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Chmielewska, Anna
Publications (10 of 16) Show all publications
Svensson, L., Chmielewski, G., Czyżewska, E., Domellöf, M., Konarska, Z., Pieścik-Lech, M., . . . Chmielewska, A. (2024). Effect of low-dose iron supplementation on early development in breastfed infants: a randomized clinical trial. JAMA pediatrics
Open this publication in new window or tab >>Effect of low-dose iron supplementation on early development in breastfed infants: a randomized clinical trial
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2024 (English)In: JAMA pediatrics, ISSN 2168-6203, E-ISSN 2168-6211Article in journal (Refereed) Epub ahead of print
Abstract [en]

Importance: Breastfed infants are at risk of iron deficiency, which is associated with suboptimal development. There is a paucity of evidence on the effects of iron supplementation on child development, and current guidelines are divergent.

Objective: To assess whether daily iron supplementation, 1 mg/kg, between 4 and 9 months in exclusively or predominantly breastfed infants improves psychomotor development at 12 months.

Design, Setting, and Participants: This was a randomized, double-blind, placebo-controlled trial conducted between December 2015 and May 2020 with follow-up through May 2023 in an outpatient setting in Poland and Sweden. Participants were healthy singleton infants born at term with birth weight greater than 2500 g who were exclusively or predominantly breastfed (>50%) and did not have anemia (hemoglobin >10.5 g/dL) at age 4 months. Exclusion criteria included major illness, congenital anomaly, food allergy, and difficulty communicating with caregivers.

Interventions: Iron (micronized microencapsulated ferric pyrophosphate), 1 mg/kg, or placebo (maltodextrin) once daily from age 4 to 9 months.

Main Outcomes and Measures: The primary outcome was psychomotor development assessed by motor score of Bayley Scales of Infant and Toddler Development III at 12 months, adjusted for gestational age, sex, and maternal education. Secondary outcomes included cognitive and language scores at 12 months; motor, cognitive, and language scores at 24 and 36 months; iron deficiency (serum ferritin <12 ng/mL), and iron deficiency anemia (iron deficiency and hemoglobin <10.5 g/dL) at 12 months.

Results: Of 221 randomized infants (111 female), 200 (90%) were included in the intention-to-treat analysis (mean [SD] age, 12.4 [0.8] months). Iron supplementation (n = 104) compared to placebo (n = 96) had no effect on psychomotor development (mean difference [MD] for motor score, -1.07 points; 95% CI, -4.69 to 2.55), cognitive score (MD, -1.14; 95% CI, -4.26 to 1.99), or language score (MD, 0.75; 95% CI, -2.31 to 3.82) at 12 months. There were no significant differences at 24 and 36 months. The intervention did not reduce the risk for iron deficiency (relative risk [RR], 0.46; 95% CI, 0.16 to 1.30) or iron deficiency anemia (RR, 0.78; 95% CI, 0.05 to 12.46) at 12 months.

Conclusion and Relevance: No benefit was found with daily low-dose iron supplementation between 4 and 9 months with respect to psychomotor development, risk of iron deficiency, or iron deficiency anemia among breastfed infants in a setting of low risk of anemia.

Place, publisher, year, edition, pages
American Medical Association (AMA), 2024
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-224848 (URN)10.1001/jamapediatrics.2024.1095 (DOI)001225475300003 ()38739382 (PubMedID)2-s2.0-85193240641 (Scopus ID)
Funder
Region Västerbotten, RV-982798Swedish Research Council, 2019-01005Swedish Society of Medicine, SLS-959720
Available from: 2024-06-11 Created: 2024-06-11 Last updated: 2024-06-11
Seliga-Siwecka, J., Fiałkowska, J. & Chmielewska, A. (2023). Effect of targeted vs. standard fortification of breast milk on growth and development of preterm infants (≤32 weeks): results from an interrupted randomized controlled trial. Nutrients, 15(3)
Open this publication in new window or tab >>Effect of targeted vs. standard fortification of breast milk on growth and development of preterm infants (≤32 weeks): results from an interrupted randomized controlled trial
2023 (English)In: Nutrients, E-ISSN 2072-6643, Vol. 15, no 3Article in journal (Refereed) Published
Abstract [en]

Human milk is recommended for very low birth weight infants. Their nutritional needs are high, and the fortification of human milk is a standard procedure to optimize growth. Targeted fortification accounts for the variability in human milk composition. It has been a promising alternative to standard fixed-dose fortification, potentially improving short-term growth. In this trial, preterm infants (≤32 weeks of gestation) were randomized to receive human milk after standard fortification (HMF, Nutricia) or tailored fortification with modular components of proteins (Bebilon Bialko, Nutricia), carbohydrates (Polycal, Nutricia), and lipids (Calogen, Nutricia). The intervention started when preterms reached 80 mL/kg/day enteral feeds. Of the target number of 220 newborns, 39 were randomized. The trial was interrupted due to serious intolerance in five cases. There was no significant difference in velocity of weight gain during the supplementation period (primary outcome) in the tailored vs. standard fortification group: 27.01 ± 10.19 g/d vs. 25.84 ± 13.45 g/d, p = 0.0776. Length and head circumference were not significantly different between the groups. We found the feasibility of targeted fortification to be limited in neonatal intensive care unit practice. The trial was registered at clinicaltrials.gov NCT:03775785.

Place, publisher, year, edition, pages
MDPI, 2023
Keywords
breastmilk, fortification, macronutrients, neonatal intensive care unit, preterm infant, supplementation, targeted modification
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-205017 (URN)10.3390/nu15030619 (DOI)000930957100001 ()36771325 (PubMedID)2-s2.0-85147894716 (Scopus ID)
Available from: 2023-02-21 Created: 2023-02-21 Last updated: 2023-09-05Bibliographically approved
Bäckström, F., Chmielewska, A., Domellöf, M. & Berglund, S. K. (2023). Normal range and predictors of serum erythroferrone in infants. Pediatric Research, 94(3), 965-970
Open this publication in new window or tab >>Normal range and predictors of serum erythroferrone in infants
2023 (English)In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 94, no 3, p. 965-970Article in journal (Refereed) Published
Abstract [en]

Background: Erythroferrone (ERFE) has been identified as a hepcidin-regulating hormone synthetized by erythroblasts correlating to the erythropoietic activity and the needs for iron substrate in bone marrow of adults. The present study aimed to assess the ERFE serum concentrations and its predictors in infants.

Methods: ERFE was explored at 4 time points during the first year of life in 45 healthy, breastfed, normal birth weight (NBW) infants, and 136 marginally low birth weight infants (LBW, 2000–2500 g) receiving iron (N = 58) or placebo (N = 78) between 6 weeks and 6 months of age.

Results: ERFE concentrations were low at birth, increasing gradually during the first year of life. In NBW infants, reference ranges (5th to 95th percentile) were at 6 weeks <0.005–0.99 ng/mL and at 12 months <0.005–33.7 ng/mL. ERFE was higher in LBW infants at 6 weeks but lower at 12 months compared to NBW and minimally affected by iron supplementation among LBW infants. Correlations of ERFE with erythropoietic and iron status markers were weak and inconsistent.

Conclusions: The role of ERFE in the crosstalk of erythropoiesis and iron homeostasis remains unclear in infants and further studies on ERFE in infants and older children are warranted within the framework of the erythropoietin–ERFE–hepcidin axis.

Impact: Normal range of erythroferrone in healthy infants is described for the first time. Erythroferrone in infants lacks correlation to iron status and markers of erythropoiesis. The findings indicate differences in infant regulation of iron homeostasis as compared to adults. The findings point to a need to study infant erythropoiesis separately from its adult counterpart. The findings may have clinical impact on management strategies of iron-loading anemia in infancy.

Place, publisher, year, edition, pages
Springer Nature, 2023
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-208066 (URN)10.1038/s41390-023-02594-2 (DOI)000971029300001 ()37069224 (PubMedID)2-s2.0-85153106442 (Scopus ID)
Funder
Region VästerbottenSwedish Research Council, 2019-01005
Available from: 2023-05-29 Created: 2023-05-29 Last updated: 2023-11-13Bibliographically approved
Seliga-Siwecka, J. & Chmielewska, A. (2023). Preterm human milk analysis confirms that all examined components change within four weeks of life [Analiza mleka kobiecego matek wcześniaków wykazała zmianę w składzie wszystkich analizowanych składników odżywczych w pierwszych czterech tygodniach życia]. Pediatria i Medycyna Rodzinna, 19(4), 398-403
Open this publication in new window or tab >>Preterm human milk analysis confirms that all examined components change within four weeks of life [Analiza mleka kobiecego matek wcześniaków wykazała zmianę w składzie wszystkich analizowanych składników odżywczych w pierwszych czterech tygodniach życia]
2023 (English)In: Pediatria i Medycyna Rodzinna, ISSN 1734-1531, Vol. 19, no 4, p. 398-403Article in journal (Refereed) Published
Abstract [en]

Introduction and objective: Human milk contains all the nutrients and bioactive components required for the optimal growth and development of newborns. It is also an optimal source of nutrition in premature infants, however it does not fully meet their nutritional demands. Studies have shown that infants fed exclusively human milk have better enteral nutrition tolerance, lower risk of necrotising enterocolitis, and improved neurodevelopmental outcomes. The aim of the study was to analyse preterm content of human milk collected from women as part of a randomised controlled trial assessing tailored nutrition.

Materials and methods: We studied 726 samples from 39 mothers of premature infants during their first postnatal four weeks. Infants were assigned to standard or tailored enteral nutrition, but all mothers were asked to pool milk samples from full breast expression at each feed across a 24-hour period twice a week. Glucose, fat, protein, and energy levels were measured using the Miris Human Milk Analyser and compared to published values. We assessed the relationship between postnatal week and human milk content.

Results: Protein content decreased over time. Median protein at four weeks of postnatal age was 1.37 and 1.32 per 100 mL (tailored vs. standard group, respectively). Lipid content increased over time. Median lipid content at four weeks of postnatal age was 4.06 and 3.82 per 100 mL (tailored vs. standard group). Glucose remained stable. Energy content increased over time only in the tailored group. Median energy at four weeks of postnatal age was 73.35 per 100 mL.

Conclusions: Variations in human milk content exist between populations and should be considered when prescribing enteral nutrition in preterm infants.

Place, publisher, year, edition, pages
Medical Communications, 2023
Keywords
human milk, nutrition, preterm
National Category
Pediatrics Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-224125 (URN)10.15557/PiMR.2023.0061 (DOI)001198140600027 ()2-s2.0-85191369860 (Scopus ID)
Available from: 2024-05-14 Created: 2024-05-14 Last updated: 2024-05-14Bibliographically approved
Szajewska, H., Shamir, R., Chmielewska, A., Stróżyk, A., Zalewski, B. M., Auricchio, R., . . . Troncone, R. (2022). Early Feeding Practices and Celiac Disease Prevention: Protocol for an Updated and Revised Systematic Review and Meta-Analysis. Nutrients, 14(5), Article ID 1040.
Open this publication in new window or tab >>Early Feeding Practices and Celiac Disease Prevention: Protocol for an Updated and Revised Systematic Review and Meta-Analysis
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2022 (English)In: Nutrients, E-ISSN 2072-6643, Vol. 14, no 5, article id 1040Article, review/survey (Refereed) Published
Abstract [en]

Uncertainty remains in regard to when, how, and in what form gluten should be introduced into the diet, particularly of infants genetically predisposed to developing celiac disease (CD). MEDLINE (PubMed), EMBASE, and Cochrane Central Register of Controlled Trials databases will be searched from inception. Randomized controlled trials (RCTs) and observational studies (cohort, case-control, or cross-sectional studies) investigating the association between early feeding practices and the risk of CD and/or CD autoimmunity will be included. In prospective studies, participants will be infants regardless of the risk of developing CD. For retrospective studies, participants will be children or adults with CD or presenting with positive serology indicative of CD. Interventions will be gluten-containing products of any type. Exposures will be breastfeeding and/or the introduction of gluten-containing products of any type. In control groups, there will be no exposure, different degrees of exposure (partial vs. exclusive breastfeeding, different amounts of gluten, etc.), or a placebo. The primary outcome measure will be CD or CD autoimmunity (i.e., anti-transglutaminase or anti-endomysial antibodies). At least two reviewers will independently assess the risk of bias using a validated risk assessment tool depending on study design. Disagreements will be resolved by discussion to achieve a consensus with the involvement of one or more additional reviewers if required. If appropriate, data will be pooled. If not, a narrative synthesis will be performed. The findings will be submitted to a peer-reviewed journal.

Place, publisher, year, edition, pages
MDPI, 2022
Keywords
Breastfeeding, Celiac sprue, Children, Feeding, Infants, Nutrition
National Category
Nutrition and Dietetics Pediatrics
Identifiers
urn:nbn:se:umu:diva-193158 (URN)10.3390/nu14051040 (DOI)000770907500001 ()35268015 (PubMedID)2-s2.0-85125956936 (Scopus ID)
Available from: 2022-03-18 Created: 2022-03-18 Last updated: 2023-09-05Bibliographically approved
Szajewska, H., Shamir, R., Stróżyk, A., Chmielewska, A., Zalewski, B. M., Auricchio, R., . . . Troncone, R. (2022). Systematic review: early feeding practices and the risk of coeliac disease. A 2022 update and revision. Alimentary Pharmacology and Therapeutics, 57(1), 8-22
Open this publication in new window or tab >>Systematic review: early feeding practices and the risk of coeliac disease. A 2022 update and revision
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2022 (English)In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 57, no 1, p. 8-22Article, review/survey (Refereed) Published
Abstract [en]

Background: The effects of early feeding practices on the risk of coeliac disease (CD) remain debated.

Aims: To update evidence on these practices on the risk of CD and/or CD-related autoimmunity (CDA), defined as anti-transglutaminase or anti-endomysial antibody positivity.

Methods: We searched MEDLINE, EMBASE and the Cochrane Library to May 2022 for randomised controlled trials (RCTs) and observational studies.

Results: We included 36 publications (30 studies). In the population at genetic risk of developing CD (HLA DQ2/DQ8-positive), exclusive or any breastfeeding and longer breastfeeding duration did not reduce the risk of developing CD/CDA during childhood. While a meta-analysis of four case–control studies showed a decreased risk for CD when gluten was introduced during breastfeeding, this was not shown in RCTs and cohort studies. Age at gluten introduction was not associated with cumulative CD/CDA risk, although two RCTs suggested that earlier gluten introduction was associated with earlier CDA appearance. Evidence from six observational studies suggests that consumption of a higher amount of gluten at weaning and/or thereafter may increase CD risk. There is insufficient evidence to determine the amount of gluten associated with an increased CD/CDA risk. Regarding whether infant feeding practices modulate the risk conferred by different HLA genotypes results were inconsistent.

Conclusions: For the population at genetic risk of CD, breastfeeding and age at gluten introduction have no effect on its cumulative incidence during childhood. There is some evidence for an effect of the amount of gluten consumed at weaning and/or thereafter on CD/CDA risk.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
National Category
Pediatrics Gastroenterology and Hepatology
Identifiers
urn:nbn:se:umu:diva-201764 (URN)10.1111/apt.17290 (DOI)000888150500001 ()36411726 (PubMedID)2-s2.0-85143485531 (Scopus ID)
Funder
European Commission, FP6‐2005‐FOOD‐4B‐36383
Available from: 2022-12-19 Created: 2022-12-19 Last updated: 2022-12-19Bibliographically approved
Berglund, S. K., Chmielewska, A., Domellöf, M. & Andersson, O. (2021). Hepcidin is a relevant iron status indicator in infancy: results from a randomized trial of early vs. delayed cord clamping. Pediatric Research, 89(5), 1216-1221
Open this publication in new window or tab >>Hepcidin is a relevant iron status indicator in infancy: results from a randomized trial of early vs. delayed cord clamping
2021 (English)In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 89, no 5, p. 1216-1221Article in journal (Refereed) Published
Abstract [en]

Background: We aimed to evaluate whether serum hepcidin is a useful indicator of iron status in infants.

Methods: Term infants (n = 400) were randomized to delayed (≥180 s) or early (≤10 s) cord clamping (CC). Iron status was assessed at 4 and 12 months. In all cases with iron depletion or iron deficiency (ID) (as defined in “Methods”) (n = 30) and 97 randomly selected iron-replete infants, we analyzed hepcidin and explored its correlation to the intervention, iron status, and perinatal factors.

Results: Serum hepcidin concentrations were significantly lower in the early CC group at both time points and in ID infants at 4 months. Median (2.5th–97.5th percentile) hepcidin in non-ID infants in the delayed CC group (suggested reference) was 64.5 (10.9–142.1), 39.5 (3.5–157.7), and 32.9 (11.2–124.2) ng/mL in the cord blood and at 4 and 12 months, respectively. The value of 16 ng/mL was a threshold detecting all cases of iron depletion/ID at 4 months. No similar threshold for ID was observed at 12 months. The strongest predictor of hepcidin at both ages was ferritin.

Conclusions: Hepcidin is relevant as iron status indicator in early infancy and may be useful to detect ID. Levels <16 ng/mL at 4 months of age indicates ID.

Impact

  • Serum hepcidin is a relevant indicator of iron status in early infancy.
  • Normal reference in healthy infants is suggested in this study.
  • Serum hepcidin may be useful in clinical practice to detect iron deficiency.
Place, publisher, year, edition, pages
Nature Publishing Group, 2021
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-173622 (URN)10.1038/s41390-020-1045-9 (DOI)000545884400001 ()32610342 (PubMedID)2-s2.0-85087307303 (Scopus ID)
Funder
Swedish Research Council, 2019-01005Knut and Alice Wallenberg FoundationRegion Västerbotten
Available from: 2020-07-22 Created: 2020-07-22 Last updated: 2022-04-04Bibliographically approved
Seliga-Siwecka, J., Chmielewska, A. & Jasinska, K. (2020). Effect of targeted vs standard fortification of breast milk on growth and development of preterm infants (<= 32weeks): study protocol for a randomized controlled trial. Trials, 21(1), Article ID 946.
Open this publication in new window or tab >>Effect of targeted vs standard fortification of breast milk on growth and development of preterm infants (<= 32weeks): study protocol for a randomized controlled trial
2020 (English)In: Trials, E-ISSN 1745-6215, Vol. 21, no 1, article id 946Article in journal (Refereed) Published
Abstract [en]

Background: Human milk is recommended for all very low birth weight infants. Breastmilk is highly variable in nutrient content, failing to meet the nutritional demands of this group. Fortification of human milk is recommended to prevent extrauterine growth retardation and associated poor neurodevelopmental outcome. However, standard fortification with fixed dose multicomponent fortifier does not account for the variability in milk composition. Targeted fortification is a promising alternative and needs further investigation.

Methods: This randomized controlled trial will recruit preterm infants (≤ 32 weeks of gestation) within the first 7 days of life. After reaching 80 ml/kg/day of enteral feeding, patients will be randomized to receive standard fortification (HMF, Nutricia) or targeted fortification (modular components: Bebilon Bialka, Nutricia—protein; Polycal, Nutricia—carbohydrates; Calogen, Nutricia—lipids). The intervention will continue until 37 weeks of post-conception age or hospital discharge. Parents and outcome assessors will be blinded to the intervention. The primary outcome measure is velocity of weight, length, and head growth until 36 weeks post-conceptional age or discharge. Secondary outcomes include neurodevelopment at 12 months assessed with Bayley Scale of Development III, repeated at 36 months; body composition at discharge and at 4 months; and incidence of necrotizing enterocolitis, sepsis, retinopathy of prematurity, and bronchopulmonary dysplasia.

Discussion: Targeted fortification has previously been shown as doable in the neonatal intensive care unit context. If it shows to improve growth and neonatal outcome, choosing the targeted fortification as a first line nutritional approach in very low birth weight infants may become a recommendation.

Trial registration: ClinicalTrials.govNCT03775785, Registered on July 2019.

Place, publisher, year, edition, pages
BioMed Central, 2020
Keywords
Preterm, Very low birth weight, Enteral nutrition, Breast milk, Fortification, Growth
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-178309 (URN)10.1186/s13063-020-04841-x (DOI)000595712600009 ()33225961 (PubMedID)2-s2.0-85096432123 (Scopus ID)
Available from: 2021-01-11 Created: 2021-01-11 Last updated: 2024-01-17Bibliographically approved
Chmielewska, A., Farooqi, A., Domellöf, M. & Öhlund, I. (2020). Lean Tissue Deficit in Preterm Infants Persists up to 4 Months of Age: Results from a Swedish Longitudinal Study. Neonatology, 117(1), 80-87
Open this publication in new window or tab >>Lean Tissue Deficit in Preterm Infants Persists up to 4 Months of Age: Results from a Swedish Longitudinal Study
2020 (English)In: Neonatology, ISSN 1661-7800, E-ISSN 1661-7819, Vol. 117, no 1, p. 80-87Article in journal (Refereed) Published
Abstract [en]

Background: At term-equivalent age, infants born prematurely are shorter, lighter and have more adipose tissue compared to term counterparts. Little is known on whether the differences in body composition persist in later age. 

Methods: We prospectively recruited 33 preterm infants (<32 weeks gestational age, mean gestational age 28.1 weeks) and 69 term controls. Anthropometry and body composition (air displacement plethysmography) were monitored up to 4 months of age. Nutrient intakes from preterm infants were collected from clinical records. 

Results: At 4 months of age preterm infants were lighter and shorter than term controls (mean weight-for-age z-score: –0.73 vs. 0.06, p = 0.001; mean length-for-age z-score: –1.31 vs. 0.29, p < 0.0001). The significantly greater percentage of total body fat seen in preterm infants at term-equivalent age (20.2 vs. 11.7%, p < 0.0001) was no longer observed at 4 months. A deficit of fat-free mass persisted until 4 months of age (fat-free mass at term-equivalent age: 2.71 vs. 3.18 kg, p < 0.0001; at 4 months: 4.3 vs. 4.78 kg, p < 0.0001). The fat mass index and fat-free mass index (taking length into account) did not differ between the groups. Nutrition had little effect on body composition. Higher protein intake at week 2 was a negative predictor of fat-free mass at discharge. 

Conclusions: At 4 months corrected age, preterm infants were both lighter and shorter than term controls and the absolute fat-free mass deficit remained until this age. Little effect of nutrition on body composition was observed.

Place, publisher, year, edition, pages
S. Karger, 2020
Keywords
Preterm infants, Body composition, Adiposity, Lean tissue
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-170796 (URN)10.1159/000503292 (DOI)000528674000011 ()31822002 (PubMedID)2-s2.0-85076527775 (Scopus ID)
Funder
Västerbotten County CouncilSwedish Research Council, 2016-02095
Available from: 2020-05-27 Created: 2020-05-27 Last updated: 2023-03-23Bibliographically approved
Chmielewska, A., Dziechciarz, P., Gieruszczak-Białek, D., Horvath, A., Pieścik-Lech, M., Ruszczyński, M., . . . Szajewska, H. (2019). Effects of prenatal and/or postnatal supplementation with iron, PUFA or folic acid on neurodevelopment: update. British Journal of Nutrition, 122(s1), S10-S15
Open this publication in new window or tab >>Effects of prenatal and/or postnatal supplementation with iron, PUFA or folic acid on neurodevelopment: update
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2019 (English)In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 122, no s1, p. S10-S15Article in journal (Refereed) Published
Abstract [en]

Neurodevelopment has been linked, among other factors, to maternal and early infant diets. The objective of this review, which is part of the NUTRIMENTHE research project 'The effect of diet on the mental performance of children' (www.nutrimenthe.com), was to update current evidence on the effects of nutritional interventions such as iron, folic acid or n-3 long-chain polyunsaturated fatty acid (LCPUFA) supplementation during pregnancy and/or in early life on the mental performance and psychomotor development of children. In May 2014, we searched MEDLINE and The Cochrane Database of Systematic Reviews for relevant studies published since 2009. The limited updated evidence suggests that iron supplementation of infants may positively influence the psychomotor development of children, although it does not seem to alter their mental development or behaviour. The use of multivitamin-containing folic acid supplements during pregnancy did not benefit the mental performance of the offspring. Evidence from randomised controlled trials (RCT) did not show a clear and consistent benefit of n-3 LCPUFA supplementation during pregnancy and/or lactation on childhood cognitive and visual development. Caution is needed when interpreting current evidence, as many of the included trials had methodological limitations such as small sample sizes, high attrition rates, and no intention-to-treat analyses. Taken together, the evidence is still inconclusive. Large, high-quality RCT to assess the effects of supplementation with iron, LCPUFA or folic acid are still needed to further clarify the effects of these, and other nutrients, on neurodevelopment. Recent recommendations from scientific societies are briefly presented.

Keywords
Folic acid, Iron, Neurodevelopment, PUFA
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-170786 (URN)10.1017/S0007114514004243 (DOI)31638499 (PubMedID)
Available from: 2020-05-15 Created: 2020-05-15 Last updated: 2020-05-15Bibliographically approved
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