Vitamin A and the nursing mother-infant dyad: evidence for intervention.

From the evidence at hand, interventions to reduce vitamin A deficiency in the breastfeeding mother and baby are likely to confer several health benefits. These include reduced puerperal morbidity, night blindness, and mortality in the mother, and reduced morbidity and mortality in the baby beginning around 6 months of age. Additional evidence is still needed to increase our confidence in these inferences, and to clarify the best interventions for achieving these outcomes. Current evidence about the effects of improved vitamin A status on early infant morbidity or mortality is mixed. There is accumulating evidence against the hypothesis that maternal vitamin A supplementation during pregnancy will reduce mother-to-child HIV transmission. There is so far no evidence about whether improved infant vitamin A status can prevent mother-to-child HIV transmission. In sum, the probable benefits of improving the vitamin A status of the breastfeeding mother and her baby are substantial, but to achieve these benefits, more aggressive interventions will be needed.