Combined iron and folic acid supplementation with or without zinc reduces time to walking unassisted among Zanzibari infants 5 to 11 months old

Combined iron and folic acid supplementation with or without zinc reduces time to walking unassisted among Zanzibari infants 5 to 11 months old

Iron and folic acid supplements help nutritionally at-risk children walk unassisted sooner.

Iron and zinc deficiencies have been associated with delayed motor development in nutritionally at-risk children, albeit inconsistently. In this community-based, randomised double-blind trial, iron and folic acid; zinc; a combination of iron, folic acid and zinc supplements; or a placebo were given daily for one year to 876 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 months at the start of supplementation. Treatment effects on changes in hemoglobin, zinc protoporphyrin, height-for-age and weight-for-age were evaluated using linear regression, and were measured at baseline and after six months of treatment. Attained motor milestone was recorded every two weeks for one year.

Iron and folic acid, with or without zinc, reduced the time it took for children to walk assisted. Children who received iron walked unassisted sooner than those who received no iron. This effect was stronger in those who had iron deficiency anemia at baseline. Iron and folic acid alone and zinc alone improved hemoglobin and zinc protoporphyrin scores compared with placebo. There were no significant treatment effects on changes in height-for-age and weight-for-age. 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.

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