山村における乳児の栄養状態と発育環境

抄録

While the nutritional conditions and mortality rate of sucklings have shown a steady improvement in Japan, there are still some backward areas far below the current levels, inter alia the remote and secluded villages among mountains.We examined 731 sucklings (ranging from 1 to 18 months old) of mountain villages in the middle part of Niigata Prefecture in regard to their physical and nursing conditions.The mortality rates of both new-born and suckling babies and also the cases of diseases among them were upwards of the mean values for the corresponding populations in the whole nation. Both in the male and the female groups, body-weight was on the national level at the time of birth, but fell below it as the month advanced, and the percentage of those weighing less than the average became larger.This tendency was more conspicuous in male than in female babies. Reported cases of artificial feeding were comparatively few, which caused us to suspect that there were not a few babies latently suffering from the insufficiency of mothers' milk.Initiation of ablactation was rather lates less than half of them began to be weaned before they were six months old. And the food used for ablactation was also predominantly inferior. No signigicant relationship was obtained, however, between body-weight, diet and anemia.
These phenomena are considered to be no other than the results brought about by the predicament that those sucklings have to be nursed against adverse conditions.From such point of view we pursued our research.Although the family system in Japan has undergone a drastic change, in remote mountain villages there still dominate the old-fashioned human relations within the family.Mothers have little right to voice there including the matter of child-care.Moreover, since mothers constitute important farming hands, nursing is in majority of cases left to the hands of grandmothers, only 36.8.% of mothers are taking care of their own babies.Under such circumstances, delivery is conducted at home in 94.0%, and doctors are called for in only 10% of the cases. Housewives' work, in addition to farming labor, includes cooking, washing and other chores.Thus they attend to a family of six on an average, with poor equipments at that few families have running water, electric appliances and other benefits of modern life.In agricultural on-seasons, mothers have to cut their sleep to 6-7 hours, and 23%of them are obliged to leave their babies home all by themselves or to bring them out to the field. 71.0% of all the mothers replied that they could not do as they were told by the public health nurses.The amount of money they were allowed to spend specifically for child-care was no more than 1, 000 a month in 80% of the cases studied, and the annual monetary income of the entire family was in the largest number of cases around \50, 000. It is about one-third of the national average income, and supposing there may be some other material income, it is still too small an amount tocover the expenses required for the conduct of child-care in the way deemed more or less satisfactory. They live far from any medical institutions; especially in winter time heavy snowfall being apt to paralyze the traffic, they are almost cut off from the outside world. Geographical inconvenience, low income and the hard labour imposed on mothers are considered to be responsible for the disease incidence of 24.7% among sucklings including mild cases, only half of whom receiving medical care, and for their poor physique mentioned above.
Under the circumstances all that we can do at present is to contrive to offer these villagers as many opportunities as possible for the supply of guidance and consultation in the matter of child-care, and for the prevention and treatment of ailments. However, the basic problem is the improvement of their living environment itself.