You & your baby : report of the Advisory Committee on Infant Mortality & Handicap in Northern Ireland.

  • Great Britain. Advisory Committee on Infant Mortality and Handicap in Northern Ireland.
Date:
1980
Catalogue details

Licence: Open Government Licence

Credit: You & your baby : report of the Advisory Committee on Infant Mortality & Handicap in Northern Ireland. Source: Wellcome Collection.

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    3.12 The hazard to health of this large number of sub-standard houses is greatly increased by very frequent overcrowding. The average household size in Northern Ireland, with 2.9 persons, is larger than in Great Britain, with 2.7 persons (Regional Statistics, 1980). In the Province 40% of all households with dependent children have 3 children or more whereas the comparable figure for Great Britain is only 2.5. The higher proportion of large families and households in Northern Ireland contributes to a higher level of overcrowding so that 17% of all households are living in dwellings below the bedroom standard compared to only 6% in Great Britain. The large amount of sub- standard housing and of overcrowding are likely to be major factors leading to a high rate of postneonatal morbidity and mortality from gastroenteritis. upper respiratory tract and other infections. 3.13 Using a definition of housing stress based on households living in sub-standard dwellings, overcrowding and economic disadvantage, the highest incidence of such stress in Northern Ireland is in the Belfast area and the western part of the Province, having 57% and 52% respectively of the house- holds affected by at least one stress factor (Northern Ireland Housing Execu- tive, 1979). These same areas have the highest rates of infant mortality and handicap. Diet and Nutrition 3.14 Although much has been written about the relationship of diet to birthweight, most of the studies concern small or selected populations. Large scale data show that women in affluent circumstances have bigger babies and fewer perinatal deaths than women in less privileged circumstances. However nutritional variables do not operate in isolation — more affluent mothers tend to have better housing, education and better health. They are inclined to smoke less, lead a less strenuous physical existence, make more use of the health and social services and give more thought to planning their families. 3.15 The most persuasive evidence that diet itself may affect reproductive performance was provided by the ‘involuntary feeding experiment’ made on a national scale by the United Kingdom during World War II. A food policy which provided extra nourishment and supplements to pregnant and lactating women was accompanied by a steep fall in the perinatal death rate between 1940 and 1948. This occurred at a time of great social upheaval and reduced medical services and it seems likely that the reduction in perinatal mortality was associated with improved maternal nutrition. 3.16 It is difficult to define a good diet particularly as ideas about certain foods tend to change. There is evidence that on average in Northern Ireland an individual eats less non-root vegetables and less fruit than in other parts of the United Kingdom (Wynn and Wynn, 1979). 3.17 The importance of vitamins has recently been highlighted in a pre- liminary report on a study of women given extra vitamins before and during early pregnancy. The study showed that a group of high risk women, who had previously given birth to one or more infants with neural tube defects and who were given multivitamins before conception and during pregnancy. had a significantly lower recurrence rate of these defects than had a similar group not so treated (Smithells and Sheppard, 1980). If this is confirmed by subsequent studies it could clearly make a significant impact on the incidence of spina bifida and anencephaly.