Bibliographic information
GuidelineWHO recommendations on maternal and newborn care for a positive postnatal experience.
Year of Publication2022
Issuing InstitutionWorld Health Organization
Recommendation
Updated
In settings with recent (within the last five years) and reliable data that indicate a high infant mortality rate (greater than 50 per 1000 live births) and a high prevalence of maternal vitamin A deficiency (> 10% of pregnant women with serum retinol concentrations < 0.70 µmol/L), providing newborns with a single oral dose of 50 000 IU of vitamin A within the first three days after birth may be considered to reduce infant mortality.
Context specific recommendation
Only in specific contexts
Certainty of evidence
High
Notes and Remarks
Remarks
- In making this recommendation, the Guideline Development Group emphasized the need to avoid harm, given the uncertainty of the evidence and the conflicting results of research studies, as well as implementation costs.
- The proposed infant mortality rate of greater than 50 per 1000 live births was calculated based on several assumptions:
- 50% of the total infant mortality rate are neonatal deaths;
- 50% of neonatal mortality occurs within 24 hours after birth;
- the post-neonatal mortality rate up to 6 months of age makes up two thirds (2/3) of the total infant mortality rate, and the mortality rate between 6 and 12 months of age makes up the remaining one third (1/3);
- the rate of 30 deaths per 1000 used in the studies accounts for deaths between enrolment in the study up to 6 months of age;
- dosing/enrolment almost always occurred within the first 24 hours after birth.