Cognitive and motor development among small-for-gestational-age infants: impact of zinc supplementation, birth weight, and caregiving practices. Iron and zinc supplementation promote motor development and exploratory behavior among Bangladeshi infants. Randomized controlled trial of the effect of zinc supplementation on the mental development of Bangladeshi infants. Iron and zinc supplementation improved iron and zinc status, but not physical growth, of apparently healthy, breast-fed infants in rural communities of northeast Thailand. Effect of zinc supplementation of pregnant women on the mental and psychomotor development of their children at 5 y of age. Impact of zinc supplementation on mental and psychomotor scores of children aged 12 to 18 months: a randomized, double-blind trial. Weekly iron supplementation does not block increases in serum zinc due to weekly zinc supplementation in Bangladeshi infants. Zinc supplementation during pregnancy and effects on mental development and behaviour of infants: a follow-up study Randomized trial of the effect of zinc supplementation on the mental health of school-age children in Guatemala. Effects of iron and zinc supplementation in Indonesian infants on micronutrient status and growth. Zinc supplementation and stunted infants in Ethiopia: a randomised controlled trial Zinc supplementation affects the activity patterns of rural Guatemalan infants. Zinc supplementation and psychosocial stimulation: effects on the development of undernourished Jamaican children. Zinc supplementation does not affect growth, morbidity, or motor development of US term breastfed infants at 4-10 mo of age. A community-based randomized controlled trial of iron and zinc supplementation in Indonesian infants: effects on growth and development. Effect of zinc supplementation between 1 and 6 mo of life on growth and morbidity of Bangladeshi infants in urban slums. Zinc Supplementation Reduces the Incidence of Acute Lower Respiratory Infections in Infants and Preschool Children: A Double-blind, Controlled Trial The effect of zinc-supplemented bread consumption on school children with asymptomatic zinc deficiency. Zinc supplementation and serum zinc during diarrhea Zinc supplements in breastfed infants Effect of zinc supplementation on development and growth of Chilean infants. Combined iron and folic acid supplementation with or without zinc reduces time to walking unassisted among Zanzibari infants 5- to 11-mo old. Zinc and iron supplementation and malaria, diarrhea, and respiratory infections in children in the Peruvian Amazon.
OBJECTIVE Infants who are born small for gestational age ( SGA ) are at risk for developmental delays , which may be related to deficiencies in zinc , an essential trace metal , or to deficiencies in their ability to elicit caregiver responsiveness ( functional isolation hypothesis ) . The objective of this study was to evaluate at 6 and 10 months of age the impact of a 9-month supplementation trial of 5 mg of zinc on the development and behavior of infants who were born SGA and to evaluate infants ' ability to elicit responsive caregiver behavior . METHODS A r and omized , controlled trial of zinc supplementation was conducted among 200 infants in a low-income , urban community in Delhi , India . Infants were recruited when they were full term ( > 36 weeks ) and SGA ( birth weight < 10th percentile weight-for-gestational age ) . Infants were r and omized to receive daily supplements of a micronutrient mix ( folate , iron , calcium , phosphorus , and riboflavin ) with or without 5 mg of zinc sulfate . The supplement was administered by field workers daily from 30 days to 9 months of age . At 6 and 10 months , infant development and behavior were measured in a clinical setting using the Bayley Scales of Infant Development II . Caregiver responsiveness , observed on an Indian version of the Home Observation for Measurement of the Environment scale , was measured during a home visit at 10 months . During both the clinic and home visits , caregivers reported on their infant 's temperament . RESULTS There were no direct effects of zinc supplementation on the infants ' development or behavior at either 6 or 10 months . In a subgroup analysis among the zinc-supplemented infants , lower birth weight infants were perceived to be more temperamentally difficult than higher weight infants ; in the control group , birth weight was not associated with temperament . Heavier birth weight infants had better scores on all measures of development and behavior at 6 months and on changes in mental and motor development from 6 to 10 months , compared with lighter birth weight infants . Boys had better weight gain and higher scores on mental development and emotional regulation than girls . Infants who were from families of higher socioeconomic status ( indexed by parental education , house size , and home ownership ) had higher scores on mental development and orientation/engagement ( exploratory behavior ) than infants who were from families of lower socioeconomic status . In keeping with the functional isolation hypothesis , caregiver responsiveness was associated with infant irritability , controlling for socioeconomic status , gender , birth weight , and weight gain . Responsive mothers were more likely to perceive their infants to be temperamentally easy than less responsive mothers . CONCLUSION Possible explanations for the lack of effects of zinc supplementation on infant development and behavior include 1 ) subtle effects of zinc supplementation that may not have been detected by the Bayley Scales , 2 ) interference with other nutritional deficiencies , or 3 ) no impact of zinc deficiency on infants ' development and behavior . The link between birth weight and irritability among infants in the zinc supplementation group suggests that the response to zinc supplementation may differ by birth weight , with irritability occurring among the most vulnerable infants . Longer term follow-up studies among zinc-supplemented infants are needed to examine whether early supplementation leads to developmental or behavioral changes that have an impact on school-age performance . The relationship between infant irritability and low maternal responsiveness lends support to the functional isolation hypothesis and the importance of asking caregivers about infant temperament 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 BACKGROUND Zinc deficiency is thought to be common in young children in developing countries and some data suggest that it may detrimentally affect children 's development . OBJECTIVE Our goal was to assess the effect of zinc supplementation on the developmental levels and behavior of Bangladeshi infants . DESIGN This was a r and omized , double-blind , controlled trial conducted in Dhaka , Bangladesh . Three hundred one infants aged 1 mo were r and omly assigned to receive either 5 mg elemental Zn or placebo daily for 5 mo , and subsequent growth and morbidity were observed . For the present study , developmental levels were assessed in a sub sample of 212 infants at 7 and 13 mo of age with use of the Bayley Scales of Infant Development , and the infants ' behavior during the tests was observed . The children 's social background s , weights , and lengths were also recorded . RESULTS The children 's nutritional status was generally poor . The  zinc-treated group had slightly lower scores on the mental development index of the Bayley Scales than did the placebo group ( beta = 3.7 , SE = 1.3 , P < 0.005 ) . This effect remained significant when nutritional status and social background were controlled for . No other significant differences between groups were noted . CONCLUSIONS The mental development index scores of the zinc-treated group were slightly but significantly lower than those of the placebo group . This finding may have been due to micronutrient imbalance . Caution should be exercised when supplementing undernourished infants with a single micronutrient Iron deficiency is prevalent in children and infants worldwide . Zinc deficiency may be prevalent , but data are lacking . Both iron and zinc deficiency negatively affect growth and psychomotor development . Combined iron and zinc supplementation might be beneficial , but the potential interactions need to be verified . In a r and omized , placebo-controlled trial using 2 x 2 factorial design , 609 Thai infants aged 4 - 6 mo were supplemented daily with 10 mg of iron and /or 10 mg of zinc for 6 mo to investigate effects and interactions on micronutrient status and growth . Iron supplementation alone increased hemoglobin and ferritin concentrations more than iron and zinc combined . Anemia prevalence was significantly lower in infants receiving only iron than in infants receiving iron and zinc combined .  Baseline iron deficiency was very low , and iron deficiency anemia was almost nil . After supplementation , prevalence of iron deficiency and iron deficiency anemia were significantly higher in infants receiving placebo and zinc than in those receiving iron or iron and zinc .  Serum zinc was higher in infants receiving zinc ( 16.7 + /- 5.2 micromol/L ) , iron and zinc ( 12.1 + /- 3.8 micromol/L ) or iron alone ( 11.5 + /- 2.5 micromol/L ) than in the placebo group ( 9.8 + /- 1.9 micromol/L ) . Iron and zinc interacted to affect iron and zinc status , but not hemoglobin . Iron supplementation had a small but significant effect on ponderal growth , whereas zinc supplementation did not . To conclude , in Thai infants , iron supplementation improved hemoglobin , iron status , and ponderal growth , whereas zinc supplementation improved zinc status . Overall , for infants , combined iron and zinc supplementation is preferable to iron or zinc supplementation alone BACKGROUND A negative effect of prenatal zinc deficiency on brain function has been well established in experimental animals , but this association in humans is controversial . OBJECTIVE We evaluated the effect of prenatal zinc supplementation on the mental and psychomotor development of 355 children whose mothers participated in a double-blind trial of zinc supplementation that result ed in increased head circumference and birth weight .  DESIGN The children took 6 tests-the Differential Ability Scales , Visual Sequential Memory , Auditory Sequential Memory , Knox Cube , Gross Motor Scale , and Grooved Pegboard tests-at a mean age of 5.3 y. The scores were compared between the children of women who received a daily oral dose of 25 mg Zn during the second half of pregnancy and the children of women who received placebo . RESULTS There were no differences in the test scores of neurologic development between the 2 groups . We analyzed the scores in 4 subgroups on the basis of maternal body mass index , because the increases in birth weight and head circumference due to the supplementation occurred only in the children of women with a body mass index ( in kg/m(2 ) ) < 26.0 in the original trial . No differences in the scores were found between these subgroups . CONCLUSIONS Zinc supplementation of women in the latter half of pregnancy had no effect on the neurologic development of their children at age 5 y. It is not known whether our findings of no positive effect in the population with apparently inadequate zinc nutriture can be readily extrapolated to other population OBJECTIVE To evaluate the effect of zinc supplementation on mental and psychomotor scores in children aged 12 to 18 months . STUDY DESIGN In this double-blind , r and omized , placebo-controlled trial , children aged 6 to 30 months received daily elemental zinc ( 10 mg for infants and 20 mg for others ) or placebo for 4 months . Bayley Scales of Infant Development II were used for development assessment in the 12- to 18-month subgroup at enrollment and the end of the study . RESULTS At the end of the study , the adjusted mean mental ( P = .36 ) and psychomotor ( P = .28 ) index scores were similar in the intervention and control groups . In a multivariate model , the baseline mental development index score was positively associated with the mother 's schooling , the child 's height for age , packed cell volumes , hospital birth , and attendance at a day care center , and was negatively associated with the child 's age . Breastfeeding , the child 's weight for height , and packed cell volumes were positively associated with the baseline psychomotor index score . CONCLUSION Zinc supplementation did not affect the mental or psychomotor development index scores in a setting in which zinc deficiency is common Because infants and young children in many developing countries are deficient in both iron and zinc , and zinc can affect iron metabolism , evaluation of optimum strategies to simultaneously supplement iron and zinc is an important public health priority . This study evaluated the efficacy of weekly supplementation of iron or zinc or both on iron , zinc , and copper status in Bangladeshi infants . In a double-blind , r and omized , controlled community trial , 6-mo-old infants were assigned to receive weekly supplements of 1 mg riboflavin ( control , n = 82 ) or 1 mg riboflavin + 20 mg iron ( n = 83 ) , 20 mg zinc ( n = 83 ) , or both ( n = 85 ) for 6 mo . Hemoglobin , serum ferritin , transferrin receptor , zinc , and copper concentrations were measured at baseline and at the end of intervention . Serum Zn increased in both groups receiving zinc ; the increase was greatest among children with low baseline serum zinc concentration . Iron status indicators did not differ among the groups before or after 6 mo of supplementation . Supplementation with either zinc or iron decreased serum copper after 6 mo . Joint supplementation did not alter the individual effects of iron or zinc supplementation in these Bangladeshi children . However , the dosing regimen may not have been adequate to achieve the desired biochemical effects BACKGROUND Zinc deficiency is widely prevalent in developing countries . Zinc supplements given to Bangladeshi pregnant women have been shown to reduce infants ' infectious disease morbidity . We assessed these infants at age 13 months to establish the effect of antenatal zinc supplementation on infant development and behaviour . METHODS The study originally consisted of 559 pregnant women who were r and omly allocated to zinc ( 30 mg daily ) or placebo ( cellulose ) from 4 months ' gestation to delivery . The effect of zinc supplementation on pregnancy outcome and on infant growth and morbidity in the first 6 months was assessed . We then r and omly selected a sub sample of 168 infants from 383 who completed the study at 6 months . When babies in this sub sample reached age 13 months , we assessed mental development with Bayley scales of infant development-II , rated behaviour on a modified version of Wolke 's scales , and measured weight and height . FINDINGS When we controlled for differences between tested and non-tested participants , infants in the placebo group had higher scores on mental development index ( regression coefficient=3.3 , SE 1.6 , 95 % CI 0.2 - 6.5 , p=0.04 ) and psychomotor development index ( 5.1 , 2.4 , 0.2 - 9.9 , p=0.04 ) than those in the zinc-supplemented group . Zinc supplementation had no significant effect on behaviour or growth . The children 's nutritional status was poor , and weight-for-age at testing was strongly related to developmental levels , which accounted for some of the treatment effect . INTERPRETATION Prenatal supplementation with zinc alone in poor women from Bangladesh does not seem to confer benefit on infants ' mental development . Such treatment should be considered with caution BACKGROUND Rates of mental illness in children are increasing throughout the world . Observational studies of depression , anxiety , and attention-deficit hyperactivity disorder suggest that zinc is an alternative treatment . OBJECTIVE We examined the effect of zinc supplementation on the mental health of school-age children in Guatemala . DESIGN From January to October 2006 , we conducted a 6-mo r and omized , double-blind , controlled trial comparing zinc supplementation ( 10 mg ZnO/d for 5 d/wk ) with a placebo ( 10 mg glucose ) in 674 Guatemalan children in grade s 1 - 4 . Outcome measures included internalizing ( ie , depression and anxiety ) and externalizing ( ie , hyperactivity and conduct disorder ) problem behaviors , positive behaviors ( ie , socialization and leadership ) , and serum zinc concentrations . RESULTS Zinc and placebo groups did not differ significantly in any behavioral measures at baseline or at follow-up . At baseline , 21.4 % of children had serum zinc concentrations < 65 μg/dL. At follow-up , both groups improved significantly , and zinc concentrations were higher in the zinc group . Increases in serum zinc concentrations were inversely associated with decreases in depressive symptoms ( estimate : -0.01 points per μg Zn/dL ; P = 0.01 ) , anxiety ( estimate : -0.012 points per μg Zn/dL ; P = 0.02 ) , internalizing symptoms ( estimate : -0.021 points per μg Zn/dL ; P = 0.02 ) , and social skills ( estimate : -0.019 points per μg Zn/dL ; P = 0.01 ) in adjusted models that were controlled for child age , sex , socioeconomic status , household , and treatment group . CONCLUSIONS Six months of zinc supplementation did not induce differences in mental health outcomes between zinc and placebo groups . However , increases in serum zinc concentrations were associated with decreases in internalizing symptoms ( ie , depression and anxiety ) in a community-based sample of children at risk of zinc deficiency . This trial was registered at clinical trials.gov as NCT00283660 In this study the effects of supplementation of iron and zinc , alone or combined , on iron status , zinc status and growth in Indonesian infants is investigated . Micronutrient deficiencies are prevalent in infants in developing countries , and deficiencies often coexist ; thus , combined supplementation is an attractive strategy . However , little is known about interactions between micronutrients . In a r and omized , double-blind , placebo-controlled supplementation trial , 478 infants , 4 mo of age , were supplemented for 6 mo with iron ( 10 mg/d ) , zinc ( 10 mg/d ) , iron + zinc ( 10 mg of each/d ) or placebo . Anthropometry was assessed monthly , and micronutrient status was assessed at the end of supplementation . Supplementation significantly reduced the prevalence of anemia , iron deficiency anemia and zinc deficiency . Iron supplementation did not negatively affect plasma zinc concentrations , and zinc supplementation did not increase the prevalence of anemia or iron deficiency anemia . However , iron supplementation combined with zinc was less effective than iron supplementation alone in reducing the prevalence of anemia ( 20 % vs. 38 % reduction ) and in increasing hemoglobin and plasma ferritin concentrations . There were no differences among the groups in growth . The growth of all groups was insufficient to maintain the same Z-scores for height for age and weight for height . There is a high prevalence of deficiencies of iron and zinc in these infants , which can be overcome safely and effectively by supplementation of iron and zinc combined . However , overcoming these deficiencies is not sufficient to improve growth performance in these infants BACKGROUND Stunting is highly prevalent in Ethiopia and many other developing countries but the reason for it is poorly understood . Zinc is essential for growth but diets in such countries often do not contain zinc in sufficient quantity or of sufficient bioavailability . Thus zinc deficiency may play a major role in stunting . The aim of the study was to investigate whether the low rate of linear growth of apparently healthy breastfed infants in a rural village in Ethiopia could be improved by zinc supplementation . METHODS A r and omised , double-blind , placebo-controlled trial was done on apparently healthy breastfed infants aged 6 - 12 months . 100 non-stunted ( length-for-age , Z score < -2 ) were matched for age and sex with 100 r and omly selected stunted ( > -2 ) infants . Infants , both stunted and non stunted , were matched by sex , age ( within 2 months ) and recumbent length ( within 3 cm ) for r and om assignment , to receive a zinc supplement ( 10 mg zinc per day , as zinc sulphate ) or placebo , 6 days a week for 6 months . Anthropometric measurements were taken monthly , data on illness and appetite were collected daily , and sample s of serum and hair were taken at the end of the intervention for the analysis of zinc . FINDINGS The length of stunted infants increased significantly more ( p<0.001 ) when supplemented with zinc ( 7.0 cm [ SE 1.1 ] ) than with placebo ( 2.8 cm [ 0.9 ] ) ; and the effect was greater ( p<0.01 ) than in non-stunted infants ( 6.6 [ 0.9 ] vs 5.0 [ 0.8 ] cm for the zinc and placebo groups respectively , p<0.01 ) . Zinc supplementation also increased the weight of stunted children ( 1.73 [ 0.39 ] vs 0.95 [ 0.39 ] kg for the corresponding placebo group , p<0.001 ) and of non-stunted children ( 1.19 [ 0.39 ] vs 1.02 [ 0.32 ] kg for the corresponding placebo group , p<0.05 ) . Zinc supplementation result ed in a markedly lower incidence of anorexia and morbidity from cough , diarrhoea , fever , and vomiting in the stunted children . The total number of these conditions per child was 1.56 and 1.11 in the stunted and non-stunted zinc supplemented children versus 3.38 and 1.64 in the stunted and non-stunted placebo-treated children , respectively . At the end of the intervention period , the concentrations of zinc in serum and hair of stunted infants , who had not been supplemented with zinc , were lower than the respective concentrations of zinc in serum and hair of their non-stunted counterparts . INTERPRETATION Combating zinc deficiency can increase the growth rate of stunted children  to that of non-stunted infants in rural Ethiopia . This would appear to be due , at least in part , to reduction in morbidity from infection and increased appetite Zinc deficiency has been associated with growth deficits , reduced dietary intake and appetite , and has been hypothesized to result in reduced activity . This r and omized , double-blind , placebo-controlled study examined whether 10 mg of oral zinc as zinc sulfate , given daily for up to 7 mo , affected activity patterns of 85 Guatemalan infants recruited at 6 - 9 mo of age . Infant activity was assessed by time sampling-observation method at 10-min intervals during a 12-h data collection period , at base line , 3 and 7 mo follow-up . Motor development and the percentage of time infants were observed in various positions ( being carried , lying down , sitting , crawling , st and ing or walking ) and engaged in various activities ( eating , sleeping , resting , crying/whining or playing ) were compared by treatment group . No differences in motor development were observed by treatment group . However , at follow-up 2 ( after 7 mo of supplementation ) , zinc-supplemented infants were significantly more frequently observed sitting up compared with lying down , and were playing during 4.18 + /- 1.95 % ( P < 0.05 ) more observations than unsupplemented infants . They were also somewhat less likely to be observed crying or whining ( P < 0.10 ) compared with those receiving the placebo . These effects are independent of other factors including infant age , motor development , sex , maternal education , family socioeconomic status and nutritional status at base line . Further research must be conducted to determine the long-term developmental importance of these differences in activity patterns associated with zinc supplementation in this setting BACKGROUND Undernourished children have poor levels of development that benefit from stimulation . Zinc deficiency is prevalent in undernourished children and may contribute to their poor development . OBJECTIVE We assessed the effects of zinc supplementation and psychosocial stimulation given together or separately on the psychomotor development of undernourished children . DESIGN This was a r and omized controlled trial with 4 groups : stimulation alone , zinc supplementation alone , both interventions , and control ( routine care only ) .  Subjects were 114 children aged 9 - 30 mo and below -1.5 z scores of the National Center for Health Statistics weight-for-age references who were recruited from 18 health clinics . Clinics were r and omly assigned to receive stimulation or not ; individual children were r and omly assigned to receive zinc or placebo . The stimulation program comprised weekly home visits during which play was demonstrated and maternal-child interactions were encouraged . The supplementation was 10 mg Zn as sulfate daily or placebo .  Development ( assessed by use of the Griffiths Mental Development Scales ) , length , and weight were measured at baseline and 6 mo later . Weekly morbidity histories were taken . RESULTS Significant interactions were found between zinc supplementation and stimulation . Zinc benefited the developmental quotient only in children who received stimulation , and benefits from zinc to h and and eye coordination were greater in stimulated children . Zinc supplementation alone improved h and and eye coordination , and stimulation alone benefited the developmental quotient , hearing and speech , and performance . Zinc supplementation also reduced diarrheal morbidity but did not significantly improve growth . CONCLUSION Zinc supplementation benefits development in undernourished children , and the benefits are enhanced if stimulation is also provided BACKGROUND It has been documented that growth patterns differ between breastfed and formula-fed infants . Some investigators have suggested that these differences may be related to differences in zinc nutriture . OBJECTIVE The objective of this study was to examine the effect of zinc supplementation on growth , morbidity , and motor development in healthy , term , breastfed infants . DESIGN We conducted a r and omized double-blind intervention comparing zinc supplementation ( 5 mg/d as zinc sulfate ) with placebo in breastfed infants aged 4 - 10 mo .  Growth and indexes of body composition and gross motor development were measured monthly from 3 to 10 mo . Morbidity data were collected weekly . RESULTS Eighty-five infants were enrolled , and 70 completed the study . The baseline characteristics , attained weight or length at 10 mo , growth velocity , gross motor development , and morbidity did not differ significantly between groups , even after control for potentially confounding variables . CONCLUSIONS The dietary zinc intake of these breastfed infants appeared to be adequate , given that zinc supplementation did not affect growth , development , or risk of infection ( although sample size for detection of differences in development or infection was limited ) . Previously described differences in growth between breastfed and formula-fed infants in such population s do not appear to be due to differences in zinc nutriture BACKGROUND Deficiencies of iron and zinc are associated with delayed development , growth faltering , and increased infectious-disease morbidity during infancy and childhood . Combined iron and zinc supplementation may therefore be a logical preventive strategy . OBJECTIVE The objective of the study was to compare the effects of combined iron and zinc supplementation in infancy with the effects of iron and zinc as single micronutrients on growth , psychomotor development , and incidence of infectious disease . DESIGN Indonesian infants ( n = 680 ) were r and omly assigned to daily supplementation with 10 mg Fe ( Fe group ) , 10 mg Zn ( Zn group ) , 10 mg Fe and 10 mg Zn ( Fe+Zn group ) , or placebo from 6 to 12 mo of age . Anthropometric indexes , developmental indexes ( Bayley Scales of Infant Development ; BSID ) , and morbidity were recorded . RESULTS At 12 mo , two-factor analysis of variance showed a significant interaction between iron and zinc for weight-for-age z score , knee-heel length , and BSID psychomotor development . Weight-for-age z score was higher in the Zn group than in the placebo and Fe+Zn groups , knee-heel length was higher in the Zn and Fe groups than in the placebo group , and the BSID psychomotor development index was higher in the Fe group than in the placebo group . No significant effect on morbidity was found . CONCLUSIONS Single supplementation with zinc significantly improved growth , and single supplementation with iron significantly improved growth and psychomotor development , but combined supplementation with iron and zinc had no significant effect on growth or development . Combined , simultaneous supplementation with iron and zinc to infants can not be routinely recommended at the iron-to-zinc ratio used in this study BACKGROUND Evidence for an effect of zinc supplementation on growth and morbidity in very young infants in developing countries is scarce and inconsistent . OBJECTIVE We assessed the effect of zinc supplementation on growth and morbidity in poor Bangladeshi infants aged 4 - 24 wk . DESIGN Infants from Dhaka slums were enrolled at 4 wk of age and r and omly assigned to receive 5 mg elemental Zn/d  ( n = 152 )  or placebo  ( n = 149 ) until 24 wk of age . They were followed weekly for information on compliance and morbidity ; anthropometric measurements were performed monthly .  Serum zinc  was assessed at baseline and at 24 wk of age . RESULTS At 24 wk of age , serum zinc concentrations were higher in the zinc than in the placebo group ( 13.3 + /- 3.8 and 10.7 + /- 2.9 micro mol/L , respectively ; P < 0.001 ) . Significantly greater weight gains were observed in the zinc than in the placebo group for 43 infants who were zinc deficient ( < 9.18 micro mol/L ) at baseline ( 3.15 + /- 0.77 and 2.66 + /- 0.80 kg , respectively ; P < 0.04 ) . In the other infants , no significant differences were observed in mean weight and length gains during the study period . Zinc-deficient infants showed a reduced risk of incidence of acute lower respiratory infection after zinc supplementation ( relative risk : 0.30 ; 95 % CI : 0.10 , 0.92 ) ; among the non-zinc-deficient infants there were no significant differences between treatment groups . CONCLUSIONS Zinc-deficient Bangladeshi infants showed improvements in growth rate and a reduced incidence of acute lower respiratory infection after zinc supplementation . In infants with serum zinc concentrations > 9.18 micro mol/L , supplementation improved only biochemical zinc status Background . Increased acute lower respiratory infection incidence , severity , and mortality are associated with malnutrition , and reduced immunological competence may be a mechanism for this association . Because zinc deficiency results in impaired immunocompetence and zinc supplementation improves immune status , we hypothesized that zinc deficiency is associated with increased incidence and severity of acute lower respiratory infection . Methods . We evaluated the effect of daily supplementation with 10 mg of elemental zinc on the incidence and prevalence of acute lower respiratory infection in a double-blind , r and omized , controlled trial in 609 children ( zinc , n = 298 ; control , n = 311 ) 6 to 35 months of age . Supplementation and morbidity surveillance were done for 6 months . Results . After 120 days of supplementation , the percentage of children with plasma zinc concentrations < 60 μg/dL decreased from 35.6 % to 11.6 % in the zinc group , whereas in the control group it increased from 36.8 % to 43.6 % . Zinc-supplemented children had 0.19 acute lower respiratory infection episodes/child/year compared with 0.35 episodes/child/year in the control children . After correction for correlation of data using generalized estimating equation regression methods , there was a reduction of 45 % ( 95 % confidence interval , 10 % to 67 % ) in the incidence of acute lower respiratory infections in zinc-supplemented children . Conclusions . A dietary zinc supplement result ed in a significant reduction in respiratory morbidity in preschool children . These findings suggest that interventions to improve zinc intake will improve the health and survival of children in developing countries BACKGROUND Zinc deficiency has been seen in developing countries in which grain-based vegetable protein is consumed more often than animal protein . This study was done to emphasize the importance of zinc-fortified foods and to investigate bioavailability of zinc in zinc-fortified bread . METHODS Serum zinc concentrations in healthy 7- to 11-year-old school children were determined . In 24 of 101 children serum zinc concentrations were below 65 micrograms/ul . These 24 children with asymptomatic zinc deficiency were divided into two equal groups . The 12 children with low serum zinc concentrations received the zinc-fortified bread providing 2 mg/kg/day elemental zinc acetate for 90 days ( zinc-supplemented group ) , whereas the other 12 children received the same quality bread with no zinc fortification ( control group ) . RESULTS By the end of the period , the zinc-supplemented group had significantly higher serum and leukocyte zinc concentrations ( p < 0.01 ) and the weight , serum albumin levels , and alkaline phosphatase increased ( p < 0.01 ) . Immune functions improved , evidence d by conversion of delayed hypersensitivity skin reactions . Zinc-fortified bread ( 2 mg/kg/day ) caused no side effects or manifestations of zinc toxicity . CONCLUSIONS The results indicate that the bioavailability of zinc in the bread is satisfactory . The use of zinc-fortified bread was found to be an economical and readily accessible method to eliminate zinc deficiency and to prevent further occurrence Objective Zinc deficiency is very common in developing countries and is more pronounced during an episode of diarrhea . Supplementation with zinc improves diarrhea and might correct zinc deficiency in both the short and longer term . Method .We conducted a nested study within a cluster r and omized treatment trial . Fifty children with diarrhea living in the zinc treated clusters , 50 children with diarrhea living in control clusters , and 50 healthy children living in the control clusters were enrolled . We assessed serum zinc at the start of the diarrhea episode , which was 1–3 days after supplementation began in zinc treated children , and again one week after the diarrhea ended and supplementation ceased . Baseline characteristics and serum zinc concentration were assessed . Results .Serum zinc was low in 44 % of healthy children at the first blood draw . Compared to healthy controls , serum zinc was 3.1 mmol/L higher among children with diarrhea who were supplemented with zinc at first blood draw and 1.3mmol/L higher 3 weeks later . Conclusion .Zinc supplementation  enhances serum zinc concentration when given as a treatment for diarrhea and helps children maintain a more adequate zinc status during the convalescent period Among breastfed infants , growth faltering in comparison with reference growth curves is common in both developing and developed countries . We performed a zinc supplementation trial in Paris , France , to find out whether such growth faltering is due to nutritional zinc deficiency . 57 breastfed infants aged 4 - 9 ( mean 5.7 ) months were r and omly assigned to receive either 5 mg zinc daily or a placebo for 3 months . Most of the infants were from low-income immigrant families and the majority were of African origin . Before supplementation there were no significant differences between the zinc and placebo groups in weight , length , or corresponding Z-scores for age . After 3 months ' supplementation , the length-for-age Z-score had increased in the zinc group and fallen in the placebo group ( + 0.21 vs -0.13 , p = 0.029 ) . This difference was due mainly to greater linear growth of boys in the zinc than in the placebo group ( 6.0 vs 4.6 cm , p = 0.02 ) . Weight gain was also significantly greater with zinc supplementation ( 1.64 vs 1.28 kg , p = 0.047 ) . Among infants breastfed for longer than 4 months , decreases in growth velocity result partly from inadequate zinc intake OBJECTIVE To evaluate the effect of zinc supplementation on growth and development during infancy .  DESIGN We r and omized 150 term neonates of low socioeconomic status to receive supplemental zinc 5 mg/d  ( SG ) or a lactose placebo  ( PG ) ; 112 completed a 1-year follow-up . All were breast-fed and given cow milk formula after weaning ; solid foods and iron were added at 5 months . Anthropometry measured monthly , psychomotor development ( PDI ) , mental development ( MDI ) , and behavior including motor quality factor were assessed by Bayley Scales at 6 and 12 months . The groups were comparable in maternal characteristics , birth weight , home environment , and mother-infant interaction . RESULTS No effects of zinc on weight , length , and weight for length at 12 months were found controlling for sex and breast-feeding . The mean PDI ( SG : 84.5 + /- 11.5 vs PG : 87.6 + /- 9.9 ) and MDI ( 90.9 + /- 10.5 vs 88.9 + /- 9.1 ) were similar ; however , 46 of 52 infants in the PG scored < 100 in MDI vs 42 of 57 in the SG ( P < .05 ) . A smaller proportion of the SG , 2 of 57 , scored low in motor quality factor at 6 months compared with the PG , 8 of 52 ( P = .02 ) . The mean at 12 months for the SG was 31.9 + /- 2.8 and for the PG 30.8 + /- 2.9 ( P < .05 ) ; zinc supplementation entered the multiple regression at 12 months ( P = .037 ) . CONCLUSIONS Zinc supplementation may have a beneficial effect on mental development and motor quality behavior of healthy term infants Iron and zinc deficiencies have been associated with delayed motor development in nutritionally at-risk children , albeit inconsistently . In this community-based , r and omized double-blind trial , iron+folic acid ( FeFA ) ( 12.5 mg Fe + 50 mug folic acid ) , zinc ( Zn ) ( 10 mg ) , and iron+folic acid+zinc ( FeFA+Zn ) supplements or a placebo were given daily for 1 y to nutritionally at-risk children in Pemba , Zanzibar . The effects of these treatments on attaining unassisted walking were evaluated using survival analysis for 354 children aged 5 - 11 mo at the start of supplementation . Treatment effects on changes in hemoglobin ( Hb ) and zinc protoporphyrin ( ZPP ) and height-for-age ( HAZ ) and weight-for-age ( WAZ ) Z scores were evaluated using linear regression . Attained motor milestone was recorded every 2 wk for 1 y. Hb , ZPP , HAZ , and WAZ were measured at baseline and after 6 mo of treatment . FeFA with or without Zn reduced the time it took for children to walk assisted . Children who received any iron  walked unassisted sooner than those who received no iron [ median difference approximately 15 d , P = 0.035 , risk ratio ( RR ) = 1.28 , 95 % CI = 1.02 , 1.61 ] and this effect was stronger in those who had iron deficiency anemia ( IDA ) at baseline ( median difference was approximately 30 d ; P = 0.002 ; RR = 1.68 ; 95 % CI = 1.21 , 2.32 ) . FeFA alone and Zn alone improved Hb and ZPP compared with placebo . There were no significant treatment effects on changes in HAZ or WAZ . The effects of treatment on time to walking may have been mediated by improvements in iron status or hemoglobin , but were not mediated through improvements in growth Iron and zinc deficiencies are common in developing countries and supplementation is one way of reversing these deficiencies . The objective of this r and omized , placebo-controlled clinical trial was to identify the effect of daily supplementation with iron , zinc , and iron plus zinc on the morbidity experience of 855 children 0.5 - 15 years of age in Peru . Single nutrient supplementation with zinc reduced diarrhea morbidity by 23 % in all children . In older children ( more than five years of age ) , iron supplementation increased morbidity due to Plasmodium vivax and diarrhea . In younger children , iron combined with zinc provided protection against P. vivax malaria , but also interfered with some of the diarrhea protection associated with zinc supplementation . No statistically significant effect was observed of either supplement on incidence of respiratory infection or anthropometric indices . Iron and zinc deficiencies should be remedied , and combined supplementation may be a good option , particularly in younger children in P. vivax malaria-endemic areas , although local endemicity and species-specific prevalence should be considered carefully when design ing any supplementation program involving iron in a malaria-endemic area
There is no convincing evidence that zinc supplementation to infants or children results in improved motor or mental development
BACKGROUND Zinc deficiency is a significant public health problem in low- and middle-income countries .
Zinc is essential for the formation and migration of neurons along with the formation of neuronal synapses .
Its deficiency could interfere with the formation of neural pathways and with neurotransmission , thus affecting behavior ( for example , attention , activity , engagement , temperament ) and development ( for example , gross and fine motor skills , social skills ) .
Zinc supplementation provided to infants and children is a possible strategy to improve the mental and motor development of infants and children at high risk of zinc deficiency .
OBJECTIVES To assess the effects of zinc supplementation compared to placebo on measures of psychomotor development or cognitive function in children .