Ancylostomiasis in England.

1661 vitamin B12 than the control foetuses, showing that vitamin-Bl2 deficiency in the mother may seriously affect the vitamin-B12 stores of the foetus. It seems probable, therefore, that infants born of vitamin-B12-deficient mothers will start life with defective body stores of this vitamin, even though cord blood levels may not be very low. As was to be expected the levels in the breast milk followed closely the serum levels. Therefore if vitamin-B1, deficiency in the mother persists the breast-fed child will have a lower intake of vitamin B, than children suckled by normal mothers. The daily requirements of the infant for vitamin B,_ are not known. However, if the daily requirement of an adult weighing 50 kg. is taken at 1 Mg. a day, the requirement of a baby weighing 3 kg. will, on a weight-for-weight basis, be approximately 60 m,ug. a day. If the normal quantity of breast milk secreted in 24 hours is taken as 500 ml., then in order to supply the infant's needs the minimum concentration of vitamin B,, in the breast milk should be in the region of 120 ,utg./ml., and anything below this concentration may lead ultimately to vitamin-B12 deficiency. When this defective vitamin-B12 intake is coupled with low body vitamin-Bl2 stores, then the infant may develop an overt vitamin-B12 deficiency, with megaloblastic anaemia and neurological changes (Jahdav et al., 1962). It may therefore be wise to treat all children born of vitamin-Bl2-deficient mothers with prophylactic parenteral vitamin B12* Animals deficient in vitamin B12 may give birth to young with skeletal and other abnormalities (O'Dell et al., 1951; Grainger et al., 1954). No such abnormalities were seen in the seven live children in this series, and macroscopic dissection of the two stillborn foetuses did not reveal any abnormality. It is not known whether the vitamin-B12 deficiency played any part in the foetal death in iftero and premature delivery in Cases 8 and 9. Summary Seven women with tropical malabsorption syndrome who had megaloblastic anaemia of pregnancy associated with vitamin-B12 deficiency were investigated, together with their babies. The women had a moderate to severe anaemia and low serum-vitamin-B12 levels. Breast milk vitamin-B,2 levels in the puerperium were similar to serum-vitamin-B1. levels. The babies had no anaemia, and had much higher serum-vitamin-B12 levels than their mothers. One baby had " intermediate " megaloblasts in its bone-marrow.