Milk and cereal products fortified with multi-micronutrients are effective in reducing anemia in children

July 23, 2012

According to a new systematic review, milk and cereal products fortified with iron and a combination of other micronutrients, such as vitamin A and zinc, are more likely to help reduce iron-deficiency anemia in children than foods fortified with iron alone.

To assess the impact of micronutrient-fortified milk and cereal products on the health of infants and small children (aged 6 months to 5 years) compared to non-fortified foods, the meta-analysis evaluated data from 18 randomized controlled trials including 5468 participants (1). The analysis showed that foods fortified with iron plus other micronutrients were more effective in improving hemoglobin levels in the blood than foods fortified with iron alone. Compared to non-fortified foods, iron plus multi-micronutrient fortification increased hemoglobin levels by 0.87 g/dl and reduced the risk of anemia by 57%. Foods fortified with iron plus multi-micronutrients also resulted in increased serum levels of vitamin A but not of zinc when compared with non-fortified foods. The evidence relating to functional health outcomes (e.g. weight gain) and morbidity was inconclusive.

The researchers concluded that multi-micronutrient-fortified milk and cereal products can be an effective way of reducing anemia in children up to three years of age in developing countries. However, a limitation of this is that fortified foods of this kind may not reach the poorest of the poor. Thus, a combination of different delivery channels, as well as affordable prices, may be needed for a successful approach.

Micronutrient deficiency is a common public health problem in developing countries, especially for infants and children in the first two years of life. As this is an important time window for child development, it is recom-mended that mothers give their children complementary foods such as micronutrient-fortified milk or cereal products from 6 months of age, in combination with continued breastfeeding. The overall effects of this approach are as yet unknown.


  1. Eichler K. et al. Effects of micronutrient fortified milk and cereal food for infants and children: a systematic review. BMC Public Health. 2012; 12:506.