25 September 2025 – The Multiple Micronutrient Supplementation Technical Advisory Group (MMS TAG) has released a new technical brief on MMS for adolescents in low- and middle-income countries. MMS is beneficial and safe for women during pregnancy, and global guidance supports its use in women, including adolescent girls, who are pregnant or breastfeeding, particularly in humanitarian settings.
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For menstruating adult women and adolescent girls, the current guidelines recommend daily iron (30-60 mg) or weekly iron (60 mg) and folic acid (2.8 mg) supplementation (IFA) to prevent anemia in settings where anemia prevalence is high (> 40% or > 20%, respectively). Countries are seeking guidance about whether existing programs providing preventive iron or IFA to adolescent girls should transition to MMS instead. To help inform these decisions, the global MMS Technical Advisory Group (MMS TAG) assessed the evidence on the benefits and safety of MMS in adolescents: pregnant, menstruating girls, and boys and girls.
The MMS TAG’s recommendation is informed by the following points:
- Among adolescent girls who are pregnant, a solid body of evidence shows MMS (compared to IFA) results in improved birth outcomes, similar to what is observed in adult pregnant women, supporting its use in this vulnerable population.
- Among adolescent girls who are not pregnant, as well as adolescent boys, a few studies indicate that (UNIMMAP) MMS, compared to IFA, can improve adolescent micronutrient status and does not differ in its impact on reducing anemia, although results may vary according to doses, frequency, duration of supplementation, baseline anemia status, sex, and location. Further clinical and implementation research is needed before firm recommendations can be made, particularly comparing daily MMS with weekly IFA. Notably, providing weekly MMS would not fulfill the folic acid requirements of adolescent girls who might subsequently become pregnant.
Given the limited evidence on the benefits of MMS in non-pregnant and non-lactating adolescent girls and the limited global MMS supply, which should be reserved for pregnant women and adolescent girls in low- and middle-income countries (LMICs), currently the MMS TAG does not recommend universally transitioning from existing IFA to MMS programs in this population.