Multiple Micronutrient Supplementation (MMS) Basics

What is MMS?

Multiple Micronutrient Supplements (MMS)

MMS is a daily nutritional supplement of vitamins and minerals for pregnant women.

It consists of 15 micronutrients, including iron and folic acid.

It is also called:

  • prenatal vitamins
  • prenatal multivitamins

Multiple micronutrients in MMS help the mother and baby

The earlier a woman begins taking MMS and consistently takes 1 each day, the greater the impact the multiple micronutrients may have on her health and the health of her child.

MMS helps:

  • Reduce anemia, night blindness, and other symptoms caused by vitamin and mineral deficiencies
  • Improve birth outcomes including proper weight
  • Decrease preterm births
  • Reduce stillbirths
  • Reduce risk of infants dying before 6 months of age
  • Support a healthy immune system
  • Promote physical and mental development in infants
  • Builds a strong foundation for your baby to grow and develop into a healthy child

MMS includes the following 15 micronutrients:

  • Vitamins B1, B3, and B6: Fetal brain and nervous system development
  • Vitamin E: Antioxidant, may help increase immunity and reduce stillbirth and prematurity
  • Vitamin D: Healthy bones, prevents rickets in infancy
  • Selenium: Supports iodine metabolism, antioxidant
  • Vitamin B2: Helps metabolism of folic acid and other B vitamins, nutrient absorption, and healthy eyes and skin
  • Zinc: Positive impact on birthweight
  • Vitamin A: Vitamin A increases iron metabolism and is important for visual health, immune function and fetal growth and development. 
  • Vitamin C: Helps with iron absorption
  • Iodine: Essential for fetal brain development
  • Vitamin B12: Important for normal cell division and nervous system developments
  • Copper: Tissue development of the infant in the first six months
  • Iron: Prevents anemia caused by iron deficiency, which is related to fatigue and weakness, increased perinatal morbidity and mortality, low birth weight, prematurity, and disrupted fetal brain development.
  • Folic Acid: Prevents birth defects early in pregnancy

MMS are easy to take

  • Take 1 (one) MMS pill/tablet a day, every day throughout pregnancy
  • A woman should begin taking MMS as soon as she knows she is pregnant
  • If there are MMS remaining in the bottle after birth, take the remaining tablets while breastfeeding
  • Do not take together with IFA
  • If a day is missed, continue taking 1 tablet a day after the missed day.  Do not take 2 pills/tablets the next day
  • Keep MMS out of reach of children
Side Effects

Minor Side Effects 

When taken as directed, some women experience:

  • Upset stomach
  • Constipation
  • Unusual or unpleasant taste in their mouth after taking MMS

Managing Side Effects 

food and water

Side effects are usually temporary and will go away as the body adjusts to the MMS.

Taking MMS at night and/or with food and water may help reduce side effects.

Pregnant women experiencing specific side-effects may be advised to do the following:

  • Headache – drink plenty of water and get plenty of sleep
  • Upset stomach and vomiting – take MMS with food or at night.
  • Constipation – eat an increased amount of foods containing fiber, such as fruits and vegetables, and increase consumption of water.

If side effects persist after the pregnant woman has tried the tips above, advise the pregnant woman to speak to her antenatal care specialist.

IFA or MMS, not both

Differences between MMS and IFA:

Similar to iron and folic acid (IFA) supplementation, MMS reduces the risk of maternal anemia. In addition, when compared to IFA supplementation, MMS also results in reduction in risk for:

  • low birth weight (LBW) infants
  • stillbirth
  • infant mortality at 6 months
  • infants being born small for their age
  • preterm birth
  • Do not offer MMS to a woman who is already taking IFA supplements.
  • Do not take both MMS and IFA.  This results in too much iron in the pregnant woman’s body.  Choose 1 or the other and take that throughout pregnancy.
  • Do not alternate MMS and IFA pills every day.  Take either 1 or the other throughout pregnancy.
Increasing Adherence

Ideas to encourage pregnant women to continue taking MMS throughout their pregnancy:

  • Discuss where to keep the MMS in her home.  Remind her to keep the MMS pills in a safe, cool, dry place as that will prevent the pills from turning color.
  • Ask the woman if she has any concerns about MMS or if there is a reason she might not take it. If so, help answer any questions and address her concerns.
  • Take MMS at the same time each day
  • Set an alarm or reminder to take MMS daily
  • Keep the bottle in a location where it is seen every day (out of reach of children)
  • Ask family or friends to help give reminders