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ORIGINAL RESEARCH COMMUNICATION |
1 From the Department of Pediatrics, University of Maryland School of Medicine, Baltimore (MMB, KL, and SWM); the Johns Hopkins University Bloomberg School of Public Heath, Baltimore (AHB and REB); and ICDDR,B: Centre for Health and Population Research, Bangladesh (AHB, KZ, LAP, SEA, MP, and JDH).
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 randomly 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.
Key Words: Iron • zinc • micronutrient supplementation • infant development • functional isolation • Bangladesh
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