Infant Nutrition and Children’s Growth and Mortality: Evidence from London’s Foundling Hospital, 1892-1919 | Abstract

We use a new and restricted-use source of longitudinal data from London’s Foundling Hospital (1892-1919) to test for the influence of infant health status and early-life circumstances on growth and mortality outcomes later in childhood. From this source, we create a new historical cohort study dataset—one which includes some of the most detailed individual-level information about children’s nutrition, growth, morbidity, and general health of any source for its time. Importantly, ours is one of the oldest such cohort datasets available, and allows for the study of early-life health in the era before modern medical and public health services. Although it is often difficult to understand how nutrition or morbidity in infancy, early childhood, or adolescence influences and is influenced by health in other developmental periods, our dataset allows us to exploit a rich set of information recorded at several different stages in the child’s life-course up to age 15—such as that on anthropometric wellbeing, disease burden, diets, and other indicators of health—to examine the influence of infant feeding and early morbidity on children’s mortality and growth.

Using this new cohort dataset, we test whether infants’ diets before they entered the hospital influenced their mortality risk at ages 0-1 and 1-5, as well as their weight for age (relative to modern standards) upon entering the hospital. We find that children who were never breastfed had substantially higher mortality risk in infancy and lower weight-for-age Z-scores upon entering the hospital than children who were breastfed. However, the protective effect of breastfeeding declines as infants get older. These results confirm the importance of infant feeding in reducing infant mortality and improving infant health, and suggest that while nutrition matters most early on, these initial deficits can be overcome through an improvement in access to nutrition and medical care of the like offered by the Foundling Hospital. Ongoing analysis tests for the effects of early disease morbidity on children’s mortality and growth within and across periods.