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Iron supplementation of young children: learning from the new evidence

Rebecca J Stoltzfus1, Rebecca Heidkamp, Donald Kenkel

  • 1Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA. rjs62@cornell.edu

Food and Nutrition Bulletin
|February 27, 2008
PubMed

Insights

Iron deficiency is common in early childhood. New evidence suggests targeted iron supplementation may benefit deficient children without increasing risks, but more research is needed.

Area of Science:

  • Pediatric Nutrition
  • Micronutrient Supplementation
  • Global Public Health

Background:

  • Early childhood is a high-risk period for iron deficiency due to high iron needs and low-iron diets.
  • Current iron supplementation recommendations are based on benefits for anemia and child development, but evidence on growth and morbidity is mixed.
  • New evidence from Nepal and Zanzibar warrants a review of iron supplementation strategies.

Purpose of the Study:

  • To review new evidence on iron supplementation in early childhood from Nepal and Zanzibar.
  • To discuss interpretations of growth and morbidity outcomes.
  • To explore cost-effectiveness and targeted supplementation strategies.

Main Methods:

  • Review of new evidence from trials in Nepal and Zanzibar.
  • Analysis of growth and morbidity outcomes.
  • Cost-effectiveness analysis of supplementation strategies.

Main Results:

  • The Zanzibar trial showed adverse effects in the general population but significant benefits for iron-deficient children.
  • Targeting supplements to iron-deficient children in Zanzibar may be cost-effective and increase benefits.
  • Evidence regarding growth and morbidity from iron supplementation remains equivocal.

Conclusions:

  • Targeted iron supplementation for deficient children in high-risk areas may be a viable strategy.
  • Operations research is needed to test targeted supplementation approaches.
  • Three options are proposed to maximize benefits and minimize risks of iron supplements in early childhood.

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