Acute lower respiratory infections (ALRI) including pneumonia, and diarrhoeal diseases are the two most common illnesses that affect the under-five children. Earlier studies have observed beneficial role of high dose vitamin A as an adjunct therapy in the treatment of both watery and invasive diarrhoeas [25, 26]. It was observed that an increase of 1 mmol/liter of retinol reduces proportion of patients with diarrhoea and respiratory disease by 50% and 80% respectively [9]. A more recent study had observed supplementation of vitamin A to under-five children to be associated with reduced frequency of diarrhoea and ALRI, and subsequent malnutrition [27]. In another study 85% of the infants attending a diarrhoea treatment centre in Bangladesh were found to have depleted vitamin A stores, as measured by relative dose response test, and 61% of them remained deficient despite receiving high dose of vitamin A [24, 28]. Healthy children receiving high dose of vitamin A may experience higher incidences of adverse manifestations such as nausea, vomiting and higher incidence of diarrhoeal episode [29], while low dose vitamin A is associated with reduced incidence of severe diarrhoea in malnourished children [15]. In India studies examined the effect of an intermediate dose (8.7 mmol; 2500 mgm), administered weekly, and did not observe any difference in the incidence, severity and or duration of diarrhea in vitamin A deficient children [30]. In another community based study, infants aged 2-15 months receiving 16700 IU vitamin A or placebo weekly for 8 weeks experienced enhanced gut repair as indicated by improved lactulose-mannitol (L:M) ratio, as compared to the hospitalized infants who received high dose. The results suggest impaired gut permeability during convalescent period. There is every possibility that the low vitamin A level during the infectious state and the low retinol concentration in malnourished children aggravates the already existing compromised gut mucosa thus necessitating the vitamin A supplementation among the hospitalized malnourished children [10].