e-Library of Evidence for Nutrition Actions (eLENA)

Vitamin A supplementation in children 6–59 months of age with severe acute malnutrition

In children who are 6–59 months of age, severe acute malnutrition is defined by a very low weight-for-height/weight-for-length, or clinical signs of bilateral pitting oedema, or a very low mid-upper arm circumference. Severe acute malnutrition affects an estimated 19 million children under 5 years of age worldwide and is estimated to account for approximately 400,000 child deaths each year.

Vitamin A deficiency affects about 190 million preschool-age children, mostly from Africa and South-East Asia, and there is evidence of an association with severe acute malnutrition. Vitamin A is essential to support rapid growth and to help combat infections and vitamin A deficiency left untreated may lead to blindness and increased risk of illness and death from childhood infections.

WHO recommendations

Children who are 6–59 months of age with severe acute malnutrition should receive the daily recommended nutrient intake of vitamin A throughout the treatment period. Children with severe acute malnutrition should be provided with about 5000 IU vitamin A daily, either as an integral part of therapeutic foods or as part of a multi-micronutrient formulation.

Children who are 6–59 months of age with severe acute malnutrition do not require a high dose of vitamin A as a supplement if they are receiving F-75, F-1002 or ready-to-use therapeutic food that complies with WHO specifications (and therefore already contains sufficient vitamin A), or vitamin A is part of other daily supplements.


This is a summary of one of several WHO recommendations on the management of SAM in infants and children. The full set of recommendations can be found in 'Full set of recommendations' and in the guidelines and guidance documents under ‘WHO documents’ below.

WHO documents

WHO documents

GRC-approved guidelines
Other guidance documents


Systematic reviews used to develop the guidelines
Clinical trials

Last update:

24 August 2016 17:01 CEST

Category 1 intervention

Guidelines have been recently approved by the WHO Guidelines Review Committee

Essential Nutrition Actions

This intervention is a component of managing children with SAM, which is an Essential Nutrition Action targeting the first 1000 days of life.

Global targets

Implementation of this intervention may contribute to the achievement of the following targets:

Global nutrition targets

Target 6: Reduce and maintain childhood wasting to less than 5%