Milk samples from 33 women from a rural area of the Ivory Coast were analyzed once a month. In two longitudinal studies covering 23 months of breast feeding, analyses of lipid components and protein were performed. The compositions remained virtually constant over 23 months of lactation except for a decrease of protein concentration during the first 6 months, a rising trend of myristic acid (14:0) and a falling trend of oleic acid (18:1). Infants were growing well on breast milk with nothing else for the first 5 months, but thereafter their growth curves were no longer satisfactory as judged by Western standards: weight for age (percentage of Harvard standards) decreased from 5 to 10 months of age to level off thereafter at a value of 80%. The mothers' weight for height remained constant. In a cross-sectional study, additional determinations were performed: aminograms, lactose, calories, iron, copper, manganese, zinc, and vitamin E. All data were compared with those of the literature. Lauric (12:0) and myristic (14:0) acids were higher, total lipids and polyunsaturated fatty acids lower than those published for Western countries. Plasma composition of the mothers showed lower levels of albumin, lipids, and polyunsaturated fatty acids as well as blood hemoglobin. Possible correlations between various variables such as milk composition, plasma levels, and anthropometry were calculated and discussed.

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Four mothers and their infants living in a rural village of the Ivory Coast were studied for maternal diet, breast milk composition and volume and infants' growth over an 18 months' period. Two of the mothers were young, had a low calorie intake and gave little supplementary nourishment to their infants; these infants had an unsatisfactory growth pattern. Two mothers were middle-aged, had a satisfactory calorie intake and their infants thrived well on breast milk alone for the first 6 months. Supplements were introduced by those mothers after their infant was 6 months old which provided adequate energy and protein intake and had a beneficial effect on the growth of the infants.Detailed biochemical analyses of diets and breast milk have been performed and dietary allowances are discussed in the light of the present results. Despite important differences in dietary intake the milks produced by the four mothers showed no significant differences in biochemical composition. The mothers with low calorie and low protein intake produced however smaller quantities of breast milk when the infants were 4 to 7 months old.Since breast milk provides a substantial amount of protein and calories for the infants even in late lactation, the implication with regard to adequate growth of the infants is to provide adequate dietary AcknowledgementsWe thank Georges N'zi, Ba Samba Sylla, Kouakou

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SUMMARY A female infant of 22 months was referred to the Hospital for Sick Children, London, because of delayed psychomotor development. Extensive investigations revealed no cause, but eventually trypanosomiasis was diagnosed. The infant had not been outside the UK, but her mother came from Zaire, where the disease is endemic, but had lived in Kinshasa, where there is no sleeping sickness. It is thought that the mother may have been asymptomatically infected by a fresh‐blood transfusion four years earlier, since no other source of infection was apparent. RÉSUMÉ Trypanosomiase congénitale chez un enfant néà Londres Une fillette de 22 mois a été addressée a L'Hôpital des Enfants Malades de Londres en raison ďun retard du développement psychomoteur. Des examens multiples ne révélérent aucune cause mais une trypanosomiase fut diagnostiquée. L'enfant n'avait pas été en dehors du Royaume Uni mais sa mére venait de Zaire ou la maladie est endémique; cependant, cette mére vivait à Kinshasa, oú il n'y a pas de maladie du sommeil. Les auteurs pensent que la mére avait été infectée asymptomatiquement par une transfusion de sang frais quatre ans plus tôt car il n'y avait aucune autre source ďinfection apparente. ZUSAMMENFASSUNG Angeborene Trypanosomiasis bei einem in London geborenen Kind Ein 22 Monate altes Mädchen wurde wegen einer verzögerten psychomotorischen Entwicklung in das Hospital für kranke Kinder in London eingewiesen. Trotz umfangreicher Diagnostik konnte die Ursache nicht festgestellt werden, aber schließlich wurde eine Trypanosomiasis diagnostiziert. Das Kind war nie außerhalb des UK gewesen, aber seine Mutter kam aus Zaire, wo die Erkrankung endemisch ist, hatte aber in Kinshasa gelebt, wo es keine Schlafkrankheit gibt. Man nimmt an, daß die Mutter vier Jahre zuvor durch eine Frischblutkonserve asymptomatisch infiziert wurde, da sich keine andere Infektionsquelle fand. RESUMEN Tripanosomiasis congenita en un niño nacido en Londres Una niña de 22 meses de edad fue ingresada en el Hospital for Sick Children de Londres debido a un retraso en el desarrollo psicomotor. Las exploraciones extensivas no revelaron ninguna etiología pero eventualmente se diagnosticó una tripanosomiasis. La niña no habia estado fuera del Reino Unido, pero su madre venia del Zaire donde la enférmedad es endemica, pero habia vivido en Kinshasa donde no hay enfermedad del suefio. Se cree qu la madre había estado infectada asintomáticamente por una transfuseón de sangre fresca hacia cuatro años ya que no era aparente ninguna otra fuente de infección.