Russian care of abandoned children prior to the twentieth century

Mothers of Misery: Child Abandonment in Russia
David L. Ransel, professor of History at Indiana,1988
Ransel looks at the establishment of foundling homes or hospitals in Russia to answer the concerns of the government for the fatalistic and devalued view of people toward infants.
For 150 years, ending with the beginning of the 20th century, a system of foundling homes shifting to fostering and back was intended by the Tsarist rule to deal humanely with unwanted children. And to comply with the Church’s pressure to protect the sanctity of the family with the growing problems of infanticide uncomfortably practiced in the face of economic pressure as belated birth control (p.11). Infant mortality due to a delay in the progressive thinking gaining ground in Western European countries, abandonment for reasons of shame, poverty and job pressures were also reasons to discard a child. As the homes developed, conditions in the homes, unintended economic motivations, and opportunity for the homes to serve as social laboratories for educating artisans and craftspeople were further if unexpected reasons to continue the problem of devaluing the life of a child. Mortality rates in foundling homes were upwards of 80% of children taken into care by the age of 22(47-48,257). Ransel’s observation on page 103 is that people actually saw the homes as a means to rid society of unwanted children.
Thomas Malthus, the Pessimist, while visiting in 1789, provided his take at a positive spin on the mortality rate of the foundling homes, “If a person wished to check population, and were not solicitous about the means, he could not propose a more effectual measure than the establishment of a sufficient number of foundling hospitals, unlimited in their reception of children.”(page # lost)
The period followed a trajectory of high infant mortality becoming an uncomfortable state of affairs, leading a paternalistic government to demand programs which initially show some success but ultimately return to high rates of mortality, which loops back to forcing the government back to instituting reforms or a new program all through the 150 years, if for no other reason than to look good on the European stage.
With a delay in progressive thinking, a paternalistic approach to care, the lack of value placed on the life of an infant beginning to wane at the end of these 150 years, what kind of changes did the twentieth century in Russia bring for these children?