Children are given high doses of Vitamin A every year as part of a campaign, but this cannot replace the daily dietary source of Vitamin A.

High-dose Vitamin A is only a temporary solution

According to experts from the Institute of Nutrition, because children’s current meals do not ensure enough Vitamin A, children are given Vitamin A supplements (high-dose Vitamin A capsules) every year. This is only a supplementary dose and cannot completely ensure the body’s Vitamin A intake. Each dose of Vitamin A supplement can only protect normal children from Vitamin A deficiency for about 3-4 months, not to mention that if children suffer from infectious diseases (measles, prolonged diarrhea, acute respiratory infections) and malnutrition, the need for Vitamin A will be even higher. Therefore, even though children have been given Vitamin A according to the campaign, it is still necessary to feed them foods containing Vitamin A.

It is also necessary to clearly identify that taking high-dose Vitamin A is only a temporary supplementary solution, the basic thing is to still give children a diet with adequate nutrients.

The purpose of giving children high doses of Vitamin A during campaigns is to prevent Vitamin A deficiency, because Vitamin A deficiency still exists in children under 36 months of age. The main cause of Vitamin A deficiency is that children’s meals do not contain enough Vitamin A, β-Carotene (pre-Vitamin A) as well as other nutrients (oil, fat, protein, etc.). In theory, when children have enough nutrients, including enough Vitamin A, it is not necessary to give them high doses of Vitamin A. However, according to recent assessment data, Vietnamese children are still in the area at risk of Vitamin A deficiency, the rate of preclinical Vitamin A deficiency is still high. On the other hand, Vitamin A status is also closely related to immunity, mortality and malnutrition in children, so the International Advisory Committee on Vitamin A has recommended that: where there is still malnutrition, children still need to be given high doses of Vitamin A. In Vietnam, organizing high-dose Vitamin A for children still needs to be implemented in the coming years, as long as child malnutrition remains a social problem. For the above reasons, although children are fed with adequate nutrients, if the locality organizes a campaign to give Vitamin A to children under 36 months, children should be given high-dose Vitamin A twice a year. Vitamin A protects the integrity of the skin epithelium, cornea, and mucous membranes. Vitamin A enhances the body’s immune system. Vitamin A plays a role in cell growth and multiplication, so it is also essential for the development process, especially for the development of embryos and children. Vitamin A is a fat-soluble vitamin (oil/fat), not soluble in water.

Supplementing vitamin A according to each stage of the child’s life

Children from 6 to 36 months old are at risk of vitamin A deficiency due to increased demand but inadequate diet or malabsorption. Children’s demand is 5-6 times higher than adults in terms of weight per kilogram. In addition, when children are sick with diseases such as measles, chickenpox, bronchitis, tuberculosis, etc., the need for vitamin A increases during the illness and food is not enough to provide, causing vitamin A deficiency. During the period when the baby is breastfed, breast milk is the main source of vitamin A. If the mother is deficient in vitamin A, the inevitable consequence is that the baby is also deficient in this vitamin. During the weaning period and later, if the supplementary meals are not diverse, the foods are not rich in vitamin A and the amount of fat or oil is lacking, vitamin A in the diet cannot be absorbed, leading to not providing enough necessary vitamin A.

It is necessary to supplement vitamin A through diversifying children’s daily meals, balancing nutritional components, especially focusing on foods such as: liver, egg yolks, butter, milk, cheese, spinach, Malabar spinach, green vegetables, pumpkin, carrots, mango, … At the same time, supplementing enough fat to facilitate the absorption of vitamin A.

Mothers who give birth need to take high doses of vitamin A / 1 tablet of 200,000 international units (IU) within 1 month after giving birth to provide to the child through breast milk. For children, high doses need to be supplemented according to the program’s regulations. Dosage is as follows:

+ Children < 6 months who are not breastfed: Take 50,000 IU of vitamin A x 1 time only

+ Children from 6 – 12 months: take 100,000 IU of vitamin A x 1 time only.

+ Children over 1 year old: Give 200,000 IU of vitamin A every 6 months.

In addition, there are currently some foods fortified with vitamin A such as sugar, milk, cooking oil. This measure is highly effective because it covers most subjects at risk of vitamin A deficiency, but is not yet widely used by the community.

Because Vietnam is still a country with a level of vitamin A deficiency that is of public health significance, natural foods and foods fortified with vitamin A still do not meet the vitamin A needs of children, so the measure of supplementing high doses of vitamin A for subjects (as above) is still considered the most effective community intervention measure today. Therefore, postpartum mothers and children from 6 to 36 months, children under 5 years old (in 22 provinces with high malnutrition rates) need to take high-dose vitamin A supplements twice a year (phase 1: June 1-2; phase 2: December).

Vitamin A is a very necessary micronutrient for pregnant women. Some research results show that pregnant women with vitamin A deficiency have a high risk of premature birth or low birth weight. Therefore, it is necessary to meet the vitamin A needs of pregnant women, the vitamin A requirement that needs to be taken into the body is 800 mcg/day. In Vietnam, the amount of vitamin A in the daily diet of pregnant women is less than half of the need.

To prevent Vitamin A deficiency during this period, pregnant women need to increase the use of animal foods (meat, fish, eggs, milk) and foods rich in precursors of Vitamin A (called Beta Carotene) found in plant foods such as dark green leaves (malabar spinach, water spinach, amaranth, squash…), ripe orange-yellow fruits such as papaya, mango, jackfruit, persimmon or red, orange-yellow fruits such as tomatoes, pumpkin, sweet potatoes… A diverse and rich diet not only provides Vitamin A for the body but also provides other nutrients to meet the nutritional needs of pregnant women. Pregnant women should absolutely not take high doses of Vitamin A (from 100,000 to 200,000 units of the Vitamin A deficiency prevention program that has been and is being implemented in Vietnam) as it can easily cause birth defects.