e-Library of Evidence for Nutrition Actions (eLENA)


An online library of evidence-informed guidelines for nutrition interventions and single point of reference for the latest nutrition guidelines, recommendations and related information.

Alternate Text All interventions

Daily iron supplementation in children and adolescents 5–12 years of age

Intervention | Last updated: 9 August 2023


Approximately 300 million children globally had anaemia in 2011. The most common cause of anaemia is thought to be deficiency in iron, an essential nutrient for development and cell growth in the immune and neural systems, as well as in regulation of energy metabolism and exercise. Iron deficiency can result from inadequate intake or absorption of dietary iron, increased need during periods of growth, and blood loss from helminth* infection or menstruation in adolescent girls.

Iron deficiency anaemia in children has been linked to increased childhood morbidity and impaired cognitive development and school performance. Children between 5 and 12 years of age are at a critical stage of intellectual development, and optimization of their cognitive performance during this period could have life-long benefits.

Evidence has shown that daily iron supplementation in children 5–12 years of age is associated with a reduced risk of iron deficiency and anaemia.

* Helminths are a group of parasites commonly referred to as worms and include schistosomes and soil-transmitted helminths

WHO Recommendations


Daily iron supplementation is recommended as a public health intervention in school-age children aged 60 months (i.e. 5 years old) and older, living in settings where the prevalence of anaemia in infants and young children is 40% or higher, for preventing iron deficiency and anaemia.

Evidence


Systematic reviews used to develop the guidelines


Effects of daily iron supplementation in primary-school-aged children: systematic review and meta-analysis of randomized controlled trials

Low M, Farrell A, Biggs BA, Pasricha SR. CMAJ. 2013;185(17):E791-802.


Oral iron supplements for children in malaria-endemic areas

Neuberger A, Okebe J, Yahav D, Paul M. Cochrane Database of Systematic Reviews. 2016; Issue 2. Art. No.: CD006589.

Summary of this review Alternate Text

Related systematic reviews


Effect of iron supplementation on haemoglobin response in children: systematic review of randomised controlled trials

Gera T, Sachdev HPS, Nestel P, Sachdev SS. Journal of Pediatric Gastroenterology & Nutrition. 2007; 44:468–486.


Cost-effectiveness Learn More Alternate Text


Relevant cost-effectiveness analyses have not yet been identified.