One of the most striking and at the same time one of the most obscure phenomena in pediatrics is the failure of infants to thrive in hospitals. The appalling infant death rate in American institutions within the twentieth century was recounted before this society by Dr. Chapin in 1915.1 It seems hard to believe that only a quarter of a century ago the death rate for infants under 1 year of age in various foundling institutions throughout the country was nearly 100 per cent.
Happily this condition has been remedied and at present the mortality of foundling infants is relatively low, not so much because care in institutions has improved but because foundling homes have been in large part replaced by the much more suitable and less lethal foster homes.
Up to twenty or twenty-five years ago the failure of infants to do well in hospitals was attributed mainly