PEDIATRICS Vol. 87 No. 5 May 1991, pp. 654-662
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The Incubator Controversy: Pediatricians and the Origins of Premature Infant Technology in the United States, 1890 to 1910

Jeffrey P. Baker MD1

1 From the Department of Pediatrics, Duke University Medical Center, Durham, North Carolina

Few physicians realize that the specialized intensive care nurseries so prominent in modern hospital care originated more than a generation or two ago. Indeed, their chief benefactors, premature infants, are so numerous that one wonders what happened to all their counterparts who had the poor fortune of having been born at the turn of the century. Although the incidence of prematurity in 1900 is unknown, it seems reasonable to infer by analogy from today's rate that roughly 6% of all newborns were born more than a month early.1 Because most such infants today appear to need at least the resources of a neonatal special care nursery,2 one is tempted to presume that few could have survived at a time when such support was unavailable.

This assumption may not be valid, however. The extensive technology of the modern nursery makes one forget that the simple measures of warming and properly feeding a premature infant can dramatically increase his or her odds of survival. In fact, as early as the 1880s, French obstetricians had demonstrated that the mortality rate of premature infants could be cut almost in half with the aid of two simple technical innovations, the incubator and the "gavage" feeding tube.3 The French built the first premature infant nurseries in the late nineteenth century around these simple but efficacious technologies.4 By the 1890s incubators began to appear in the United States, stimulating a period of unprecedented interest in the treatment of prematurity. The climax of this activity was reached in the early 1900s as the enthusiasm for incubators translated into their display, complete with live infants, in a series of international expositions.

Submitted on February 12, 1990
Accepted on June 15, 1990




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