The Valley of the Shadow of Birth

Dr Clement Smith (1901–1988) of Boston, pioneer of modern neonatal medicine: Figure 1

“…The second tragedy concerned the delayed feeding of premature infants for two and sometimes three or four days after birth and was based as we have seen on the belief that the often oedematous premature infant had an excess of fluid and also that early feeding might lead to inhalation pneumonia 7 11. In 1954, Yllpo pointed out the ill wisdom of this policy, and by the end of the 1950s the hazards of dehydration and neonatal hypoglycaemia had become clear to all 12…”

“…Clement Smith had a particular interest in premature babies—the “preemies” as they were known. In 1951, he described their management in Boston7:…”

The Swing of the Pendulum: Presidential Address to the American Pediatric Society[6]

“…Neonatology became a logical extension of the specialty of pediatrics. But the fetus, even before he is subjected to the hazards of delivery-that dangerous period which Dr. CLE-MENT SMITH [5] has SO aptly called 'the passage through the valley of the shadow of birth'-may be seriously affected by environmental factors altering his usually well-protected intrauterine existence. Two further logical steps in the accumulation of knowledge about the newborn required the study of the fetus and of the embryo.…”