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Footnotes :



1  Wegman ME. Annual Summary of Vital Statistics - 1991. Pediatrics, December 1992, 90: 6: 835-845. See page 838 left, bottom, page 843, and Table 8: Specifically diagnosed respiratory distress syndrome of newborn


2  National Center for Health Statistics. Advance report of final mortality statistics, 1990. Monthly vital statistics report; vol 41 no 7, suppl. Hyattsville, Maryland: Public Health Service, 1993. See page 41, Table 23: Deaths under 1 year and infant mortality rates for 61 selected causes by race: United States, 1990:


3 Phelps DL. National Eye Institute Grant Application No. 1 U10 EY09962-01, Multicenter Trial of Supplemental Therapeutic Oxygen for Prethreshold Retinopathy of Prematurity (STOP-ROP). See page 44 bottom, Section 2 A. "A small increase in oxygen administration could alleviate the chronic marginal hypoxia and frequent brief hypoxic episodes among the survivors of premature birth who have chronic lung disease. These can lead to growth failure, pulmonary hypertension, and even death due to cor pulmonale. 


4 Maksimak J. The Premature Infant, in Nutrition and Feeding of Infants and Toddlers, by Howard RB, Winter HS, Little, Brown and Company, Boston, 1984, 266-271, page 267, second half.


5 Silverman WA: Retrolental fibroplasia: a modern parable. Grune & Stratton, Inc., New York, 1980, see Chapter on "Oxygen Treatment Practices in Premature Infant Care", pages 43-51, see page 43.


6 Hess JH. Oxygen Unit for Premature and Very Young Infants. American Journal of Diseases of Children, April 1934, 47: 4: 916-917.


7 Phelps DL. Vitamin E and Retinopathy of Prematurity: The Clinical Investigator's Perspective on Antioxidant Therapy: Side Effects and Balancing Risks and Benefits. Birth Defects: Original Article Series, 1988, 24: 1: 209-218, see page 234 top.


8 Schlesinger ER. Fetal and Neonatal Mortality: A Public Health Problem. The New York State Journal of Medicine, July 15, 1952, 1758-1763, see page 1761 left, top.


9 Avery ME and Oppenheimer EH: Recent increase in mortality from hyaline membrane disease. Journal of Pediatrics, 1960, 57: 553-559, as cited in Silverman WA: Retrolental fibroplasia: a modern parable. Grune & Stratton, Inc., New York, 1980, pages 53-55 and 208.


10 Vignec AJ, Moser A, Ellis R. Angelos P. Current Trends in Premature Care. New York State Journal of Medicine, 1952, 52: Pt. 2: 1764-1769, see page 1768 right, top


11 U.S. Department of Commerce, Bureau of the Census: Statistical Abstract of the United States 1987, Vital Statistics No. 87: Live Births, by Place of Delivery; Median and Low Birth Weight; and Prenatal Care: 1960 to 1984, page 62 top.


12 Schlesinger ER. Fetal and Neonatal Mortality: A Public Health Problem. New York State Journal of Medicine, 1952, 52 Pt. 2: 1758-1763. See page 1761 left, top.


13 Silverman WA: Retrolental fibroplasia: a modern parable. Grune & Stratton, Inc., New York, 1980, page 37.


14 Silverman WA: Retrolental fibroplasia: a modern parable. Grune & Stratton, Inc., New York, 1980, pages 62-63, and 65, 193; citing Cross KW: Cost of preventing retrolental fibroplasia? Lancet, 1973, 2: 954-956, and Bolton DPG, Cross KW:  Further observations on cost of preventing retrolental fibroplasia. Lancet, 1974, 1: 445-448.


15 Sources of data for Figure 1: Neonatal Mortality Rates 1915-1985 from National Center for Health Statistics, Vital Statistics of the United States, 1985, Vol. , Mortality, part A, sect. 2, page 1, as reproduced in Meckel RA. Save the Babies: American Public Health Reform and the Prevention of Infant Mortality 1850-1929, Johns Hopkins University Press, Baltimore, 1990, Appendix B, pages 238-9; Neonatal Mortality Rates 1980-1989 and Deaths Within Seven Days 1970 and 1980-1989 from U.S. Bureau of the Census, Statistical Abstract of the United States: 1992 (112th edition), Washington, DC, 1992, see No. 110: Fetal and Infant Deaths, page 80 middle; Neonatal Mortality Rates 1989-1991 from Wegman ME. Annual Summary of Vital Statistics - 1991. Pediatrics, December 1992, 90: 6: 835-845. See page 842, Table 7, with data credited to National Center for Health Statistics; Day-of-Birth Death Rates 1937-1969 from Silverman WA: Retrolental fibroplasia: a modern parable. Grune & Stratton, Inc., New York, 1980, rates scaled from Fig. 9.4. on page 65, originally published by Bolton DPG, Cross KW: Further observations on cost of preventing retrolental fibroplasia. Lancet, 1974, 1: 445-448.


16 CBS "Sixty Minutes", 1/19/1992, as cited in Dervin D. Psychohistorical Models. The Journal of Psychohistory, Spring 1993, 20: 4: 427-452.






Preemies gasping for breath


are denied the breathing help they need 


Davidpreem01.jpg (20108 bytes)

Medical oxygen- starving practices and experiments
by H. Peter Aleff, written 1992

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1. Unacceptable risks for uncertain benefits

Many premature babies die or suffer major permanent injuries because they do not receive enough oxygen in their first few days when they need it most1,2,3

Until the often still immature lungs of these preemies can extract enough of this life- sustaining gas from the air they breathe, they need this essential nourishment in higher concentrations than babies more ready for the transition to life outside the womb.

Their need for more concentrated oxygen is similar to their need for the higher concentrations of essential food proteins which mothers of preemies provide in their milk as compared to that from mothers who carried their babies to term4.  The difference is that Nature tailors their food to their needs, but not their air.

Physicians have thus recommended since the turn of the century to help premature babies with higher- than- normal concentrations of oxygen, and many have fed them such enriched baby- fare of the lungs with consistent success and no harmful side effects5, 6.

However, in 1954 the preemies' physicians began to curtail this choice remedy for respiratory diseases to the brink of babies turning blue from asphyxiation, and sometimes beyond. Even today, they still minimize the concentration of supplementary oxygen as well as the time they allow the preemies to enjoy any enriched breathing, despite their lack of knowledge what safety margin, if any, they have in so depriving the preemies, and despite the often confirmed experience that reducing the oxygen supply for preemies increases the mortality and morbidity among them.

The official reason for this systematic lung starvation is the nursery doctors' fear that too much oxygen could cause the babies to develop retinopathy of prematurity (ROP), formerly also called retrolental fibroplasia.

This retinal disease common in intensive care nurseries affects now to some degree up to two thirds of the smallest premature babies and up to one third of the larger ones. Most of the affected infants recover with minor or no immediately noticeable damage to their eyes, but many do not. Among the most susceptible babies, those with birth weights around three pounds or less, ROP was said to have in 1985 severely impaired the vision of about one in ten, and to have completely blinded up to about one in fifty7.

Back in 1952, shortly before the oxygen starvation regimen was introduced, and a dozen years after the sudden appearance of the disease, the incidence of "gross visual defects" from ROP among the babies born in the same birth weight group in the state of New York was reported as about one in eighteen8.

A few years after that report, the prescription to prevent this disease with oxygen restrictions was found to have cost the lives of an estimated extra one in twenty babies9 in a more than eight times larger10 group of mostly heavier-born preemies from the Baltimore region. That is, the rate of deaths from the cure around Baltimore was about eight times higher than the rate of gross visual defects from the disease had been in the state of New York.

The one-in-twenty extra deaths estimate is based on a review of autopsy reports in 1960 at Johns Hopkins Hospital in Baltimore. Two physicians there compared the rates of death from hyaline membrane disease, or breathing problems, among preemies with birth weights between 1000 and 2500 grams during five years before the oxygen rationing and five years after its beginning. They found that the hyaline membrane disease death rate had more than doubled, and that this sudden increase in that one cause had raised the overall mortality among those babies from 8% before the oxygen withholding doctrine to 13% after its introduction.

That comparison covered 1152 and then 1492 autopsy reports at one hospital; extrapolations from such small groups can be unreliable because the sample may not be representative. However, all the intensive care nurseries from Coast to Coast followed essentially similar oxygen policies based on the same suddenly introduced and much publicized official guidelines, with presumably very similar effects.

One can thus at least gain an impression about the order of magnitude for the respiratory distress epidemic by applying the 5% increase in mortality in and around Baltimore to the about 315,000 babies born nationwide in 1960 with birth weights below 2500 grams11. This calculation yields roughly 16,000 extra deaths per year in the United States from the oxygen withholding. Since the babies with birth weights below 1000 grams who were not included in the Baltimore review were even more likely to have died from lack of oxygen, the true toll was probably even higher.

The babies would certainly have been better off without this prevention effort: in the years before the oxygen throttling, ROP severely impaired the vision of at most up to 2,000 babies per year in the United States12 and totally blinded less than 1,000 among these13.

Two British researchers arrived in the early 1970s at surprisingly similar conclusions by an entirely different method. They compared the actual and expected mortality rates on the day of birth and during the first month of life for the periods before and during the oxygen restrictions, and they saw a striking picture emerge: after several decades of a steadily incremental decline, at the beginning of the oxygen withholding the graph of these rates began to diverge sharply from its projected path.

Instead of further diminishing, the annual toll in early deaths suddenly stagnated and even rose. The researchers took the differences between the projected and the reported death rates as related to the oxygen rationing and then divided the so calculated number of extra deaths by the difference in ROP cases before and during the oxygen rationing. By this method, they computed that the practice of oxygen withholding had cost in England and Wales about 16 deaths for each case of blindness prevented14

Oxydeathsgraph.gif (10386 bytes)

The United States mortality records15 plotted in Figure 1 at left show a similar distortion in the death rate evolution, parallel to that in England, and consistent with the magnitude of the sudden

mass dying the Baltimore autopsy reviewers and the British death rate comparers had documented.

When the oxygen rationing began, the U.S. early mortality rates, too, suddenly stagnated and even rose, instead of continuing to decline along the exponential learning curve which they had been following for some time. All the extra babies who died succumbed on their first day when breathing is hardest and the need for oxygen greatest; even some of those who would otherwise have died during days two to twenty- eight now died on day one, escaping the agony of prolonged doomed struggle but confirming that this first day had indeed become much more difficult for the weaker preemies. You may appreciate the cost in lives from the "suffocation-bulge" in the death rates when you compare the hump it made in the graph with the almost invisible impact on those rates from the much celebrated clinical revolution caused a decade earlier by the arrival of antibiotics.

These different but converging lines of evidence suggest thus that during its early and most uncompromising years, the oxygen starvation doctrine was steadily slaying more than twice as many Americans per year than the Vietnam war ever did. Or each day about twice as many real preemies in America than the 22 fictitious preemies in Kuwait whose one- time alleged death inflamed the public with Gulf war fever and is said to have swayed the war- deciding vote16.

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