Absorption of high-dose enteral vitamin A in low-birth-weight neonates.

A randomised, double-blind placebo-controlled trial was designed to determine whether high-dose (25,000 IU) enteral vitamin A, to correct deficiency, would be absorbed and well tolerated in low-birth-weight (LBW) neonates. Thirty-five LBW infants (950-1700 g; gestational age 27-36 weeks) were allocated to receive either placebo or vitamin A (25,000 IU) via nasogastric tube on the first day of the study (between 36 and 60 hours after delivery). The dose was repeated on study days 4 and 8. Serum retinol concentrations were determined pre- and post-supplementation. Toxic effects of vitamin A were monitored by noting vomiting, drowsiness and irritability, and palpating for a bulging fontanelle. The mean serum retinol concentration was significantly higher following supplementation in the vitamin A-treated group than in the placebo group (45.77 +/- 17.07 micrograms/dl v. 12.88 +/- 6.48 micrograms/dl; P = 0.0001). Toxic effects were not detected in any of the infants. In conclusion, high-dose enteral vitamin A is well absorbed in LBW neonates and three doses of 25,000 IU given over a period of 8 days are not associated with any detectable toxic effects.