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BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7501.1171 (Published 19 May 2005) Cite this as: BMJ 2005;330:1171
  1. Alison Tonks, associate editor (atonks@bmj.com)

    Educating mothers improves nutrition and growth in infants

    Malnutrition is probably responsible for half of all preventable infant deaths worldwide and causes anaemia and stunted growth in survivors. Educating poor communities about good nutrition can help, but local projects are often hard to sustain. Researchers from Peru got round the problem by recruiting government health centres to deliver practical, easy to understand, nutritional advice to new mothers in local shanty towns. They also introduced a system of accreditation to motivate staff.

    A cluster randomised trial of the new approach found that it worked. At 18 months, infants from the six areas with a nutritionally accredited health centre or community hospital were better fed and were 1 cm taller, 200 g heavier, and three times less likely to have stunted growth than infants from six control areas (8/171 (5%) v 26/165 (16%); odds ratio 3.04, 95% CI 1.21 to 7.64; figure). Most infants in both groups did not get an adequate daily intake of iron and zinc: at 9 months, 99% of controls and 93% of intervention infants were not getting enough iron, and 87% of controls and 77% of intervention infants were not getting enough zinc.

    Credit: LANCET

    These results show that government run health facilities can be effective educators, making a real and potentially lasting difference to infants living nearby.

    Lancet 2005 May 10; doi 10.1016/S0140-6736(05)66426-4

    Targeted screening fails children with high serum concentrations of lead

    Lead toxicity is still a big problem for American children. The US Centers for Disease Control and Prevention estimates that at least 2.2% of preschool children in the United States have serum concentrations of lead that exceed the defining threshold of 10 μg/dl. Despite the size of the problem, universal screening was abandoned in 1997 and replaced with targeted screening of vulnerable children, such as those living in poor or old housing. Even that is patchy and inadequate, according to a …

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