Vitamin A supplementation
Vitamin A deficiency is a worldwide nutritional problem. The well being of millions of babies and infants and mothers are threatened by this deficiency ( calculated to be 127 million ) and 7 million pregnant women. .
Most developing countries provide vitamin A supplements to infants and new mothers according to WHO recommendations. However, in 2002, the International Vitamin A Consultative Group recommended a higher dose of vitamin A. Momodou Darboe and colleagues ( Darboe et al 2007, effectiveness of an early supplementation scheme of high-dose vitamin A versus standard WHO protocol in Gambian mothers and infants: a randomised controlled trial designed a randomised controlled trial Lancet vol 369 pp 2088-96 ) ( 25000 IU v three doses of 50000 IU) to assess both dosing regimens.
No significant differences were noted for primary outcomes—
maternal vitamin A concentration at 2 months;
infant vitamin A at 5 months;
H pylori infection at 12 months;
maternal pneumococcal carriage at 12 months;
infant pneumococcal carriage at 12 months;
and infant gut mucosal damage at 12 months.
The investigators concluded that they saw no additional benefits of the high-dose regimen and recommend that the WHO regimen should not be changed.
In a Comment, Bernard Brabin Lancet 2007 Infant vitamin A supplementation : consensus and controversy pp 2054-56) discusses the controversy surrounding the selection of the optimum dose. The higher dosage raises concerns about overdosage.
- Martin Eastwood