Pediatricians often meet the challenge of taking care of children with recurrent infections. Gastrointestinal and respiratory infections are the causes of recurrent morbidity and significant mortality among children in developing countries. IgA is important in protecting the surface tracts like digestive and respiratory tracts and IgA deficiency, even though often transient, is the most common immunodefi-ciency(1). The use of bovine colostrum rich in IgA is being advised in children for prevention and treatment of various conditions(2). The rationale behind this is the fact that secretory IgA (SIgA) can resist proteolytic degradation and can survive in the harsh environments of digestive and respiratory tracts. As it is abundant in secretions like tears, saliva and mucosal linings, it is also the first antibody to come in contact with different antigens(1). Bovine and human SIgA is found to be homologous and colostrum have identified as a rich source of SIgA(2). SIgA is said to act as blocking and neutralizing antibody and also inhibit potential harmful activation of proinflammatory B pathway in the epithelium and enhance stromal clearance of antigen-NF that has breached the mucosal barrier(3). However, in those with IgA deficiency, there may be potential harmful IgG antibodies against cows’ milk and ruminant serum proteins and against IgA. If the anti-IgA antibodies are of the IgE type, there may be fatal anaphylactic reactions after transfusion of blood and blood products(1). Hence, only specially washed RBCs or blood from IgA deficient individuals are advised(1). Can the use of bovine colostrum in those with suspected immuno-deficiency cause such adverse effects?

2. Patel K, Rana R. Pedimune in recurrent respiratory infection and diarrhea.- the Indian experience- The PRIDE study. Indian J Pediatr 2006; 73: 565-591.