News article

Multiple micronutrient powders (MNP) to correct anaemia in young children

Posted:  Monday, June 27, 2016

Multiple micronutrient powder (MNP) supplementation likely to reduce childhood anaemia

Anaemia still continues to be a public health problem in the developing world. It is prevalent in children from developing countries such as Bangladesh, especially among infants in the age group of 6–23 months. In a study published in the journal BMC Nutrition, the relative efficacy of multiple micronutrient powder (MNP) supplementation in correcting anaemia among children under the age of 2 years was assessed for two months and four months . The study also examined the morbidities affecting these children and compared them with a similar group of children without MNP supplementation.

The observational study was based on the ongoing Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health (MAL-ED) in an urban slum in Bangladesh. Children aged 6–23 months were grouped according to the duration of MNP supplementation: two months (402 children) and four months (578 children). Blood samples were collected at enrolment and after 5 months of MNP supplementation. Haemoglobin (Hb) content was analysed using the direct cyanmethemoglobin method. Health workers recorded the morbidity episodes of the subjects by visiting of the homes of the subjects twice a week for 5 months.

The results showed that the prevalence of anaemia improved significantly at 2 months and 4 months of MNP supplementation. However, plasma Hb increased significantly only after 4 months’ supplementation; and there was 2.5% enhancement of the Hb level. The adherence to MNP supplementation for the 2-month and 4-month MNP groups was comparable.

Comorbidities such as diarrhoea, cough, and fever had comparable incidence in both groups during the supplementation periods. However, a significantly lower incidence was observed for acute lower respiratory tract infection (ALRI) in the 4-month supplementation group. In comparison to MAL-ED children without MNP supplementation within the age group of 6-11 months, there were greater incidences of diarrhoea and ALRI in the 2-month group and greater incidences of diarrhoea and cough in the 4-month group.

In conclusion, the daily allowance of MNP containing 12.5 mg iron, 5 mg zinc, 300 μg vitamin A, 150 μg folic acid, and 50 mg of vitamin C for six days a week till 4 months was more effective than 2 months supplementation in improving Hb status in children. Educating mothers and healthcare providers about opting for home fortification of complementary foods with MNP is a feasible strategy in combating childhood anaemia.

News Source: Mahfuz M, Alam MA, Islam MM, et al. Effect of micronutrient powder supplementation for two and four months on hemoglobin level of children 6–23 months old in a slum in Dhaka: a community based observational study. BMC Nutrition. 2016 Apr 12;2(1):1.