Letter from Dept. of Public Health about the Care of the Premature Baby

Poston Public Health Document

A document was sent from the Department of Public Health to an incarceration camp in Poston, Arizona in August 1943, titled “Important Points on the Care of the Premature Baby.”  It explains the steps that need to be taken to carry out three important requirements for the care of a premature baby: the baby should be kept warm, protected against infection, and well nourished.  The instructions provide an insight on how premature infants were cared for in Poston. The document was possibly most relevant to Mrs. Miure, the public health nurse of the camp (“Medical Personnel”).

Although health care in the internment camps was free, it proved to be inadequate in many different ways.  There were frequent shortages in equipment, medicine, milk, and other supplies; additionally, there was a shortage in medical personnel, especially nurses, which caused many overworked doctors/nurses and treatment delays.  The shortage of nurses was so significant that internees were trained as nurse’s aides in a rushed and insufficient training program (PJD 163-164).

By comparing these instructions to those in the American Journal of Nursing of 1945, we see a number of omissions in the Public Health document.  The first requirement that is elaborated upon in the document is the need to keep the baby warm.  The instructions state that upon delivery of the baby, he/she should be wrapped in a warm blanket and placed into a warm bed.  There are many specific points that are left out such as the temperature of the bed.

Cheiko Neeno, a Nurse's Aide student at the Poston Hospital, feeding a baby in the children's ward

According to the American Journal of Nursing, as the infant develops and weighs more, the temperature of the heated bed should gradually decrease.  Infants need to be kept in an environment of a specific temperature based on their weight.  Infants that weigh less than three pounds need a bed that is maintained at 90 degrees (F), infants of 3-4 pounds need 85 degrees, infants of 4-5 pounds need 80 degrees, and infants of 5 ½ pounds need 75 degrees.  Also, the document states that the temperature of the room should be kept at a constant rate between 75 and 80 degrees; however, this is not entirely accurate.

Although a 75-80 degree room temperature works for most infants, it cannot be set in stone for every one of them.  The temperature may be adjusted to cater to the needs of any particular infant based on his/her reaction to the environment.  In addition, as the temperature decreases, the humidity requirement increases; the ideal humidity is noted to be approximately 55 to 65 percent (Wallinger 898).  The humidity of the baby’s environment is just as important as the temperature, however this valuable information is absent in the Public Health document as well.  Although it does state, “If the air is very dry, moisture should be added so as to prevent drying out of the baby’s respiratory tract,” it does not identify/explain the device used to measure the air’s dryness, nor does it specify how much moisture should be added to the air.

However, Poston was located in a dry, hot desert, where aspects of the indoor environment, such as temperature and humidity, may have been difficult to control.  Similarly, the Gila River incarceration camp was located in the middle of a desert.  The incarcerees at Gila constructed their own homemade cooling systems, in which a fan would blow out air that was cooled by a water source.  The makeshift air conditioning system allowed the people to live in 80-degree rooms when the weather was up to 100-115 degrees (Hoshida).  It is reasonable to believe that the incarcerees at Poston may have also had to create their own A/C units to ward off the harsh outdoor heat.  As for the Poston hospital, an exact depiction of the A/C system used there remains questionable, but it may be assumed that it was not advanced and flexible enough to maintain an absolutely ideal environment for all of the premature infants.

To protect the infant from infection, the Public Health document includes a few precautions that should be taken, one being that flies, mosquitoes, and all other insects should be kept out of the room.  This is indicated as a precaution because it may have been a major issue in the hospital due to its poor conditions, which allowed insects to easily make their way into rooms.  Also, it is important to point out that the instructions omitted the necessity of an “observation room” where any seemingly ill premature infants could have been moved to and checked up on; the separation of well-infants and ill-infants would prevent any illnesses from spreading (Wallinger 900).

As for the instructions regarding the nourishing of the baby, this section seems more thorough than the instructions for the other two requirements.  The instructions state that the infant does not need to be fed milk or water for up to 12 hours after its birth; however, it could have been up to 18 hours, or even longer, to make sure that the infant developed a gagging reflex before it was fed by mouth (Wallinger 899).  Obviously, it was extremely important for infants, premature and mature, to be fed milk to benefit their health and development.  In the oral history of Aiko Herzig, a mother who had given birth to her daughter in one of the internment camps, as well as a significant leader and activist throughout the redress movement in the 1980’s, she mentioned that her child was born with an allergy to the powdered milk provided by the camp.  Herzig should have fed her canned Carnation milk, but the medical personnel told her that those were only sent to the armed forces.  Herzig, who received minimum salary, could not afford to buy canned milk from outside of the camp.  As a result, her daughter was frequently hospitalized with stomach disorders because she was deprived from the appropriate type of milk.  She lacked much of the nutrition that would have been provided by canned milk during her infantry, which has affected her health for the rest of her life (Herzig interview).  The Public Health document did not distinguish what type of milk would be the most appropriate to feed to the infants because Poston presumably only had powdered milk as well, which only adds to the numerous inadequacies found in the document and in the camp’s health care.

By Tammy Chen

Works Cited

Aiko Herzig, interview by Emiko Omori and Chizu Omori, 20 Mar. 1994, Emiko and Chizuko

Omori Collection, Densho.

Hoshida, George Y.  Life of a Japanese Immigrant Boy in Hawaii &

America.  Self-published, 1982.

“Important Points on the Care of the Premature Baby Aug. 1943” Folder 74, in the Sally Lucas

Jean papers #4290, Southern Historical Collection, The Wilson Library, University of North Carolina at Chapel Hill.

“Medical Personnel,” in the Sally Lucas Jean papers #4290, Southern Historical Collection, The

Wilson Library, University of North Carolina at Chapel Hill.

Wallinger, Elgie M. “Nursing Care of the Premature Infant.” The American Journal of Nursing

45.11 (1945): 898-901. Web. 1 Mar. 2012.

 

Infant Care

Direction for Mothers - Sally Lucas Jean Papers

These documents focus specifically on recommended infant care in the camps. They provide an interesting perspective on medical care, as well as nutrition, during the internment of Japanese Americans during World War II. Furthermore, these documents offer a historically accurate source for comparing medical protocol in the camps with that of the rest of American society during the 1940s.

Issued by the War Relocation Authority’s Department of Public Heath, these documents detail the recommendations of health officials in the camps to new mothers on the matter of feeding their newly born infants. According to these suggestions, mothers should incorporate cod liver oil into their infants’ diet before they are even a month old for the prevention of rickets and add orange juice shortly after. Furthermore, mothers should breastfeed their infants every four hours for the first four months, gradually weaning their children until the age of eleven months. At around five months, mothers were advised to begin adding strained cooked cereals to their babies’ diets, adding strained cooked vegetables and egg yolks soon after. Mothers were told to feed their infants strained stewed fruits at around seven months, continuing to increase the variety and amount of their children’s diets as they grew older. By the end of the twelfth month, mothers were supposed to give their infants three meals a day and allow them to begin feeding themselves in a high chair.

Nurse's Aid student caring for infant at Poston Hospital

During the incarceration, life was certainly difficult for new mothers, for they had to attempt meet the nutritional requirements of their new infants in an atmosphere that was hardly conducive to such needs. While the camps lacked resources accessible to mothers outside the camps, several camps, such as Jerome in Colorado, housed a special refrigerator in the mess hall to fulfill some of the mothers’ immediate needs, specifically baby food and formulas (Okumura interview). Yukiko Miyahara, who stayed in the Santa Anita assembly center, appreciated the special baby stations from which mothers could obtain a small amount of baby food and milk when needed (Miyahara interview). However, most camps, including Manzanar, only distributed powdered milk, causing a relative lack of nutrition for infants allergic to this milk substitute, which angered Aiko Herzig-Yoshinaga, mother of an affected infant. Canned milk was typically reserved for the army and those who could afford to pay for it themselves, an impossibility for Japanese American mothers trying to survive on minimum salaries (Herzig interview). Some families in Poston sacrificed their ration of milk at a meal to provide for an infant in the family, since there were no special formulas for infants provided (Okimoto interview). On the other hand, many mothers, including Yukiko Miyahara, chose to nurse their babies for reasons of convenience and personal preference (Miyahara interview). However, despite the inevitable restrictions of life in the camps, the recommendations by health officials there were surprisingly similar to those of physicians in American society.

Mother with infant and child during evacuation

As these documents advocated the use of cod liver oil and orange juice, physicians outside the camps similarly recommended these substances as a means of obtaining Vitamins A, C, and D (Whipple 169-170). While the age recommendations for solids such as cereal, fruits, vegetables, and egg yolks are relatively similar to those in the camps, meat, as well as toast, was typically incorporated into infants’ diets around the age of seven months in American society, while mothers in the camps were not told to feed their young babies this delicacy within the first year. Perhaps this was due to a shortage or relative lack of such expensive food in the camps, or perhaps officials genuinely did not believe meat needed to be incorporated at such a young age (Whipple 173-178). The most reasonable explanation for this disparity is the rationing of meat, as well as canned milk, among civilians during World War II by the War Food Administration (Collingham 114-117,417-423, 431-432, 478). Regardless of the motives behind this exclusion, one cannot help but find it interesting that typical recommendations for infants’ diets both within the camps and in American society differed only in those areas involving foods considered more expensive and significantly less available during wartime.

Mother waiting in line with children

When examining the nutritional recommendations for infants during the decades surrounding World War II, one must also recognize the increasing popularity of baby foods at the time. Especially in the post-war era, many mothers and physicians believed their infants would benefit from solid food as early as possible. Thus, while breast milk and cow’s milk were considered sufficient sources of nutrients for infants in the 1920s, opinion dramatically shifted in the 1930s with the rising availability of canned baby foods such as those produced by the Gerber’s company. Evidently, in the years before World War II and the incarceration, the focus of mothers and physicians throughout America drastically shifted from breastfeeding to an accelerated incorporation of solids to meet infants’ nutritional requirements (Bentley).

In summary, these documents from the Sally Lucas Jean papers provide an intriguing account of life during World War II, particularly when analyzing infant care in the internment camps. Moreover, they serve as a useful resource when comparing the treatment of infants in the camps to that of babies living outside the camps in American society. Though one can conclude that standards of infant nutrition in the camps were relatively similar, though slightly modified due to the availability of supplies, to those outside the camps, many oral histories of mothers in the camps suggest that most of these needs were not actually met during the incarceration.

 

Laura Hanson

 

Works Cited

“A Guide to a Baby’s Feeding the First Year” Folder 74: Poston, Arizona, Japanese-Americans, 1942, in the Sally Lucas Jean papers #4290, Southern Historical Collection, The Wilson Library, University of North Carolina at Chapel Hill.

http://dc.lib.unc.edu/u?/ead,217651

 

Bentley, Amy. Booming baby food: infant food and feeding in post-World War II America. Michigan Historical Review Fall 2006: 63. Online.

http://go.galegroup.com/ps/i.do?action=interpret&id=GALE%7CA156290842&v=2.1&u=unc_main&it=r&p=AONE&sw=w&authCount=1

 

Collingham, Elizabeth. The taste of war: World War Two and the battle for food. London: Allen Lane. 2011. Print.

 

“Direction to Mothers” Folder 74: Poston, Arizona, Japanese-Americans, 1942, in the Sally Lucas Jean papers #4290, Southern Historical Collection, The Wilson Library, University of North Carolina at Chapel Hill.

http://dc.lib.unc.edu/u?/ead,217608

 

Herzig, Aiko, interview by Emiko Omori and Chizu Omori, March 20, 1994, Emiko and Chizuko Omori Collection, Densho.

[Densho ID: denshovh-haiko-02-0010]

 

Miyahara, Yukiko, interview by Kirk Peterson, April 10, 2009, Manzanar National Historic Site Collection, Densho.

[Densho ID: denshovh-myukiko_2-01-0008]

 

Okimoto, Ruth Y., interview by Tom Ikeda, April 8, 2011, Densho.

[Densho ID: denshovh-oruth-01-0010]

 

Okumura, Toyoko, interview by Tom Ikeda, February 15, 1997, Japanese American National Museum Collection, Densho.

[Densho ID: denshovh-otoyoko-01-0012]

 

Whipple, Dorothy Vermilya. Our American babies: the art of baby care. New York: M. Barrows and company, inc., 1944. Online.

http://babel.hathitrust.org/cgi/pt?id=coo.31924003492653;page=root;view=image;size=100;seq=1