BMJ  2008;336:1385-1386 (21 June), doi:10.1136/bmj.39575.486609.80 (published 16 June 2008)

Editorials

Vitamin A supplements in newborns and child survival

Benefit depends on the setting, baseline infant mortality, and vitamin A deficiency

The first 150 words of the full text of this article appear below.

Vitamin A supplementation at 6-72 months of age has become a mainline intervention for improving survival in populations with endemic vitamin A deficiency.¹ However, in the same setting, supplementation at 1-6 months of age has little or no effect on mortality, whether given with immunisation or not.^{2 3}

Giving vitamin A supplements to newborns within the first few days of life significantly reduced early infant mortality in Asian populations with endemic maternal vitamin A deficiency andhigh infant mortality.^{4 5 6} In Africa, however, this strategy had no beneficial effect on early infant survival in an urban setting⁷ or—as reported in the accompanying paper by Benn and colleagues—in a peri-urban setting.⁸

How can these findings be reconciled? Some might suggest that a meta-analysis of all the newborn dosing studies would provide a more accurate estimate of the true effect on early infant mortality. But combining these studies would be a fundamental mistake, because the . . . [Full text of this article]

¹ Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA

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