In the 19th century, it was incredibly dangerous to be a child.
As of 1900, about 18 percent, or nearly one in five, American children died before their fifth birthday. The most common causes were infectious diseases — pneumonia, diphtheria, dysentery, measles, and other illnesses ran rampant through households, and children were especially at risk.
Cities, in particular, were “cauldrons of infection,” Samuel Preston, a demographer and co-author of the book Fatal Years: Child Mortality in Late Nineteenth-Century America, told me. But around the country, communicable diseases were “rites of passage of childhood, some of them far worse than others, but all of them causing serious morbidity, and a lot of them causing death,” said Howard Markel, a historian of medicine who has studied epidemics.