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Very interesting question. Of course, the bleak dog-eat-dog world that we are presented with in the grim pages of Coram Boy is very different from the situation in our contemporary world today. It does paint a very despairing view of childhood where children are dispensable and terribly fragile. In this hard-hitting book we are very soon presented with pictures of tremendous violence and neglect as Otis, the so called "Coram Man", collects illegitimate children and as often as not kills them soon after.
He nodded curtly at Meshak. "Get the space. There's a good ditch just here. We'll dig them in," he jerked his head in the direction of the panniers strapped to the train of mules. "I don't want to take them into Gloucester."
... Nothing to deep or careful. There was a lot of water. Just dig a hole deep enough to submerge the bundles. Foxes would do the rest...
I think in a sense the reason why we are presented with such shocking images towards the beginning of the book is to present a sharp contrast between the conditions that children today have to live in and the conditions of children just a few centuries ago. Jamilia Gavin, in her introduction, seems to indicate that she wrote this book to highlight the conditions of children in this time but then also to capture the story of one man who was key in changing this perception of children:
It was often entirely a mater of luck if a child was kindly and lovingly reared, and it was to redress this that Captain Thomas Coram opened his hospital in 1741. It was people like him who gradually changed the whole perception of child care and who touched the conscience of the nation.
Thus, I don't think this novel relates to contemporary thoughts about childhood, it rather sets out to show where our ideas about childhood have emerged from and how they have changed so radically thanks to the work of individuals such as Thomas Coram.
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