title: Effect on infant illness of maternal supplementation with 400 000 IU vs 200 000 IU of vitamin A.
abstract: OBJECTIVE
  Postpartum vitamin A supplementation is a strategy used to combat vitamin A deficiency and seems to reduce maternal/infant morbidity and mortality. However, studies have shown that a dose of 200 000 IU (World Health Organization [WHO] protocol) does not seem to provide adequate retinol levels in maternal breast milk, infant serum, and infant tissue. The objective of this study was to compare the effect of postpartum maternal supplementation with 400 000 IU (International Vitamin A Consultative Group protocol) compared with 200 000 IU of vitamin A on infant morbidity.
  
  
  METHODS
  This was a randomized controlled, triple-blinded clinical trial conducted at 2 public maternity hospitals in Recife in northeastern Brazil. There were 276 mother-child pairs that were allocated to 2 treatment groups: 400 000 IU or 200 000 IU of vitamin A. They were followed up for >6 months to evaluate infant morbidity.
  
  
  RESULTS
  Fever (rate ratio [RR]: 0.92 [95% confidence interval (CI): 0.75-1.14]), diarrhea (RR: 0.96 [95% CI: 0.72-1.28]), otitis (RR: 0.94 [95% CI: 0.48-1.85]), acute respiratory infection (RR: 1.03 [95% CI: 0.88-1.21]), the need for intravenous rehydration (RR: 2.08 [95% CI: 0.64-2.07]), and the use of antibiotic treatment (RR: 0.80 [95% CI: 0.43-1.47]) did not differ significantly between the 2 treatment groups.
  
  
  CONCLUSIONS
  Our findings suggest that postpartum maternal supplementation with 400 000 IU of vitamin A does not provide any additional benefits in the reduction of illness in children aged <6 months; therefore, we do not support the proposal to increase the standard vitamin A dose in the existing WHO protocol.
authors.affiliation: Department of Nutrition, Universidade Federal de Pernambuco, Brazil. tacimest@hotmail.com
authors.forename: Taciana Fernanda dos Santos
authors.initials: TF
authors.lastname: Fernandes
authors.forename: José Natal
authors.initials: JN
authors.lastname: Figueiroa
authors.forename: Ilma Kruze
authors.initials: IK
authors.lastname: Grande de Arruda
authors.forename: Alcides da Silva
authors.initials: Ada S
authors.lastname: Diniz
mesh_terms: D000284:Administration, Oral; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003968:Diarrhea, Infantile / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control*; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008895:Milk, Human / Q000737:chemistry; D009017:Morbidity / Q000639:trends; D049590:Postpartum Period; D016896:Treatment Outcome; D014801:Vitamin A / Q000008:administration & dosage* / Q000493:pharmacokinetics; D014802:Vitamin A Deficiency / Q000188:drug therapy* / Q000453:epidemiology; D014815:Vitamins / Q000008:administration & dosage / Q000493:pharmacokinetics; D055815:Young Adult
chemical_list: D014815:Vitamins; D014801:Vitamin A