Poor nutrition during pregnancy can have serious consequences for both maternal and child health. A new research collaboration – ‘Mother’s Micronutrient Supplement for Pregnancy and Lactation’ (MoMS) – between researchers in Kenya, Norway and Denmark aims to develop and test a new, improved dietary supplement to reduce incidences of low birth weight, improve maternal and child health, and enhance growth and cognitive development in children. MoMS is funded by the Bill & Melinda Gates Foundation and the Novo Nordisk Foundation with a total of DKK 68 million ($ 9.87 million / € 9.5 million).

Women’s nutrient needs increase during pregnancy. While nutrient intake from foods is preferred and is a long-term solution, in many low and middle-income countries, the available diet means that pregnant women are not getting enough nutrients. This can lead to low birth weight, poor maternal and child health and impaired cognitive development. Therefore, in 2020, the WHO recommended the use of MMS (Multiple Micronutrient Supplement) – a daily dose consisting of 15 essential vitamins and minerals. Many countries are today in the process of transitioning from using iron-folic acid alone to MMS as part of the standard for antenatal care.

New global health standards

Excitingly, emerging research suggests that the multiple micronutrient supplement could be further optimized. The reason may be that some of the essential nutrients are not included in the current version of MMS or the doses are on the lower end. Therefore, increased doses and the inclusion of other nutrients in a new and improved MMS version – MMS+ – has the potential to improve efficacy, which is the reason for the MoMS project, says project manager Dr Zipporah Bukania, Senior Principal Research Scientists at the Centre for Public Health Research, Kenya Medical Research Institute (KEMRI):

“Nutrient deficiencies during pregnancy can have serious consequences for both maternal and child health. That is why it is crucial that we improve the nutrition of pregnant women for the benefit of their fetuses and their children. This grant is a great recognition of that, and our goal is that the research will not only improve health in the participating areas, but also form the basis for new global health standards for pregnant women and their children,” says Dr. Zipporah Bukania.

Micronutrients with potential for positive effects

The Scandinavian part of MoMS is organized in collaboration with Associate Professor Benedikte Grenov at the Department of Nutrition, Exercise and Sports at the University of Copenhagen and Professor Tor A. Strand from the University of Bergen and Innlandet Hospital Trust. Both have worked for many years on child nutrition in low- and middle-income countries and its impact on children’s growth and development. They believe there is great potential in including more nutrients in MMS:

“Our goal is to develop a new product that includes the two nutrients docosahexaenoic acid (DHA) and choline and higher doses of vitamin B3, since we believe that this can have a positive effect on women, fetuses and children. Specifically, DHA and choline are thought to have a positive effect on children’s cognitive development. So if women and fetuses do not get the necessary nutrients during pregnancy, it can impact the child for life,” says Associate Professor Benedikte Grenov.

The main part of MoMS takes place in the western part of Kenya in Bungoma County. Here, there is a high degree of food insecurity with poor dietary diversity where the diet consists mainly of starchy foods, such as ‘ugali’, made from maize flour or from a mix of sorghum/millet with cassava flour and vegetables. Alternatives to ugali include tubers and roots such as sweet potatoes, while the population has a low intake of fish and animal protein.

A total of 3000 pregnant women will be recruited for the project. The women will be closely monitored throughout pregnancy and after birth, both mothers and children will be examined several times during the children’s first year of life.

Lasting change and improved health

For the Novo Nordisk Foundation, the ambition is also to create the basis for lasting change, says Senior Vice President Arne Astrup, Professor, MD:

 “We now know that malnutrition during pregnancy and the first years of life contributes to the development of a wide range of serious and chronic diseases such as cardiovascular disease and diabetes, and thus to the future prospects of an entire country. I therefore hope that with this project we can help improve local health facilities, train health workers, change health behavior and strengthen capacity both locally and with the government. We need to create structural, lasting change, both regionally and globally.”

MoMS started on 1 December 2024 and is expected to end on 31 December 2029.