1 Beth Israel Hospital, Boston, Massachusetts 02115
The apparent basis of Dr. Keitel's disapproval of the use of gastrostomy in feeding certain premature infants, as stated in his first letter (Pediatrics, 34:293, 1964), rests in his premise "that gastrostomies may have increased the mortality rate." In that letter he noted that the over-all national mortality rate for infants weighing about 1,000 gm at birth is approximately 90%, and that approximately 65% expire within the first 24 hours. Subtracting 65% from 90% he determined that "the approximate death rate of infants with a birth weight of about 1,000 gm after the first day of life is 25%," a figure which (for reasons given below) was inappropriate for comparison with our mortality rate of 36% who survived the first day of life.