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Neonatal zinc supplementation for prevention of mortality and morbidity in breastfed low birth weight infants: Systematic review of randomized controlled trials

  • Gulani, Anjana1
  • Bhatnagar, Shinjini2
  • Sachdev, H. P. S.1,
  • 1 B-16 Qutab Institutional Area, Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, Ansari Nagar, New Delhi, India , Ansari Nagar, New Delhi (India)
  • 2 All India Institute of Medical Sciences, Centre for Diarrheal Diseases Research and Nutrition, Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Ansari Nagar, New Delhi, India , Ansari Nagar, New Delhi (India)
Published Article
Indian Pediatrics
Publication Date
Feb 01, 2011
DOI: 10.1007/s13312-011-0043-8
Springer Nature


ObjectivesTo evaluate whether zinc supplements prevent mortality and morbidity in breastfed low birth weight infants.MethodsAll randomized or qausi-randomized trials with individual or cluster allocation and using concurrent controls were included. Study population included LBW infants irrespective of gestational status who were exclusively or predominantly breastfed at the initiation of intervention. Intervention comprised zinc salts given as tablets or syrups orally to provide at least 1 RDA of elemental zinc for at least a period of 14 days, introduced within one month of birth. Electronic databases were searched irrespective of language and publication status.FindingsThree trials from developing countries met the inclusion criteria. Limited data did not indicate a reduced risk of mortality (1 trial, RR=1.11; 95% CI 0.57 to 2.18 at one year), hospitalization rate (1 trial, odds ratio 1.10; 95% CI 0.87 to 1.39), acute respiratory infection (1 trial), or diarrhea (2 trials). However, the trial reporting on mortality was not adequately powered for evaluating this outcome. There was no evidence of an increase in weight (3 trials) or height (2 trials) at either 6 months or one year of age, or of an increased risk of vomiting following zinc supplementation. Serum zinc levels at the end of intervention were significantly higher in the supplemented group (2 trials).ConclusionsIn view of no convincing evidence of benefits from the limited data available, currently there is no justification for recommending routine zinc supplementation for breastfed LBW newborns in developing countries.

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