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Recommendation

Indian Pediatrics 2001; 38: 37-42

National Consultation on Benefits and Safety of Administration of Vitamin A 
to Pre-school Children and Pregnant and Lactating Women


This National Consultation was held under the auspices of Ministry of Health and Family Welfare at New Delhi on 29th and 30th September, 2000 to discuss the cumulative scientific and epidemiological evidence on benefits and safety of administration of vitamin A to preschool children and pregnant and lactating women. The aim was to provide objective guidelines to the Ministry of Health and Family Welfare, Government of India for future direction with respect to the National Program for Prophylaxis Against Blindness in Children Caused Due to Vitamin A Deficiency. The list of invited participants is enclosed as Appendix I.

 Conclusions and Recommendations

1. Issue: National Program for Prophylaxis Against Blindness in Children Caused Due to Vitamin A Deficiency (VAD): Past and Present Status and Changing Profile of VAD and its Current Status.

1.1 Conclusions of the Discussions on Scientific Presentations

1.1.1. In India, the magnitude of clinical VAD has declined significantly but exists as a public health problem in scattered pockets.

1.1.2. The problem of clinical VAD varies from cluster to cluster within selected districts.

1.1.3. There is a need for a careful evalua-tion of the current profile of clinical VAD and the reasons for change in VAD profile in the country.

1.2 Specific Recommendations

1.2.1. The existing data on VAD should be analyzed by independent groups of Epidemiologists, Statisticians, Nutritionists, Pediatricians, Ophthalmologists and Obstetricians to assess the current status of VAD.

1.2.2. The National Program for Prophylaxis against Blindness in Children Caused Due to Vitamin A Deficiency requires re-examination and the time has come that VAD control should be a part of the primary health care.

1.2.3. The National Program for Prophylaxis against Blindness in Children Caused Due to Vitamin A Deficiency should clearly define the quantifiable outcomes of implementation of the program.

1.2.4. Since, multiple nutritional problems co-exist in the same population, while executing any program to control them, a holistic approach should be adopted for combating nutritional deficiencies and vertical approach aimed at single nutrient should be discouraged.

2. Issue: Administration of Synthetic Vitamin A to Pregnant and Lactating Women

2.1 Conclusions of the Discussions on Scientific Presentations

2.1.1. Pregnant and lactating women should be encouraged to improve their overall nutrition. Principles of consuming balanced diet with diversification in food items are necessary to maintain adequate macro and micro-nutrient status.

2.2. Specific Recommendations

2.2.1. As part of comprehensive antenatal and postnatal care, women should be screened for night blindness. If pregnant/lactating women have night blindness, they should be referred to the physician in the nearby Primary Health Center or any other health facility for appropriate management. In view of the poten-tial toxic and teratogenic effects of high doses of vitamin A, pregnant and lactating women with symptoms of night blindness should be treated wit