Background: Many breastfed babies in Ireland receive formula supplementation within 24 hours of birth. We explored (a) impact of formula supplementation on the likelihood of developing cow's milk protein allergy (CMPA) and (b) current practice of formula supplementation (<24 hours) among mothers intending to breastfeed. Method:Fifty-five CMPA-diagnosed children, fed at <24 hours of age (breast only, formula only or breast with formula supplementation), were recruited, and 55 milktolerant age-and sex-matched controls were identified retrospectively in Cork University Maternity Hospital. Two logistic regressions (LoR) examined neonatal feed types on likelihood of developing CMPA while controlling for parental atopy and infant sex. Formula supplementation was then prospectively measured among a separate group of 179 breastfeeding mothers. Linear regression (LiR) analysis was used to examine the subjective and objective reasons for formula supplementation, in addition to examining pre-existing factors.Results: Two LoR examined the infant groups: exclusively breastfed, exclusively formula-fed or breastfed with formula supplementation. The first LoR model which showed only formula supplementation was significant in prediction of development of CMPA (χ 2 (3) = 25.74, P < .05), with 74% diagnostic accuracy when parental atopy and infant sex were controlled for. Breastfed infants given formula supplements were 7.03 (95% CI, 1.82-27.25) times more likely to exhibit CMPA than those who were exclusively breastfed. Formula supplementation was significant (OR 16.62, 95% CI 3.89-71.11), indicating that breastfed infants who were given formula supplements were 16 times more likely to exhibit CMPA than those who were exclusively bottle-fed. Exclusively formula-fed infants (odds ratio 0.42, 95% CI, 0.16-1.07) were not significantly more likely to exhibit CMPA than those who were exclusively breastfed in either model (P > .05). About 45.8% of breastfed infants (<24 hours) received supplemental formula. LiR investigated importance of the subjective and objective reasons, in predicting formula supplementation. This model was significant F(8,170) = 66.95, P < .05) explaining 75% of total variance. The subjective factors 'no latch' and 'mum unwell' were the strongest predictors (β > .45). Objective factors and pre-existing factors had lower ß values with only mode of delivery and infant hypoglycaemia being significant. Conclusion: Breastfed babies are still being put at significantly increased risk of CMPA by receiving supplemental formula in the first 24 hours of life, despite the | 811 KELLY Et aL.

No abstract

BRIEF REPORT were confirmed in all cases on histochemical staining of biopsy specimens thereby strongly suggesting a causal relationship. The clinical location at an injection site and the presence of high numbers of eosinophils in our case support the interpretation of this lesion as an injection site reaction. Contact allergy to Al has been demonstrated in 85%-95% following the development of persistently itchy nodular granulomatous reactions to Al-adsorbed vaccines. 1 In this case series, eight of the nine children patch tested were positive for contact allergy to Al (Table S1). The parents of these children were also advised that the use of Al-containing products such as deodorants and cosmetics should be avoided. It is important to remind parents that this reaction is benign, that the majority will resolve with time and that the protection afforded through vaccination outweighs the potential discomfort. Pruritic vaccination granulomas can cause considerable parental anxiety and stress and the cutaneous nodules can be irritating and upsetting for the children affected. Healthcare professionals need to be aware of this potential adverse reaction to routinely used vaccines in order to avoid delay in diagnosis.

Background: SARS-CoV-2 antibody testing in community settings may help us better understand the immune response to this virus and therefore help guide public health efforts. Aim: Conduct a seroprevalence study of IgG antibodies in Irish GP clinics. Design and Setting: Participants were 172 staff and 799 patients of 15 general practices in the Midwest region of Ireland. Methods: This seroprevalence study utilised 2 manufacturers’ point-of-care (POC) SARS-CoV-2 IgM-IgG combined antibody tests, offered to patients and staff in general practice from mid-June to mid-July 2020. Results: Immunoglobulin G (IgG) seroprevalence was 12.6% in patients attending general practice and 11.1% in staff working in general practice, with administrative staff having the lowest seroprevalence at 2.5% and nursing staff having the highest at 17.6%. Previous symptoms suggestive of SARS-CoV-2 and history of a polymerase chain reaction (PCR) test were associated with higher seroprevalence. IgG antibodies were detected in approximately 80% of participants who had a previous PCR-confirmed infection. Average length of time between participants’ positive PCR test and positive IgG antibody test was 83 days. Conclusion: Patients and healthcare staff in general practice in Ireland had relatively high rates of IgG to SARS-CoV-2 compared to the national average at the time (1.7%). Four-fifths of participants with a history of confirmed COVID-19 disease still had detectable antibodies an average of 12 weeks post-infection. While not proof of immunity, SARS-CoV-2 POC testing can be used to estimate IgG seroprevalence in general practice settings.

No abstract