Until the early 20th century, poverty and destitution were widespread, and many parents struggled to feed and clothe their children. Outdoor relief, the precursor of universal credit, did not provide enough to live on.
While illegitimate children in the community did not have a good chance of survival, within the Foundling Hospital in its early days the statistics are similarly bleak. Between 1741 and 1760 the overall mortality rate for Foundling Hospital children was 61%, and 53% for those who were nursed by families in the countryside. This may be due to the fact that many were in very poor health when they first came to the Hospital.
Mortality also appears to have increased between 1756 and 1760. During this era, known as the General Reception, the government gave funding to the Foundling Hospital on the condition that they admit all children (within age limitations). During this period, many sick or dying children were taken across the country to London for admission and the mortality rate rose to 81%. After the General Reception, infant mortality rates decreased to 28.6% (1771-1797), although the overall child mortality rate remained high (46%).
Healthcare from the best physicians
Compared with poor children in the wider community, most children at the Foundling Hospital were likely to have a better diet, better medical care and to have a healthier lifestyle.
From the very beginning, the Foundling Hospital was a very fashionable charity. Its governors, trustees and supporters were among the wealthiest and most powerful people in Georgian England. It could (and did) call upon the greatest physicians of the day to advise on all aspects of the care of the children, including their diet.
Sir Hans Sloane, physician to George II, advocated breastfeeding and it is probably because of this advice that the infant foundlings were placed out in the country with wet nurses (women who breast-fed babies other than their own). The women became the children’s foster mothers for the first few years of their lives. The countryside was thought to be a healthier place to live for the children, with cleaner air. The Foundling Hospital established an inspection system to try and ensure the children were well cared for.
When they returned to the Foundling Hospital at the age of five, the children led very regimented lives, with a strict routine. However, there were positives for their health: from 1744 all Hospital pupils were inoculated against smallpox, although this only became national policy in 1853. In the 1700s, there was no known cure for smallpox. Many people died from, or were left scarred by, the disease. However, prevention – in the form of inoculation – was becoming established in Britain by the time the Foundling Hospital opened in 1741.
One of pioneers of inoculation in Britain was Dr Richard Mead, who was also a Founding Governor of the charity. In June 1743, the governors said that all children taken into the Foundling Hospital should be inoculated against smallpox. Most were inoculated on admission and so there were few infections among the foundlings. Our archives include details in reports to the governors by the Foundling Hospital’s nurses and doctors. In 1749, the governors announced that no-one could be employed by the hospital unless they had already had smallpox, and so could be assumed to be immune.
The children also had a far better diet than other children in the community, often eating meat, and eating fresh vegetables almost every day. Their accommodation was clean, they had good clothing, regular bedtimes and more opportunities for exercise. From 1815 they also had baths!
However, many children became ill when they returned to the Hospital from their foster homes. Children in institutional care in the 18th and 19th centuries were particularly prone to infections such as conjunctivitis, scabies, and ringworm. Institutions were also prone to epidemics of infectious diseases such as scarlet fever and measles.
Healthcare in the 20th century
At the end of the Second World War, there were seven million dwellings in Britain with no hot water supply, about six million without an indoor toilet, and about five million without a bath. The Foundling Hospital children had better living conditions than poor children in the community: at the Foundling Hospital School in Berkhamstead in 1935 there was hot running water and central heating as well as a swimming pool, a library and a gymnasium. The children placed there were notably bigger and stronger than those they used to compete against from the local schools.
Prepared with the help of Dr Harriet Ward CBE, Emeritus Professor of Child and Family Research at Loughborough University and Honorary Research Fellow, The Rees Centre, Department of Education University of Oxford.