This combination tablet is indicated to improve the nutritional status of women throughout pregnancy. It is a micronutrient supplement and should not be used as a substitute for a balanced diet during pregnancy.

Multiple Micronutrient Supplements (MMS) is a nutritional supplement designed for use during pregnancy, based on the United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP) formulation in accordance with WHO specifications. It contains 15 essential micronutrients, including Iron and Folic Acid (IFA), in doses that closely match the recommended dietary allowances for pregnancy. This formulation is intended to meet the increased nutritional requirements of both the mother and the developing fetus during pregnancy, even when a balanced diet is available. It supports normal maternal physiological function and helps reduce the risk of preterm birth, low birth weight (LBW), and small-for-gestational-age (SGA) infants, as well as other long-term health consequences in children. It also helps prevent anemia, a condition caused by insufficient production of red blood cells. Micronutrient deficiency is a major risk factor for LBW.

Evidence shows that early use of MMS in pregnancy provides significant benefits for both mothers and infants, beyond iron-folic acid (IFA) supplementation alone. MMS has been shown to improve birth outcomes by reducing the risk of low birth weight by about 12%, small-for-gestational-age births by about 8%, and preterm births. The 2017 Lancet meta-analysis confirmed that MMS significantly reduces the risk of low birth weight, SGA births, preterm delivery, and neonatal mortality.

Objective

• To establish Multiple Micronutrient Supplements (MMS) as an effective intervention for reducing Low Birth Weight (LBW).
• To replace Iron and Folic Acid (IFA) supplementation with MMS in Bangladesh, thereby reducing the prevalence of LBW.

This is the first UNIMMAP-formulated and WHO-recommended Multiple Micronutrient Supplement (MMS) introduced in Bangladesh from LMIC settings, designed to meet the additional nutritional needs during pregnancy and reduce LBW prevalence.

Each film-coated tablet contains:

• Vitamin A (Retinyl Acetate): 800 mcg RAE
• Vitamin C (Ascorbic Acid): 70 mg
• Vitamin D (Cholecalciferol): 5 mcg (200 IU)
• Vitamin E (Vitamin E Acetate): 10 mg α-TE
• Vitamin B1 (Thiamine Mononitrate): 1.4 mg
• Vitamin B2 (Riboflavin): 1.4 mg
• Vitamin B3 (Niacinamide): 18 mg NE
• Vitamin B6 (Pyridoxine HCl): 1.9 mg
• Folic Acid: 680 mcg DFE (400 mcg)
• Vitamin B12 (Cyanocobalamin): 2.6 mcg
• Iron (Ferrous Fumarate): 30 mg
• Iodine (Potassium Iodide): 150 mcg
• Zinc (Zinc Gluconate): 15 mg
• Selenium (Sodium Selenite): 65 mcg
• Copper (Cupric Gluconate): 2 mg

Multiple Micronutrient Supplements (MMS) are based on the UNIMMAP formulation and contain 15 essential micronutrients required in small amounts for normal growth, development, and physiological function. During pregnancy, deficiencies of nutrients such as vitamin A, iron, iodine, and folate are common due to increased maternal and fetal demands. Such deficiencies can negatively affect maternal health, pregnancy outcomes, and newborn health. Evidence shows that MMS provides superior benefits compared to iron-folic acid alone, improving birth outcomes by reducing low birth weight, small-for-gestational-age births, and preterm delivery.

Take only one tablet daily starting as soon as possible after conception and continue to use 180 tablets for 6 months throughout the pregnancy or as directed by the physician. It is not recommended for children and adolescents.

No drug interactions have been reported with this product.

Not recommended for individuals with known hypersensitivity to any of the ingredients.

When taken at the recommended daily dose, it is generally safe and does not cause adverse health effects in almost all individuals.

This product is recommended for use only during pregnancy.

Accidental overdose of iron-containing products is a major cause of fatal poisoning in children under 6 years of age. In case of accidental overdose, immediately consult a doctor or go to the nearest hospital.

The tolerable upper intake levels of the ingredients are significantly higher than those in the UNIMMAP formulation, which is considered safe for almost all individuals in the general population. However, iron overdose may cause gastrointestinal side effects such as constipation, nausea, vomiting, diarrhea, abdominal pain, and loss of appetite, and requires medical consultation.

Keep out of the reach of children. Store between 15°C to 30°C. Protect from light and moisture.