Safety of vitamin A supplementation of postpartum women and young children

It is now known that the previous World Health Organization (WHO) recommendation for vitamin A supplementation of postpartum women (200,000 IU) is not sufficient and that larger doses are well tolerated. The new recommendation is to give women 400,000 IU during the first eight weeks postpartum, as two 200,000-IU doses separated by at least 24 hours. The most common side effect of large doses of vitamin A in young infants is bulging of the fontanelle. This side effect is rare (0%-8%), spontaneously resolves within 72 hours, and is not associated with significant short- or long-term clinical consequences. A 50,000-IU dose is safe for young infants, but doses greater than 50,000 IU may be harmful, especially for infants under four months of age. The revised WHO recommendation for infants zero to five months old is 150,000 IU as three doses of 50,000 IU with a one-month interval between doses.