Nutrient requirements of the premature infant and recommended nutrient intakes

In summary, the nutrient requirements of the premature infant are not well defined, but the CPS Nutrition Committee has provided a systemic framework for describing recommended nutrient intakes. These current recommended intakes appear to provide safe quantities of nutrients that support intrauterine growth rates. Still uncertain, however, is the extent to which the recommended intakes lead to the provision of energy and nutrients in quantity and composition in amounts that allow the premature infant to achieve all aspects of normal in utero development, especially that of the nervous system

Multi-micronutrient Sprinkles including a low dose of iron provided as microencapsulated ferrous fumarate improves haematologic indices in anaemic children: a randomized clinical trial.

Home-fortification of complementary foods with micronutrients (including iron) as Sprinkles is a new strategy to control iron deficiency and anaemia in developing countries. However, the most effective dose and form of iron is not known. The purpose of this study was to compare the efficacy of various doses (12.5, 20 or 30 mg) and treatment methods (multi-micronutrient Sprinkles vs. ferrous sulphate drops) on haemoglobin (Hb) concentration after 8 weeks of treatment in anaemic children. In total, 133 anaemic Ghanaian children (Hb 70-99 g L(-1)) aged 6-18 months were randomly assigned to one of five daily interventions for 8 weeks. Out of the five interventions, four used Sprinkles, and one used iron drops. Of the four Sprinkles groups, three included 12.5, 20 or 30 mg of iron as ferrous fumarate, and one included 20 mg of iron as ferric pyrophosphate. The iron drops group included 12.5 mg of iron as liquid ferrous sulphate. Hb concentrations were measured at baseline, week 3 and week 8. The primary outcome measure was Hb concentration at 8 weeks after treatment. We compared differences in Hb and ferritin concentrations and prevalence of iron deficiency anaemia (Hb 8.5 mg L(-1)) from baseline to 8 weeks within and between groups. Adherence and reporting of side effects (staining of the teeth, ease of use, diarrhoea and darkening of stools) were compared between groups. Mean change in Hb was 1.4 g L(-1) (SD = 1.8) (P = 0.0001). Change in Hb concentrations from baseline to 8 weeks was significant in all groups (P = 0.0001-0.0007), with no differences across groups. Geometric means of serum ferritin varied from 18.6 to 44.0 microg L(-1) at baseline. At week 8, these means were in the interval of 48.0-78.3 microg L(-1), with no group differences. Prevalence of iron deficiency anaemia decreased significantly from baseline to 8 weeks in all groups with the exception of the iron drops group, with no group differences. Adherence was lower in the drops group (64%) as compared with Sprinkles groups (84%). Greater staining of the teeth and less ease of use were reported in the drops group as compared with Sprinkles groups. A dose as low as 12.5 mg of iron as ferrous fumarate when provided as Sprinkles may be effective in anaemic children

DUAL FORTIFICATION OF SALT WITH IRON AND IODINE IN WOMEN AND CHILDREN IN RURAL GHANA

ABSTRACTObjective: To test the effi cacy of double-fortifi ed salt (DFS) on the anaemia and iodine defi ciency(ID) status of women and their children.Design: Double-blind randomised controlled trial.Setting: Sekyere West District of Ghana.Subjects: In this eight-month trial, mildly anaemic or non-anaemic, non-pregnant, non-lactatingwomen were randomised into three groups receiving: DFS plus weekly placebo (n = 61); iodisedsalt plus weekly 70 mg iron supplement (n = 65); or iodised salt (IS) plus weekly placebo (controlgroup, n = 58). Correspondingly, their mildly anaemic and non-anaemic children aged 1-5 years wererandomised into two groups receiving either the DFS (n = 23) or IS alone (control group, n = 59).Results: At the end of the intervention, prevalence of anaemia in women remained unchangedin the DFS or IS plus weekly iron supplement group, but signifi cantly increased by 19.5% inthe control group (P = 0.039). In children, prevalence of anaemia in the DFS group signifi cantlydecreased by 21.7% (P = 0.025) while no change was observed in the control group. ID decreasedsignifi cantly in all groups of women (P < 0.001) and children (P < 0.05), with no difference amonggroups of women and children.Conclusion: While the use of DFS prevented anaemia in women, it had a signifi cant role in boththe prevention and treatment of anaemia in children. Both the DFS and IS signifi cantly reducedID in women and children to a similar degree