保育乳児の臨床的研究

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  • ホイク ニュウジ ノ リンショウテキ ケンキュウ
  • Clinical Studies on the Infants in a Nursery
  • 原著
  • Original Article

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Studies were made of 107 infants cared for at Chiba Prefectural Nursery during a period from 1954 (when it was founded) to 1959, and their physical and mental development was compared with that of infants cared for at home, who served as controls. 1. The infants entrusted to the care of the nursery on the grounds of their parents being sick accounted for 37.3 per cent of the infants under study. Along with twins, which accounted for 6.8 per cent, they are expected to increase in number hereafter. The foundlings, which accounted for 7.3 per cent, occupied only a small percentage of the total. 2. The infants who were before the 3rd postnatal month and the 6th postnatal month when taken to the nursery accounted for 31.1 and 60.3 per cent, respectively, of the total. Since 44.8 per cent of the infants discharged from the nursery were under a year old, it followe that 45.9 per cent of the total stayed there for less than 6 months, indicating that many of the infants under study stayed there for a short period. The fact that unavoidable circumstances compelled 5.8 per cent of the total to stay there even after they had become two years old (an age at which the infants are legally required to leave the nursery), however, seems to indicate the need for adequate measures to cope with the situation. 3. In the body weight and kaup index, many infants were below the normal (Kuriyama) and control levels when they were admitted to the nursery. 4. Within 6 months after being admitted, 77.6 per cent had reached the normal level. Few were below the normal level when they were discharged. 5. The diet on which the infants were fed in the nursery has been prepared in accordance with a menu prescribed by a nutrition list. Because the expenditure on this item was small, however, the diet barely met the caloric requirements provided for by the office of Scientific Techniques. 6. The serum total protein, blood sugar and blood Cl levels of the infants under study were normal.

The amounts of vitamin B_1 and B_2 detected in the blood and urine were nearly normal. The infants were not found to be deficient in them. 7. Diarrhea and pyrexia were present in 84 and 54.3 per cent, respectively, of the infants under study immediately after being admitted. 8. The morbidity among the infants under study was 11.6 per cent on an average. There has been a decrease in the morbidity of infectious diseases since 1957. Despite strenuous efforts made for the prevention of an infection, pseudocholera infantum prevailed in 1954, measles in 1958, and rubeolla in 1959 in the nursery. 9. Being suspected of suffering from vitamin D deficiency, the insants under study were examined and classified by Hire's method of point system. There were 2 infants with points over 3.1, 7 with points between 1.2 and 3.0, and 6 with points below 1.1. Sun bath and administration of vitamin D solution (chocola D) brought about a clinical improvement. A case report on an infant with 3.8 points who has been cured of vitamin D deficiency is presented. 10. All the infants whose blood pictures were studied had hypochromic anemia. Administration of Chocola-B-Fe Syrup resulted in the increased hemoglobin content of the blood. 11. The mortality among the infants under study was 4.67 per cent. 12. The development of speech was delayed in the infants under study, as compared with normal infants. Thanks to the efforts of volunteer workers, however, there has been an improvement in the retarded speech. There was a marked difference between the I.Q. of the infants under study, which was 82.1 and that of the controls, which was 121.7. Some infants showed a decrease in I.Q. during the period when they were cared for in the nursery.

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