The effect of iron deficiency and mental stimulation on Indonesian children's cognitive performance and development. Treatment with iron increases weight gain and psychomotor development. Iron deficiency anemia: adverse effects on infant psychomotor development. Low prevalence of iron-deficiency anaemia among Inuit preschool children: Nunavut Inuit Child Health Survey, 2007-2008. Infancy: mental and motor development. Effects of Vitamin A Supplementation on Iron Status Indices and Iron Deficiency Anaemia: A Randomized Controlled Trial The ratio of serum transferrin receptor and serum ferritin in the diagnosis of iron status A Study of the Effects of Latent Iron Deficiency on Measures of Cognition: A Pilot Randomised Controlled Trial of Iron Supplementation in Young Women Prevalence & etiology of nutritional anaemias in early childhood in an urban slum. Iron treatment normalizes cognitive functioning in young women. Risk factors for iron deficiency in a hospitalized urban New Zealand population. Iron fortified follow on formula from 9 to 18 months improves iron status but not development or growth: a randomised trial Maternal iron deficiency anemia affects postpartum emotions and cognition. Prevention of iron deficiency and psychomotor decline in high-risk infants through use of iron-fortified infant formula: a randomized clinical trial. Randomized Trial of Early Versus Late Enteral Iron Supplementation in Infants With a Birth Weight of Less Than 1301 Grams: Neurocognitive Development at 5.3 Years' Corrected Age Effects of iron deficiency on attention and learning processes in preschool children: Bandung, Indonesia. Iron deficiency anaemia: continuous versus intermittent treatment in anaemic children. Effect of Iron Deficiency Anemia in Pregnancy on Child Mental Development in Rural China Efficacy of daily vs. weekly supplementation of iron in schoolchildren with low iron status. 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. Is cooking food in iron pots an appropriate solution for the control of anaemia in developing countries? A randomised clinical trial in Benin. Cognitive deficits in iron-deficient and iron-deficient anemic children. Home Intervention Improves Cognitive and Social-Emotional Scores in Iron-Deficient Anemic Infants
Three studies conducted in Indonesia will be described . Soewondo ( 12 ) investigated the relation of iron deficiency and cognitive function and impact of iron supplementation on verbal intelligence , attention and concept learning among iron deficient children without anemia and iron deficient anemic children . Half of 176 children , aged 3 - 6 years , received elemental Fe for 8 weeks and the other half received  placebo . There were significant changes from pre to post intervention evaluations in ferritin , transferrin saturation , free erythrocyte protoporphyrin , and hemoglobin in the iron deficient anemic children . Pre and post treatment psychological test data showed that iron deficiency anemia produced alterations in cognitive processes related to visual attention and concept acquisition . These alterations can be reversed with iron treatment . Idjradinata ( 4 ) assessed the impact of iron supplementation on iron deficient infant 's mental and psychomotor development . Hundred twenty six subjects aged 12 to 18 month were r and omly assigned to either iron treatment or placebo intervention . After 4 months of iron supplementation , the hemoglobin , ferritin and transferrin saturation changed significantly in the iron deficient infants . A developmental delay was observed in the iron deficient anemic infants before intervention and the conditions were reversed after 4 months of iron treatment . Soemiarti ( 8) examined the effectiveness of a  training course  given to mothers of children aged 12 to 24 month on the rearing environment and consequently to the child 's development .  The subjects were 69 mothers of 20 - 35 years old . The training lasted for 21 days by giving mothers training using the program " Ibu Maju Anak Bermutu " . The rearing environment improved , also the child 's mental and psychomotor development Previous work at this hospital and elsewhere has shown that anaemia in toddlers is common and is associated with psychomotor delay . It seemed unclear , however , whether this association was cause and effect or merely due to the same underprivileged environment . A double blind r and omised intervention study was , therefore , performed . After an initial assessment 97 children with anaemia ( haemoglobin 8 - 11 g/dl ) aged 17 - 19 months received either iron and vitamin C or vitamin C only ( control group ) for two months and were then reassessed . The children who received the iron had an increased rate of weight gain and more of them achieved the expected rate of development . While iron deficiency anaemia is unlikely to be the only factor in the slower development of children living in underprivileged circumstances , it can at least be easily identified and treated . Routine child health surveillance in such areas should include a haemoglobin determination In a double-blind , placebo-control prospect i ve cohort study of 196 infants from birth to 15 months of age , assessment was made at 12 months of age of the relationship between iron status and psychomotor development , the effect of a short-term ( 10-day ) trial of oral iron vs placebo , and the effect of long-term ( 3 months ) oral iron therapy . Development was assessed with the mental and psychomotor indices and the infant behavior record of the Bayley Scales of Infant Development in 39 anemic , 30 control , and 127 nonanemic iron-deficient children . Anemic infants had significantly lower Mental and Psychomotor Developmental Index scores than control infants or nonanemic iron-deficient infants ( one-way analysis of variance , P less than .0001 ) . Control infants and nonanemic iron-deficient infants performed comparably . No difference was noted between the effect of oral administration of iron or placebo after 10 days or after 3 months of iron therapy . Among anemic infants a hemoglobin concentration less than 10.5 g/dL and duration of anemia of greater than 3 months were correlated with significantly lower motor and mental scores ( P less than .05 ) . Anemic infants failed specifically in language capabilities and body balance-coordination skills when compared with controls . These results , in a design in which intervening variables were closely controlled , suggest that when iron deficiency progresses to anemia , but not before , adverse influences in the performance of developmental tests appear and persist for at least 3 months despite correction of anemia with iron therapy . If these impairments prove to be long st and ing , prevention of iron deficiency anemia in early infancy becomes the only way to avoid them OBJECTIVE To report the prevalence rates and correlates for anaemia , iron deficiency ( ID ) and iron-deficiency anaemia ( IDA ) among Inuit preschool-aged children . DESIGN A cross-sectional study  assessed iron intake , demographic information , medical history , anthropometrics , Hb , ferritin , C-reactive protein and antibodies to Helicobacter pylori . SETTING Sixteen selected Inuit communities in Nunavut Territory , Canada . SUBJECTS Inuit ( n 388 ) aged 3 - 5 years r and omly recruited from communities . RESULTS Anaemia ( 3 - 4 years : Hb < 110 g/l ; 5 years : Hb < 115 g/l ) was prevalent in 16·8 % of children . The prevalence of ID ( ferritin < 12 μg/l ) was 18·0 % and that of IDA was 5·4 % . When ID was defined as ferritin < 10 μg/l , 10·8 % of children were iron deficient and 3·3 % had IDA . In multiple logistic regression , boys were more likely to be iron deficient ( OR = 2·28 , 95 % CI 1·17 , 8·25 ) , but no other risk factor emerged for ID . Three- to 4-year-olds were less likely than 5-year-olds to have anaemia from causes other than ID ( OR = 0·11 , 95 % CI 0·08 , 0·58 ) . Anaemia from other causes was more common among children residing in crowded homes ( OR = 2·30 , 95 % CI 1·37 , 12·31 ) and those treated for past-year ear infection ( OR = 1·35 , 95 % CI 1·05 , 7·21 ) . CONCLUSIONS The low prevalence of ID and IDA is encouraging , but efforts are still needed to reduce rates as they continue to be higher than general population rates . Household crowding and infections may contribute to anaemia and warrant further research In a prospect i ve cohort study of 196 infants from birth to age 15 mo , the relationship of iron status to psychomotor development , the effect of a short-term trial of oral iron or placebo , and the effect of longer-term oral iron therapy was assessed . Development was assessed with the Bayley Scale of Infant Development in anemic , nonanemic , iron-deficient , and control children . Anemic infants had significantly lower indices than did control or nonanemic , iron-deficient infants . Control infants and nonanemic , iron-deficient infants performed comparably . No difference between the effect of oral administration of iron or placebo was noted after 10 d or 3 mo of iron therapy . A hemoglobin concentration of less than 105 g/L and anemia duration greater than 3 mo were correlated with significantly lower motor and mental scores , suggesting that when iron deficiency progresses to anemia , adverse influences in the performance of developmental tests appear and persist , despite iron therapy Iron deficiency anaemia ( IDA ) is the most common nutritional deficiency in the world including developed and developing countries . Despite intensive efforts to improve the quality of life of rural and aboriginal communities in Malaysia , anaemia and IDA are still major public health problems in these communities particularly among children . A r and omized , double-blind , placebo-controlled trial was conducted on 250 Orang Asli ( aboriginal ) schoolchildren in Malaysia to investigate the effects of a single high-dose of vitamin A supplementation ( 200,000 IU ) on iron status indices , anaemia and IDA status . The effect of the supplement was assessed after 3 months of receiving the supplements ; after a complete 3-day deworming course of 400 mg/day of albendazole tablets . The prevalence of anaemia was found to be high : 48.5 % ( 95 % CI = 42.3 , 54.8 ) . Moreover , 34 % ( 95 % CI = 28.3 , 40.2 ) of the children had IDA , which accounted for 70.1 % of the anaemic cases . The findings showed that the reduction in serum ferritin level and the increments in haemoglobin , serum iron and transferrin saturation were found to be significant among children allocated to the vitamin A group compared to those allocated to the placebo group ( p < 0.01 ) . Moreover , a significant reduction in the prevalence of IDA by almost 22 % than prevalence at baseline was reported among children in the vitamin A group compared with only 2.3 % reduction among children in the placebo group . In conclusion , vitamin A supplementation showed a significant impact on iron status indices and IDA among Orang Asli children . Hence , providing vitamin A supplementation and imparting the knowledge related to nutritious food should be considered in the efforts to improve the nutritional and health status of these children as a part of efforts to improve the quality of life in rural and aboriginal communities Laboratory tests used in the diagnosis of iron status lack specificity in defining iron deficiency anaemia ( IDA ) and anaemia of inflammation ( AI ) . The  serum transferrin receptor ( sTfR ) may provide more information in this regard . The iron status of 561 pre‐school children was determined and classified using the conventional measurements . The value of the concentration of sTfR , the ratio of sTfR ( µg/ml ) to LogSF ( µg/l ) ( TfR‐Index ) , and the Log of the ratio of sTfR ( µg/l ) to SF ( µg/l ) − ( LogTfR : Fer ratio ) , in the classification of the iron status were determined by comparing their distributions across the classification of iron status . Although there were significant differences in sTfR and TfR‐Index across the categories of iron status , there was considerable overlap . All subjects with iron deficiency had LogTfR : Fer ratio > 2·55 , whereas in all subjects classified as AI it was < 2·55 , thus clearly separating the two . The LogTfR : Fer ratio was not able to exclude IDA in the presence of inflammation . However , in cases of combined IDA and AI the LogTfR : Fer ratio was < 2·55 but increased to > 2·55 after resolution of the inflammation . This novel method of calculating the LogTfR : Fer ratio may provide a more precise classification of the iron status of children Rates of iron deficiency are high amongst healthy young women .  Cognitive impairment occurs secondary to iron deficiency in infants and children , but evaluation of the impact on cognition among young women is inconsistent . The aim was to determine the suitability of the IntegNeuro test battery for assessing cognitive function in iron-deficient and iron-sufficient young women . A pilot double-blinded , placebo-controlled intervention trial was conducted in iron-deficient ( serum ferritin ≤ 20 μg/L and haemoglobin > 120 g/L ) and iron-sufficient young women ( 18–35 years ) . Cognitive function and haematological markers of iron status were measured at baseline and follow-up . Iron-deficient participants ( n = 24 ) were r and omised to receive placebo , 60 mg or 80 mg elemental iron daily supplements for 16 weeks . A control group of iron-sufficient participants ( n = 8) was allocated to placebo . Change scores for Impulsivity and Attention were significantly greater in plasma ferritin improvers than in non-improvers ( p = 0.004 , p = 0.026 ) . IntegNeuro was easy to administer and acceptable to young women . Based on the differences in Memory and Attention scores between iron-deficient participants on iron treatment and those on placebo , it was decided that between 26 and 84 participants would be required in each iron treatment group for an adequately powered extension of this pilot RCT The present study was carried out to find out the prevalence and etiology of nutritional anaemia among preschool children from an urban slum . R and omly selected 300 children aged 3 months-3 yr were analysed over a period of one year for estimating prevalence of nutritional anaemia . Prevalence was also assessed by the rise in haemoglobin after 8 wk of haematinic supplementation in 159 of the 300 subjects . Ninety anaemic children were evaluated for the etiology of anaemia . Prevalence of anaemia , as judged by WHO recommended ' cut-off ' value of haemoglobin < 11 g/dl , was 76 per cent while comparable value of 74.8 per cent was derived by response to haematinic supplementation .  Pure iron deficiency anaemia ( IDA ) was detected in 41.4 per cent ( 37/90 ) of anaemic children . Vitamin B12 deficiency alone or in combination with iron was diagnosed in 14.4 and 22.2 per cent anaemic children respectively . Similarly folate deficiency , IDA with infection and anaemia of chronic diseases ( ACD ) was diagnosed in 2.2 , 3.3 and 12.2 per cent cases respectively . Childhood anaemia continues to be a significant public health problem in preschoolers and iron deficiency is by far the commonest nutritional cause of anaemia . Vitamin B12 deficiency per se or in combination with iron is an important yet not commonly recognised cause of anaemias in preschool children in the community BACKGROUND Evidence suggests that brain iron deficiency at any time in life may disrupt metabolic processes and subsequently change cognitive and behavioral functioning . Women of reproductive age are among those most vulnerable to iron deficiency and may be at high risk for cognitive alterations due to iron deficiency . OBJECTIVE We aim ed to examine the relation between iron status and cognitive abilities in young women . DESIGN A blinded , placebo-controlled , stratified intervention study was conducted in women aged 18 - 35 y of varied iron status who were r and omly assigned to receive iron supplements or a placebo .  Cognition was assessed by using 8  cognitive performance tasks  ( from Detterman 's Cognitive Abilities Test ) at baseline ( n = 149 ) and after 16 wk of treatment ( n = 113 ) . RESULTS At baseline , the iron-sufficient women ( n = 42 ) performed better on cognitive tasks ( P = 0.011 ) and completed them faster ( P = 0.038 ) than did the women with iron deficiency anemia ( n = 34 ) . Factors representing performance accuracy and the time needed to complete the tasks by the iron-deficient but nonanemic women ( n = 73 ) were intermediate between the 2 extremes of iron status . After treatment , a significant improvement in serum ferritin was associated with a 5 - 7-fold improvement in cognitive performance , whereas a significant improvement in hemoglobin was related to improved speed in completing the cognitive tasks . CONCLUSIONS Iron status is a significant factor in cognitive performance in women of reproductive age . Severity of anemia primarily affects processing speed , and severity of iron deficiency affects accuracy of cognitive function over a broad range of tasks . Thus , the effects of iron deficiency on cognition are not limited to the developing brain OBJECTIVE To determine which dietary practice s and sociodemographic factors are associated with iron deficiency anaemia ( IDA ) and iron deficiency ( ID ) in hospitalized New Zeal and children . METHODOLOGY A prospect i ve study of children 8 - 23 months of age hospitalized with an acute illness from 1997 to 1999 . Iron deficiency was defined as abnormal values for two out of three of serum ferritin ( < 10 micro g/L ) , serum iron saturation ( < 10 % ) and red cell distribution width ( > 14.5 % ) . Iron deficiency anaemia ( IDA ) was defined as ID + serum haemoglobin concentration < 110 g/L. Those with IDA or ID were compared separately with those who were not iron deficient . RESULTS Three hundred and ninety-one children were enrolled . Two hundred and twenty had IDA , 73 had ID and 98 were not iron deficient . In a multivariate analysis , those children who had a diagnosis of pneumonia ( odds ratio 4.43 , 95 % CI 1.49 , 13.13 ) were Pacific ( odds ratio 6.31 , 95 % CI 2.14 , 18.63 ) , were currently drinking breast milk ( odds ratio 10.22 , 95 % CI 2.95 , 35.42 ) , had a mother who restricted her meat intake during pregnancy ( odds ratio 4.40 , 95 % CI 1.53 , 12.64 ) or lived in a household with more than three children ( odds ratio 7.42 , 95 % CI 1.88 , 29.34 ) were at increased risk of IDA . Those children who were Pacific ( odds ratio 5.44 , 95 % CI 1.37 , 21.65 ) or who drank tea ( odds ratio 7.88 , 95 % CI 1.10 , 56.33 ) were at increased risk of ID . Those with a diagnosis of gastroenteritis ( odds ratio 0.16 , 95 % CI 0.03 , 0.75 ) were at decreased risk of ID . CONCLUSIONS Both dietary and non-dietary factors are associated with an increased risk of IDA and ID in New Zeal and children . In this hospitalized sample , more non-dietary than dietary factors were associated with poor iron status AIMS Iron deficiency anaemia is associated , in observational studies , with developmental disadvantage . This study tested the hypothesis that feeding iron supplemented formula from 9 to 18 months of age would improve developmental performance . SUBJECTS AND METHODS 493 healthy children aged 9 months being fed pasteurised cows ’ milk were recruited from three UK centres . They were r and omised to : cows ’ milk as before , formula containing 0.9 mg/litre iron , or formula containing 1.2 mg/litre iron , until 18 months of age . Bayley mental and psychomotor developmental indices were measured at 18 months , as were growth and haematological indices . RESULTS Children fed iron fortified formula had higher plasma ferritin concentrations , but there were no significant intergroup differences in development or growth . CONCLUSIONS There are no developmental or growth advantages in children given iron supplemented formula , but a benefit for a minority who were anaemic , or the possibility that a benefit may emerge at a later age , can not be excluded The aim of this study was to determine whether iron deficiency anemia ( IDA ) in mothers alters their maternal cognitive and behavioral performance , the mother-infant interaction , and the infant 's development . This article focuses on the relation between IDA and cognition as well as behavioral affect in the young mothers . This prospect i ve , r and omized , controlled , intervention trial was conducted in South Africa among 3 groups of mothers : nonanemic controls and anemic mothers receiving either placebo ( 10 microg folate and 25 mg vitamin C ) or daily iron ( 125 mg FeS0(4 ) , 10 microg folate , 25 mg vitamin C ) . Mothers of full-term normal birth weight babies were followed from 10 wk to 9 mo postpartum ( n = 81 ) . Maternal hematologic and iron status , socioeconomic , cognitive , and emotional status , mother-infant interaction , and the development of the infants were assessed at 10 wk and 9 mo postpartum . Behavioral and cognitive variables at baseline did not differ between iron-deficient anemic mothers and nonanemic mothers . However , iron treatment result ed in a 25 % improvement ( P < 0.05 ) in previously iron-deficient mothers ' depression and stress scales as well as in the Raven 's Progressive Matrices test . Anemic mothers administered placebo did not improve in behavioral measures . Multivariate analysis showed a strong association between iron status variables ( hemoglobin , mean corpuscular volume , and transferrin saturation ) and cognitive variables ( Digit Symbol ) as well as behavioral variables ( anxiety , stress , depression ) . This study demonstrates that there is a strong relation between iron status and depression , stress , and cognitive functioning in poor African mothers during the postpartum period . There are likely ramifications of this poorer " functioning " on mother-child interactions and infant development , but the constraints around this relation will have to be defined in larger studies OBJECTIVE To determine the efficacy of iron-fortified infant formula in preventing  developmental delays and abnormal behavior . DESIGN Double-blind , r and omized , controlled trial . SETTING Urban hospital clinic . PARTICIPANTS A total of 283 healthy , bottle-fed infants from very low income families . Children with prematurity , low birth weight , and major anomalies and those who had received more than 2 weeks of evaporated-milk feedings were excluded . The groups were similar for sociodemographic background variables . Fifty-eight infants ( 20.5 % ) dropped out before any outcome data were gathered ; 225 , 204 , 186 , and 154 remained at 6- , 9- , 12- , and 15-month assessment s , respectively . INTERVENTION Iron-fortified formula ( 12.8 mg iron per liter ) versus regular formula ( 1.1 mg iron per liter ) . MAIN OUTCOME MEASURES Iron status was measured on venous blood by determination of hemoglobin , serum iron and iron-binding capacity , serum ferritin , and free erythrocyte protoporphyrin values . The Bayley Scales of Infant Development ( mental and psychomotor indexes ) and two factors of the Infant Behavior Record ( test affect and task orientation ) were the outcomes of interest . RESULTS All measures of iron status were significantly different between groups ( p < 0.001 ) . Psychomotor development patterns differed between groups ( F3,520 , 3.4 ; p = 0.02 ) with time . Mean values were similar at 6 months but differed at 9 and 12 months of age ( p < 0.001 ) , with a decline of 6.4 points in the regular-formula group . By 15 months of age the differences were no longer significant ( p = 0.23 ) . Mental development and behavior were not affected . CONCLUSIONS Iron-fortified formula significantly reduced iron deficiency in a high-risk group of infants and prevented a decline in psychomotor development quotients . This effect may be transient , and its long-term significance needs further study BACKGROUND . Iron deficiency in early childhood may impair neurodevelopment . In a masked , r and omized , controlled trial of early versus late enteral iron supplementation in preterm infants with birth weights of < 1301 g , early iron supplementation reduced the incidence of iron deficiency and the number of blood transfusions . OBJECTIVE . We sought to examine whether early enteral iron supplementation improves neurocognitive and motor development in these infants . METHODS . Children who participated in the above mentioned trial were evaluated by applying the Kaufmann Assessment Battery for Children and the Gross Motor Function Classification Scale at the age of school entry . RESULTS . Of the 204 infants initially r and omized , 10 died and 30 were lost to follow-up . A total of 164 ( 85 % of the survivors ) were evaluated at a median corrected age of 5.3 years . In this population ( n = 164 ) , the mean ( ±SD ) mental processing composite in the early iron group was 92 ( ±17 ) versus 89 ( ±16 ) in the late iron group . An abnormal neurologic examination was found in 17 of 90 versus 26 of 74 , and a Gross Motor Function Classification Scale score of > 1 was found in 2 of 90 versus 5 of 74 , respectively . Fifty-nine of 90 children in the early iron group were without disability , compared with 40 of 74 in the late iron group . Severe disability was found in 5 of 90 versus 6 of 74 children and 67 of 90 versus 49 of 74 qualified for regular schooling , respectively . CONCLUSIONS . Early enteral iron supplementation showed a trend toward a beneficial effect on long-term neurocognitive and psychomotor development and showed no evidence for any adverse effect . Because the initial study was not design ed to evaluate effects on neurocognitive development , the power was insufficient to detect small but potentially clinical ly relevant improvements . Additional studies are required to confirm the trend towards a better outcome observed in the early iron group A double-blind clinical trial was conducted in Indonesia to assess effects of iron supplementation on performance of iron-depleted and iron-deficient anemic children in discrimination and oddity learning tasks . Half these children received elemental Fe for 8 wk ; the others received a placebo . There were significant changes from pre- to postintervention evaluations in ferritin , transferrin saturation , free erythrocyte protoporphyrin , and hemoglobin among the anemic and iron-depleted children ; no changes were observed among the placebos or any of the iron-replete children . The magnitude of hematological changes in anemic children treated with iron was small ; yet , after treatment the children 's mean ferritin , transferrin saturation , and hemoglobin values were above the cutoff points used for the definition of iron-deficiency anemia ( IDA ) . Pre- and posttreatment psychological test data show that IDA produces alterations in cognitive processes related to visual attention and concept acquisition , alterations reversed with iron treatment Iron deficiency anaemia is a common disorder among paediatric population . Traditionally , oral iron is given for treatment on daily basis . We undertook this study to compare the results of intermittent with continuous oral iron therapy in children . The study was conducted at Combined Military Hospital ( CMH ) , Lahore . Children ( aged 1 to 6 ) with iron deficiency anaemia ( Hb 11 g/dl ) were allocated at r and om into two groups , A ( n = 27 ) and B ( n = 28 ) . The mean Hb of group A , before treatment , was 8.56 ( + /- 1.51 ) g/dl and that of group B was 8.32 ( + /- 1.68 ) g/dl . Group A was given daily oral dosage of 6 mg/kg of elementAL iron whereas group B was given the same dosage of iron but only 3 days a week . After 2 months of treatment the Hb of group A rose to a mean of 11.06 ( + /- 0.72 ) g/dl and that of group B was increased to 11.3 ( + /- 0.90 ) g/dl , respectively . The difference , in the rise of Hb of two groups , was not statistically significant . It was concluded that in our sample of population , the results of intermittent and continuous oral iron therapy , for iron deficiency anaemia in children aged 1 to 6 years , were identical OBJECTIVE : To determine the impact of iron deficiency anemia ( IDA ) in pregnancy on young child development . METHODS : A 2-year follow-up of 850 children born to women who participated in a double-blind cluster r and omized controlled trial of prenatal micronutrient supplementation in western rural China . These women were r and omly assigned to receive either daily folic acid , iron/folic acid ( 60 mg iron ) , or multiple micronutrients ( with 30 mg iron ) during pregnancy . Children were categorized into the prenatal-IDA and prenatal – non-IDA groups based on the mother ’s hemoglobin in the third trimester . Each group contained 3 subgroups based on mother ’s treatment : folic acid , iron/folic acid , and multiple micronutrients .  Bayley scales of infant development were administered to the children to assess their development at 3 , 6 , 12 , 18 , and 24 months of age . RESULTS : Compared with the prenatal – non-IDA group , the prenatal-IDA group showed a significantly lower mental development index at 12 , 18 , and 24 months of age . The adjusted mean difference was 5.8 ( 95 % confidence interval [ CI ] , 1.1–10.5 ) , 5.1 ( 95 % CI , 1.2–9.0 ) , and 5.3 ( 95 % CI , 0.9–9.7 ) , respectively . Further analysis showed that the mental development indexes in the prenatal-IDA group and prenatal – non-IDA group were similar with supplementation of iron/folic acid but were significantly lower in the prenatal-IDA group with supplementation of folic acid or multiple micronutrients . CONCLUSIONS : Prenatal IDA in the third trimester is associated with mental development of the child . However , prenatal supplementation with sufficient iron protects child development even when the woman ’s IDA was not properly corrected in pregnancy Iron deficiency anemia ( IDA ) is still a major nutritional and public health problem in developing countries . The prevalence among young children and pregnant women is particularly high . Daily oral supplementation with medicinal iron is considered an effective strategy for reducing the incidence of IDA but non-compliance is a major problem with this strategy . We undertook this study to compare the results of once-weekly vs. daily oral iron supplementation in schoolchildren . Sixty children ranging between 5 and 10 years with iron deficiency anemia were selected from a school in Karachi , Pakistan and were divided into two equal groups , i.e. , daily and weekly supplementation groups . Hemoglobin ( Hb ) , hematocrit ( Hct ) , serum iron , total iron binding capacity ( TIBC ) , and serum ferritin were determined before the start of the study . Ferrous sulfate ( 200 mg ) was given daily to the daily supplementation group and once-weekly to the weekly supplementation group for 2 months . When post-supplementation values of the above-mentioned parameters were determined , a significant improvement was observed in all parameters in both groups . It is concluded that once-weekly iron supplementation is as effective as daily supplementation for the treatment of iron deficiency anemia . Moreover , weekly iron supplementation is cost effective and has no or fewer side-effects 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 OBJECTIVE To evaluate the effect of two types of iron pots on haemoglobin ( Hb ) and serum ferritin ( SF ) concentrations in young children ( 6 - 24 months ) , adolescent girls ( 11 - 15 years ) and women of reproductive age ( 15 - 44 years ) , whose households were provided with  iron pots  for cooking food over a period of 6 months , compared with controls . DESIGN AND METHODS We r and omly assigned 161 households including 339 individuals from the three subgroups to cast iron pots , blue steel pots or oral iron supplements ( control ) . In the control group , children received micronutrient Sprinkles , and adolescent girls and women received iron tablets daily for 6 months . We measured Hb , SF and C-reactive protein concentrations at baseline and 6 months , and compared groups using regression models . RESULTS Anaemia prevalence ( Hb < 110 g l(-1 ) in infants , Hb < 120 g l(-1 ) in girls or women ) was 47 % ( cast iron group ) , 50 % ( blue steel group ) and 50 % ( control ) at baseline . At 6 months , there were no significant differences in Hb concentrations among groups ; however , differences in SF concentrations were significant ( P < 0.0001)--the control group had higher SF concentrations compared with the groups using iron pots . Also , differences in the prevalence of iron-deficiency anaemia ( IDA ; anaemia plus SF < 15 microg l(-1 ) ) were almost significant between cast iron and control groups ( P = 0.08 ) , and blue steel and control groups ( P = 0.05 ) . CONCLUSION There is no evidence that iron cooking pots are effective against IDA . Further research is warranted to determine whether the iron leached from the pots is bioavailable Eighteen- to 60-month-old iron-deficient anemic children given iron therapy ( n = 25 ) and a control group matched for mother 's educational level showed no significant difference in mean mental development score at baseline . The control group 's mean score was increased significantly over baseline score at 3 and 6 months and was significantly higher than the experimental group 's mean score at 3 months . Although the experimental group demonstrated hematologic correction over 6 months , mean mental development score showed no significant improvement . Scores for an iron deficient not anemic group given iron ( n = 22 ) , despite complete hematologic correction over the six months of observation , and for its control group , did not change significantly . Baseline scores for an iron-deficient not anemic placebo group ( n = 23 ) and for its control group were not significantly different . At 3 months the control group score had increased significantly , whereas that for the experimental group had not . When experimental and control subjects were matched on baseline mental development score , the control subjects experienced increases in scores over time , further confirming an impaired ability to improve scores with repeated testing in the experimental groups . Behavioral rating data ( responsiveness to examiner , responsiveness to environment , and emotional tone ) revealed significant differences between the iron-deficient anemic group and its control group at 3 and 6 months , with the control group rated more responsive , suggesting that iron deficiency , alone or in association with anemia , may have some lasting effect on behavior and development . Group differences were also found between the mean number of occurrences of multiple stressful events . Failure to show improvement in scores in the iron-deficient anemic group may reflect the fact that those children were less testable than were children in the control group , despite repeated testings , a theory supported by the infant behavior rating data . This may be related to some irreversible behavioral deficit or to an adverse environmental milieu ( e.g. , stress ) BACKGROUND : Iron-deficiency anemia ( IDA ) is associated with alterations in infant behavior and development that may not be corrected with iron therapy . OBJECTIVE : To determine if a home-based intervention to foster child development improves behavior and development of infants with IDA . METHODS : Infants with IDA and nonanemic infants aged 6 and 12 months were treated with oral iron and r and omly assigned to a year of surveillance or intervention . Infants in the surveillance group were visited weekly , and information on iron intake , feeding , and health were recorded . Infants in the intervention were visited weekly , and the home visits included an hour-long program to foster child development by providing support to the mother-infant relationship . The number of infants enrolled was 128 ( 66 who received intervention ) and 149 ( 70 intervention ) at 6 and 12 months , respectively . Psychologists who were unaware of iron status and intervention assignment assessed infants ' cognitive , motor , and social-emotional development ( Bayley Scales ) at the beginning , midpoint , and end of the year ; 116 6-month-olds and 134 12-month-olds had at least 2 assessment s. Hierarchical linear modeling was used to analyze change over time . RESULTS : Infants with IDA , regardless of enrollment age , were rated as less positive in social-emotional behavior at baseline . There were significant interactions between iron status and intervention associated with change in cognitive performance and positive social-emotional behavior . Infants with IDA who received intervention had developmental trajectories comparable to those of nonanemic infants in the intervention and surveillance groups , but these infants did not catch up in social-emotional behavior . Infants with IDA who received surveillance showed less increase in cognitive scores and had declines in positive social-emotional ratings . CONCLUSIONS : Home-based intervention to foster child development improved cognitive and social-emotional scores in infants with IDA , but social-emotional differences remained between infants with IDA and those without IDA
REVIEW ER 'S CONCLUSIONS There is no convincing evidence that iron treatment of young children with IDA has an effect on psychomotor development discernable within 5 - 11 days .
The effect of longer term treatment remains unclear but the data would be compatible with clinical ly significant benefit .
BACKGROUND Iron deficiency and iron deficiency anaemia ( IDA ) are common in young children .
It has been suggested that the lack of iron may have important effects on children 's psychomotor development and cognitive function .
OBJECTIVES To determine the effects of iron therapy on psychomotor development and cognitive function in iron deficient children less than 3 years of age .