Ferrous sulfate plus folic acid for anemia in children
What it found
In children aged 6 to 24 months, ferrous sulfate plus folic acid reduced anemia more than ferrous sulfate alone.
The treatment also raised hemoglobin in children who were not anemic.
What they found
Studies in people
Anemia was common
At the start, 56.1% of the children were anemic. Most cases were mild, and none were severe.
Treating anemia
After treatment, anemia prevalence was 14% in the folic acid group and 34.9% in the placebo group. The authors say folic acid was a protective factor for reducing anemia.
Preventing anemia
In children who were not anemic at the start, the number of new anemia cases did not differ between the groups. But hemoglobin rose in those given folic acid.
Hemoglobin increase
Anemic children in both groups had a significant rise in hemoglobin. The rise was larger with folic acid but the difference between groups was not statistically significant.
Folic acid levels
In anemic children, folic acid levels went up significantly after supplementation with ferrous sulfate plus folic acid, but not with ferrous sulfate plus placebo.
What the authors conclude
“Iron plus folic acid was effective for the treatment of anemia and improvement of hemoglobin level in non-anemic children.”
Also in their conclusions
- They conclude that a supplementation program with ferrous sulfate and folic acid was effective in reducing anemia prevalence in children and improved hemoglobin levels in non-anemic children.
- They say such a program is easy to implement and does not require the mother to give the medication at home.
- They recommend that children need nutritional follow-up and monitoring of anemia, and that this type of program can be run at daycare centers or preschools.
How it was done
The authors wanted to assess how common anemia was in young children in daycare centers and how well ferrous sulfate with folic acid worked to treat and prevent it.
They studied 196 children aged 6 to 24 months in municipal daycare centers in Goiânia, Brazil. Anemic children received ferrous sulfate at 4.2mg/kg/day with either folic acid or a placebo, and non-anemic children received a lower dose of 1.4mg/kg/day, for about three months.
What it can’t tell you
- This was a randomised trial, so it can show cause and effect for the treatments tested. But it cannot show what would happen with different doses, other iron forms, or in other settings.
- The study lasted about three months, so it cannot show longer-term effects or whether anemia would return after the program stopped.
The paper
- Title
- Treatment and prevention of anemia with ferrous sulfate plus folic acid in children attending daycare centers in Goiânia, Goiás State, Brazil: a randomized controlled trial
- Type
- Randomised controlled trial
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Hadler MC, Sigulem DM, Alves Mde F, Torres VM (2008). Treatment and prevention of anemia with ferrous sulfate plus folic acid in children attending daycare centers in Goiânia, Goiás State, Brazil: a randomized controlled trial. Cadernos de saude publica. doi:10.1590/s0102-311x2008001400011Free full textPubMed 18670706DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error