Document Detail


Vitamin A supplementation of women postpartum and of their infants at immunization alters breast milk retinol and infant vitamin A status.
MedLine Citation:
PMID:  12421835     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Vitamin A supplementation of lactating mothers and of infants at the time of diphtheria-pertussis-tetanus (DPT) and oral polio vaccine (OPV) immunizations have both been suggested as measures to prevent deficiency among infants. This multicenter randomized, double-blind, placebo-controlled trial was conducted in Ghana, India and Peru to determine the effect of maternal vitamin A supplementation on breast milk retinol and of maternal and infant supplementation on infant vitamin A status. Mothers in the intervention group received 60 mg vitamin A (as retinol palmitate) at 18-42 d postpartum; their infants were given 7.5 mg three times, i.e., at 6, 10 and 14 wk of age with DPT and OPV immunizations. Mothers and infants in the comparison group received a placebo. Maternal supplementation resulted in higher breast milk retinol at 2 mo postpartum [difference in means 7.1, 95% confidence interval (CI), 3.4, 10.8 nmol/g fat] and lower proportion of mothers with breast milk retinol < or = 28 nmol/g fat (15.2 vs. 26.6%, 95% CI of difference -16.6, -4.1%). At 6 and 9 mo, maternal supplementation did not affect breast milk retinol or the proportion of mothers with low breast milk retinol. Vitamin A supplementation of the mothers and their infants reduced the proportion of infants with serum retinol < or = 0.7 micro mol/L (30.4 vs. 37%, 95% CI of difference -13.7, 0.6%) and that with low vitamin A stores as indicated by the modified relative dose response (MRDR) > 0.06 (44.2 vs. 52.9%, 95% CI of difference -16.6, -0.9%) at 6 mo. Supplementation had no effect at 9 mo. The beneficial effect of supplementation on breast milk retinol and infants' vitamin A status varied by site. It was greatest in India followed by Ghana and Peru. At the doses used, maternal supplementation improved breast milk retinol status at 2 mo (P < 0.001) and maternal and infant supplementation modestly increased (P = 0.03) infant vitamin A status at 6 mo of age. Additional strategies to improve vitamin A status of 6- to 9-mo-old infants must be considered.
Authors:
Rajiv Bahl; Nita Bhandari; Mohammed A Wahed; Geeta T Kumar; Maharaj K Bhan;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The Journal of nutrition     Volume:  132     ISSN:  0022-3166     ISO Abbreviation:  J. Nutr.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-11-07     Completed Date:  2002-12-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0404243     Medline TA:  J Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3243-8     Citation Subset:  IM    
Affiliation:
The WHO/CHD Immunization-Linked Vitamin A Group.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aging
Dietary Supplements
Diphtheria-Tetanus-Pertussis Vaccine / administration & dosage
Double-Blind Method
Female
Ghana
Humans
Immunization Programs
India
Infant
Infant, Newborn
Male
Milk, Human / chemistry*
Nutritional Status*
Peru
Placebos
Poliovirus Vaccine, Oral / administration & dosage
Postpartum Period*
Vitamin A / administration & dosage*,  analysis*,  blood
Vitamin A Deficiency / prevention & control*
Chemical
Reg. No./Substance:
0/Diphtheria-Tetanus-Pertussis Vaccine; 0/Placebos; 0/Poliovirus Vaccine, Oral; 11103-57-4/Vitamin A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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