ABSTRACT
The beginnings of newborn medicine and its rapid advance in America since the early
twentieth century are reviewed through presentation of ideas that have influenced
the givers of care. Newly born infants attained patient status at the end of the 19th
century when Budin gave them hospital charts and Ballantyne designed the blueprint
for continuity of maternal-infant care. These achievements gave impetus to the task
of preserving infant life. In 1915, the United States established a birth registration
area permitting calculation of infant mortality rates. These rates became the guide
and yardstick for measuring progress in newborn care. Since 1915 infant mortality
has decreased tenfold as survival increased successively in the postnatal infant,
the neonate, and recently in the premature. Pediatricians began to supervise newborn
nurseries after World War I. During depression years, national efforts were expended
for the premature. After World War II, pediatricians moved close to birth, assessing
and treating in the delivery room. Special care and intensive care nurseries sprang
up in the 1960s. In the past 25 years, improvements in ventilation and life support
systems have enhanced survival of compromised and immature infants. Today, newborn
medicine is spectacularly successful in lowering neonatal mortality but is beset by
costs, ethics, legal concerns, and the burden of survival morbidity. Controversy such
as exists today is not new to newborn medicine; it has been its constant companion
throughout history.
