0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

More Proof That Home Fortification Is of Value in Children With Iron Deficiency Anemia

Stanley Zlotkin, CM, MD, PhD, FRCPC
Arch Pediatr Adolesc Med. 2012;166(9):869-870. doi:10.1001/archpediatrics.2012.1514.
Text Size: A A A
Published online

Extract

Most trials examining the impact of micronutrient powders on anemia and iron status have been efficacy studies where variables were controlled and the interventions were closely supervised. A meta-analysis of efficacy trials demonstrated that Sprinkles, a micronutrient powder, were as effective as iron drops and had fewer adverse effects.1 In the prevention trials, the risk for anemia was cut in half.

The trial by Jack et al2 was somewhat unique in that it was designed as an effectiveness trial. Its goal was to determine whether Sprinkles could be successfully delivered to a free-living population of infants through an existing government health service in Cambodia. The trial compared nutrition education alone with the combination of nutrition education and micronutrient powder on nutritional outcomes including anemia status, zinc and vitamin A levels, and anthropometry in infants, starting at 6 months of age. The nutrition education was quite intensive and took the form of verbal and written instructions, pictures, and cooking demonstrations based on Cambodian foods and nutrition recommendations for infants at 6 months of age. All subjects were followed up monthly for 6 months. The results were quite conclusive and not surprising. Nutrition education alone, even when intensively communicated and clearly demonstrated, was inferior to the same nutrition education combined with micronutrient powders in terms of its impact on anemia status in infants between 6 and 11 months of age. When age-appropriate infant foods are fortified, in this case through home fortification with micronutrient powder containing iron, iron status and anemia rates were improved. This is not surprising because we know that human milk is not a good source of iron (20-40 μg/dL; to convert to micromoles per liter, multiply by 0.179), and we know that even if an infant is born at full term with a full endowment of stored iron, by 6 to 9 months of age, the iron will be incorporated into hemoglobin until stores are totally depleted, at which time anemia will become apparent.3 Multiple studies in developing and developed countries have demonstrated higher rates of iron depletion in longer vs shorter duration of exclusive breastfeeding.

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 3

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Jobs
brightcove.createExperiences();