Iron supplementation in healthy children under two years of age

Abstract

Objective:To determine whether routine iron supplementation, in healthy children up to two years old, affects the psychomotor development, the anthropometry and morbimortality. Data sources: MEDLINE database and evidence-based medicine sites. Review methods: The authors searched evidence-based reviews, guidelines, meta-analysis, systematic reviews and randomized controlled trials, using the MeSH terms: Iron, Infant, Dietary Supplements. The search was limited to articles published between January 2000 and December 2009, in English, French, Spanish and Portuguese. The Strength of Recommendation Taxonomy of the Journal American Family Physician was used to assess the Level of Evidence. Results:We found a total of 163 studies, of which we selected nine. One guideline, two evidence based reviews, two meta-analysis, one systematic review and three clinical trials met the inclusion criteria. Among the studies reviewed, there was no influence on psychomotor development, anthropometry, morbimortality in healthy children without risk factors and supplemented with iron. In children with increased risk for iron deficiency anemia the iron supplementation has proved to be beneficial. Conclusions: There is currently no evidence of benefit for routine iron supplementation in children without risk factors up to two years old. Routine supplementation with iron for up to twelve months of age is recommended in children who have an increased risk of iron deficiency anaemia (Strength of Recommendation B - SOR B). Additional controlled, randomized and high quality studies about iron supplementation in healthy children are needed.