Multiple micronutrient powders for point-of-use fortification of foods consumed by children 6–23 months of age
Infants and children are the groups that are most vulnerable to micronutrient deficiency, given the high vitamin and mineral intake they need to support their rapid growth and adequate development. Vitamin and mineral deficiencies, particularly of vitamin A, iron and zinc contribute significantly to morbidity and mortality in children under 5 years of age.
Interventions to prevent and/or treat micronutrient deficiencies exist, including promotion of breastfeeding, fortification of staple and complementary foods, and provision of supplements. However, implementation bottlenecks and barriers (including lack of adherence to dosing regimens, low acceptability, poor distribution channels, lack of availability of skilled health workers) may reduce the effectiveness and impact of these, and other interventions to address micronutrient deficiencies.
Multiple micronutrient powders have been developed as alternative way of providing micronutrients to populations where other interventions are difficult to implement. Multiple micronutrient powders are single-dose packets of vitamins and minerals in powder form that can be sprinkled onto any ready to eat semi-solid food consumed at home, school or any other point of use. The powders are used to increase the micronutrient content of a child's diet without changing their usual dietary habits.
Multiple micronutrient powders have been shown to reduce the risk of iron deficiency and anaemia in infants and young children, 6-23 months of age.
WHO recommendations
In populations where the prevalence of anaemia in children under 2 years of age or under 5 years of age is 20% or higher, point-of-use fortification of complementary foods* with iron-containing micronutrient powders in infants and young children aged 6–23 months is recommended, to improve iron status and reduce anaemia.
*According to the WHO publication, Complementary feeding: report of the global consultation, appropriate complementary feeding should start from the age of 6 months, with continued breast feeding up to 2 years or beyond. Further guidance on complementary feeding may assist the implementation of this guideline, including the WHO/PAHO publication, Guiding principles for complementary feeding of the breastfed child and the WHO publication, Guiding principles for feeding non-breastfed children 6–24 months of age.
Additional information, including a suggested scheme for use, can be found in the guidance summary, and in the guideline under 'WHO documents' below.
WHO documents
GRC-approved guidelines
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Use of multiple micronutrient powders for point-of-use fortification of foods consumed by infants and young children aged 6–23 months and children aged 2–12 years
Publication date: 2016
Other guidance documents
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Complementary feeding: report of the global consultation: Summary of guiding principles
Publication date: 2003 -
Guiding principles for complementary feeding of the breastfed child
Publication date: 2003 -
Guiding principles for feeding non-breastfed children 6-24 months of age
Publication date: 2005
Evidence
Systematic reviews used to develop the guidelines
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Home fortification of foods with multiple micronutrient powders for health and nutrition in children under 2 years of age
De-Regil LM, Suchdev PS, Vist GE, Walleser S, Peña-Rosas JP.
Cochrane Database of Systematic Reviews. 2011; Issue 9. Art. No.: CD008959.
(Update has been submitted for publication) - Summary of this review
- Podcast (Cochrane)
Related systematic reviews
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Effectiveness of Micronutrient Powders (MNP) in women and children
Salam RA, MacPhail C, Das JK, Bhutta ZA.
BMC Public Health. 2013;13 Suppl.3:S22.