Limited evidence suggested that iron supplementation produced a small improvement in cognitive development but had no effect on physical growth .
CONCLUSIONS : In 2 to 5 year olds , daily iron supplementation increases hemoglobin and ferritin .
There is a concerning lack of data on the effect of iron supplementation on clinical ly important outcomes including anemia , ID anemia , ID , and cognitive development .
BACKGROUND AND OBJECTIVES : Iron deficiency ( ID ) is the most common cause of anemia worldwide .
The prevalence is highest among preschool-aged children .
Iron is widely administered to children with or at risk for ID , but evidence of benefit among 2- to 5-year-old children has not been evaluated by systematic review .
We summarize the evidence for the benefit and safety of daily iron supplementation with regard to hematologic , growth , and cognitive parameters in 2 to 5 year olds .
Effects of routine prophylactic supplementation with iron and folic acid on admission to hospital and mortality in preschool children in a high malaria transmission setting: community-based, randomised, placebo-controlled trial
BACKGROUND Anaemia caused by iron deficiency is common in children younger than age 5 years in eastern Africa . However , there is concern that universal supplementation of children with iron and folic acid in areas of high malaria transmission might be harmful . METHODS We did a r and omised , placebo-controlled trial , of children aged 1 - 35 months and living in Pemba , Zanzibar . We assigned children to daily oral supplementation with : iron ( 12.5 mg ) and folic acid ( 50 mug ; n=7950 ) , iron , folic acid , and zinc ( n=8120 ) , or placebo ( n=8006 ) ; children aged 1 - 11 months received half the dose . Our primary endpoints were all-cause mortality and admission to hospital . Analyses were by intention to treat . This study is registered as an International St and ard R and omised Controlled Trial , number IS RCT N59549825 . FINDINGS The iron and folic acid-containing groups of the trial were stopped early on Aug 19 , 2003 , on the recommendation of the data and safety monitoring board . To this date , 24 076 children contributed a follow-up of 25,524 child-years . Those who received iron and folic acid with or without zinc were 12 % ( 95 % CI 2 - 23 , p=0.02 ) more likely to die or need treatment in hospital for an adverse event and 11 % ( 1 - 23 % , p=0.03 ) more likely to be admitted to hospital ; there were also 15 % ( -7 to 41 , p=0.19 ) more deaths in these groups . INTERPRETATION Routine supplementation with iron and folic acid in preschool children in a population with high rates of malaria can result in an increased risk of severe illness and death . In the presence of an active programme to detect and treat malaria and other infections , iron-deficient and anaemic children can benefit from supplementation . However , supplementation of those who are not iron deficient might be harmful . As such , current guidelines for universal supplementation with iron and folic acid should be revised
Limited evidence suggested that iron supplementation produced a small improvement in cognitive development but had no effect on physical growth .
CONCLUSIONS : In 2 to 5 year olds , daily iron supplementation increases hemoglobin and ferritin .
There is a concerning lack of data on the effect of iron supplementation on clinical ly important outcomes including anemia , ID anemia , ID , and cognitive development .
BACKGROUND AND OBJECTIVES : Iron deficiency ( ID ) is the most common cause of anemia worldwide .
The prevalence is highest among preschool-aged children .
Iron is widely administered to children with or at risk for ID , but evidence of benefit among 2- to 5-year-old children has not been evaluated by systematic review .
We summarize the evidence for the benefit and safety of daily iron supplementation with regard to hematologic , growth , and cognitive parameters in 2 to 5 year olds .