Dia Roberts and Margarete Sandelowski, "Early Parental Interactions With and Perceptions of Multiple Birth Infants," Journal of Avant-garde Nursing thirty, no. i (1999): 200–10; Robert 50. Goldenberg and Dwight J. Rouse, "Prevention of Premature Birth," New England Journal of Medicine 339, no.five (1998): 313–xx; and  L.A. Schieve et al., "Live-Birth Rates and Multiple-Nativity Risk Using In Vitro Fertilization." Periodical of the American Medical Clan 282, no. 19 (1999): 1832–38.

[38] Stephen Northward. Wall, and John Colin Partridge, "Death in the Intensive Intendance Plant nursery: Physician Exercise of Withdrawing and Withholding Life Support," Pediatrics 99, No. 1 (January 1997): 70; Mark Sklansky, "Neonatal Euthanasia: Moral Considerations and Criminal Liability," Periodical of Medical Ethics 27, (2001): v–11; and Jaideep Singh, John Lantos, and William Meadow, "End-of-Life Afterwards Birth: Death and Dying in a Neonatal Intensive Intendance Unit," Pediatrics 114, No. 6 (December 2004): 1620–26.

Elizabeth A. Reedy is an Instructor of Nursing at Penn Land College of Nursing - Abington.

smithmher1991.blogspot.com

Source: https://www.nursing.upenn.edu/nhhc/nurses-institutions-caring/care-of-premature-infants/

Share this post