BREAST-FEEDING STATUS ALTERS THE EFFECT OF VITAMIN-A TREATMENT DURINGACUTE DIARRHEA IN CHILDREN

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