It is well known that a pregnant woman needs good nutrients, but in a developing country like Bangladesh it is common to find pregnant malnourished 'carrying' women.
Not much is known about the optimal timings for feeding an underweight or low BMI pregnant woman or about the effects of Multiple Micronutrients Supplement (MMS) interventions on postnatal child growth.
AdvertisementA study was undertaken in Bangladesh to evaluate the effect of prenatal food and multiple micronutrients intervention.
In the large, randomized trial, 4436 pregnant women and their children were studied for 6- 8 years. The women were given supplements either early (immediately after pregnancy) or later (during their own time of choice).
The nutrient supplement categories included-
• 30 mg Fe and 400 ug folic acid (Fe30F),
• 60 mg Fe and 400 ug folic acid (Fe60F) or
• MMS- along with 30mg iron and folate.
The Multiple Micronutrients Supplement (MMS) group received 15 different vitamins and minerals and contained various combinations of micronutrients. The women in the study were given food supplements in powder form consisting of roasted rice powder, roasted pulse powder, molasses and soybean oil. This was to be mixed with water to be consumed.
All the various combinations lead to the 6 food and micronutrient groups and the subjects were separated randomly into any one of the food and micronutrient group.
The study revealed that the children (especially boys) of women who received food intervention early on were less likely to be stunted during the first five years of their life. However, children born to women who received multiple micronutrients were more likely to be stunted in comparison to the standard iron- folate combination.
Why MMS intervention during prenatal period promoted stunting is unclear! Studies conducted in other part of the world suggested the contrary.
One of the reasons could be that the micronutrients interacted among themselves to produce adverse effects. The other reason could be that the dose was too small to benefit fetal development.
The WHO recommends iron and folate supplements to pregnant women. The present study did not discover any greater benefit on the fetus by the additional consumption of Multiple Micronutrients Supplement.
Reference: "Effects of prenatal food and micronutrient supplementation on child growth from birth to 54 months of age: a randomized trial in Bangladesh"Ashraful Isalm Khan et al; BMC Nutrition Journal 2011.
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