According to a systematic review published early online in the British Medical Journal, there is no evidence of a reduced risk of mortality and possibly morbidity or of increased early adverse effects after neonatal supplementation with vitamin A.

Researchers sought to evaluate the effect of neonatal vitamin A supplementation on infant mortality, morbidity and, early adverse effects. Prophylactic vitamin A supplementation for children aged 1-4 is considered to be an effective intervention for improving child survival in developing countries. The meta-analysis included data from 6 trials which had studied the effects of prophylactic vitamin A supplementation on morbidity, mortality and adverse effects, in neonates.

The following results were reported:

• There was no convincing evidence of a reduced risk of mortality during infancy (relative risk 0.92, 95% confidence interval 0.75 to 1.12, P=0.393) or of an increase in early adverse effects including bulging fontanelle (1.16, 0.81 to 1.65, P=0.418).
• Limited data (from one to four trials) did not indicate a reduced risk of mortality during the neonatal period (0.90, 0.75 to 1.08, P=0.270), cause specific mortality, common morbidities (diarrhoea and others), or admission to hospital.

The authors concluded that there is therefore no justification for initiating supplementation with vitamin A for the reduction of infant mortality and morbidity.