A study at 21 hospitals in seven developing countries (Bangladesh, Dominican Republic, Ethiopia, Indonesia, Philippines, Tanzania, and Uganda) has highlighted problems in the care of very ill children (Lancet2001;357:106–10). These included lack of adequate triage, poor assessment of sick children, delayed treatment, poorly organised emergency treatment areas, lack of essential supplies, inappropriate treatment, inadequate monitoring, and low levels of knowledge in staff. Better training of staff and assessment and accreditation of hospital departments are needed.

In Belarus (JAMA2001;285:413–20) 31 maternity hospitals and polyclinics were randomised to breast feeding promotion along the lines of the World Health Organisation and United Nations Baby-Friendly Hospital Initiative or non-intervention. Over 17 000 mother–singleton term infant pairs entered the study. Rates of exclusive breastfeeding (intervention v non-intervention) at 3 and 6 months were 43% v 6%, and 8%v 0.6%. At 12 months, breastfeeding of any degree was continuing in 20% v 11%. The intervention group had less risk of gastroenteritis (9%v 13%) and of eczema (3%v 6%) in the first year. The incidence of respiratory infections was 39% in each group.

The incidence of attention deficit/hyperactivity disorder (ADHD) in a 1976–1982 Rochester, Minnesota birth cohort followed up to a mean age of 15 years was 7.5% (JAMA2001;285:60–6). Children with ADHD were significantly more likely than others to suffer major injuries or to develop asthma. They needed …