Preliminary findings on iron supplementation and learning achievement of rural Indonesian children. Improvements in growth following iron supplementation in young Kenyan school children. Weekly iron supplementation for the prevention of anemia in pre-school children: a randomized, double-blind, placebo-controlled trial. A randomized placebo-controlled trial of iron supplementation in breastfed young infants initiated on complementary feeding: effect on haematological status. Effectiveness of daily and weekly iron supplementation in the prevention of anemia in infants. Daily and weekly iron supplementation and physical growth of school age Indonesian children. Studies in iron supplementation of preschool children. [Effect of daily or once weekly iron supplementation on growth and iron status of preschool children]. Use of microencapsulated iron(II) fumarate sprinkles to prevent recurrence of anaemia in infants and young children at high risk. Failure of twice-weekly iron supplementation to increase blood haemoglobin and serum ferritin concentrations: results of a randomized controlled trial. Double-blind randomized controlled trial of rolls fortified with microencapsulated iron. Weekly iron supplements given by teachers sustain the haemoglobin concentration of schoolchildren in the Philippines. 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. School-administered weekly iron supplementation – Effect on the growth and hemoglobin status of non-anemic Bolivian school-age children
A randomized placebo-controlled trial Iron supplementation and physical growth of rural Indonesian children. Effects of iron supplementation and nutrition education on haemoglobin, ferritin and oxidative stress in iron-deficient female adolescents in Palestine: randomized control trial. Greater effectiveness of daily iron supplementation scheme in infants.
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 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 OBJECTIVE This study analyses the impact of weekly iron supplementation with ferrous sulphate heptahydrate ( FeSO4 ) in 5-year-olds compared with placebo , on hemoglobin ( Hb ) and hematocrit ( Ht ) values and anemia . DESIGN The study concerns a cluster-r and omized , placebo-controlled double-blind trial . Intervention participants received 50 mg elemental iron for 14 weeks . SETTING The study population comprised pre-school children ( n = 135 ) from one r and omly chosen public school in the northeast of Brazil . SUBJECTS Participants were 5-year-old students from a public school . RESULTS Mean Hb and Ht values increased after iron supplementation , with p < 0.0001 . There was no statistically significant increase in the placebo group . After intervention , anemia prevalence reduced only in the intervention group , from 48.0 % to 26.0 % . CONCLUSIONS Weekly iron supplementation was effective in reducing anemia in 5-year-olds To combat iron deficiency manifesting around six months of age , iron-fortified complementary feeding has been recommended . In developing countries , in view of the poor bioavailability of iron from predominantly cereal-based diets and the high cost of fortification , medicinal iron supplementation is an alternative intervention . This double-blind r and omized  placebo-controlled trial was conducted from April 1999 to March 2000 in the Out-patient Department of a tertiary hospital in New Delhi , India , to evaluate the haematological effects of medicinal iron supplementation to breastfed young infants initiated on complementary feeding . One hundred healthy non-low birth-weight , predominantly breastfed infants aged 4 - 6 months were r and omized into two groups to receive either iron ( 2 mg/kg/day ) ( IS group ; n=49 ) or placebo drops ( P group ; n=51 ) beginning with the initiation of home-based non-fortified complementary feeding .  Haematological parameters and anthropometry of mothers and infants were measured at baseline and repeated for infants after four and eight weeks of recruitment . Seventy-one subjects ( 35 in the IS group and the 36 in P group ) came for the first follow-up , and of these , 43 ( 19 in the IS group and 24 in the P group ) reported for the second visit . The adjusted ( for maternal and baseline infant ferritin ) serum ferritin levels were significantly higher in the IS group at both the follow-ups ( p=0.006 ) . The adjusted ( for maternal ferritin and baseline infant ferritin ) change in haemoglobin was significantly higher only at the second follow-up ( 0.7 g/dL ; 95 % confidence interval [ CI ] 0.3 - 1.0 g/dL ) . The adjusted rise in haemoglobin was higher in initially anaemic infants ( at second follow-up by 1 g/dL ; 95 % CI 0.5 - 1.6 g/dL ) . Medicinal iron supplementation , at the time of initiating complementary feeding , to breastfed young infants result ed in an elevation of serum ferritin and haemoglobin . The response was higher in initially anaemic infants . From a programmatic perspective , evidence needs to be generated on the relative merits of selective ( anaemic ) versus general supplementation and daily versus weekly supplementation OBJECTIVE To evaluate the effectiveness of universal prophylactic targeting with iron sulfate on daily or weekly basis in the prevention of anemia in infants . METHODS R and omized clinical field trial with children between ages six and 12 months seen at primary health care units in the municipality of Rio de Janeiro , Brazil , between 2004 and 2005 . Three concurrent cohorts were compared : daily group ( n=150 ; 12.5 mg Fe/day ) ; weekly group ( n=147 ; 25 mg Fe/week ) and control group . The intervention consisted of universal supplementation with iron sulfate for 24 weeks , combined with educational adherence-promoting measures . OUTCOME mean serum hemoglobin concentration , distribution and prevalence of anemia ( Hb<110.0 g/l ) at age 12 months . Effectiveness was evaluated considering both intent to treat and adherence to protocol , using multiple regression analysis ( linear and Poisson ) . RESULTS Groups were homogeneous in terms of descriptive variables . The intervention was implemented successfully , with high adhesion to protocol in both groups , and no statistical difference between them . After adjustment , only the daily regimen showed a protective effect . Adherence analysis demonstrated an evident dose-response effect on mean Hb and prevalence of anemia only for the daily regimen . No protective effect was detected for the weekly regimen . CONCLUSIONS Universal supplementation with iron sulfate from six to 12 months of age was effective in increasing serum Hb and decreasing risk of anemia only when administered on a daily basis 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 1 . The effect of daily supplements of 20 - 30 mg inorganic iron as ferrous sulphate on the growth , activity and haematological status of preschool children was studied for 3.5 , 7 and 12 months and compared to that of children who served as controls . All children were given their daily requirements of energy and protein . In addition , they received 5 microgram cyanocobalamin and 200 microgram folic acid . 2 . Fe supplementation increased the haemoglobin , serum Fe and percentage saturation of transferrin and reduced the unsaturated Fe-binding capacity significantly compared to corresponding values for the controls . 3 . Height and activity were unaffected by Fe supplements . 4 . Of the children 45 % had haemoglobin values below 110 g/l at the end of 7 - 12 months of Fe supplementation 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 OBJECTIVE To compare the effectiveness of microencapsulated iron(II ) fumarate sprinkles ( with and without vitamin A ) , iron(II ) sulfate drops , and placebo sprinkles in preventing recurrence of anaemia and to determine the long-term haematological outcomes in children at high risk of recurrence of anaemia 12 months after the end of supplementation . METHODS A prospect i ve , r and omized , placebo-controlled design was used to study 437 Ghanaian children aged 8 - 20 months who were not anaemic ( haemoglobin > or = 100 g/l ) . Four groups were given microencapsulated iron(II ) fumarate sprinkles , microencapsulated iron(II ) fumarate sprinkles with vitamin A , iron(II ) sulfate drops or placebo sprinkles daily for six months . Primary outcome measures were change in haemoglobin and anaemic status at baseline and study end . Non-anaemic children at the end of the supplementation period were reassessed 12 months after supplementation ended . FINDINGS Overall , 324 children completed the supplementation period . Among the four groups , no significant changes were seen in mean haemoglobin , ferritin or serum retinol values from baseline to the end of the supplementation period . During the trial , 82.4 % ( 267/324 ) of children maintained their non-anaemic status . Sprinkles were well accepted without complications . At 12 months post-supplementation , 77.1 % ( 162/210 ) of children with no intervention remained non-anaemic . This proportion was similar for children among the four groups . CONCLUSION In most children previously treated for anaemia , further supplementation was not needed to maintain their non-anaemic status . These results may have important implication s for community intervention programmes in which initial high-dose treatment is needed because of a high prevalence of anaemia In order to increase the intestinal absorption of iron whilst simultaneously minimising the side-effects and thus increasing compliance , once- or twice-weekly , instead of daily , iron supplementation has been widely recommended . In a r and omized , placebo-controlled , double-blind study in western Kenya , a tablet of ferrous dextran ( containing 60 mg elemental iron ) or an identical-looking placebo tablet was provided twice-weekly for 12 months to each child or adult investigated . At baseline each subject had a moderately low blood concentration of haemoglobin ( Hb ) . Initial Hb and serum ferritin ( SF ) concentrations were determined and each subject was tested for malarial and helminth infection and treated , if necessary , with the appropriate anthelminthic drug(s ) . Overall , 200 children ( aged 4 - 15 years ) and 129 adults ( aged 16 - 63 years ) completed the 12-month study . At baseline , 47.5 % of the children and 58.1 % of the adults were anaemic  , hookworm ( detected in 60.0 % of the children and 69.9 % of the adults ) was the most common helminth infection , and malaria was endemic . The results of bivariate analyses indicated that twice-weekly iron supplementation had no significant effect on blood Hb or SF concentrations , either in the children or the adults investigated . The results were confirmed in multiple linear-regression analyses , which revealed that the predictors of the final Hb concentration in the children investigated were age and infection , after enrollment , with Ascaris lumbricoides . Gender and the serum concentration of alpha-1-antichymotrypsin ( ACT ) at final follow-up were predictors of the final SF concentration in the children . In adults , the predictors of the final Hb concentration were gender and HIV infection , and the predictors of the final SF concentration were age and the serum concentration of ACT at the final follow-up . Twice-weekly iron supplementation did not increase Hb or iron stores in children or adults . Since compliance appeared to be high , this lack of effect may be the result of an inadequate dose of iron or of subjects who have deficiencies in micronutrients other than iron OBJECTIVE To evaluate the impact of the fortification of rolls with microencapsulated iron sulfate with sodium alginate on the hemoglobin levels in preschoolers as compared to controls . METHODS Double-blind r and omized controlled trial comprised of children aged 2 to 6 years with initial hemoglobin exceeding 9 g/dL from four not-for-profit daycares r and omly selected in the city of São Paulo - Brazil . Children of 2 daycares ( n = 88 ) received rolls with fortified wheat flour as the exposed group ( EC ) and children of 2 daycares ( n = 85 ) received rolls without fortification as the control group ( CG ) over a 24-week period . Rolls with 4 mg iron each were offered once a day , five days a week . Hemoglobin concentrations were determined in capillary blood by HemoCue ® at three moments of trial : baseline ( Ml ) , after 12 and 24 weeks of intervention ( M2 , M3 ) . RESULTS Hemoglobin concentration presented significant increase up to M3 in EG ( 11.7 - 12.5 - 12.6 g/dL ) and in CG ( 11.1 - 12.4 - 12.3 g/dL ) with higher elevations in children initially with anemia . There was significant reduction in the occurrence of anemia from 22 % to 9 % in EG and from 47 % to 8.2 % in CG at M3 . CONCLUSION Rolls fortified with microencapsulated iron sulfate were well tolerated , increased hemoglobin levels and reduced the occurrence of anemia , but with no difference compared to the control group OBJECTIVES To examine the effectiveness of weekly iron supplements given for 10 weeks by teachers to children in rural schools in the Philippines . METHODS Forty-nine rural primary schools took part in the study and were r and omly assigned to two groups : children in 25 schools received a weekly tablet providing 108 mg iron while children in 24 schools acted as controls . All children were dewormed before the start of the iron supplementation . The haemoglobin concentration of a systematic sample of one in three children in two classes in each school was estimated before and 5 - 17 weeks after the end of the iron supplementation . RESULTS A total of 1510 children aged 7 - 12 years were studied at both surveys . The mean haemoglobin concentration of children in the intervention group did not change significantly ; in the untreated group it fell by 3.8 g/l and the prevalence of anaemia rose from 14.3 % to 25.6 % . The difference between study groups was significantly larger amongst the younger children ( 7 - 8 years ) , and was observed in both anaemic and non-anaemic children . CONCLUSION Even where anaemia is only a mild public health problem , weekly iron supplements given by teachers may prevent a fall in the haemoglobin concentration , and can benefit both anaemic and non-anaemic children 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 Summary Background Recent data suggest that daily iron supplementation of iron-replete children could impair their growth . If verified for weekly iron supplementation these results would markedly complicate targeting and implementing school-based weekly iron supplementation programs . Aim of the study To ascertain the effect of weekly iron supplementation on the growth and hemoglobin status of non-anemic school-age children . Subjects and methods 73 Bolivian non-anemic school-age children r and omly assigned to the treatment group ( n=37 ; receiving supplements containing FeSO4 during 18 weeks ) or the control group ( n=36 ; receiving a placebo during the same period ) . Hemoglobin concentration and anthropometric measures were determined for each child at the beginning ( T0 ) and the end ( T18 ) of the study . Results The treatment group did not show any significant variation in hemoglobin concentration between T0 and T18 ( −1.6±10.4 g/L ; P=0.40 ) whereas the control group showed a significant decrease in hemoglobin concentration ( −4.6±10.9 g/L ; P=0.03 ) . Anthropometric changes were not significantly different between the treatment and the control groups for weight , ( 1.63±1,11 kg vs 1.88±0.79 kg ; P=0.30 ) , height ( 2.35±0.94 cm vs 2.11±1.03 cm ; P=0.34 ) or mid-upper arm circumference ( 0.29±0.57 cm vs 0.22±0.54 cm ; P=0.64 ) . Conclusion In our study , weekly iron supplementation of non-anemic school-age children had no negative effect on their growth while having a positive effect in preventing significant decreases in hemoglobin concentration . These results suggest that in regions where iron deficiency anemia ( IDA ) is prevalent , a simple and cost-effective way to control IDA in school-age children is to give weekly iron supplements to all children at school 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 Background Iron deficiency and iron-deficiency anaemia are associated with oxidative stress , but their role is largely unclear . Information is scarce on the effects of iron supplementation on biomarkers of oxidative stress in humans . Aims This study evaluated the effectiveness of iron supplementation and nutrition education on improving the levels of haemoglobin and ferritin , and decreasing oxidative stress among iron-deficient female adolescents in Gaza , Palestine . Methods A total 131 iron-deficient female adolescents were recruited and allocated r and omly into 3 different groups . The iron supplementation group ( A ) received 200 mg of ferrous fumarate weekly during the 3-month intervention , the iron supplementation with nutrition education group ( B ) received iron supplements with nutrition education sessions , and the control group ( C ) did not receive any intervention . The levels of haemoglobin , ferritin and malonyl dialdehyde were measured at baseline , after 3 months ( at which point the intervention was stopped ) , and then 3 months later . Trial registration number : ACTRN12618000960257 . Results Haemoglobin levels increased significantly after supplementation in both groups A and B. At the follow-up stage ( 3 months after stopping the intervention ) , iron and haemoglobin levels in group B continued to increase and malonyl dialdehyde decreased . In Group A , haemoglobin , ferritin and malonyl dialdehyde levels decreased after 3 months of stopping the intervention . No changes were seen in Group C. Conclusions A nutrition programme should be adopted and integrated into comprehensive intervention programmes to target iron-deficiency anaemia among female adolescents in Palestine OBJECTIVE To assess the effectiveness of weekly and daily schemes of preventive supplementation with supplementary iron to prevent iron deficiency anemia in non-anemic infants . METHODS A prospect i ve population study with a quantitative approach and preventive intervention was performed in the city of Viçosa , Southeastern Brazil , in 2007 - 8 . A total of 103 non-anemic children , aged between six and 18 months of age , were selected , corresponding to 20.2 % of the children registered with and cared for by Equipes de Saúde da Família ( Family Health Teams ) . Children were divided into two supplementation groups : daily dosage recommended by the Sociedade Brasileira de Pediatria ( Brazilian Society of Pediatrics ) ( group 1 , n=34 ) and weekly dosage recommended by the Brazilian Ministry of Health ( group 2 , n=69 ) . Assessment s were made in the beginning of the study and after six months , with hemoglobin dosage ( portable ss-Hemoglobin-meter ) and anthropometric and dietary assessment s being performed and socioeconomic question naire applied . Impact indicators used were prevalence of anemia , hemoglobin variation , adherence to and side effects of supplements . RESULTS Groups were homogeneous in terms of socioeconomic , biological and before-intervention health variables . After six months of supplementation , higher means of hemoglobin were found in group 1 than in group 2 ( 11.66 ; SD=1.25 and 10.95 ; SD=1.41 , respectively , p=0.015 ) ; in addition to lower prevalences of anemia ( 20.6 % and 43.5 % , respectively , p=0.04 ) . Only ' supplementation time ' influenced severe anemia ( p=0.009 ) . Statistically significant differences were not found for the ' adherence to supplementation ' and ' side effects ' variables . CONCLUSIONS The daily dosage recommended by the Sociedade Brasileira de Pediatria was found to be more effective to prevent anemia in infants , when compared to the dosage used by the Ministry of Health . The weekly dosage recommended by the Brazilian government program needs to be review ed to increase the effectiveness of prevention of anemia in infants cared for in public health services
This systematic review indicates that iron supplementation increases  Hb levels in children significantly but modestly .
The increase is greater in subjects who are anaemic at the start of the trial and lower in malarial hyperendemic areas and in those consuming iron-fortified food .
OBJECTIVE To evaluate the effect of iron supplementation on  haemoglobin ( Hb ) in children through a systematic review of r and omised controlled trials .