| Community Nutrition Action for Child Survival |
|Part I - Community nutrition problems and interventions|
|Unit 4: Introducing weaning practices in the community|
Weaning practices are often the most important causes of malnutrition in children from six months to three years of age. Habits of child feeding are based on the quantity and quality of food available; on beliefs about what is and isn't good for young children; on time available for food preparation; and on custom. Recommendations for changes in weaning practices must be practical and they must be acceptable to the community.
In this session, participants analyze common weaning practices in their regions and develop strategies for changing the current practices that result in malnutrition of weaning-age children.
Time: 1 1/2 - 2 hours
- Flipchart and marking pens
- Handout - "Guidelines for Weaning"
- Handout - "Changing Weaning Practices"
To the Trainer:
Before this session, write a short description of the common weaning practices that are detrimental to the nutrition of weaning-age children. The problem statement can be written directly on the Handout - "Changing Weaning Practices,. or it can be copied and distributed separately. An example is provided on the handout.
1. Distribute the Handout - "Guidelines for Weaning" and review with the trainees.
2. Ask trainees to think of the common weaning practices in their areas by answering the following questions:
- At what age are the first foods other than breast milk given to children
- What foods are routinely given to children six months to two years old (daily)
- What foods are never given
- How many times a day are young children fed
- At what age do most women stop breastfeeding their children
3. Conduct a discussion of common weaning problems by asking trainees to compare the practices in their areas to the "Guidelines for Weaning. "
4. Ask trainees to explain why they think families follow the current weaning practices. Summarize their responses giving emphasis to the following points:
- Foods are sometimes not available
- Mothers (and fathers) do not have enough time to prepare food and feed young children
- Beliefs about foods for young children restrict the foods they are given to eat
- Customs or habits of feeding
- Lack of knowledge about food and nutrition
5. Divide trainees into small work groups (5 - 7 persons from the same region if possible). Distribute the Handout - "Changing Weaning Practice" to each trainee. In this activity, work groups will develop plans for improving weaning practices in a village. A problem statement describing the specific weaning behaviors that they have been asked to improve should be given to each group.
6. Tell work groups that their plans should describe what they will do and how they will do it. Plans should be:
- Practical or "doable" with the resources of most families
- Acceptable to the families
7. When work groups finish, ask each group to describe the changes in feeding practices they would recommend and their plan for helping families in the project area change these practices.
8. Point out similarities and differences in the plans. Make a list on the flipchart of the types of activities proposed by the work groups. Add other activities that might be appropriate.
9. Congratulate trainees on their efforts and remind them that every plan for change will be slightly different based on the experience, training and perceptions of the group members as well as the information they have about attitudes and practices in the community. As community project managers, we should be ready to change our plans as our information and experiences increase and as conditions change in the community.
Guidelines FOR WEANING
Weaning is the period when new foods are introduced to a child's diet while breastfeeding continues. The weaning period begins between four and six months and may continue until about three years of age.
1. Breastfeeding alone is normally sufficient until an infant is 4-6 months of age.
2. From 4-6 months, soft foods should be added gradually to the diet.
3. When foods are first introduced they should be mashed smoothly; by about nine months, foods can be finely chopped; by two years, most children can manage adult foods.
4. From six months to two years, a child should be fed four to six small meals each day in addition to breastfeeding.
5. After six months, an infant should be eating body-building, energy and protective foods plus breast milk every day.
6. Food for young children, once prepared, should never be stored without refrigeration for more than two hours.
7. The hands of both mother and child should be washed before handling food.
8. Use a clean cup and spoon for feeding young children never use feeding bottles!
Changing MEANING PRACTICES
1. Problem Statement
Example: 40 % of the children ages 1-3 years in our project area are suffering from malnutrition. Mothers breastfeed until their children are 2-3 years, but in most villages, other foods are not given regularly until children are 9-12 months old. Young children are fed a constant diet of maize porridge, banana, cassava and other starchy foods. Even though body-building foods like beans and eggs are produced by most families, they are rarely given to young children. Since it is customary to eat two meals a day, young children are fed in the morning and again in the evening when their parents finish work in the fields.
2. What changes in feeding practices would improve the nutrition of weaning-age children in this project area?
3. What actions could be taken to help families change their current weaning practices?