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The Bioarchaeology of Children This book is the first to be devoted entirely to the study of children���s skeletons from archaeological and forensic contexts. It provides an exten- sive review of the osteological methods and theoretical concepts of their analysis. Non-adult skeletons provide a wealth of information on the physical and social life of the child from their growth, diet and age at death, to factors that expose them to trauma and disease at different stages of their lives. This book covers non-adult skeletal preservation the assessment of age, sex and ancestry growth and development infant and child mortality including infanticide weaning ages and diseases of dietary deficiency skeletal pathology personal identification and expo- suretotraumafrombirthinjuries,accidentsandchildabuse,providingnew insights for undergraduates and postgraduates in osteology, palaeopathol- ogy and forensic anthropology. M A R Y E. L EW I S is a lecturer at the University of Reading and has taught palaeopathology and forensic anthropology to undergraduate and postgraduate students for over 10 years. Mary is also an advisor to the police and has served as a registered forensic anthropologist for the Ministry of Defence.

The Bioarchaeology of Children This book is the first to be devoted entirely to the study of children���s skeletons from archaeological and forensic contexts. It provides an exten- sive review of the osteological methods and theoretical concepts of their analysis. Non-adult skeletons provide a wealth of information on the physical and social life of the child from their growth, diet and age at death, to factors that expose them to trauma and disease at different stages of their lives. This book covers non-adult skeletal preservation the assessment of age, sex and ancestry growth and development infant and child mortality including infanticide weaning ages and diseases of dietary deficiency skeletal pathology personal identification and expo- suretotraumafrombirthinjuries,accidentsandchildabuse,providingnew insights for undergraduates and postgraduates in osteology, palaeopathol- ogy and forensic anthropology. M A R Y E. L EW I S is a lecturer at the University of Reading and has taught palaeopathology and forensic anthropology to undergraduate and postgraduate students for over 10 years. Mary is also an advisor to the police and has served as a registered forensic anthropologist for the Ministry of Defence.

Cambridge Studies in Biological and Evolutionary Anthropology Series editors H U M A N E C O L O G Y C. G. Nicholas Mascie-Taylor, University of Cambridge Michael A. Little, State University of New York, Binghamton G E N E T I C S Kenneth M. Weiss, Pennsylvania State University H U M A N EVO L U T I O N Robert A. Foley, University of Cambridge Nina G. Jablonski, California Academy of Science P R I M A T O L O G Y Karen B. Strier, University of Wisconsin, Madison Also available in the series 21 Bioarchaeology Clark S. Larsen 0 521 65834 9 (paperback) 22 Comparative Primate Socioecology P. C. Lee (ed.) 0 521 59336 0 23 Patterns of Human Growth, second edition Barry Bogin 0 521 56438 7 (paperback) 24 Migration and Colonisation in Human Microevolution Alan Fix 0 521 59206 2 25 Human Growth in the Past Robert D. Hoppa & Charles M. FitzGerald (eds.) 0 521 63153 X 26 Human Paleobiology Robert B. Eckhardt 0 521 45160 4 27 Mountain Gorillas Martha M. Robbins, Pascale Sicotte & Kelly J. Stewart (eds.) 0 521 76004 7 28 Evolution and Genetics of Latin American Populations Francisco M. Salzano & Maria C. Bortolini 0 521 65275 8 29 Primates Face to Face Agust����n Fuentes & Linda D. Wolfe (eds.) 0 521 79109 X 30 Human Biology of Pastoral Populations William R. Leonard & Michael H. Crawford (eds.) 0 521 78016 0 31 Paleodemography Robert D. Hoppa & James W. Vaupel (eds.) 0 521 80063 3 32 Primate Dentition Daris R. Swindler 0 521 65289 8 33 The Primate Fossil Record Walter C. Hartwig (ed.) 0 521 66315 6 34 Gorilla Biology Andrea B. Taylor & Michele L. Goldsmith (eds.) 0 521 79281 9 35 Human Biologists in the Archives D. Ann Herring & Alan C. Swedlund (eds.) 0 521 80104 4

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The Bioarchaeology of Children Perspectives from Biological and Forensic Anthropology Mary E. Lewis University of Reading

cambridge university press Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, S��o Paulo Cambridge University Press The Edinburgh Building, Cambridge cb2 2ru, UK First published in print format isbn-13 978-0-521-83602-9 isbn-13 978-0-511-25742-1 �� Cambridge University Press 2007 2006 Information on this title: www.cambridge.org/9780521836029 This publication is in copyright. Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. isbn-10 0-511-25742-2 isbn-10 0-521-83602-6 Cambridge University Press has no responsibility for the persistence or accuracy of urls for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Published in the United States of America by Cambridge University Press, New York www.cambridge.org hardback eBook (NetLibrary) eBook (NetLibrary) hardback

Contents Acknowledgements page x 1 The bioarchaeology of children 1 1.1 Children in archaeology 1 1.2 A history of childhood 2 1.3 Children in biological anthropology 10 1.4 Children in forensic anthropology 13 1.5 Summary 19 2 Fragile bones and shallow graves 20 2.1 Introduction 20 2.2 Fragile bones? 23 2.3 Little people . . . little things . . . 26 2.4 The marginalised child? 30 2.5 Obstetric deaths 33 2.6 Summary 37 3 Age, sex and ancestry 38 3.1 Non-adult ageing 38 3.2 Sex determination 47 3.3 Ancestry 55 3.4 Summary 58 4 Growth and development 60 4.1 Introduction 60 4.2 Skeletal development and ossification 61 4.3 Prenatal and postnatal growth 62 4.4 Puberty and the growth spurt 64 4.5 Factors affecting growth 66 4.6 Growth studies: methods and concerns 68 4.7 Interpretations of past growth 74 4.8 Bone density 76 4.9 Estimations of stature 77 4.10 Summary 79 vii

viii Contents 5 Difficult births, precarious lives 81 5.1 Introduction 81 5.2 Infant mortality rates 81 5.3 Reconstructing child mortality 86 5.4 Infanticide 87 5.5 Summary 96 6 Little waifs: weaning and dietary stress 97 6.1 Introduction 97 6.2 Properties of human breastmilk 97 6.3 Weaning and infection 99 6.4 Ancient feeding practices 100 6.5 The osteological evidence 103 6.6 Weaning and bone chemistry analysis 115 6.7 Specific diseases of malnutrition 119 6.8 Summary 132 7 Non-adult skeletal pathology 133 7.1 Introduction 133 7.2 Non-specific infections 134 7.3 Endocranial lesions 141 7.4 Infantile cortical hyperostosis 143 7.5 Tuberculosis 146 7.6 Congenital syphilis 151 7.7 Skeletal pathology and personal identification 159 7.8 Summary 162 8 Trauma in the child 163 8.1 Introduction 163 8.2 Properties of paediatric trauma 163 8.3 Types of fracture 165 8.4 Birth trauma 168 8.5 Non-adult trauma in the archaeological record 169 8.6 Physical child abuse 175 8.7 Clinical features of child abuse 176 8.8 Child abuse in the archaeological record 181 8.9 Summary 183 9 Future directions 184 9.1 Is absence of evidence evidence of absence? 185 9.2 Failure to adapt: children as non-survivors 186

Contents ix 9.3 Tom, Dick or Harriet? Sexing non-adults 187 9.4 The future 188 References 189 Index 248

Acknowledgements Many friends and colleagues have provided advice and encouragement in the preparation and writing of this book. In particular, Charlotte Roberts, Keith Manchester and Jenny Wakely were instrumental in first introducing me to human remains, and Charlotte Roberts has continued to provide invaluable advice and support throughout my career. I am indebted to many who pro- vided unpublished data, assistance, access to images and comments on drafts of the text: Kristine Watts, Anthea Boylson, Louise Loe, Hella Eckardt, Louise Humphrey, Roberta Gilchrist, Margaret Cox, Rebecca Gowland, Rebecca Redfern, Gundula M��uldner, Luis Rios, Bill White, Donald Ortner and Richard Steckle. I also thank the team at Cambridge University Press, Tracey Sanderson, Dominic Lewis, Emma Pearce and Anna Hodson. I am thankful to all my friends and colleagues at the Department of Archaeology in Reading for making it such a stimulating place to work and who have allowed me the time and funds needed to finish this book. Finally, I am grateful to my family for their continued support. Figures 6.4, 8.4 and 8.5 are from the research slide collection of D. J. Ortner, Department of Anthropology, Smithsonian Institution, Washington, DC, digi- tised and made available through funds supporting National Science Foundation grant SES-0138129 by R. H. Steckel, C. S. Larsen, P. W. Sculli and P. L. Walker (2002), A History of Health in Europe from the Late Paleolithic Era to the Present (Mimeo, Columbus, OH). These images are reprinted with their kind permission. Figures 6.9���6.11, 7.1, 7.2 and 8.6 are of specimens from the Human Remains Collection, Biological Anthropology Research Centre, Department of Archaeological Sciences, University of Bradford. Many of these photographs were taken by Jean Brown, to whom I am very grateful. Every effort has been made to acknowledge copyright holders, but in a few cases this has not been possible. Any omissions brought to my attention will be remedied in future editions. x

1 The bioarchaeology of children 1.1 Children in archaeology This book reviews the current status of children���s skeletal remains in biological and forensic anthropology. Child skeletons provide a wealth of information on their physical and social life from their growth and development, diet and age at death, to the social and economic factors that expose them to trauma and disease at different stages of their brief lives. Cultural attitudes dictate where and how infants and children are buried, when they assume their gender identity, whether they are exposed to physical abuse, and at what age they are considered adults. Similarly, children may enter the forensic record as the result of warfare, neglect, abuse, murder, accident or suicide and the presence of young children within a mass grave has powerful legal connotations. The death of a child under suspicious circumstances is highly emotive and often creates intense media coverage and public concern, making the recovery and identification of their remains more pressing. In forensic anthropology, techniques used to provide a biological and personal identification as well as the cause and manner of death provide particular challenges. The study of children and childhood in social archaeology emerged out of gender theory in the 1990s, and has gradually increased in its sophistication, moving children out of the realm of women���s work, to participating and active agents in the past, with their own social identity, material culture and influence on the physical environment around them. Children who were once invisible in the archaeological record are slowly coming into view. The primary data for the archaeology of childhood are the children themselves, and in order to progress this new discipline, it is important to examine how bioarchaeologists derive the data from which social interpretations are made, and the limitations that are inherent in the methods and nature of immature skeletal material, including the impact of the burial environment on their recovery. Comparativestudiesofchildrenfromarchaeologicalcontextshavebeencom- plicated by the eclectic use of terminology that both describes the skeleton as a child and prescribes an age for the individual. For example, the use of the term ���infant��� properly assigned to those under 1 year of age, has been used to describe children aged up to 5 years, whereas ���juvenile��� can be divided into ���juvenile I��� 1

2 The bioarchaeology of children Table 1.1 Age terminology used in this volume Term Period Embryo First 8 weeks of intra-uterine life Fetus From 8 weeks of intra-uterine life to birth Stillbirth Infant born dead after 28 weeks gestation Perinatal, perinate Around birth, from 24 weeks gestation to 7 postnatal days Neonatal, neonate Birth to 27 postnatal days Post-neonatal 28���346 postnatal days (1 year) Infant Birth to 1 year Non-adult ���17 years Child 1���14.6 years Adolescent 14.6���17.0 years Adult 17 years or ���juvenile II��� with a variety of ages assigned. One of the most popular terms used by osteologists to describe children is ���sub-adult���. This term is problem- atic as it has been used to define a specific age category within the childhood period. More fundamentally, sub-adult implies that the study of these remains is somehow less important than that of the adults (i.e. sub = below). Through- out this book children are described as ���non-adults��� encompassing all children recovered from the archaeological record up to the age of 17 years. Additional terms divide this overarching category into critical physiological periods of the child���s life (Table 1.1). These terms are used for ease of reference and provide a biological basis for discussion they are not intended to describe the complex social experience of the youngest members of every society, past or present. This book is divided into nine chapters, covering the development of child- hood archaeology and the osteological study of non-adult remains factors affecting preservation assessment of their age, sex and ancestry growth and development infant and child mortality including infanticide weaning ages and diseases of dietary deficiency skeletal pathology and exposure to trauma from birth injuries, accidents and child abuse. The final chapter considers some future directions for the study of children in bioarchaeology. The following sections explore the gradual development of childhood theory in archaeology and the rise of research into non-adult skeletal remains in both biological and forensic anthropology. 1.2 A history of childhood Studies of the history of childhood began in 1960 when Philip Ari`es published Centuries of Childhood: A Social History of Family Life. Ari`es argued that

A history of childhood 3 the ���childhood��� we know today, which may perhaps be described as a period of ���cosseted dependency��� (Derevenski, 2000:4), did not exist until the early modern period. Prior to this, parents were unsympathetic and detached from their children, dressing them and expecting them to behave as miniature adults. Such indifference was considered a coping mechanism to the constant threat of infant mortality (Ari`es, 1960). In the past, we were led to believe, a child���s upbringing was a combination of neglect and cruelty. Further debates in the 1970s developed the theme (De Mause, 1974 Shorter, 1976 Stone, 1977), while later discourses began to challenge this traditional view (Attreed, 1983 Hanawalt, 1986, 1993 Swanson, 1990 Shahar, 1992). Historians and social archaeologists have now updated and revised our impressions of childhood. In past societies, stages of life that correspond to childhood were recognised and marked by social events or burial practices. Many parents loved their children, sometimes to distraction. For example, Finucane (1997) concentrated on the ���miracle��� texts of the medieval period which contained numerous tales of family andvillagereactionstoachild���sdeathorillness,withparentscrippledbygriefor friends and relatives praying by a riverbank for the recovery of a drowned child. Although important, these studies focussed on the attitude of adults towards children, rather than viewing the past through a child���s eyes. The study of children and childhood in archaeology emerged out of gender theory in the 1990s (Derevenski, 1994, 1997 Moore and Scott, 1997). Previ- ously, children had been considered ���invisible��� in the archaeological record, but a feminist reassessment of the past placed specific emphasis on gender and age and with this, on the nature of childhood. Lillehammer (1989) was one of the first to address the role of children in archaeology. She suggested that through the use of burial, artefacts, ethnography and osteology we could gain insight into the relationship the child had both with its physical environment and the adult world. This was followed by an examination of documentary and archaeological evidence for the child in the Anglo-Saxon and medieval peri- ods (Coulon, 1994 Crawford, 1999 Orme, 2001), with Scott (1999) providing a multicultural view on aspects of infancy and infanticide. Crawford (1991) studied the Anglo-Saxon literature for clues as to when children were subject to adult laws. Beausang (2000) expanded this theory of childhood to incorpo- rate the concepts and practice of childbirth in the past, with the recognition of birthing artefacts in the archaeological record. Although a promising start, these studies have been criticised for maintaining the idea that children were passive recipients in their communities, invariably linked to the activities of women (Wilkie, 2000). Furthermore, the category of ���child��� is often used in order to investigate the construction of ���adult��� (Derevenski, 2000). Neither approach allows us to explore the role of the child as an independent agent in the past. Wilkie (2000) went some way to redress this balance when she used evidence

4 The bioarchaeology of children of the toy industry in the eighteenth and nineteenth centuries to illustrate how, through their own material culture, children displayed their sense of identity and defined their own distinctive social networks and liaisons. 1.2.1 Defining childhood B O R E D O M !!! S H O O T I N G !!! S H E L L I N G !!! P E O P L E B E I N G K I L L E D !!! D E S P A I R !!! H U N G E R !!! M I S E R Y !!! F E A R !!! That���s my life! The life of an innocent eleven-year-old schoolgirl!! . . . A child without games, without friends, without sun, without birds, without nature, without fruit, without chocolate or sweets . . . In short, a child without a childhood. Extract from the diary of a child in the Sarajevo conflict, 1992 from Cunningham (1995:1) As this entry from the diary of a child in war-torn Sarajevo testifies, children have an expectation of what childhood should be. No matter what period we are examining, childhood is more than a biological age, but a series of social and cultural events and experiences that make up a child���s life. Childhood can be defined as a period of socialising and education, where children learn about their society, gender roles and labour through play. The initial dependence on their parents for nourishment and protection slowly diminishes as the child ages and becomes an independent member of society. The time at which these transitions take place varies from one culture to another, and has a bearing on the level of interaction children have with their environment, their exposure to disease and trauma, and their contribution to the economic status of their family and society. The Western view of childhood, where children do not commit violence and are asexual, has been challenged by studies of children that show them learning to use weapons or being depicted in sexual poses (Derevenski, 2000 Meskell, 2000). What is clear is that we cannot simply transpose our view of childhood directly onto the past. Bogin (1997, 1998) takes an evolutionary approach to childhood theory. Childhood is a period in the human life cycle not found in any other mammal, and for Bogin this is defined as a period of time between the ages of 3 and 7 years, when ���the youngster is weaned from nursing but still depends on older people for feeding and protection��� (Bogin, 1997:64). The child is constrained by its immature dentition, small digestive system and calorie-demanding brain, which influence the type and amounts of food it can consume. ���Juvenility��� occurs with the eruption of the permanent dentition, and when children are able to procure and consume their own foods, as the brain and body growth diminish to less than 50% of total energy needs, and they undergo a cognitive shift. This period begins at the age of 7 and ends with the onset of puberty (c.10 years