To the Editor.—Feeding gastrostomy as an elective procedure for the management of small premature infants has been advanced by a number of authors including myself and colleagues.13 I am aware, through much correspondence and personal contact, that the method has been widely adopted. This is very disturbing since evidence that it is sufficiently safe has not been available.
Over the past five years we have performed 21 such gastrostomies on infants weighing less than 1,500 gm (3 lb 8 ounces) at birth and surviving 72 hours before being subjected to surgery. Five of these infants died, none in the immediate postoperative period, but all after surviving days or weeks. The cause of death was infection, proven by positive blood culture in three, suspected on clinical grounds, but unproven by culture in the remaining two.
An attempt to assess, through controlled study, the impact of feeding gastrostomy on mortality