Maternal, Newborn, and Child Health
MNCH Nutrition Interventions
Maternal, Newborn, and Child Health
MNCH Nutrition InterventionsNutrition for Pregnant Women
Supporting Maternal Nutrition During Pregnancy and Lactation
Maternal nutrition plays a vital role in shaping the health of both the mother and the developing baby. Adequate nutrition during pregnancy and lactation supports fetal growth, reduces the risk of complications such as low birth weight, preterm birth, and maternal morbidity, and lays the groundwork for the child’s long-term health and development.
Despite its importance, poor maternal nutrition remains a major global health challenge. The WHO estimates that around 20 million infants are born with low birth weight each year, much of it linked to maternal undernutrition. Maternal anemia, primarily due to iron deficiency, affects nearly 40% of pregnant women worldwide, increasing the likelihood of maternal mortality and adverse birth outcomes. Undernutrition in mothers also perpetuates intergenerational cycles of poor health, contributing to childhood stunting and developmental delays.
WHO’s Recommendations on Antenatal Care for a Positive Pregnancy Experience and the 2020 Nutritional Interventions Update highlight the importance of dietary diversity, iron and folic acid (IFA) supplementation, and the use of multiple micronutrient supplements (MMS) to enhance pregnancy outcomes.
This section of the toolkit equips healthcare providers and local health leaders with the tools and guidance needed to deliver evidence-based nutrition interventions, helping to ensure that every pregnancy is a healthy one.
What Are the Benefits of Good Nutrition for Pregnant Women?
- Improves Maternal Health: Reduces anemia, gestational diabetes, and hypertensive disorders.
- Enhances Birth Outcomes: Lowers the risk of low birth weight and preterm birth.
- Supports Fetal Development: Ensures proper growth and reduces the risk of congenital anomalies.
- Strengthens Immune Systems: Reduces susceptibility to infections for both mother and baby.
- Promotes Long-Term Health: Improves cognitive development and reduces the risk of chronic diseases in children.
How to Implement
1. Assess Nutritional Status and Provide Counseling
- Conduct thorough nutritional assessments during antenatal care, including dietary recall, weight, height, and BMI measurements.
- Use lab tests to identify micronutrient deficiencies (e.g., iron, folic acid, Vitamin D).
- Provide personalized counseling based on the woman’s needs, cultural context, and food preferences.
- Educate women about consuming a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats.
- Monitor maternal weight gain using WHO-recommended guidelines.
2. Provide Micronutrient Supplementation
- Offer multiple micronutrient supplements (MMS) or iron (30–60 mg) and folic acid (400 mcg) daily to all pregnant women.
- Ensure consistent supply and access through health facilities or community-based distribution systems.
- Promote adherence by conducting regular follow-ups and reminders.
3. Promote Dietary Diversity and Food Security
- Encourage home gardening, small livestock rearing, and the use of local, nutritious foods.
- Address food insecurity by supporting local food systems, safety nets, and nutrition-sensitive agriculture.
- Emphasize the importance of culturally appropriate and locally available nutrient-rich foods.
4. Engage the Community and Raise Awareness
- Organize community education sessions involving family members and local leaders.
- Use multiple communication channels (e.g., posters, radio, community events) to share key nutrition messages.
- Establish support groups for pregnant and lactating women to encourage peer learning and support.
5. Integrate Nutrition with Health Services
- Embed maternal nutrition into antenatal care, postnatal care, immunization, and other MNCH services.
- Strengthen referral systems between community programs and healthcare facilities for better continuity of care.
6. Apply a Multisectoral Approach
- Collaborate with agriculture programs to boost access to nutrient-rich foods.
- Work with the education sector to integrate maternal nutrition into health education and school programs.
- Leverage social protection programs (e.g., food vouchers, cash transfers) to support food-insecure pregnant women.
- Promote WASH (Water, Sanitation, and Hygiene) practices to prevent infections linked to malnutrition.
- Partner with the private sector to improve the availability and affordability of fortified foods.
- Advocate for policies that support maternal nutrition, such as maternity leave, breastfeeding support, and financial aid.
What’s the Evidence?
- The Lancet Series on Maternal and Child Undernutrition: Multiple landmark series (2008, 2013, 2021) that established the evidence base for maternal nutrition interventions. The series identified the critical 1000-day window from conception to 24 months and demonstrated that maternal undernutrition contributes to 800,000 neonatal deaths annually.
- The Lancet Child & Adolescent Health: Comprehensive updates showing strengthened evidence for antenatal multiple micronutrient supplementation in reducing stillbirths, low birthweight, and small-for-gestational age births.
- Effectiveness of nutrition counseling for pregnant women in low‐ and middle‐income countries to improve maternal and infant behavioral, nutritional, and health outcomes: Nutrition counseling may improve some maternal and infant health and behavioral nutrition outcomes, but more high‐quality studies are needed
Key Indicators
- Proportion of pregnant women receiving multiple micronutrient supplementation or IFAS.
- Incidence of preterm birth and low birth weight.
- Proportion of pregnant women receiving appropriate nutrition counseling.
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Tips
- Personalize dietary recommendations based on individual needs.
- Encourage early initiation of prenatal nutrition interventions.
- Engage male partners and families in maternal nutrition education.
- Foster multi-sectoral collaboration with agriculture and food security programs, WASH, Education, and women’s economic empowerment programs.
- Use digital tools for tracking dietary intake and supplementation adherence.
Challenges
- Limited access to nutritious foods, especially in resource-constrained settings.
- Cultural beliefs and practices that may hinder healthy dietary choices.
- Inadequate healthcare infrastructure and human resources.
- Low levels of awareness and knowledge about maternal nutrition.
- Food insecurity and poverty.
- Lack of intersectoral collaboration.
- Resistance to adopt multiple multi-nutrient supplementation by health systems.
Key Resources
- Recommendations on antenatal care for a positive pregnancy experience. WHO 2016
- Antenatal care recommendations for a positive pregnancy experience: Nutritional interventions. WHO 2020
- New Evidence Should Inform WHO Guidelines on Multiple Micronutrient Supplementation in Pregnancy. The Journal of Nutrition 2019
- Effect of multiple micronutrient supplementation during pregnancy on maternal and birth outcomes. BMC Public Health 2011
- Nutrition: An Introduction Global Health eLearning
- Interim Country-level Decision-making Guidance for Introducing Multiple Micronutrient Supplementation for Pregnant Women. UNICEF
- FIGO nutrition checklist for pre-pregnant/ early pregnant women
