Vitamin A supplementation in neonates
Vitamin A deficiency is a public health problem in many parts of the world, particularly Africa and South-East Asia. In infants and children, vitamin A is essential to support rapid growth and to help combat infections. Inadequate intakes of vitamin A may lead to vitamin A deficiency which can cause visual impairment in the form of night blindness and may increase the risk of illness and death from childhood infections, including measles and those causing diarrhoea.
Generally, infants are born with low vitamin A stores and are dependent on external sources, most importantly breast milk. In settings where vitamin A deficiency and/or undernutrition is common, infants are likely to receive inadequate amounts of vitamin A from breast milk due to poor maternal nutritional status.
In many countries where vitamin A deficiency is a public health problem, vitamin A supplements are provided to children 6–59 months of age to reduce the risk of illness and death and there has been considerable interest in vitamin A supplementation in the neonatal period to achieve the same outcomes. Results from studies to date – including three large trials conducted in India, Ghana and Tanzania – are inconsistent, however, with most providing no clear indication of benefit of neonatal vitamin A supplementation.
WHO recommendations
At the present time, neonatal vitamin A supplementation (that is, supplementation within the first 28 days after birth) is not recommended as a public health intervention to reduce infant morbidity and mortality.
Additional information for this recommendation can be found in the guidance summary and in the guideline, under 'WHO documents' below.
This is one of several WHO recommendations on vitamin A supplementation. The full set of recommendations can be found in 'Full set of recommendations'.
WHO documents
GRC-approved guidelines
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Neonatal vitamin A supplementation
Publication date: 2011
Evidence
Systematic reviews used to develop the guidelines
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Neonatal vitamin A supplementation for the prevention of mortality and morbidity in term neonates in developing countries
Haider BA, Bhutta ZA.
Cochrane Database of Systematic Reviews. 2011; Issue 10. Art. No.: CD006980. -
Summary of this review
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Vitamin A supplementation for the prevention of morbidity and mortality in infants six months of age or less
Gogia S, Sachdev HS.
Cochrane Database of Systematic Reviews. 2011; Issue 10. Art. No.: CD007480.
Related Cochrane reviews
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Neonatal vitamin A supplementation for the prevention of mortality and morbidity in term neonates in low and middle income countries
Haider BA, Sharma R, Bhutta ZA.
Cochrane Database of Systematic Reviews. 2017; Issue 2. Art. No.: CD006980. -
Vitamin A supplementation for the prevention of morbidity and mortality in infants one to six months of age
Imdad A, Ahmed Z, Bhutta ZA.
Cochrane Database of Systematic Reviews. 2016; Issue 9. Art. No.: CD007480.
Related systematic reviews
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Neonatal vitamin A supplementation and infant survival
Kirkwood B, Humphrey J, Moulton L, Martines J.
The Lancet. 2010; 376(9753):1643–1644. -
Vitamin A supplementation and neonatal mortality in the developing world: a meta-regression of cluster-randomized trials
Rotondi MA, Khobzi N.
Bulletin of the World Health Organization. 2010; 88(9):697–702. -
Neonatal vitamin A supplementation for prevention of mortality and morbidity in infancy: systematic review of randomised controlled trials
Gogia S, Singh Sachdev H.
British Medical Journal. 2009; 338:b919.