title: Effects of zinc and iron supplementation fail to improve motor and language milestone scores of infants and toddlers.
abstract: OBJECTIVE
  To assess the effects of zinc and iron-folic acid supplementation on motor and language milestones in Nepali children.
  
  
  METHODS
  Five hundred forty-four children 4 to 17 mo old residing in Ishwarpur, Nepal were randomized to receive placebo, iron-folic acid, zinc, or zinc plus iron-folic acid daily. Data were collected at baseline and at 3-mo intervals for 1 y. The main effects of zinc and iron folic-acid supplementation were estimated for motor and language milestones. Crude and adjusted mean cumulative changes in scores from visits 1 to 5 and adjusted rates of change were modeled.
  
  
  RESULTS
  Adjusted differences in motor milestone scores from visits 1 to 5 and rates of change were not significantly different for the zinc and non-zinc groups (adjusted β = -0.7, 95% confidence interval [CI] -1.4 to 0.01; adjusted β = -0.1, 95% CI -0.5 to 0.3, respectively). Motor milestones in children receiving and not receiving iron supplements were not significantly different (adjusted β = 0.1, 95% CI -0.7 to 0.8, from visits 1 to 5; adjusted β = 0.1, 95% CI -0.3 to 0.5, for rate of change). Children receiving zinc had a 0.8 lower mean crude change in language score from visits 1 to 5 compared with children not receiving zinc (95% CI -1.3 to -0.3), but the significance was lost after adjustment (adjusted β = -0.2, 95% CI -0.6 to 0.2, for visits 1 to 5; β = -0.1, 95% CI -0.3 to 0.2, for rate of change). No significant difference in motor or language milestone scores from iron supplementation was observed.
  
  
  CONCLUSIONS
  After 1 y, neither zinc nor iron-folic acid supplementation in Nepali children improved the attainment of motor or language milestones.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. psurkan@jhsph.edu
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Surkan
authors.forename: Emily H
authors.initials: EH
authors.lastname: Siegel
authors.forename: Shivani A
authors.initials: SA
authors.lastname: Patel
authors.forename: Joanne
authors.initials: J
authors.lastname: Katz
authors.forename: Subarna K
authors.initials: SK
authors.lastname: Khatry
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Stoltzfus
authors.forename: Steven C
authors.initials: SC
authors.lastname: Leclerq
authors.forename: James M
authors.initials: JM
authors.lastname: Tielsch
mesh_terms: D001921:Brain / Q000254:growth & development; D004032:Diet; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D019266:Iron, Dietary / Q000008:administration & dosage*; D007804:Language Development; D008297:Male; D009048:Motor Skills / Q000187:drug effects* / Q000502:physiology; D009390:Nepal; D010919:Placebos; D015032:Zinc / Q000008:administration & dosage*
chemical_list: D019266:Iron, Dietary; D010919:Placebos; D005492:Folic Acid; D015032:Zinc