Malnourished children are deficient in RBP, facilitating excretion of the resultant free, unbound form of vitamin A either through urine or faces, a situation that is aggravated during acute infections. Vitamin A, when administered in a single high dose, presumably circulates in free form in the extra cellular fluids before being taken up by the liver. This free form of vitamin A perhaps affects sodium and water metabolism causing 'pseudotumor cerebri', an adverse event of hypervitaminosis A [47]. Thus a mega dose supplementation may not be yielding any better effect in the severely malnourished children.