Effect of Zinc & Multiple Micronutrient Supplements on Growth in Tanzanian Children

Abstract

BackgroundPoor child growth increases the risk of mortality and impaired development.ObjectiveTo determine the effect of daily zinc and/or multivitamin (vitamins B, C & E) supplements on the growth of infants in Tanzania.MethodsIn this randomized, 2x2 factorial, double blind clinical trial, 2400 infants were randomized to zinc (Zn), multivitamins (MV), both supplements (Zn + MV), or placebo (P) at age 6 weeks and followed for 18 months.ResultsAt 19 months of age, 20%, 6% and 11% of children were stunted, wasted and underweight respectively. Median compliance was 96% of the allocated regimen. Mean change in weight‐for‐age z‐scores (WAZ) in the Zn + MV, Zn, MV and P groups were ‐0.36, ‐0.61, ‐0.52, ‐0.50 respectively (p for interaction <0.001). Mean change in weight‐for‐height (WHZ) in the four groups were ‐0.31, ‐0.57. ‐0.42, ‐0.35 (p for interaction <0.001). There was no significant effect of treatment on change in height‐for‐age (HAZ), nor on rates of stunting, wasting or underweight.ConclusionDespite the small effect on mean change in WAZ & WHZ, daily provision of MV and/or Zn supplements to Tanzanian infants beginning in early infancy did not reduce rates of underweight, stunting or wasting over 18 months of follow‐up. Alternative approaches to prevent growth faltering in vulnerable populations should be pursued.