Low concentrations of immunoglobulin A (IgA) in breast milk may predispose to cow's milk allergy in the infant. A study of mothers and genetically at risk infants in Helsinki (Pediatric Research2000;48:457–62) showed that breast milk IgA concentrations were significantly lower in the mothers whose babies later developed cow's milk allergy. A breast milk IgA concentration of less than 0.25 g/l at between 6 days and 4 weeks postpartum increased the risk of cow's milk allergy 15 fold. The IgA in breast milk may limit the ingress of food allergens through the intestine and possibly limits the amount of allergen in the breast milk.

Between 1981 and 1998, 44 children were admitted to the Royal Hospital for Sick Children in Edinburgh with non-accidental head injury (Developmental Medicine and Child Neurology2000;42:591–4). Thirty two had early post traumatic seizures (EPTS). Six children died of whom five had EPTS. Fourteen children were neurologically normal on follow up, including all of those who survived and did not have EPTS. Sixteen had moderate or severe neurological problems. All of these had had EPTS and it had been resistant to treatment in 11 of them. Eight children had late post traumatic epilepsy the occurrence of which was related not to the severity of EPTS but to the severity of late neurological abnormality. It is argued therefore, that the main determinant of severe late disability is the severity …