Impact of Home Fortification of Complementary Feeding with Vitamins and Minerals in Brazilian Infants: A Multi-center Pragmatic Trial

Abstract

Objectives: To assess the effectiveness of home fortification with vitamins and minerals for the prevention of anemia and iron deficiency in infants younger than 1 year of age: a multi-center Brazilian study. Methods: A pragmatic controlled trial in the primary healthcare. A total of 983 infants was recruited from Rio Branco, Olinda, Goiânia and Porto Alegre. At study baseline, a control group (CG) of infants 10 to 15 months of age (n= 521) was recruited in the routine healthcare. In parallel, an intervention group (IG) of infants 6 to 8 months of age (n= 462) was submitted to an intervention involving home fortification with multiple micronutrient powder (MNP) given once a day with semi-solid foods (fruit puree or salty meals) during 60 days. After 6 months of the intervention, hemoglobin and transferrin soluble receptor (TfR) were analyzed by comparing IG and CG, both comprising infants 10-15 months of age. Results: The intervention group had significantly higher hemoglobin and lower TfR concentrations than did the CG. Mean values (SD) of hemoglobin and median (IQ) of TfR were statistically different in IG when compared with CG: 120.4 (10.6) g/L and 28.74 (10.4; 52.1) mcg/dL versus 116.6 (13.4) g/L and 32.6 (12.3, 83.1) mcg/dL, respectively. The overall prevalence of anemia and iron deficiency was lower in IG (14.3% and 30.1%) when compared with CG (23.1% and 37.4%), respectively. Conclusions: Home fortification of complementary feeding in a routine primary healthcare was effective for reducing the prevalence of anemia and iron deficiency in our study population.