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Black MM, Baqui AH, Zaman K, Persson LA, El Arifeen S, Le K, McNary SW, Parveen M, Hamadani JD, Black RE. 2004. Iron and zinc supplementation promote motor development and exploratory behavior among Bangladeshi infants. American Journal of Clinical Nutrition (AM J CLIN NUTR), 2004 Oct; 80, 903-10.
DATABASE
CINAHL
SEARCH TERMS
(((infants) and iron) and deficiency) AND infants)
STRUCTURED ABSTRACT
Study Design: Double blind randomised controlled trial
Setting: Bangladeshi
Participants: 221 infants from rural Bangladesh at risk of micronutrient deficiencies
Intervention: the infants were randomly assigned to 1 of 5 treatment conditions. One contained mixture of iron (20 mg). another contained mixtures of zinc (20 mg). the third contained a mxture of iron and zinc. The fourth group had a multivitamin which comprised 16 vitamins and minerals, including iron and zinc. Finally the control group had riboflavin (this was added to all the other mixtures to allow Double Blind Trial. They were give this weekly from 6 to 12 mo. Multivariate analyses were conducted which looked at development and behaviour for each supplementation group, There were controls in place also to account for variables
Outcomes: Weight was measured to 0.1 kg, length to 0.1 cm. Blood tests were obtained via the finger by paramedics for Hemoglobin levels. Motor, mental, and behavioral development were assessed with the Bayley II assessment tool. After the administration of the mental and motor scales, the psychologist completed the Behavior Rating Scale, this included 3 factors: orientation-engagement, emotional regulation, and motor quality. The quality and quantity of stimulation and support available to a child in the home were measured by using the HOME scale.
Follow-up period: assessment at 6 months and 12 months with the results compared with vitamin intake results
Main Results: when iron and zinc are administered with other micronutrients they had a beneficial effect on infant motor development. It was also noted that when iron and zinc were administered individually they had a beneficial effects on orientation-engagement, this was also the case when given in combination. Two-thirds of the infants tested were mildly anaemic, no treatment effects on hemoglobin concentration were observed, and hemoglobin was not associated with measures of development or behaviour.

CRITICAL ANALYSIS
Internal validity
Randomisation and allocation: Participants were chosen at random and a variety of vitamins were given to allow a broad scope of practice. These participants were recruited at 6mths and assessed until 12 months allowing the assessment of development over time
Similarity of groups: The group members are all from rural Bangladeshi region and have similar socioeconomically backgrounds. Most are