Not much is known about the optimal timings for feeding an
underweight or low BMI pregnant woman or about the effects of Multiple
(MMS) interventions on postnatal child growth.
A 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).
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
different vitamins and minerals and contained various combinations of
micronutrients. The women in the study were given food supplements
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.
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
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.