Caring about life : Infant mortality in Ådalen, Sweden, during the 19th century

During the first half of the nineteenth century infant mortality rates in Ådalen, an agrarian region in northern Sweden, were among the highest in the country. During the second half of the century the region experienced a rapid population growth and a restructuring of the economy in conjunction with the expansion of the sawmill industry. Infant mortality rates peaked in the 1870s but then declined to a level near the national average, despite the pressures of rapid industrialisation. Using an analytical model which emphasizes the role of the mother in infant care, variables that affect infant mortality are considered. The central argument is that a mother can either lessen or increase the impact of detrimental influences on infant survival, depending on her store of knowledge and how she is able to use it. The variables are broadly grouped into three categories: socio-economic, cultural and medical/health issues. The primary sources are church records, provincial physician’s reports and folklore documents. The results demonstrate that socio-economic factors were only important in the sense that better living conditions made it easier for a mother to care for her child. The high level of infant mortality in the region was due mainly to cultural factors that resulted in a weak breast-feeding tradition. Since it was thought that breast milk was insufficient, infants were put on a diet containing herring and gruel served in cow’s horn at a very early age, resulting in a variety of diarrhoeal afflictions. Although the provincial physicians strongly recommended breast feeding, most mothers continued the practice and the tradition remained unchanged. The decline of infant mortality was mainly due to the impact of midwives. They introduced new hygienic practices in conjunction with deliveries and in the handling of supplementary foods which resulted in a decrease of both neonatal and post-neonatal deaths