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The Journal of Nutrition Vol. 127 No. 1 January 1997, pp. 59-63
Copyright ©1997 by the American Society for Nutritional Sciences

Breast-Feeding Status Alters the Effect of Vitamin A Treatment During Acute Diarrhea in Children

Manuscript received 11 April 1996. Initial reviews completed 30 May 1996. Revision accepted 6 September 1996.

Nita Bhandari, Rajiv Bahl, Sunil Sazawal, and Maharaj K. Bhan

Division of Gastroenterology and Nutrition, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India

Vitamin A administration in children reduces the incidence of severe diarrhea during the subsequent few months. We therefore examined the effect of treatment with vitamin A during acute diarrhea on the episode duration and severity. In a double-blind controlled field trial, 900 children 1 to 5 y of age with acute diarrhea of <= 7 d duration were randomly assigned to receive vitamin A (60 mg) or a placebo. Children were followed up at home every alternate day until they recovered from the diarrheal episode. In all study children, those treated with vitamin A had a significantly lower risk of persistent diarrhea [odds ratio (OR) 0.30, 95% confidence interval (CI) 0.07-0.97], but there was no effect on the mean diarrheal duration or the mean stool frequency. In the subgroup of children who were not breast-fed, the mean diarrheal duration [ratio of geometric means (GM) 0.84, 95% CI 0.72-0.97], mean number of stools passed after the intervention (ratio of GM 0.73, 95% CI 0.56-0.95), the proportion of episodes lasting >= 14 d (P = 0.002) and the percentage of children who passed watery stools on any study day (OR 0.40, 95% CI 0.21-0.77) were significantly lower in those treated with vitamin A. We conclude that administration of vitamin A during acute diarrhea may reduce the severity of the episode and the risk of persistent diarrhea in non-breast-fed children. Similar benefit was not seen in breast-fed children.

Key words: vitamin A, acute diarrhea, severity, breast-feeding, children.




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Copyright © 1997 by American Society for Nutrition