Multiple micronutrient supplements can make pregnancy joyful for mother and child -Experts

Pregnancy and childbearing are key life events, and some studies have discussed the joy of the mother and the father before, during, and after childbirth.
Pregnancy is a potentially stressful period in a woman’s life, and women with unhappy pregnancies have been shown to engage in negative behaviors, such as tobacco and alcohol consumption that may be harmful to the mother and fetus.
Children born to unhappy mothers tend to experience poorer outcomes at birth, such as lower birth weight and preterm, and there are no ready factors for this menace but “hidden hunger.”
The term “hidden hunger” is used to describe vitamin and mineral deficiency. When someone’s habitual diet consists of foods that lack necessary levels of micronutrients, the resulting health impacts may not always be visible.
Micronutrient malnutrition has been associated with a wide range of physiological impairments, including metabolic disorders, reduced immune, endocrine, and cognitive function, and delayed or inadequate physical development.
Some micronutrient deficiencies may also be an underlying cause of chronic disease. Magnesium, for example, is present in a variety of foods, from greens to whole grains, yet it is under-consumed which indicates that low magnesium intake has been associated with a greater risk of several chronic diseases, including cardiovascular disease (CVD), type 2 diabetes, metabolic syndrome, depression, and impaired cognition.
According to Mr.Yadika Charles, a Nutrition officer at UNICEF, “Hidden hunger,” in simple language, is the presence of multiple micronutrient deficiencies, particularly iron, zinc, iodine, and vitamin A, which can occur without a deficit in energy intake as a result of consuming an energy-dense, but nutrient-poor diet.
Findings show that this menace affects more than two billion people worldwide, particularly in low- and middle-income countries where there is reliance on low-cost food staples, and the diversity of the diet is limited.

Finding a way to improve the nutritional quality of diets for the poorest people in an economy characterized by inflation and hardship like Nigeria should be the concern of every responsible government as enshrined in the UN sustainable development goals, particularly sustainable development goal 2: end hunger, achieve food security and improved nutrition and promote sustainable agriculture.
Investigation by Weekend Peoples Daily revealed that this hidden hunger has led to an average prevalence of anemia of 60% among children aged 6–59 months and pregnant women.
Mr.Yadika Charles, the Nutrition officer at UNICEF who spoke at a stakeholders meeting on the Scale-Up of Multiple Micronutrient Supplements(MMS) in Zaria recently, opined that poor nutrition during pregnancy carries many risks for both mother and child, hence Nigeria has approved a switchover to multiple micronutrient supplementation (MMS) to ease those dangers, and advocates say rapid implementation will save lives.
Corroborating this, Kaduna State State Commissioner of Health, Umma Kaltume Ahmed observed that Inadequate nutrition can lead to anemia in mothers and children.
She stressed that the government and the stakeholders are targeting every pregnant woman and child because every woman who is pregnant needs MMS.
According to her, Kaduna State has a 76.1% of anemia in Women and Children under 5. Pregnant Women, more than 56.1% of women have anemia; for men, it’s 22.1%, and for young girls, it is above 40% which shows that there’s a disproportionate value.
“Men who earn income have access to what they want to eat, but women who have to eat based on what is cooked in the house have the worst values.
“It indicates that there are gaps and our mission is to bring it down to zero if possible and to change the negative behavior, encouraging positive practices for their good health,” She said.
The Commissioner described the MMS as an administration that functions differently like a magic dose that gives all the needed nutrients to develop and strengthen the immune system and care for general health and even skin.
“We are hoping to get the supplement as soon as possible; the stakeholder’s engagement is to get everybody on Board; we have representatives from various Ministries, like Agriculture, health, and the rest. We have CSOs and planning officers.
Explaining what MMS is, Kaduna State Nutrition Officers (SNO) Mrs Ramatu Haruna said, “Antenatal Multiple Micronutrient Supplementation (MMS) for pregnant women has been proven to improve maternal nutrition status and, in comparison with iron and folic acid supplements (IFAS), and it further reduce the risk of adverse birth outcomes such as preterm birth, stillbirth, low birth weight, and small-for-gestational-age birth.”
Mrs Haruna disclosed that the State is working round the clock on the scale-up of the MMS for improved pregnancy outcomes in Kaduna state and educating stakeholders on multiple micronutrient supplementation and its importance.
She added that MMS is a more nutritional supplement that contain a combination of essential vitamins and mineral or minerals usually formulated to meet the specific nutritional needs of individuals, especially during pregnancy.
“Multiple micronutrient supplementations are designed to address multiple micronutrient deficiencies simultaneously, which are common in many populations, particularly in low and middle countries.
“The benefits of micronutrients especially in the reduction of maternal maternity. It prevents anemia and supports blood production. It also reduces the risk of neural tube defects in the developing fetus.
“Micronutrient supplementation is very important because it contains 13 to 15 vitamins that aid in prevention and improve maternal nutrients. It also helps women to meet their increased nutritional needs during pregnancy and breastfeeding.
“It also reduces birth complications and decreases the risk of preterm birth congenital abnormality. It supports the fetus’s development, that is, the unborn baby, and provides key nutrients that are important to the growth and development of the baby in the womb. Then it also addresses multiple deficiencies.
“Many women suffer from multiple micronutrient deficiencies and multiple Micronutrient supplements help in addressing this collectively rather than single nutrient supplementation.
“This shows that the MMS is far better than the single nutrient supplementation. MMS is often recommended for pregnant and breastfeeding women because of the increase in nutritional demands. It serves as a promoter as per maternal health programs to increase pregnancy outcome and reduce maternal and child mobility and maternity,” She said.
Authenticating this, the Kaduna State Team Lead for Alive & Thrive (A&T), Mrs. Sarah Kwasu, disclosed that half of all under-five mortality is caused by underlying maternal and child undernutrition, including micronutrient deficiencies.
The A&T State Team Lead observed that the high prevalence of anemia in women of reproductive age and pregnant women in Nigeria is widely recognized as an important public health problem because of its negative consequences for pregnancy outcomes and its impact on maternal mortality.
She explained that in addition to anemia, deficiencies such as vitamin A, zinc, vitamin B12, iodine, and folate are also widespread in Nigeria and harm pregnancy outcomes.
Mrs. Sarah Kwasu lamented that improvements in the natural diet and behavioral change are difficult to achieve over a short time for populations in resource-constrained countries.
She therefore, suggested that combining all micronutrients in a multi-supplement and delivering a multiple micronutrient supplement to women in targeted groups is more programmatically feasible and should be embraced.
“Over the past five decades, iron and folic acid (IFA) supplementation has become a core component of antenatal care for pregnant women around the globe.
“While iron and folic acid are critical nutrients, we now know that they are not the only nutrients that pregnant women may need to support their health and the health of their child.
“Compared to IFA supplementation, MMS better ensures that babies are born healthy, and it has the greatest benefits when taken by malnourished women.”
She tasked all stakeholders to brace up for the scaling of MMS in Kaduna State, saying her organization, A&T, has been at the forefront of educating Nutrition Focal Persons (NFPs) across the 23 LGAs of Kaduna State on Multiple Micronutrient Supplements (MMS) for pregnant women in the state.
“A&T is currently building the capacity of selected community volunteers (CVs) in the 23 LGAs on community mobilization and demand creation.”
Similarly, the Project Manager, of Accelerating Nutrition Results in Nigeria (ANRiN), Dr. Zainab Idris Kwaru said Pregnancy increases the daily requirement of several vitamins and minerals to meet the nutritional needs of the developing fetus and other metabolic functions.
Antenatal MMS, according to her, is designed to address these heightened demands, which are often not met through diet alone, noting that it is particularly useful for pregnant women in resource-poor settings where micronutrient intake is typically low due to poor dietary diversity, limited access to nutritious food, gender inequity, and prevalent social norms.
Dr. Zainab disclosed that the United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP) MMS is an internationally accepted and standardized formulation that contains 15 essential vitamins and minerals, including iron and folic acid, in recommended doses.
In 2021, UNIMMAP MMS was included in the World list of Essential medicine and the federal government has since followed suit.
She explained that, in comparison with iron and folic acid supplements (IFAS), further reduce the risk of adverse birth outcomes such as preterm birth, stillbirth, low birth weight, and small-for-gestational-age birth, Scaling up programs that deliver MMS to vulnerable mothers is now an urgent priority.
This requires efficient supply chain systems and building awareness of its health benefits among mothers, communities, and maternal healthcare providers.
A pregnant mother, Amina Shehu, from Ikara local government Area of Kaduna State, said she is seven months pregnant and struggled to eat a balanced diet.
According to her, “It does not come to my mind to add fruits and vegetables to my diet, as the prices of local foodstuffs have skyrocketed in recent times.”
She therefore, called on the government at all levels to Scaling up programs that deliver MMS to vulnerable mothers like her now to reduce the high rates of anaemia among pregnant women.
This requires efficient supply chain systems and building awareness of its health benefits among mothers, communities, and maternal healthcare providers.
Experts who spoke to Peoples Daily Weekend agreed that Multiple micronutrient supplementation is often recommended for pregnant and breastfeeding women because of the increase in nutritional demands it serves as a promoter as per maternal health programs to increase pregnancy outcomes and reduce maternal and child mobility and maternity.
Dr.Aisha Iman, who works in a private Hospital in Abuja, stressed that Anaemia in children is a major global public health concern, especially in developing countries, and it is one of the major causes of childhood mortality, and the MMS is a remedy that the government should embrace.
Pregnancy significantly increases the calories and micronutrients a woman’s body requires, explained Dr Francis Ohanyido, a physician and consultant to public health nonprofit Vitamin Angels in Nigeria.
Dr Iman fears that the rate of anemia and other diseases linked to deficiencies among pregnant women could rise amid food inflation, as women like Amina find it harder to access dietary sources of important micronutrients like vitamins A, C, D, E, B1 (thiamine), B2 (riboflavin), B3 (niacin), B6, B12 and folic acid, and minerals like iron, zinc, iodine, copper and selenium.
To tackle the risks of anemia in pregnant women and under-five children, Dr.Iman called for the rollout of Multiple Micronutrient Supplement (MMS), a tiny pill that packages 15 vitamins and minerals.
Antenatal MMS is designed to address these heightened demands, which are often not met through diet alone. It is particularly useful for pregnant women in resource-poor settings where micronutrient intake is typically low due to poor dietary diversity, limited access to nutritious food, gender inequity, and prevalent social norms.
Multiple micronutrient supplementation is often recommended for pregnant and breastfeeding women because of the increase in nutritional demands it serves as a promoter as per maternal health programs to increase pregnancy outcomes and reduce maternal and child mobility and maternity.
MMS is delivered in the form of a tablet, capsule, powder, or liquid that provides a combination of vitamins and minerals in the right amounts. It is often accompanied by nutrition education and counseling to help ensure daily consumption.
The nutrition officer at UNICEF, Yadika Charles, disclosed to this reporter that several states in Nigeria have taken up these national-level guidelines and have made a commitment to transition from IFAS to MMS.
“Plateau, Kwara, Katsina, Jigawa, Gombe, Adamawa, Borno, and Kaduna states have committed to roll out MMS. Six hundred million naira has been released by four states as part of the Match Child Nutrition Fund,” he revealed.
“It will cost Nigeria US$ 26.5 million to procure sufficient MMS to effectively tackle anemia in pregnant women and children aged under five, Charles said.
“To be realistic, we have targeted that 60% of pregnant women in Nigeria will have access to MMS in three years,” he said.
Reacting to this, Abimbola Adelaide, a pregnant woman in Kaduna North LGS, cried out that poor nutrition during pregnancy carries many risks for both mother and child.
Therefore government at all levels in the country should immediately implement a switchover to multiple micronutrient supplementation (MMS) to tackle these dangers as rapid implementation will save lives.