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Australian Paediatric Association: Founded in 1950, the Association was of vital importance to the developing specialty of paediatrics in Australia. It became the Australian College of Paediatrics in 1978 and then joined with the Royal Australasian College of Physicians in 1998 to form the Division of Paediatrics and Child Health.

Chemotherapy for childhood leukaemia: Melbourne paediatrician John Colebatch published the first Australian controlled trial in 1950, testing a chemotherapeutic drug in children with acute lymphatic leukaemia. This was followed by multicentre trials in Australia of treatment for leukaemia and other childhood malignancies. A majority of children with acute leukaemia can now be cured, and national and international collaborative randomised controlled trials have become the standard method for evaluating treatment.

Management of premature infants: Recognition by Kate Campbell (Melbourne paediatrician) in 1951 that high concentrations of ambient oxygen caused retrolental fibroplasia in premature infants led to a major change in the management of premature infants and was an important milestone in the development of neonatology as a paediatric subspecialty.

Introduction of triple antigen: Triple antigen was introduced to Australia in 1953. In 1957, the Australian Paediatric Association's recommendation to the National Health and Medical Research Council that all infants should be vaccinated routinely with triple antigen against diphtheria, pertussis and tetanus was accepted.

Liberal hospital visiting times: Daily visiting by parents was introduced at the Royal Children's Hospital, Melbourne, in 1953, and two years later the Royal Alexandra Hospital for Children, Sydney, introduced extended visiting. This substantially reduced the emotional trauma of hospital admissions. Previously, visiting had been restricted in the erroneous belief that cross-infection would be increased, and the children would be upset and more difficult to care for.

Vaccination for Aboriginal children: In 1954, to help reduce communicable diseases -- whooping cough, diphtheria and tetanus -- a routine vaccination program was commenced for Aboriginal children in the Northern Territory.

Nasotracheal intubation: Melbourne anaesthetists Ian McDonald and John Stocks, in the British Journal of Anaesthesia in 1965, described prolonged nasotracheal intubation in infants and children, which was crucial in the development of intensive care for infants and children. It provided an alternative to tracheostomy for artificial ventilation, which had a very high complication rate.

Australian Paediatric Journal: Established in 1965 by the Australian Paediatric Association, the Australian Paediatric Journal subsequently became the Journal of Paediatrics and Child Health. It publishes quality research in paediatrics from Australia and the Asia-Pacific region.

Management of childhood asthma: From 1969 onwards, Howard Williams and Ken McNicol (of Melbourne's Royal Children's Hospital Research Foundation) published a series of articles clarifying the prevalence and natural history of asthma in children. These articles substantially changed the way childhood asthma was managed. They emphasised the importance of basing treatment on the pattern of symptoms, and the use of bronchodilators, rather than antibiotics, in the treatment of wheezy episodes.

Preventing childhood injury: From 1969 regulations and programs were introduced in Australia to reduce morbidity and mortality of childhood injury (eg, safety standards for children's nightwear, other programs to reduce the risk of burns, compulsory child restraints in motor vehicles, and legislation to require that crash helmets be worn by bicyclists).

Rotavirus in viral gastroenteritis: In 1973, Ruth Bishop, Ian Holmes, Geoff Davidson and colleagues (from the Royal Children's Hospital, Melbourne, and the Department of Microbiology, University of Melbourne) showed that rotavirus was the most important cause of viral gastroenteritis in infants and children. This was an important step in the understanding of this major worldwide cause of childhood morbidity and mortality. Vaccines are being developed in attempts to prevent this infection.

Emergency transport services: The Neonatal Emergency Transport Service and the Paediatric Emergency Transport Service were established in Melbourne in 1976 and 1980, respectively. These two services have reduced morbidity and mortality from critical illness in neonates, infants and children presenting away from major tertiary centres.

Fragile X syndrome: Recognition of fragile sites in chromosomes and identification in 1977 by Grant Sutherland (Adelaide Children's Hospital) of the fragile X syndrome, one of the more common causes of mental retardation, has led to an understanding of its familial nature and to in-vitro diagnosis.

Adolescent Health Survey: Undertaken in Melbourne in 1992, this survey of 4000 adolescents provided essential information on risk factors for health problems and prevalence of such problems in adolescents. It was crucial in establishing adolescent health as an independent specialty with an academic base.

Australian Childhood Immunisation Register: Established in 1995, the Register is an essential database of the vaccination status of Australian children and allows those whose vaccination is incomplete to be identified. There are now incentives for parents to to have their children fully vaccinated.

Peter D Phelan
Emeritus Professor of Paediatrics
University of Melbourne, Melbourne, VIC

Don M Roberton
McGregor Reid Professor of Paediatrics
University of Adelaide, Adelaide, SA

Mike South
Director, Department of General Medicine
Royal Children's Hospital Melbourne, VIC
and Associate Professor, Department of Paediatrics
University of Melbourne, VIC

Above photograph courtesy Royal Children's Hospital Archive, Victoria. Photographer: Laurie Richards.

©MJA 2001
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