Chronic recurrent multifocal osteomyelitis (CRMO) is a rare disease of children characterized by aseptic inflammation of the long bones and clavicles. No infectious etiology has been identified, and CRMO has been associated with a number of autoimmune diseases (including Wegener's granulomatosis and psoriasis). The relationship between CRMO and inflammatory bowel disease is poorly described. Through an internet bulletin board subscribed to by 500 pediatric gastroenterologists, we identified six inflammatory bowel disease patients (two with ulcerative colitis, four with Crohn's colitis) with confirmed CRMO. In all cases, onset of the bony lesions preceded the onset of bowel symptoms by as much as five years. Immunosuppressive therapy for the bowel disease generally resulted in improvement of the bone inflammation. Chronic recurrent multifocal osteomyelitis should be considered in any inflammatory bowel disease patient with unexplained bone pain or areas of uptake on bone scan. CRMO may be a rare extraintestinal manifestation of inflammatory bowel disease; alternatively, certain individuals may be genetically predisposed to the development of both diseases.

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Two 4 week old infants are reported who suffered apparent life threatening events (ALTE) while being cradled in adult arms. The events, which could be reproduced under controlled circumstances, were not associated with any struggling by the infants. Alteration of infant holding practices in both cases resulted in cessation of the events. A case of cardiorespiratory arrest during breast feeding in an 8 week old infant that was unnoticed by her mother is also described. These cases suggest that certain infants may not respond normally to airway occlusion while being held or nursed, and show that careful study of the events surrounding ALTE may reveal contributing environmental factors. If ALTE occur around feeding time, observation of how caretakers place the infant during and after feeding may be informative. (Arch Dis Child 1995; 73: 502-504)

Summary A retrospective study was made of the relation between the cord serum sodium levels and the intravenous administration to the mother of 5 per cent dextrose and oxytocin. Of the 203 mothers studied, 106 received intravenous fluid before delivery. The mean sodium levels of babies of mothers who had intravenous fluid (133±4.2 (SD) mmol/1) was significantly lower than for babies of mothers who had not (138±4.3(SD)mmol/l).

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