Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age

This Cochrane Review (updated February 2020) assessed the effects and safety of home (point-of-use) fortification of foods with multiple micronutrient powders (MNPs) on nutrition, health and developmental outcomes in children under two years of age. 

It includes 29 randomised controlled trials (33,147 children) in low- and middle-income countries, comparing MNP (formulated with at least iron, zinc and vitamin A), with placebo, no intervention, or use of iron-containing supplements (i.e. standard practice). 

The review authors found that, compared with no intervention or placebo, home fortification with MNP reduced the risk of anaemia by 18% (moderate-certainty evidence) and iron deficiency by 53% (high-certainty evidence); increased haemoglobin concentrations (low-certainty evidence) and iron status (moderate-certainty evidence) at follow-up; and had no effect on weight-for-age (moderate-certainty evidence). Compared with daily iron supplementation, MNP had similar results for anaemia (low-certainty evidence) and haemoglobin concentrations (very low-certainty evidence), but less diarrhoea (low-certainty evidence). Reporting of deaths was infrequent, but no trials reported deaths due to the intervention, and while few studies reported morbidity outcomes, MNP did not increase diarrhoea, upper respiratory infection, malaria or all-cause morbidity. 

Read the full, updated review on the Cochrane Library