title: The effect of vitamin A supplementation with 400 000 IU vs 200 000 IU on retinol concentrations in the breast milk: A randomized clinical trial.
abstract: The vitamin A nutritional status is marginal for most of the newborns, and the prevention of that deficiency is promoted by breastfeeding. The Ministry of Health of Brazil established the National Vitamin A Supplementation Program, giving mega-doses of this nutrient to women right after delivery, in order to provide adequate vitamin A content in the breast milk and The International Vitamin A Consultative Group has supported the recommendation, to supplement with 400 000 IU of VA immediately after delivery. This study compares retinol concentrations in breast milk (colostrum, 2 and 4 months) from mothers supplemented during immediate postpartum with 400 000 IU versus 200 000 IU of vitamin A.
  
  
  
  A randomized, controlled, triple-blind trial, conducted in two public maternities in Recife, Northeast Brazil. Two hundred and ten mothers were recruited and allocated into two treatment groups: 400 000 IU or 200 000 IU of Vitamin A and monitored for 4 months.
  
  
  
  There was no significant difference between retinol concentrations in breast milk between treatment groups (400 000 IU vs 200 000 IU) in the studied period: 2 months (p = 0.790) and 4 months (p = 0.279), although a progressive reduction of concentrations throughout the study was observed in both treatment groups, 400 000 IU (p < 0.0001) and 200 000 IU (p < 0.0001).
  
  
  
  The absence of an additional effect of a higher dosage justifies the 200 000 IU supplementation, according to the World Health Organization. Registered under ClinicalTrials.gov Identifier No. NCT00742937.
authors.affiliation: Departament of Nutrition, Federal University of Pernambuco, Brazil.
authors.forename: Marília Tokiko Oliveira
authors.initials: MT
authors.lastname: Tomiya
authors.affiliation: Departament of Nutrition, Federal University of Pernambuco, Brazil; Institute of Integral Medical Professor Fernando Figueira - IMIP, Pernambuco, Brazil. Electronic address: ilmakruze@hotmail.com.
authors.forename: Ilma Kruze Grande
authors.initials: IK
authors.lastname: de Arruda
authors.affiliation: Departament of Nutrition, Federal University of Pernambuco, Brazil.
authors.forename: Alcides
authors.initials: A
authors.lastname: da Silva Diniz
authors.affiliation: Departament of Nutrition, Federal University of Pernambuco, Brazil.
authors.forename: Raquel Araújo
authors.initials: RA
authors.lastname: Santana
authors.affiliation: Departament of Nutrition, Federal University of Pernambuco, Brazil.
authors.forename: Karina Correia
authors.initials: KC
authors.lastname: da Silveira
authors.affiliation: Institute of Integral Medical Professor Fernando Figueira - IMIP, Pernambuco, Brazil.
authors.forename: Luciana Marques
authors.initials: LM
authors.lastname: Andreto
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D003126:Colostrum / Q000737:chemistry; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008895:Milk, Human / Q000737:chemistry*; D009752:Nutritional Status; D049590:Postpartum Period; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014801:Vitamin A / Q000008:administration & dosage* / Q000032:analysis; D014802:Vitamin A Deficiency / Q000517:prevention & control; D055815:Young Adult
chemical_list: D014801:Vitamin A
keywords: Human milk; Mega doses; Vitamin A