The Angela Cannings case has raised many questions

She had been diagnosed as having Munchausen's Syndrome by Proxy (MSBP), implying that she may have caused or exaggerated her child's illness.

The judges reserved judgement in a second, similar appeal.

They were the first care cases to reach appeal since Angela Cannings' murder conviction was quashed in December.

'Sinister motives'

Evidence from cot death expert Prof Meadow helped convict Mrs Cannings and another mother, Sally Clark, of murder. Both were eventually cleared.

On Wednesday, Andrew McFarlane, who represented the mother who lost her appeal, told the court the Cannings appeal went to the root of the "dogma or fashion" for concluding sinister motives in cases where no medical explanation is available.

The doctor took a completely dogmatic approach in an area where he had no real experience Stephen Cobb QC

Mr McFarlane said the child, who was identified as Child U throughout the hearing, had been taken to hospital four times with unexplained breathing problems.

The child was taken into care after the doctors diagnosed attempted smothering, despite no other signs of abuse.

However, Judith Rowe QC, for the local authority, said the Cannings judgement did not "undermine" the original judge's decision which had been considered and was not just based on medical evidence.

'Deliberate injections'

Miss Rowe said that in U's case, the experts carried out a very careful exercise, did not leap to inappropriate conclusions and were alive to the possibility of natural causes.

In the second case, the child, now 11, had been taken to hospital on 11 separate occasions suffering from rigors - a condition caused by blood infections leading to extremely high temperatures and convulsions.

Doctors who investigated the illness said it might have been caused by deliberate injections of the child with faeces, urine or water from flower pots.

Cases involving Professor Meadow's evidence are being reviewed

But on Thursday, Stephen Cobb QC, representing the second child's mother, told the court the doctor who had given evidence against her admitted he had little experience in the field.

He had relied "upon some unpublished research by Prof Roy Meadow, pre-Sally Clark and pre-Angela Cannings, to influence the court that his opinion had validity".

Criticism rejected

The doctor "took a completely dogmatic approach, not considering any possibilities other than fabricated illness syndrome in an area where he had no real experience, as he was subsequently forced to accept", Mr Cobb added.

He told the court the case showed "the dangers of relying on the evidence of an expert witness who gives evidence without clear support from other medical research or literature of experience".

The appeals were heard by three senior judges including president of the Family Division Dame Elizabeth Butler-Sloss.

She said the judges would give their reasons for rejecting the first appeal at a later date but said the court did not accept the criticism of that three doctors involved in the case.