This guideline provides global, evidence-informed recommendations on daily iron supplementation in infants and children, as a public-health intervention for the prevention of anaemia and iron deficiency. It includes recommendations for iron
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supplementation in countries where malaria is prevalent.
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Guideline
Iron deficiency is one of the most common forms of nutritional deficiencies, particularly among vulnerable groups such as women, children and low-income populations. Iron deficiency often precedes anaemia, and anaemia during pregnancy is one of the strongest predictors of anaemia duri
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ng the postpartum period, beginning just after childbirth throughout the subsequent 6 weeks. The consequences of iron deficiency and anaemia during the postpartum period can be serious and have long-term health implications for the mother and her infant.
This guideline reviews the evidence on the safety and effectiveness of iron supplementation in postpartum women.
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Updated 17 April 2020
Improving care for women during pregnancy and around the time of childbirth to prevent and treat pre-eclampsia and eclampsia is a necessary step towards the achievement of the health targets of the Sustainable Development Goals (SDGs). Efforts to prevent and reduce morbidity a
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nd mortality due to these conditions can help address the profound inequities in maternal and perinatal health globally. To achieve this, healthcare providers, health managers, policy makers and other stakeholders need up-to-date and evidence-informed recommendations to guide clinical policies and practices.
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In where under-five mortality is high and vitamin A deficiency is a public health problem, two high-dose supplements of vitamin A per year, spaced four to six months apart, can strengthen children’s immune systems and improve their chances of survival.
During much of early childhood – from
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6 months to 5years of age – two high doses of vitamin A every year can prevent blindness and hearing loss, boost children’s immunity against diseases like measles and diarrhoea and provide critical protection against death. Like all forms of malnutrition, vitamin A deficiency is a marker of inequality. In countries where diets are lacking in vitamin A and infections and deaths are prevalent, supplementation programmes give vulnerable children a better chance to survive, develop and thrive.
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Vitamin D deficiency is thought to be common among pregnant women, particularly during the winter months, and has been found to be associated with an increased risk of pre-eclampsia, gestational diabetes mellitus, preterm birth, and other tissue-specific conditions.
This guideline is intended for
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a wide audience including policy-makers, their expert advisers, and technical and programme staff at organizations involved in the design, implementation and scaling-up of nutrition actions for public health.
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Evidence from a systematic review on antenatal zinc supplementation was evaluated as part of the World Health Organization (WHO) antenatal care (ANC) guideline development process in 2016, and the following recommendation on zinc
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supplementation was made: “Zinc supplementation for pregnant women is only recommended in the context of rigorous research.” The Guideline Development Group (GDG) made this recommendation because it felt that the evidence on the intervention was incomplete and that more research was necessary.
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The World Health Organization’s comprehensive antenatal care (ANC) guideline WHO recommendations on antenatal care for a positive pregnancy experience was first published in 2016 with the objective of improving the quality of routine health care that all women and adolescent girls receive during p
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regnancy. The overarching principle – to provide pregnant service users with a positive pregnancy experience – aims to encourage countries to expand their health-care agendas beyond survival, with a view to maximizing health, human rights and the potential of their populations. Recognizing that ANC provides a strategic platform for important health-care functions, including health promotion and disease prevention, 14 out of the 49 recommendations in the WHO 2016 ANC guideline relate to nutritional interventions in pregnancy.
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Vitamin A supplementation (VAS) programs targeted at children aged 6–59 months are implemented in many countries. By improving immune function, vitamin A (VA) reduces mortality associated with measles, diarrhea, and other illnesses. There is curre
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ntly a debate regarding the relevance of VAS, but amidst the debate, researchers acknowledge that the majority of nationally-representative data on VA status is outdated. To address this data gap and contribute to the debate, we examined data from 82 countries implementing VAS programs, identified other VA programs, and assessed the recentness of national VA deficiency (VAD) data.
Article published in: Nutrients, 2017, 9, 190
https://doi.org/10.3390/nu9030190
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This Topic Guide has been compiled to provide an overview of undernutrition in the context of development. The focus of the Guide is on undernutrition, defined as the outcome of insufficient (quantity and quality) of food intake (hunger) and repeated infectious diseases. Undernutrition includes bein
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g underweight for one’s age, too short for one’s age (stunted), underweight for one’s height (wasted), and deficient in vitamins and minerals (micronutrient malnutrition). This review does not focus on the other component of malnutrition, which is overnutrition
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This Technical Brief reviews current practice and evidence on nutrition-specific preventive approaches to MAM, providing practical guidance for implementers and programme managers, and highlighting gaps in evidence and guidance.