How multiple micronutrient supplementation can help shape healthier futures for mothers and babies

Health & Nutrition 06/22/2020

5min read

By: Talking Nutrition Editors

  • With an increased need for nutrients to support both their own and their infant’s health and development, pregnant women are particularly vulnerable to micronutrient deficiencies. In low and middle-income countries, limited access to healthy, nutritious food can make it more difficult for expectant mothers to meet the recommended levels of vitamins and minerals through their diet alone.
  • New joint guidance on maternal nutrition in the context of COVID-19 by UNICEF, the World Food Programme (WFP), the Global Nutrition Cluster and the Global Technical Assistance Mechanism for Nutrition (GTAM) recommends introducing multiple micronutrient supplements (MMS) in settings with a high prevalence of nutritional deficiencies or where food supplies are significantly disrupted.
  • In a recent webinar run by Devex and sponsored by DSM, key partners from the public and private sector joined together to discuss the latest evidence showing the outcomes of MMS vs iron and folic acid supplements (IFAS). Here, we share how governments, non-governmental organizations (NGOs), donors and businesses can work together to accelerate the implementation of MMS interventions worldwide to improve maternal nutrition and protect the most vulnerable mothers and babies.

Malnutrition in mothers: what’s the risk?

A global health concern, hidden hunger is a form of malnutrition that often goes undetected and occurs when the body lacks the essential vitamins and minerals necessary to sustain overall health and/or development. With an increased need for nutrients to support both their own health and the infant’s development, pregnant women are particularly vulnerable to micronutrient deficiencies. For expectant mothers in low and middle-income countries, limited access to healthy, nutritious food often means that it is more difficult to meet the recommended levels of vitamins and minerals through their diet alone. The current COVID-19 pandemic is also likely to disrupt food systems in many parts of the world, making it even more difficult for some pregnant women to receive effective prenatal nutrition.

Poor nutrient intakes may affect their own and their babies’ short- and long-term health. The World Health Organization (WHO) guidelines currently recommend iron and folic acid supplements (IFAS).1 These guidelines, which were introduced in 2016, are scheduled to be updated in 2020. While iron and folic acid are important, they are not the only micronutrients considered essential for maternal health and early life development. Research suggests that multiple micronutrient supplements (MMS) achieve better birth outcomes, helping to shape healthier and brighter futures for mothers and children worldwide.2

<p>Related webinar</p>

Related webinar

Devex recently presented a webinar in partnership with DSM to drive the MMS agenda forward with the goal of improving prenatal nutrition worldwide. The panel discussion brought together key partners from the public and private sector to accelerate efforts to implement effective nutrition interventions at scale. Stakeholders from the Micronutrient Forum, Sight and Life (access Sight and Life’s new special report on MMS here), Vitamin Angels, Nutrition International and the Summit Institute of Development (SID) Indonesia explored the latest evidence showing the outcomes of MMS vs IFAS and how governments, NGOs, donors and businesses can work together to accelerate the implementation of MMS interventions worldwide to improve maternal nutrition and protect the most vulnerable mothers and babies.

What are the benefits of MMS?

MMS are specifically developed for pregnant women and in consideration of regional dietary preferences. These solutions can provide 15 or more essential, science-backed micronutrients — including iron, folic acid, zinc, calcium and vitamins A, C and D — that provide health benefits to mother and child. They are designed to be consumed daily in a single, convenient dose, making it easy for expectant mothers to incorporate MMS into their diet and lifestyle. Compared to IFAS alone, MMS can reduce preterm births by 4 to 8%, the number of infants born with a low birthweight (LBW) by 12%, the number of small for gestational age (SGA) newborn infants by 3 to 8%, the number of stillbirths by 5% and overall 6-month infant mortality by 7%.3,4,5,6 These figures highlight the potential positive impact of MMS on maternal and infant health, which, in turn, can decrease the burden malnutrition puts on healthcare systems in low and middle-income countries.7

Transitioning from IFAS to MMS is cost-effective, as studies in various countries, including India and Bangladesh, have demonstrated.8,9 To better support governments in assessing the benefits of MMS over IFAS, including health outcomes and returns on investment, Nutrition International developed the MMS Cost-Benefit Tool to support the decision making process and accelerate the implementation of these vital programs, with results now available for 32 countries.

The power of education

Once MMS interventions have been rolled out, education initiatives must follow to raise awareness about the benefits of MMS among not only pregnant women, but also healthcare workers — as they are likely to be the first point of contact for expectant mothers. It is important for governments to receive credible, science-led data on the topic and have access to the right tools to translate and disseminate the information. Behavioral change programs can also be introduced locally to provide expert guidance to women during pregnancy, increase adherence to MMS programs and support positive results.

Collaboration is key to success

MMS interventions, when implemented successfully and complemented by educational strategies, can improve prenatal nutrition to ensure maternal health and optimal physical and cognitive development of infants. This has the potential to empower women and allow children to perform better in school and later in life — ultimately, fuelling economic growth.

To effectively introduce MMS programs worldwide, the public and private sector must work together. Strong partnerships between governments, NGOs, donors and businesses can accelerate the implementation of MMS interventions at scale to protect the most nutritionally vulnerable women and babies and create a better and more sustainable future for all. The importance of collaboration will only continue to rise as the world adjust to a ‘new normal’, in light of the current COVID-19 pandemic. New joint guidance on maternal nutrition in the context of COVID-19 by UNICEF, the World Food Programme (WFP), the Global Nutrition Cluster and the Global Technical Assistance Mechanism for Nutrition (GTAM) recommends introducing MMS in settings with a high prevalence of nutritional deficiencies or where food supplies are significantly disrupted. Together, the public and private sector can strengthen micronutrient supply chains and fill gaps in maternal nutrition to create a healthier tomorrow and contribute to achieving zero hunger by 2030 (SDG 2).

A great example of such a partnership is the Healthy Mothers, Healthy Babies Accelerator by the Bill and Melinda Gates Foundation’s Goalkeepers initiative. Led by the Micronutrient Forum, it aims to dramatically advance the introduction of MMS programs through coordinated action over the next three years. The accelerator brings together nearly $50 million in financial and in-kind contribution and is predicted to reach 17.5 million pregnant women and their newborns globally, including Myanmar, Indonesia and Bangladesh. One of the Healthy Mothers, Healthy Babies Accelerator’s 10 partners from the private sector, academia and civil society, DSM is committed to increasing access to low-cost, high-quality MMS and accelerate the introduction of MMS programs in low and middle-income countries.

With decades of experience in maternal nutrition, DSM is well-positioned to provide the scientific insights, technical know-how and the nutritional solutions required to successfully implement MMS programs across the world. This will ensure pregnant women in low and middle-income countries can meet the recommended levels of micronutrients for optimal maternal nutrition and infant development.

For more information on multiple micronutrient supplements and how to implement effective MMS interventions, download our whitepaper or contact us on www.nutritionimprovement.com.

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Tags: SENIOR MANAGEMENTPREGNANCYNUTRITION IMPROVEMENTHEALTH & NUTRITIONTARGETED HEALTH SOLUTIONSDIETARY SUPPLEMENTS
References

[1] Cochrane, Vitamin and mineral supplements for women during pregnancy, https://www.cochrane.org/CD004905/PREG_vitamin-and-mineral-supplements-women-during-pregnancy,  accessed 6 February 2020. 

[2] Bill and Melinda Gates foundation, Goalkeepers, https://www.gatesfoundation.org/goalkeepers/accelerators/maternal-nutrition/, accessed 6 February 2020.

[3] B. A. Haider et al., ‘Multiple-micronutrient supplementation for women during pregnancy.’, Cochrane Database Syst Rev., no. 4, pg.  1465-1858, 2017.

[4] E.R. Smith et al., ‘Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality: a meta-analysis of individual patient data from 17 randomised trials in low-income and middle-income countries.’, The Lancet Global Health, vol. 5, no. 11, pg. 1090-1100, 2017.

[5] Cochrane, Vitamin and mineral supplements for women during pregnancy, https://www.cochrane.org/CD004905/PREG_vitamin-and-mineral-supplements-women-during-pregnancy,  accessed 6 February 2020.

[6] Bill and Melinda Gates foundation, Goalkeepers,  https://www.gatesfoundation.org/goalkeepers/accelerators/maternal-nutrition/, accessed 6 February 2020.

[7] C. R. Sudfeld et al., ‚New Evidence Should Inform WHO Guidelines on Multiple Micronutrient Supplementation  in Pregnancy’, The Journal of Nutrition, vol. 149, no. 3, pg. 359–361, 2019.

[8] B. Kashi et al., ‘Multiple Micronutrient Supplements Are More Cost-effective Than Iron and Folic Acid: Modeling  Results from 3 High-Burden Asian Countries.’, The Journal of Nutrition, vol. 149, no. 7, pg.  1222-1229.

[9] R. Engle-Stone et al., ‘Replacing Iron-Folic Acid With Multiple Micronutrient Supplements Among Pregnant Women in Bangladesh and Burkina Faso: Costs, Impacts, and Cost-Effectiveness’, Ann N Y Acad Sci, vol. 1444, no.1, pg. 35-51, 2019.

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