[Effect of daily or once weekly iron supplementation on growth and iron status of preschool children]. The effect of iron therapy on the growth of iron-replete and iron-deplete children. Daily and weekly iron supplementation and physical growth of school age Indonesian children. Improvements in growth following iron supplementation in young Kenyan school children. Iron supplementation and physical growth of rural Indonesian children. Preliminary findings on iron supplementation and learning achievement of rural Indonesian children. Long-term supplementation with iron does not enhance growth in malnourished Bangladeshi children. Iron supplementation improves appetite and growth in anemic Kenyan primary school children. Effects of three different iron supplementations in term healthy infants after 5 months of life. Iron supplementation improves iron status and reduces morbidity in children with or without upper respiratory tract infections: a randomized controlled study in Colombo, Sri Lanka. Iron Supplementation in Pregnancy or Infancy and Motor Development: A Randomized Controlled Trial Iron status of breastfed infants is improved equally by medicinal iron and iron-fortified cereal. Iron and zinc supplementation promote motor development and exploratory behavior among Bangladeshi infants. Impact of iron supplementation and deworming on growth performance in preschool Beninese children Adverse effect of iron supplementation on weight gain of iron-replete young children Effectiveness of nutrition education, iron supplementation or both on iron status in children. The impact of weekly iron supplementation on the iron status and growth of adolescent girls in Tanzania.
OBJECTIVE The effect of daily and once weekly iron supplementation on hemoglobin(Hb ) , serum ferritin ( SF ) , erythrocyte protoporphyrin ( EFP ) in whole blood , prevalence of iron deficiency , body weight and height of preschool children was compared in this study . METHODS Preschool children ( n = 353 ) from one kindergarten in Baotou City , was recruited . All children were divided into three groups by class , and received either daily or once weekly iron supplementation , or a placebo ( control ) for 14 weeks . RESULTS The prevalence of iron deficiency was reduced in both intervention groups , and the rate in the group supplemented with iron once weekly was significantly lower than that of the control group(P < 0.05 ) . The levels of Hb , SF , increased after once weekly and daily iron supplementation . Weight gain and WAZ were greater in children who received daily supplement than in those who received placebo .  Height gain and HAZ were not significantly different among three groups . CONCLUSION Daily micronutrient supplement can improve growth of preschool children . Once weekly iron supplement is effective same as daily supplement in improving iron status and reducing the prevalence of iron deficiency in the preschool children This prospect i ve , double-blind , placebo-controlled trial was design ed to study the effect of iron therapy on the growth of iron-replete and iron-deficient children , and to study the change in iron status in iron-deficient children with iron therapy . One hundred and fifty children ( aged 6 - 24 months ) were included in the study . After an informed written consent , 100 healthy children , who were iron replete ( group I ) according to preset criteria , were r and omly allocated to receive iron supplements 2 ng/kg/day ( group IA ) or placebo ( group IB ) . Fifty iron-deficient children ( group II ) were administered iron syrup 6 mg/kg/day . Growth parameters ( weight , length and head-circumference ) and hematological parameters were studied for 4 months . Iron therapy , as compared with placebo , produced a significant improvement of mean monthly weight gain ( p < 0.001 ) and linear growth ( p < 0.001 ) in the iron-deficient children . However , it significantly decreased the weight gain ( p < 0.001 ) and linear growth ( p < 0.001 ) of iron-replete children . Caution should therefore be exercised while supplementing iron to children with apparently normal growth and when the iron status of the child is not known OBJECTIVE To investigate the effect of 3 months iron supplementation on physical growth among anemic school children given daily and weekly and to know the response based on hemoglobin level . SUBJECT One hundred forty-four children were measured for height , weight and hemoglobin level . Ninety seven children were anemic ( 67.36 % ) with Hb level < 12 g/dl and forty seven children were non anemic . anemic children were divided into 2 subgroups and r and omly assigned to either daily and weekly Fe treatment for 12 weeks . The non anemic group were treated with weekly iron supplementation , which was accepted by the parents . OUTCOME MEASURES Children 's height , weight , and hemoglobin of T1 and T2 food recall method was used to know calorie , protein , vitamin C and iron intake in both daily and weekly subgroups . Three days food recall was performed in the second and third months by a nutritionist . RESULT After iron supplementation , the hemoglobin level in both group increased significantly . The average change of hemoglobin between the 2 groups gave no significant difference . W/A and H/A after iron supplementation showed significantly increased in both groups . The average change of W/A and H/A between the 2 groups gave no significant difference . CONCLUSION Daily and weekly iron supplementation showed no significant difference in increasing of hemoglobin level and physical growth . Further research must be done with appropriate sample size and well design The study was conducted to determine whether provision of oral supplementary iron to primary school children in Kenya would improve their growth .  Children in the two lowest grade s who satisfied study criteria were allocated to either an  iron-supplementation group ( n = 29 ) or a placebo group ( n = 26 ) . At the baseline before intervention the groups did not differ significantly in age , sex ratio , prevalence and intensity of intestinal helminthic infections , most anthropometric measurements or hemoglobin levels . Although the study lasted for 32 weeks , children only took iron or placebos on school days thus omitting weekends and school holidays . Examination at the end of the study showed that the iron-supplemented children had grown significantly more in terms of weight , weight for height , arm circumference and skinfold thickness compared with the placebo group . Hemoglobin levels had also improved significantly . We conclude that where iron deficiency anemia and undernutrition are prevalent in children , iron supplementation will improve growth and hemoglobin levels The effect of oral iron supplementation on blood Fe levels and physical growth in 119 rural Indonesian school children was assessed in this double-blind study . The children were classified into anemic and normal groups according to their initial hemoglobin and transferrin saturation levels and were r and omly assigned to either Fe or placebo treatment for 12 wk . Hematological , anthropometric , and morbidity data were collected before and after the treatment period . Before treatment , anemic subjects were smaller and had higher morbidity than normal subjects . Treatment with 10 mg ferrous sulfate.kg-1.d-1 for 12 wk result ed in a significant improvement in anemic subjects ' hematological status , growth velocity , and level or morbidity The effects of oral iron supplementation on blood iron levels and learning achievement in 130 rural Indonesian school children were assessed in this double-blind study . The children were classified into anemic and nonanemic groups according to their initial hemoglobin and transferrin saturation levels and were r and omly assigned to either iron or placebo treatment for 3 mo . Hematological , anthropometric , and learning-achievement data were collected before ( T1 ) and after ( T2 ) the treatment period and 3 mo later . The means and st and ard deviations suggest that supplementation with 10 mg ferrous sulfate per kilogram body weight per day for 3 mo result ed in an apparent improvement in anemic subjects ' hematological status and learning-achievement scores . No tests of statistical comparisons are reported To evaluate the effect of long-term oral iron supplementation on growth , 250 children aged 6 - 71 mo were studied in a r and omized double-blind controlled trial . The intervention group received 125 mg of ferrous gluconate ( 15 mg elemental iron ) plus multivitamins ( vitamins A , D and C ) ; the comparison group received only multivitamins daily for 12 mo .  Weight ( kg ) and height ( cm ) were measured every month . Eighty three percent of the children continued the treatment for one year . The weight increment over the 12-mo period was 1.35 + /- 0.65 kg ( mean + /- SD ) in the intervention group and 1.39 + /- 0.54 kg in the comparison group . The height increments were 6.01 + /- 1.47 and 6.18 + /- 1.58 cm in the intervention and comparison groups , respectively . Mean weight and height increments did not differ ; in an analysis stratified according to different age and nutritional categories , they also did not differ between the two groups , indicating that long-term iron supplementation does not increase growth in children A r and omized , double-blind , placebo-controlled iron supplementation trial was conducted in Kenya to examine the effect of iron supplements on appetite and growth in 87 primary school children .  Sustained-release ferrous sulfate ( 150 mg ) or placebo tablets were provided daily at school for 14 wk . Prior to tablet administration , baseline anthropometry , iron nutritional status ( hemoglobin and serum ferritin ) , parasitic infections and clinical indicators of morbidity were measured . A baseline appetite test was conducted twice on each child by quantitatively measuring the ad libitum consumption of a midmorning snack . In addition , each child was asked for a subjective assessment of his or her appetite . Follow-up exams and appetite tests were identical to those at baseline . Findings indicated that provision of iron supplements result ed in improved growth and improved appetite ( in terms of both energy intake of the snack and child report of appetite ) as compared with children receiving the placebo . The increased energy intake from the snack was 10 % of the daily estimated energy intake for children of this same age group living elsewhere in Kenya . Further research into the underlying physiological mechanisms may shed light on the relationship between iron nutritional status and appetite The aim of this study was to investigate the effects of different doses of iron on haematological status of breastfed infants . One hundred and thirteen infants were r and omized into four groups at 5 months of age .  Iron supplementation was given at doses of 1 mg/kg/day , 2 mg/kg/day , and 2 mg/kg/every other day in the first three study groups , respectively , and the last group received placebo . The hematological values , except hemoglobin , were higher in the group supplemented with iron at a dose of 2 mg/kg/day , and ferritin values were statistically higher in the group supplemented with iron at a dose of 2 mg/kg/every other day than in the group supplemented with iron at a dose of 1 mg/kg/day . We suggest that intermittent iron supplementation is more effective than a daily regimen in equal dosages BACKGROUND Iron deficiency anemia and recurrent infections are common among children of low socioeconomic status . OBJECTIVE The objective was to evaluate the effects of iron supplementation on iron status and morbidity in children with or without infection . DESIGN Children aged 5 - 10 y were recruited for a r and omized , controlled , double-blind study from out patients attending the Children 's Hospital , Colombo , Sri Lanka . Clinical , inflammatory , nutritional , and iron statuses were determined at baseline and after the intervention . Children with a history of recurrent upper respiratory tract infections ( URTIs ) and with laboratory and clinical evidence of a current URTI constituted the infection group ( n = 179 ) , and children without infection constituted the control group ( n = 184 ) . Subjects in both groups were supplemented with ferrous sulfate ( 60 mg Fe ) or placebo once daily for 8 wk . Morbidity from URTIs , the number of gastrointestinal infections , and compliance were recorded every 2 wk . RESULTS The overall prevalence of anemia was 52.6 % . Iron supplementation significantly improved iron status by increasing hemoglobin ( P < 0.001 ) and serum ferritin ( P < 0.001 ) concentrations from baseline values in the children with or without infection . There was no significant improvement in iron status in the children who received placebo . In both the infection group and the control group , the mean number of URTI episodes and the total number of days sick with an URTI during the period of intervention were significantly lower ( P < 0.005 and P < 0.001 , respectively ) in the children who received iron supplements than in those who received placebo . CONCLUSION Iron supplementation significantly improves iron status and reduces morbidity from URTIs in children with or without infection BACKGROUND AND OBJECTIVE : Insufficient iron levels for optimal fetal and infant development is a concern during pregnancy and infancy . The goal of this study was to assess the effects of iron supplementation in pregnancy and /or infancy on motor development at 9 months . METHODS : The study was a r and omized controlled trial ( RCT ) of infancy iron supplementation linked to an RCT of pregnancy iron supplementation  , conducted in Hebei , China . A total of 1482 infants were r and omly assigned to receive placebo ( n = 730 ) or supplemental iron ( n = 752 ) from 6 weeks to 9 months . Gross motor development ( assessed by using the Peabody Developmental Motor Scale , Second Edition , instrument ) was the primary outcome . Neurologic integrity and motor quality were secondary outcomes . RESULTS : Motor outcome was available for 1196 infants , divided into 4 supplementation period groups : ( 1 ) placebo in pregnancy/placebo in infancy ( n = 288 ) ; ( 2 ) placebo in pregnancy/iron in infancy ( n = 305 ) ; ( 3 ) iron in pregnancy/placebo in infancy ( n = 298 ) ; and ( 4 ) iron in pregnancy/iron in infancy ( n = 305 ) . Using the Peabody Developmental Motor Scale , instrument , iron supplementation in infancy but not pregnancy improved gross motor scores : overall , P < .001 ; reflexes , P = .03 ; stationary , P < .001 ; and locomotion , P < .001 . Iron supplementation in infancy improved motor scores by 0.3 SD compared with no supplementation or supplementation during pregnancy alone . Effects of iron supplementation in infancy alone were similar to effects with iron in both pregnancy and infancy . CONCLUSIONS : The RCT design supports the causal inference that iron supplementation in infancy , with or without iron supplementation in pregnancy , improved gross motor test scores at 9 months BACKGROUND Although uncommon , iron deficiency ( ID ) occurs in breastfed infants . The regular provision of iron may prevent ID . OBJECTIVE The objective was to test the feasibility and effectiveness of 2 modalities of providing iron ( medicinal iron or iron-fortified cereal ) to breastfed infants . The study tested the hypothesis that regular provision of iron improves iron status of breastfed infants without adverse effects . DESIGN In this prospect i ve , r and omized , open-label trial , breastfed infants received on a regular basis either medicinal iron ( n = 48 ) or an iron-fortified fruit-cereal combination ( n = 45 ) from 4 to 9 mo or no intervention ( control group ; n = 59 ) . The interventions provided 7.0 - 7.5 mg ferrous sulfate/d . Infants were enrolled at 1 mo and were followed to 2 y. Iron-status indicators were determined periodically , stool characteristics were recorded , and growth was monitored . RESULTS The regular provision of iron led to improved iron status during and for some months after the intervention . Both sources of iron were about equally effective . Iron affected stool color but had no effect on feeding-related behavior . However , medicinal iron was associated with a small but significant reduction in length gain and a trend toward reduced weight gain . ID anemia was observed in 4 infants ( 2.3 % ) , most of whom had a low birth iron endowment .  Mild ID was common in the second year of life . CONCLUSIONS Regular provision of medicinal iron or iron-fortified cereal improves the iron status of breastfed infants and may prevent ID . Both modalities are equally effective , but medicinal iron leads to somewhat reduced growth . This trial was registered at Clinical Trials.gov as NCT00760890 BACKGROUND Iron and zinc deficiency are prevalent during infancy in low-income countries . OBJECTIVES The objectives were to examine whether a weekly supplement of iron , zinc , iron+zinc , or a micronutrient mix ( MM ) of 16 vitamins and minerals would alter infant development and behavior . DESIGN The participants were 221 infants from rural Bangladesh at risk of micronutrient deficiencies .  Development and behavior were evaluated at 6 and 12 mo of age by using the Bayley Scales of Infant Development II and the Home Observation Measurement of Environment ( HOME ) scale . In this double-blind trial , the infants were r and omly assigned to 1 of 5 treatment conditions : iron ( 20 mg ) , zinc ( 20 mg ) , iron+zinc , MM ( 16 vitamins and minerals , including iron and zinc ) , or riboflavin weekly from 6 to 12 mo . Multivariate analyses were conducted to examine the change in development and behavior for each supplementation group , with control for maternal education , HOME score , months breastfed , anemia , growth at 6 mo , and change in growth from 6 to 12 mo . RESULTS Iron and zinc administered together and with other micronutrients had a beneficial effect on infant motor development .  Iron and zinc administered individually and in combination had a beneficial effect on orientation-engagement . Two-thirds of the infants were mildly anemic , no treatment effects on hemoglobin concentration were observed , and hemoglobin was not associated with measures of development or behavior . CONCLUSION The beneficial effects of weekly iron and zinc supplementation on motor development and orientation-engagement suggest that infants benefit from these minerals when administered together Objective : To assess the effects of iron and deworming on linear growth performance of preschoolers . Design : Three-month r and omized , double-blind and placebo-controlled trial . The children were allocated to four treatments : iron ( 60 mg elemental iron/day)+albendazole ( 200 mg/day for 3 consecutive days , repeated 1 month later ) , iron+albendazole-placebo , albendazole+iron-placebo or placebos . The supplementation was supervised . Subjects : A group of 177 children aged 3–5 y was selected from low-income households in a rural area in southern Bénin . A complete data set was analysed for 140 subjects . Many children were stunted ( 58 % had height-for-age Z-score < −2 ) , none were wasted ( 2 % had weight-for-height Z-score < −2 ) and 76 % were anemic ( Hb<110 g/l).Main outcome measures : Anthropometric parameters , hemoglobin and eggs per gram feces . Results : No significant difference in changes in anthropometric parameters was observed between study groups , and also not in a sub- sample of stunted and anemic subjects . Changes in hemoglobin were highest in the iron-treated subjects at the end of the 3-month intervention period ( P=0.032 ) . The difference between the iron and the placebo groups remained significant even 7 months later ( P=0.022 ) . The difference was 5 g/l in both periods . Ascaris lumbricoides and hookworm infections decreased significantly in albendazole-treated subjects ( P<0.05 ) . Conclusions : In addition to recurrent parasitic infection burden , the children may have multiple micronutrient deficiencies . Therefore , it may be interesting to study appetite and food intake of young toddlers in relation to health and linear growth performance in poor environments . Sponsorship : The Nestlé Foundation ( Lausanne , Switzerl and ) .European Journal of Clinical Nutrition ( 2001 ) 55 , The efficacy of iron supplementation for iron-deficient subjects is in no doubt . However , the assumption that iron supplementation of iron-replete subjects is harmless may not be valid . We have studied the effect of iron supplementation on growth rate in 47 iron-sufficient young children ( 12 - 18 months ) in Indonesia . The children were r and omly assigned either ferrous sulphate ( 3 mg/kg daily ) or placebo every day for 4 months . Before treatment the length , weight , and arm circumference of the two groups were similar . During the 4 months of supplementation the rate of weight gain was significantly greater in the placebo group than in the iron-supplemented group ( 0.106 [ SE 0.010 ] vs 0.070 [ 0.011 ] kg every 2 weeks , p = 0.02 ) . The rates of gain in length and arm circumference did not differ significantly by treatment . There were no differences between the groups in rates of respiratory and gastrointestinal infections . These results suggest that iron supplementation of iron-replete children may retard their growth OBJECTIVE A community-based , r and omized trial was design ed to compare the effect of nutrition education and /or iron supplementation ( weekly ) on iron status of children in an urban slum in Delhi . METHODS Four hundred and fifty one children , 9 - 36 months of age and their caretakers ( mothers ) , assigned to one of the following groups were included in the cohort . Group 1 , nutrition education . Group 2 , supplementation ( with 20 mg elemental iron ) . Group 3 , nutrition education with supplementation ( with 20 mg elemental iron ) and Group 4 , control given placebo . The intervention program was of four months duration , with a treatment phase of 8 wk followed by 8 wk of no treatment . RESULTS Post intervention , at 8 wk and at 16 wk , the hemoglobin change in the nutrition education , supplementation , nutrition education with supplementation and control groups was 2.9 , 1.9 , 3.8 and -5.9 % , respectively and 2.1 , -1.9 , 0 and -9.3 % , respectively ( as compared to initial values ) . There was no significant effect of any of the intervention at 8 weeks . At 16 wk , there was significant positive effect of nutrition education group ( p less than 0.05 ) . The percent change in serum ferritin value at 16 wk in the nutrition education , supplementation , nutrition education with supplementation and control groups was 5.7 , -2.3 , -3.4 and -40 % , respectively . Serum ferritin values were significantly higher for the nutrition education group ( p < 0.001 ) as compared to the control . At 16 wk , the nutrition education group mothers showed significantly higher nutrition knowledge and the dietary iron intake of children was significantly higher than their control group counterparts ( p < 0.0001 ) . CONCLUSION The study suggests that nutrition education did have a positive effect on the iron status possibly by improving the dietary iron intake We evaluated the effect of weekly doses of 400 mg of ferrous sulphate for 4 months on the iron status of adolescent girls in a controlled trial in Tanga , Tanzania . Supplementation led to a significantly greater increase in serum ferritin compared with the control group ( + 15.6 microg/l vs. 8.6 microg/l ) ( P = 0.002 ) but there was no significant difference in change in haemoglobin . Children given iron showed a significantly greater weight gain than controls ( + 2.4 kg vs. + 1.4 kg ) ( P = 0.03 ) . Weekly iron supplementation may be an effective means of increasing iron stores and growth in children vulnerable to iron deficiency
Significant heterogeneity was evident , and its predictors included greater weight-for-age in supplemented children in malaria hyperendemic regions and greater weight-for-height for children above 5 years of age , but a negative effect on linear growth in developed countries and with supplementation for 6 months or longer .
This review did not document a positive effect of iron supplementation on the physical growth of children .
OBJECTIVE To evaluate the effect of iron supplementation on  physical growth in children through a systematic review of r and omised controlled trials ( RCTs ) .