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close this book Community Nutrition Action for Child Survival
close this folder Part I - Community nutrition problems and interventions
close this folder Unit 4: Introducing weaning practices in the community
View the document Session 1: Changing weaning practices
View the document Session 2: Making improved meaning foods in the home
View the document Session 3: Weaning food practice
View the document Session 4: Case study: Village weaning food projects in Thailand
View the document Session 5: Weaning foods - Village production techniques

Session 2: Making improved meaning foods in the home

High quality weaning foods can be made from the foods found in most homes. Individual and group education activities in the community should include practical recipes and demonstrations of improved weaning foods made from locally available ingredients.

Purpose:

Using the Weaning Food Square, trainees will develop improved weaning mixes from foods available in their regions. They will discuss alternative methods for home preparation of weaning foods and answer a simple set of questions to predict acceptance of new weaning food recipes.

Time: 1 hour

Materials:

- Flipchart and marking pens

- Handout - "Making Improved Weaning Foods Using the Weaning Food Square"

- Handout - "Why Add Energy Supplements to Weaning Foods? "

- Large drawing of the Weaning Food Square - Samples or pictures of local foods

Steps:

1. Introduce the session topic. Emphasize the need to give families practical advice about improved weaning mixtures that can be made from foods found in the home, with little or no extra work.

2. Post a large drawing of the Weaning Food Square at the front of the room, and explain that it can be a useful tool for planning improved weaning recipes from foods in their regions.

3. Describe each section of the Weaning Food Square and the types of foods belonging in each one. Ask trainees to name the foods grown or sold in their regions that belong in each section of the square. Write the names of the foods mentioned, or attach pictures of the foods, to the correct section of the large Weaning Food Square.

4. Distribute the Handout - "Why Add Energy Supplements to Weaning Foods?" and discuss with trainees.

5. Distribute the Handout - "Making Improved Weaning Foods Using the Weaning Food Square." Divide trainees into work groups of 3-4 persons each. Each work group will develop at least three improved weaning foods by completing the steps on the handout.

6. Review the steps on the handout one at a time, allowing work groups 5-10 minutes to complete each step before proceeding to the next.

7. When you reach Step 3 - Preparing Ingredients, make the following points, There are three principal ways of preparing improved weaning foods:

- Using foods from the family's meal

- Adding one or more new ingredients to the traditional porridge or gruel fed to infants

- Combining ingredients that are not typically used for child feeding in a new recipe

Simple methods of preparation that are the same as those used in every day food preparation are most likely to be accepted.

Methods of preparation that reduce extra cooking time will also guarantee that a weaning food recipe is prepared often.

8. Concerning Step 4 - Calculating Amounts of Ingredients: Nutritionists familiar with the nutrient values of local foods should calculate average portion sizes for each commonly available ingredient. Trainees should be given portion sizes for raw and cooked foods in terms of volume (ml) and common household measures (i.e., tea cup, eating spoon), as in the upcoming Example. The basic goals for a weaning food serving for one child, for one meal are:

- 300-350 kilo calories;

- 5-6 grams of reference protein;

- 200-300 ml volume.

A table showing the approximate raw weights and proportions of staple and protein supplements to achieve these goals is provided as a trainer's reference on page I-4,9.

9. When work groups finish Steps 4 and 5, ask them to write their completed recipes on newsprint and to present them to the group.

10. Use page 6 of the handout, to give each of the recipes a score for predicted community acceptance. Discuss the advantages and disadvantages of specific recipes with the group.

Look for recipes that build on traditional methods of food preparation and those that require little extra time for preparation!

11. Ask work groups to select 1-2 of their recipes for demonstration. (In some cases, the trainer may want to choose recipes to assure that a variety of weaning mixes are made.) Work groups should plan their demonstrations, listing and, in some cases, collecting needed supplies and cooking utensils.

Go on to Session 3!

EXAMPLE

STANDARD PORTION SIZES FOR WEANING FOOD INGREDIENTS

Ingredients

Raw Volume

Cooked Volume

Staple

   

Rice

100 ml (1/2 tea cup)

200 ml (1 tea cup)

Maize

100 ml (1/2 tea cup)

300 ml (1 1/2 tea cup)

Protein Supplement

   

Legume

30 ml (2 tablespoons)

60 ml (5-6 table spoons, 1/4 cup)

Milk

180-200 ml (1 tea cup)

same

(whole, liquid)

   

Vegetable Supplement

   

Leafy green

-

20 ml (1-2 table green spoons)

Squash/Carrot

-

 

Energy Supplement

   

Oil, Fat

5-10 ml

same

 

(1-2 teaspoons)

 

Sugar

10-20 ml

 
 

(1 tablespoon)

 

 

A table of this type should be developed locally to be included on page 3 of the Handout - "Making Improved Weaning Foods Using the Weaning Food Square. "

TRAINER'S REFERENCE

Table 22. Calculated amounts of ingredients for Basic Mixes - using edible portions of raw foods

Staples (g)

Supplement (g)

Oats

Wheat

Rice

Sorghum, millet

Maize

Potato

Sweet Potato

Yam

Taro, Cocoyam

Banana

Plantain

Cassava,
Flour, gari

                         
 

75

80

65

75

55

320

125

165

150

105

85

40

Legume (g)

5

10

25

10

35

20

50

40

45

55

55

55

 

60

60

55

55

50

250

150

175

150

140

115

50

Soybeans (g)

10

15

20

15

25

20

25

20

20

25

30

30

 

65

65

65

60

60

280

175

190

180

165

150

60

Dried skimmed milk (g)

5

10

15

15

15

15

20

15

15

20

20

20

 

55

55

45

45

40

220

100

115

115

100

90

35

Dried whole milk (g)

10

15

25

20

25

20

30

30

25

30

30

30

 

65

65

65

65

65

300

180

210

195

185

160

70

Chick or lean meat (g)

10

20

25

25

35

25

35

35

30

40

45

45

 

65

70

70

70

70

310

210

240

220

210

180

75

Fresh fish (g)

15

30

30

25

20

25

35

35

40

40

45

50

 

65

65

65

60

65

300

180

220

190

190

150

60

Egg (g)

10

25

30

30

25

25

35

25

25

30

45

50

1. The basic mixes have been calculated to give the best possible protein value (i.e. amino-acid score). The least amount of protein food is used to supplement the staple to provide the basis of a meal for a child of about two years of age.

2 To each of these basic mixes 10 g of oil OR 5 g of oil and 10 g of sugar OR 20 g of sugar should be added.

3. Each mix then provides about 350 kcal (approximately one-third of the daily needs of a two-year-old child).

4. Each mix has the same protein value and provides the approximate equivalent of 5-6 g of reference protein.

5. The weights given for the staple and the supplement are for raw foods. See Chapter 15 for variations for the supplements.

6. The volumes of most of the basic mixes are between 200-300 ml when the water absorbed by the food is taken into account.

Cameron, M; and Hofvander, Y. Manual on Feeding Infants and Young Children, Oxford Press, 1983, p. 119.

HANDOUT

MAKING IMPROVED WEANING FOODS USING THE WEANING FOOD SQUARE

Breast milk

A

B

Energy Foods

Body-Building Foods

Cereal grains

Legumes

Tubers

Animal foods

Roots

 

C

D

Protective Foods

High-Energy

(Vitamins and Minerals)

Supplements

   

Vegetables

Fats

Fruits

Oils

 

Sugar

Breast milk is in the middle of the Food Square because it is a complete food until a child reaches 4-6 months of age.

By the time a growing child is six months old, he needs breast milk plus foods from each of the other parts of the Food Square every day.

Recipes for improved weaning foods can be made by combining at least one food from each part of the Food Square. Recipes should include:

An Energy Food: This is usually a cereal grain like rice, corn, wheat, sorghum, millet or oats. It can also be potato, cassava, yam, banana or plantains, and other starchy roots.

A Body-Building Food: All legumes and animal products such as meat, milk, fish, eggs, chicken, etc., are included in this box. Choose a low-cost food that can be found in most homes. This will usually include legumes, eggs and fish.

A Protective Food: These include all leafy green vegetables and fruits.

A High-Energy Supplement: All oil, fats, natural and processed sugars including honey.

Breast milk

A

B

Energy Foods

Body-Building Foods

C

D

Protective Foods

High-Energy

(Vitamins and Minerals)

Supplements

To make your own recipes for improved weaning foods, follow these steps:

Step 1. Classifying Local Foods: In each of the parts of the Weaning Food Square above, write the appropriate foods available in the homes of most families you work with. Use the description on the first page of this worksheet to decide in which part (A, B. C, D) the foods belong.

Step 2. Choosing Ingredients: Choose at least one food from each of the parts of the square. Practice making different combinations from the available foods by completing the exercise below:

Recipe 1

Recipe 2

A.

A.

B.

B.

C.

C.

D.

D.

Note: Unless animal foods are produced by the families or available at very low cost, they should be not included in your recipes. Always choose foods that most families grow or produce or those that you will help them produce as part of your project.

Step 3. Preparing Ingredients: On the worksheet that follows, describe how you will prepare the foods for each recipe. First, write the ingredients for your recipes in the spaces provided, then describe how they will be prepared and how much time it will take. (Page 5)

Preparation should be simple, involving as few steps as possible. It should not take too much time. Preparation of foods for children from six months to one year requires mashing and straining. For children 1-3 years, it may include chopping or mashing. Foods may be cooked together or cooked separately and then combined in the meal. The simplest and most successful recipes are usually those that use foods from the family meal, which are separated once cooked, and are prepared according to the ages of the children.

Step 4. Calculating Amounts of Ingredients: The amount of each food in a recipe depends on the number of children to be served, the ages of the children and whether you are using foods that are raw or cooked.

Use the following chart when figuring how much of each food to use in your recipe. These amounts are based on the needs of one child age 1-2 years, for one meal. For younger children use less of each ingredient, but make sure they are in the same proportions. For older children, add a little more of each.

Standard Portion Sizes for Weaning Food Ingredients*

* To be developed by local nutritionist prior to training.

 

Raw Volume

Cooked Volume

Staples

   

Protein Supplements

   

Vitamin/Mineral Supplements

   

Energy Supplements

   

Step 5. Meals for More Than One Child: Calculate how much of each ingredient will be required to prepare the recipe for several Children. Do this by writing the amount of cooked or raw ingredient you will use for one child, on the worksheet. Write this amount in local measurements, i.e., 1 handful, 1 1/2 tea cups, 1 eating spoon, etc. Multiply by the number of children the recipe will serve to find the total amount of each ingredient needed.

You have now developed several recipes for improved weaning foods using the foods available in most of the homes in your area. Once you learn the approximate amounts and types of foods to use, you will be able to develop improved weaning foods without the help of this guide.

REMEMBER:

Improved weaning foods include at least one food from each of the sections of the Weaning Food Square.

Successful recipes for improved weaning foods are simple and require little extra time.

Ingredients for improved weaning foods must be those available in every home.

WORKSHEET:

Recipe 1

Ingredients

Amount for
One Child

X

Number of Children

X

Amount Needed

A.

 

X

 

X

 

B.

 

X

 

X

 

C.

 

X

 

X

 

D.

 

X

 

X

 

 

Describe the preparation and cooking time and other ingredients.

 

 

Recipe 2

Ingredients

Amount for
One Child

X

Number of Children

X

Amount Needed

A.

 

X

 

X

 

B.

 

X

 

X

 

C.

 

X

 

X

 

D.

 

X

 

X

 

Describe the preparation and cooking time and other ingredients.

 

 

 

PREDICTING THE ACCEPTANCE OF A NEW WEANING FOOD

First, calculate the cost for four or five servings of the new weaning food $ __________.

Then answer the following questions for each new recipe:

 

Yes

No

- Is the cost of the weaning food reasonable when compared to the resources of poor families?

   

- Are all of the ingredients required available in most homes?

   

- Are the ingredients that are not available in most homes available at low cost in the community market?

   

- Is total preparation time 10 minutes or less? (If the weaning food is cooked with the family's food, mark yes.)

   

- Is the weaning food prepared the way that most foods are prepared or together with the family's food?

   

- Are all of the ingredients believed to be good for children?

   

- Does the weaning food taste and look like the food eaten in the community?

   

Give each recipe a score:

Each "No" receives 0 points. Each "Yes" receives 1 point. Now, add the total score.

TOTAL: __________.

A perfect score of 7 means that we can predict good acceptance of the new weaning food. Lower scores may mean that a recipe will need extra promotion to gain acceptance in the community.

A score of 5 or less, may mean that a recipe is not likely to gain the acceptance of the community.

If the cost of the new weaning food is too high, it will not be accepted by the community.

HANDOUT

WHY ADD HIGH-ENERGY SUPPLEMENTS TO WEANING FOODS?

A small child can only eat a small amount at one time: about one and a half cups of food by one year of age. In order to get maximal energy, a child must eat several small meals during the day, and those meals must include as much energy as possible.

Oils, fats and sugars contain large amounts of energy. For example, 1 tablespoon of oil contains the same amount of energy as 3 1/2 tablespoons of uncooked maize flour, or more than 7 tablespoons of cooked maize flour.

By adding a little oil, fat or sugar to a child's food we can increase the amount of energy without increasing the amount of food.

Adding oil also reduces the amount of food to be eaten because less water can be added to porridges and gruels when they are cooked. A little oil keeps porridge smooth, with less water.

The following examples show how energy supplements improve the nutrition quality of weaning foods.

EXAMPLE 1

1/2 cup maize flour (uncooked) + water = 235 energy units

1/2 cup maize flour (uncooked) + 1 teaspoon oil + water = 315 energy units

EXAMPLE 2

To get as much energy as he needs from one meal during the day, a child of one year must eat:

- more than 2 cups of porridge if it is made with only maize flour and water


More than 2 cups

- 1 1/2 cups of porridge if it is made with maize flour and a high-energy supplement


1 ½ cups

QUESTION: What will happen to a child who is fed porridge without a high-energy supplement?

ANSWER: Because the child can only eat about 1 - 1 ½ cups of porridge at one meal, if he is fed porridge without a high-energy supplement he will not get the energy he needs from three meals a day. He will become malnourished.

SOLUTION:

- Encourage the addition of high-energy supplements to all weaning foods.

- Encourage four to five small meals for children during the weaning period. Feed small children frequently with high energy weaning foods.

Note: A little bit of oil or sugar is enough! Be careful not to add too much. Mothers will tell you that too much oil can cause diarrhea in young children.