e-Library of Evidence for Nutrition Actions (eLENA)


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Vitamin A supplementation in neonates

Intervention | Last updated: 22 June 2023


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.

 



Evidence


Systematic reviews used to develop the guidelines


Neonatal vitamin A supplementation for the prevention of mortality and morbidity in term neonates in low and middle income countries

Haider BA, Bhutta ZA. Cochrane Database of Systematic Reviews 2011, Issue 10. Art. No.: CD006980.

Summary of this review Alternate Text

Vitamin A supplementation for the prevention of morbidity and mortality in infants six months of age

Gogia S, Sachdev HS.Cochrane Database of Systematic Reviews 2011, Issue 10. Art. No.: CD007480.

Summary of this review Alternate Text

Related Cochrane reviews


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.

Summary of this review Alternate Text

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.

Summary of this review Alternate Text

Related systematic reviews


Neonatal vitamin A supplementation and infant survival

Kirkwood B, Humphrey J, Moulton L, Martines J. The Lancet. 2010; 376(9753):1643–1644.


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.


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.


Cost-effectiveness Learn More Alternate Text


Implementation of this intervention is not recommended.