Abstract
The role of vitamin A in improving child health and survival in vitamin A deficient regions of the works was firmly established in the early 1990’s, after a series of randomized trials showed that vitamin A supplementation decreased mortality in children 6 months to 5 years of age by around 24%.1 However the importance of vitamin A to health outcomes in women of reproductive age and infants 0–6 months of age remains a topic of debate and area of active research. The prupose of this to highlight the important questions from a public health perspective, and to discuss the latest ideas and research results related to health outcomes in lactating women an their young infants. In the process, we will make the the argument that while our understandings remain imperfect, the evidence at hand is sufficient to justify more aggressive interventions to improve the vitamin A status of prefnant and lactating mothers and young infants.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
G. H. Beaton, R. Martorell, K. A. L’Abbe, B. Edmonston, G. McCabe, A. C. Ross et al., Effectiveness of Vitamin A Supplementation in the Control of Young Child Morbidity and Mortality in Developing Countries (University of Toronto, Toronto, 1992).
S.A. Tanumihardjo, Muherdiyantiningsih, D. Permaesih, A. M. Dahro, Muhilal, D. Karyadi et al., Assessment of the vitamin A status in lactating and nonlactating, nonpregnant Indonesian women by use of the modified-relative-dose-response (MRDR) test, Am J Clin Nutr 60:142–147 (1994).
R. J. Stoltzfus and B. A. Underwood, Breast-milk vitamin A as an indicator of the vitamin A status of women and infants, Bull WHO 73:703–711 (1995).
J. H. Humphrey and R. E. Rice, Vitamin A supplementation of young infants, Lancet 356:422–424 (2000).
J. H. Humphrey, T. Agoestina, A. Juliana, S. Septiana, H. Widjaja, M. C. Cerreto et al., Neonatal vitamin A supplementation: effect on development and growth at 3 y of age, Am J Clin Nutr 68:109–117 (1998).
P.J. Iliff, J. H. Humphrey, A. I. Mahomva, P. Zvandasara, M. Bonduelle, L. Malaba et al., Tolerance of large doses of vitamin A given to mothers and their babies shortly after delivery, Nutr Res 19:1437–1446 (1999).
J. Katz, K. P. West Jr, S. K. Khatry, E. K. Pradhan, S. C. LeClerq, P. Christian et al., Maternal low-dose vitamin A or beta-carotene supplementation has no effect on fetal loss and early infant mortality: a randomized cluster trial in Nepal, Am J Clin Nutr 71:1570–1576 (2000).
A. L. Rice, R. J. Stoltzfus, A. de Francisco, J. Chakraborty, C. L. Kjolhede, M. A. Wahed, Maternal vitamin A or beta-carotene supplementation in lactating Bangladeshi women benefits mothers and infants but does not prevent subclinical deficiency, JNutr, 129:356–365 (1999).
K. P. West Jr, J. Katz, S. K. Khatry, S. C. LeClerq, E. K. Pradhan, S. R. Shrestha et al., Double blind, cluster randomised trial of low dose supplementation with vitamin A or beta carotene on mortality related to pregnancy in Nepal. The NNIPS-2 Study Group [see comments], Brit Med J 318:570–575 (1999).
J. Katz, S. K. Khatry, K. P. West Jr, J. H. Humphrey, S. C. LeClerq, E. K. Pradhan et al., Night blindness is prevalent during pregnancy and lactation in rural Nepal, JNutr 125:2122–2127 (1995).
P. Christian, K. P. West Jr, S. K. Khatry, J. Katz, S. LeClerq, E. K. Pradhan et al., Vitamin A or beta-carotene supplementation reduces but does not eliminate maternal night blindness in Nepal, J Nutr 128:1458–1463 (1998).
M. J. Dibley and M. Hakimi, Preliminary analysis of Zibuvita trial for Mother Care Technical Advisory Group Meeting 1998 (unpublished).
H. N. Green, D. Pindar, G. Davis, E. Mellanby, Diet as a prophylactic agent against puerperal sepsis with special reference to vitamin A as an anti-infective agent, Brit Med J ii:595–598 (1931).
H. M. Evans, The effect of inadequate vitamin A on the sexual physiology of the female, J Biol Chem 77:651–654 (1928).
K. A. Mason and E. T. Ellison, Vaginal comification as a criterion of vitamin A deficiency in the rat, Anat Rec 58:80 (1934).
K. D. Blackfan and S. B. Wolbach, Vitamin A deficiency in infants, A clinical and pathological study, J Pediatr 3:679–706 (1933).
W. K. Sietsema and H. F. DeLuca, A new vaginal smear assay for vitamin A in rats, J Nutr 112:1481–1489 (1982).
J. H. Humphrey, T. Agoestina, L. Wu, A. Usman, M. Nurachim, D. Subardja et al., Impact of neonatal vitamin A supplementation on infant morbidity and mortality, J Pediatr 128:489–496 (1996).
K. P. West Jr, J. Katz, S. R. Shrestha, S. C. LeClerq, S. K. Khatry, E. K. Pradhan et al., Mortality of infants < 6 mo of age supplemented with vitamin A: a randomized, double-masked trial in Nepal, Am J Clin Nutr 62:143–148 (1995).
WHO/CHD Immunization-Linked Vitamin A Supplementation Study Group, Randomized trial to assess benefits and safety of vitamin A supplementation linked to immunization in early infancy, Lancet 352:1257–1263 (1998).
R. S. Beach, E. Mantero-Atienza, G. Shor-Posner, J. J. Javier, J. Szapocznik, R. Morgan et al., Specific nutrient abnormalities in asymptomatic HIV-1 infection [see comments], AIDS 6:701–708 (1992).
J. D. Bogden, H. Baker, O. Frank, G. Perez, F. Kemp, K. Bruening et al., Micronutrient status and human immunodeficiency virus (HIV) infection, Ann NYAcad Sci 587:189–195 (1990).
D. Moodley, J. Moodley, A. Coutsoudis, H. M. Coovadia, E. Gouws, Vitamin A levels in normal and HIV-infected pregnant women, S Afr Med J 88:1029–1032 (1998).
R. D. Semba, N. M. Graham, W. T. Caiaffa, J. B. Margolick, L. Clement, D. Vlahov, Increased mortality associated with vitamin A deficiency during human immunodeficiency virus type 1 infection, Arch Intern Med 153:2149–2154 (1993).
R. D. Semba, W. T. Caiaffa, N. M. Graham, S. Cohn, D. Vlahov, Vitamin A deficiency and wasting as predictors of mortality in human immunodeficiency virus-infected injection drug users [see comments], J Infect Dis 171:1196–1202 (1995).
A. Coutsoudis, R. A. Bobat, H. M. Coovadia, L. Kuhn, W. Y. Tsai, Z. A. Stein, The effects of vitamin A supplementation on the morbidity of children born to HIV-infected women [see comments], Am J Public Health 85:1076–1081 (1995).
W.W. Fawzi, R. L. Mbise, E. Hertzmark, M. R. Fataki, M. G. Herrera, G. Ndossi et al., A randomized trial of vitamin A supplements in relation to mortality among human immunodeficiency virus-infected and uninfected children in Tanzania, Pediatr Infect.Dis J 18:127–133 (1999).
R. D. Semba, P. G. Miotti, J. D. Chiphangwi, A. J. Saah, J. K. Canner, G. A. Dallabetta et al., Maternal vitamin A deficiency and mother-to-child transmission of HIV-1 [see comments], Lancet 343:15931597 (1994).
R. W. Nduati, G. C. John, B. A. Richardson, J. Overbaugh, M. Welch, J. Ndinya-Achola et al., Human immunodeficiency virus type 1-infected cells in breast milk: association with immunosuppression and vitamin A deficiency, Jlnfect Dis 172:1461–1468 (1995).
A. Coutsoudis, K. Pillay, E. Spooner, L. Kuhn, H. M. Coovadia, Randomized trial testing the effect of vitamin A supplementation on pregnancy outcomes and early mother-to-child HIV-1 transmission in Durban, South Africa, South African Vitamin A Study Group, AIDS 13:1517–1524 (1999).
W. W. Fawzi, G. Msamanga, D. Hunter, E. Urassa, B. Renjifo, D. Mwakagile et al., Randomized trial of vitamin supplements in relation to vertical transmission of HIV-1 in Tanzania, JAIDS 23:246–254 (2000).
R. D. Semba, N. Kumwenda, T. E. Taha, D. R. Hoover, T. C. Quinn, Y. Lan et al., Mastitis and immunological factors in breast milk of human immunodeficiency virus-infected women, J Hum Lad 15:301–306 (1999).
S. M. Filteau, A. L. Rice, J. J. Ball, J. Chakraborty, R. Stoltzfus, A. de Francisco et al., Breast milk immune factors in Bangladeshi women supplemented postpartum with retinol or beta-carotene, Am J Clin Nutr 69:953–958 (1999).
R. D. Semba and M. C. Neville, Breast-feeding, mastitis, and HIV transmission: nutritional implications, Nutr Rev 57:146–153 (1999).
S. M. Filteau, G. Lietz, G. Mulokozi, S. Bilotta, C. J. Henry, A. M. Tomkins, Milk cytokines and subclinical breast inflammation in Tanzanian women: effects of dietary red palm oil or sunflower oil supplementation, Immunology 97:595–600 (1999).
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2002 Springer Science+Business Media New York
About this chapter
Cite this chapter
Stoltzfus, R.J., Humphrey, J.H. (2002). Vitamin A and the Nursing Mother-Infant Dyad. In: Davis, M.K., Isaacs, C.E., Hanson, L.Å., Wright, A.L. (eds) Integrating Population Outcomes, Biological Mechanisms and Research Methods in the Study of Human Milk and Lactation. Advances in Experimental Medicine and Biology, vol 503. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-0559-4_4
Download citation
DOI: https://doi.org/10.1007/978-1-4615-0559-4_4
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4613-5132-0
Online ISBN: 978-1-4615-0559-4
eBook Packages: Springer Book Archive