Iron and zinc supplementation promote motor development and exploratory behavior among Bangladeshi infants

Am J Clin Nutr. 2004 Oct;80(4):903-10. doi: 10.1093/ajcn/80.4.903.

Abstract

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.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Anemia, Iron-Deficiency / complications
  • Anemia, Iron-Deficiency / drug therapy
  • Anemia, Iron-Deficiency / epidemiology
  • Bangladesh
  • Child Development / drug effects*
  • Child Development / physiology
  • Dietary Supplements
  • Double-Blind Method
  • Drug Combinations
  • Drug Synergism
  • Exploratory Behavior / drug effects
  • Female
  • Growth / drug effects
  • Humans
  • Infant
  • Infant Behavior / drug effects*
  • Infant Behavior / physiology
  • Infant Nutrition Disorders* / complications
  • Infant Nutrition Disorders* / drug therapy
  • Infant Nutrition Disorders* / epidemiology
  • Iron, Dietary / administration & dosage*
  • Iron, Dietary / therapeutic use
  • Male
  • Micronutrients / administration & dosage*
  • Micronutrients / deficiency
  • Micronutrients / therapeutic use
  • Psychomotor Performance / drug effects
  • Riboflavin / administration & dosage
  • Riboflavin / therapeutic use
  • Rural Population
  • Zinc / administration & dosage*
  • Zinc / deficiency
  • Zinc / therapeutic use

Substances

  • Drug Combinations
  • Iron, Dietary
  • Micronutrients
  • Zinc
  • Riboflavin