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Knowledge Hub

The Knowledge Hub of the Healthy Mothers Healthy Babies Consortium brings together existing knowledge, guidance and tools and other useful resources related to women nutrition, maternal nutrition and evidence-based interventions targeting women, such as prenatal Multiple Micronutrient Supplementation (MMS).

The Knowledge Hub is a dynamic, publicly accessible repository. It will be expanded and further improved over time, and we ask your help in this. Please share any resources that you believe should be included in this Knowledge Hub, and send them to [email protected].

Knowledge Bytes

In an effort to make accurate information on multiple micronutrient supplementation (MMS) during pregnancy more accessible to a larger audience, a special series of short videos called ‘Knowledge Bytes’ are presented here. Each short video features a global expert who addresses and explains a specific question related to MMS such as the WHO recommendations on MMS in the context of COVID 19, the science behind MMS, UNIMMAP Open-Access Specification for MMS.

Watch this space for Knowledge Bytes in the coming weeks to learn more about MMS.

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  • Global
  • Research
  • Guidance document
Robert E. Black September 2021

Knowledge Byte 1: Scientific Evidence on MMS

This presentation provides an overview of the scientific evidence on multiple micronutrient supplements (MMS).

  • Global
  • Policy and policy development
  • Guidance document
WFP, UNICEF, GTM, Global Nutrition Cluster

Protecting Maternal Diets and Nutrition Services and Practices in the Context of COVID-19

 This brief provides interim programmatic guidance on actions to protect the diets and nutrition services and practices of pregnant women and breastfeeding mothers during the mitigation phase of the COVID-19 response. Disseminating this guidance and documenting emerging evidence and lessons learned will be key to implementing the most appropriate and effective responses in the face of this pandemic. 

  • South Asia
  • Research
  • Case study
Lucy Widasari

Preconception Studies in Indonesia

This is a comprehensive presentation on research studies on preconception care in Indonesia to improve maternal and newborn health with a special focus on the benefits of multiple micronutrient supplements (MMS) on maternal and newborn health outcomes compared to iron-folic acid (IFA).

  • Global
  • Advocacy
  • Guidance document
Micronutrient Forum April 2020

Multiple Micronutrient Supplementation-Webinar Slides

The presentation provides a brief introduction to multiple micronutrient supplementation (MMS), its efficacy, use during COVID-19, and global commitments to scale up MMS.

  • East and Southern Africa
  • Policy and policy development
  • Report
National Planning Commission (Malawi) and Copenhagen Consensus Center Larsen et al. August 2021

Cost benefit analysis of improving neonatal and maternal health outcomes in Malawi – Technical Report

This report presents cost-benefit analyses for two promising interventions within Malawi’s Ante-natal Care (ANC) system to improve maternal and newborn health. The first is BEmONC5, a compacted set of five specific interventions taken from within the conventional basic emergency obstetric and newborn care package and the second is multiple micronutrients supplementation (MMS). Additional interventions considered in the main analysis include the conventional 15-intervention package of basic emergency obstetric and newborn care (BEmONC) interventions and calcium supplementation in pregnancy, which were not found to be as cost-effective as the first two. According to this report, replacing the existing IFA supplements with MMS for pregnant women would lead to 1300 to 1600 averted stillbirths and neonatal deaths per year. Scaled up to full coverage across Malawi, this program would require an investment of MWK 1.5 – 2.5 billion (USD 2.0m – 3.4m) annually over the next 10 years.

 

  • Asia
  • Research
  • Scientific publication
British Medical Journal Zeng et al. August 2008

Impact of micronutrient supplementation during pregnancy on birth weight, duration of gestation, and perinatal mortality in rural western China: double blind cluster randomised controlled trial

In this study, villages in northwest China were randomized for all pregnant women to take either daily folic acid (control), iron with folic acid (IFA), or multiple micronutrient supplements (MMS) with a recommended allowance of 15 vitamins and minerals. Birth weight was 42 g higher in the MMS group compared with the folic acid group. IFA was associated with a significantly reduced risk of early preterm delivery. There was a significant increase in haemoglobin concentration in both IFA and MMS groups compared with folic acid alone. There were no significant differences for perinatal mortality, but IFA was associated with a significantly reduced early neonatal mortality by 54%.

  • South Asia
  • Research
  • Scientific publication
Journal of American Medical Association Persson et al. May 2012

Effects of Prenatal Micronutrient and Early Food Supplementation on Maternal Hemoglobin, Birth Weight, and Infant Mortality Among Children in Bangladesh – The MINIMat Randomized Trial

This study assessed the effects of prenatal multiple micronutrient supplementation (MMS) and an early invitation to food supplementation on maternal hemoglobin level, birth weight, and infant mortality in Bangladesh. Pregnant women were randomized into 6 groups; iron-folic acid (IFA) with 30 mg of iron and 400 μg of folic acid, IFA with 60 mg of iron and 400 μg of folic acid, or MMS containing a daily allowance of 15 micronutrients, including 30 mg of iron and 400 μg of folic acid, combined with food supplementation (608 kcal 6 days per week) either by early invitation (9 weeks’ gestation) or usual invitation (20 weeks’ gestation). The early invitation with MMS group had an infant mortality rate of 16.8 per 1000 live births vs 44.1 per 1000 live births for usual invitation with IFA with 60 mg of iron and 400 μg of folic acid. Early invitation with MMS group had an under 5-year mortality rate of 18 per 1000 live births compared to 54 per 1000 live births for usual invitation with IFA with 60 mg of iron and 400 μg of folic acid. Usual invitation with MMS group had the highest incidence of spontaneous abortions and the highest infant mortality rate. Results showed that among pregnant women in poor communities in Bangladesh, treatment with multiple micronutrients, including IFA combined with early food supplementation, vs a standard program that included treatment with iron and folic acid and usual food supplementation, resulted in decreased childhood mortality.

  • Latin America and the Caribbean
  • Research
  • Scientific publication
The American Journal of Clinical Nutrition Ramakrishnan et al. March 2003

Multiple micronutrient supplementation during pregnancy does not lead to greater infant birth size than does iron-only supplementation: a randomized controlled trial in a semirural community in Mexico

This study was a randomized, double-blind clinical trial in semirural Mexico to compare the effects of multiple micronutrient supplements (MMS) with those of iron supplements during pregnancy on birth size. Pregnant women received supplements, 6 days a week at home, as well as routine antenatal care, until delivery. Both supplements contained Iron but the MMS group also received 1–1.5 times the recommended dietary allowances of several micronutrients. Both groups did not differ significantly in terms of the birth size of newborns. The results suggest that MMS during pregnancy does not lead to greater infant birth size than does iron-only supplementation.

  • South Asia
  • Research
  • Scientific publication
Journal of American Medical Association West et al. December 2014

Effect of Maternal Multiple Micronutrient vs Iron–Folic Acid Supplementation on Infant Mortality and Adverse Birth Outcomes in Rural Bangladesh The JiVitA-3 Randomized Trial

This study assessed the effects of antenatal multiple micronutrients vs iron-folic acid (IFA) supplementation on 6-month infant mortality and adverse birth outcomes in Bangladesh. Women were provided supplements containing 15 micronutrients or IFA alone, taken daily from early pregnancy to 12 weeks postpartum. Results showed that antenatal multiple micronutrient supplements (MMS) compared with IFA supplementation did not reduce all-cause infant mortality to age 6 months but resulted in a non–statistically significant reduction in stillbirths and significant reductions in preterm births and low birth weight.

  • South Asia
  • Research
  • Scientific publication
Journal of American Medical Association Pediatrics Gutpa et al. January 2007

Multimicronutrient Supplementation for Undernourished Pregnant Women and the Birth Size of Their Offspring

This randomized, double-blind, placebo-controlled trial evaluated the effect of multimicronutrient supplementation (MMS) for undernourished pregnant women in Delhi, India, on the birth size of their offspring, the incidence of low-birth-weight (LBW) infants, and early neonatal morbidity. The intervention group received a multimicronutrient supplement (MMS) containing 29 vitamins and minerals once a day, from enrollment until delivery. The comparison group received a placebo for 52  days, with 85% compliance. All participants also received iron and folic acid (IFA) supplements. Infants in the micronutrient group were heavier by 98 g and measured 0.80 cm longer and 0.20 cm larger in midarm circumference compared with the placebo group. Incidence of low birth weight declined from 43.1% to 16.2% with multimicronutrient supplementation and that of early neonatal morbidity declined from 28.0% to 14.8%. Therefore, compared with IFA supplementation, MMS given to undernourished pregnant women may reduce the incidence of low birth weight and early neonatal morbidity.