IRON SUPLEMENTATION IN HEALTHY INFANTS – WHICH EVIDENCE?

Introduction: Iron deficiency is the most prevalent nutritional deficiency worldwide, with potential repercussions on children’s growth and cognitive development. Exclusive breastfeeding provides iron needs in the first six months of term infant‘s life, with an appropriate birth weight, as long as the mother has enough reserves. After six months, a gradual depletion in iron supplies occurs. Aim: Assess the impact of daily oral iron supplementation on growth and cognitive development of healthy term infants. Methods:Research articles published between January 2000 and December 2015, in English or Portuguese, in the following databases: NGC, NHS British, CMA, Cochrane, DARE, Bandolier, Clinical Evidence, EBM and PubMed. MESH terms: iron, dietary supplements and infant. Inclusion criteria: healthy term infants aged less than 12 months, with appropriate birth weight and exclusive breastfeeding until 6 months; comparison between oral iron supplementation isolated vs placebo/normal eating; clinical outcomes – reduced morbimortality and evaluation of growth or cognitive development. Level of evidence (LE) and strength of recommendation (SOR) were based on Strength of Recommendation Taxonomy scale. Results:Ten articles were selected: 6 systematic reviews, 2 clinical trials and 2 original articles, all including a patient-oriented outcome (LE-1). Most of the findings suggest that oral iron supplementation in healthy term infants have no significant beneficial effects on children’s growth or cognitive development. Conclusion: There’s not sufficient evidence to recommend, preventively, daily iron supplementation in healthy term infants (SOR-B). More longitudinal and patient-oriented studies are needed, with a robust methodology and pursuing major clinical outcomes.