Linkages, comp feeding recipe book

Transcription

Complementary Feeding Recipes for
Ethiopian Children 6-23 Months Old
A Practical Cooking and Feeding Guide
AUGUST 2006
Contains daily recipes for
Staple Group 1: maize/enset
Staple Group 2: teff/wheat/barley
Staple Group 3: maize/sorghum
Federal Democratic Republic
of Ethiopia
Ministry of Health
This publication is supported by
This publication was developed by LINKAGES: Breastfeeding, LAM, Related
Complementary Feeding, and Maternal Nutrition Program, and was made possible through
funding from the United States Agency for International Development (USAID) provided
to the Academy for Educational Development (AED) under the terms of Cooperative
Agreement No. HRN-A-00-97-00007-00. The opinions expressed herein are those of the
authors and do not necessarily reflect the views of the USAID or AED.
Table of Contents
Section I: Ethiopian Infant & Young Child Feeding Recommendations
A. Feeding infants 0-5 months old . . . . . . . . . . . . . . . . . . . . . . . . . . . .
B. Feeding children 6-23 months old . . . . . . . . . . . . . . . . . . . . . . . . . .
C. Responsive feeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section II: Complementary Feeding of Infants 6-11 months of age
A. Ethiopian Feeding Guidelines: infants 6-11 months . . . . . . . . . . .
B. Recipes for Three Staple Groups:
Group 1: maize and enset
Recipe 1: Bulla porridge enriched with milk, carrots and
oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 2: Maize porridge enriched with kidney beans,
tomato and oil/butter . . . . . . . . . . . . . . . . . . . . . . .
Recipe 3: Bulla porridge enriched with milk, tomato and
oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe4: Mashed potato enriched with kale, carrot milk and
oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 5: Bulla and pea porridge enriched with pumpkin and
oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 6: Maize porridge enriched with milk, tomato and
oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 7: Mashed beef heart with potato, carrot, kale, egg
and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 8: Enjera with shiro, onion and tomato . . . . . . . . . . . .
Group 2: teff, wheat and barley
Recipe 9: Teff porridge enriched with milk, carrot, tomato
and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 10: Wheat porridge enriched with milk, pumpkin
and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 11: Mashed potato porridge enriched with tomato,
milk and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 12: Barley porridge enriched with milk, pea/bean
flour, carrots and oil/butter . . . . . . . . . . . . . . . .
Recipe 13: Enjera with shiro, onion, carrot and tomato . . . .
Recipe 14: Enjera with meat, potato, kale and oil/butter. . . .
Group 3: maize and sorghum
Recipe 15: Sorghum porridge enriched with tomato, carrot,
milk and oil/butter . . . . . . . . . . . . . . . . . . . . . . . .
Page
2
3
4
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
Recipe 16: Maize porridge enriched with pumpkin, milk and
oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 17: Sorghum porridge enriched with Tomato, carrot
and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 18: Mashed potato enriched with carrot, milk and
oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 19: Sorghum porridge enriched with pea flour, kale
and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 20: Maize porridge enriched with pumpkin, tomato
and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 21: Potato porridge enriched with carrot, egg and
oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section III: Complementary Feeding of Children 12-23 months of age
A. Ethiopian Feeding Guidelines: children 12-23 months . . . . . . . . .
B. Recipes for Three Staple Groups:
Group 1: maize and enset
Recipe 22: Enjera with kale, potato, egg and oil/butter,
with milk to drink . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 23: Enjera with potato, carrot, kale and egg, with
milk to drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 24: Bulla porridge enriched with kale, milk and
oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 25: Enjera with meat and kale, with milk to drink. . .
Group 2: teff, wheat and barley
Recipe 26: Teff porridge enriched with pea flour, carrot
milk and oil/butter, with milk to drink . . . . . . . . .
Recipe 27: Barley porridge enriched with kale, egg, milk and
oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 28: Enjera with lentile and carrot sauce, with milk
to drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Group 3: maize and sorghum
Recipe 29: Sorghum porridge enriched with pea flour,
carrot and oil/butter, and milk to drink . . . . . . .
Recipe 30: Enjera with potato and carrots, with milk to
drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 31: Sorghum porridge enriched with kale, milk and
oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipe 32: Enjera with meat and kale sauce, with milk to
drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22
23
24
25
26
27
29
30
31
32
33
34
35
36
37
38
39
40
References
Annex 1: Key ‘Essential Nutrition Action’ Messages for Feeding Infants 0-5 months
Annex 2: Key ‘Essential Nutrition Action’ Messages for Feeding Children
6-23 months
Annex 3: Food Composition Table
Annex 4: Different types of cups used to measure quantities in different
localities
Acknowledgments
This book focuses on ‘how to’ adequately feed young children 6-23 months
and was adopted from materials originally developed by Ethiopian Health and
Nutrition Research Institute, all of which are listed in the reference
section. We are grateful to have had this valuable technical background on
which to develop this present document.
We would like to give special thanks to Dr. Victoria Quinn, Dr. Agnes B.
Guyon Dr.Hana NekaTebeb and Ms Mulu G/medhin for their encouragement
in the preparation and production of this book on how to feed children 6-23
months of age in Ethiopia. Special thanks are also given to Aster Mekonen
for her help in the LINKAGES/Ethiopia kitchen during the testing of the
recipes. Appreciation is also extended to other members of the LINKAGES
team and colleagues from other organizations, foremost the Federal
Ministry of Health, for their input and support.
LINKAGES/Ethiopia
August 2006
Introduction
Studies show that malnutrition is a significant health problem for infants
and young children in Ethiopia. Though poverty is the underlining cause of
malnutrition, inadequate food security, sup-optimal infant caring practice
and limited access to water and sanitation services are also important causes
of child malnutrition. Improved child care and infant feeding practices are
important interventions for reducing infant and young child malnutrition.
The purpose of this book is to provide service providers with information
necessary for counseling mothers and child caretakers on how to feed their
children 6-23 months, specifically on aspects of complementary feeding in
addition to continued breastfeeding. Complementary feeding means giving
other foods in addition to breast milk starting when an infant is 6 months
old since at this time breastmilk alone is not sufficient to meet a growing
infant’s nutritional needs.
Complementary foods are needed to fill the
calorie, protein and micronutrient gap between the total nutritional needs of
the child and the amount provided by breast milk.
The book contains simple nutritious complementary feeding recipes that can
be prepared from locally available foods for three major staple eating areas
of the country, including (1) maize/enset/teff, (2) wheat/barley, and (3)
sorghum/maize. The recipes have been developed to meet the changing
nutritional needs of children in two age groups, 6-11 months and 12-23
months, in terms of calories, consistency and thickness. It is assumed that
children are still receiving breast milk, thus the amounts and types of foods
have been determined to provide the additional nutrients needed from
complementary foods1. These amounts conform to the recommendations
contained in the internationally accepted Guiding Principles on the
Complementary Feeding of the Breastfed Child (PAHO 2002) as well as well
as take into account the adaptation of these principles by the Federal
Ministry of Health in Ethiopia (see Annex 2 for Ethiopia’s Essential
Nutrition Action Messages). Techniques for mothers and child caretakers
to more effectively feed children using a ‘responsive feeding approach’ are
also presented.
The recipes contained also assume that there will be about food losses during cooking.
Thus ingredient amounts have been adjusted upwards to account for expected losses and
provide the calories needed by a breastfed child from complementary foods, roughly 300
calories at 6-11 months of age and 550 calories at 12-23 months of age.
1
For all the recipes contained in this book, a commonly found measuring unit, a
70 ml ‘bunna’ coffee cup, was used. Using this type and size coffee cup
allows for standardization of recipes, nutrition messages and IEC tools.
Annex 4 shows some other cups occasionally used in certain localities in the
country. The equivalent number of 70 ml coffee cups is shown for each of
these other types of measuring cups so that appropriate conversions can be
made by service providers working in these localities of the country.
Section I
Ethiopian Infant & Young Child Feeding
Recommendations
0 to 23 months
1
A. Ethiopian Feeding Guidelines: birth to 6 months
1
B. Ethiopian Feeding Guidelines: 6 to 23 months
1
C. ENCOURAGING YOUR CHILD TO EAT
COMPLEMENTARY FOODS
“RESPONSIVE FEEDING”
Definition: Responsive feeding is a method a mother or child caretaker can
use to encourage the child to eat and to finish his/her meals.
Importance of responsive feeding:
When feeding him/herself, a child may not eat enough. He/she is easily
distracted. Therefore he/she needs help. When a child does not eat
enough, he/she will become malnourished.
•
•
•
•
•
Let the child eat from his/her own plate (caregiver
then knows how much the child is eating)
Sit down with the child and encourage him/her if
needed.
Offer food the child can take and hold; the young
child often wants to feed him/herself. Encourage him/her to, but make
sure most of the food goes into his/her mouth.
Mother/caregiver can use her fingers (after washing) to feed child.
Feed the child as soon as he/she starts to get
hungry.
• The child should eat in his/her usual setting.
• As much as possible, the child should eat with
the family in order to create an atmosphere
promoting his/her psycho-affective
development.
• Do not insist if the child does not want to eat.
• If the child refuses to eat, wait or put it off
until later.
• Play with the child while he/she eats.
• Make sure the child is not thirsty (but do not give
him/her too much drink before or during meals).
• Congratulate the child when he/she eats.
• Parents, family members (older children), child caretakers can
participate in active feeding.
1
Section II
Complementary Feeding
of Infants 6-11 months of age
The first part of this section presents a “field tool” for field workers to use with mothers to
counsel on the feeding of infants 6 to 11 months of age. This field tool emphasizes i.) continued
breastfeeding, ii.) types and amounts of complementary foods to give, as well as iii.) key practices
for the nutritional care of sick children. A complete list of all messages related to the
complementary feeding of infants 6-11 months of age is contained in Annex 2.
The second part of the section contains practical recipes based on locally available foods that
mothers can use to prepare nutritious meals for their infants. These recipes are based on the
assumption that infants are still being breastfed, and thus aim to provide the additional nutritional
requirements from complementary foods needed by breastfed infants in this age group. Recipes
are presented for each of the three major staple food eating groups. It is recognized that the
iron content of local foods and its bioavailability is limited, thus, iron supplements or foods
fortified with iron should be used whenever available.
** Encourage families to add meat each day to the following recipes when possible **
2
RECIPE 1: BULLA PORRIDGE ENRICHED WITH MILK, CARROTS
AND OIL/BUTTER
In one day, along with breast milk, your 6-11 month old baby can eat:
•
•
3 coffee cups of enriched bulla porridge fed over 2-3 feedings
1 banana as mekses
Feed even more food if baby wants to eat more!
How to prepare the enriched porridge:
Ingredients
Bulla flour
Milk
Carrot
Butter/oil
Water
Iodized
salt
Lemon
Banana
1.
2.
3.
4.
5.
Amount
just over 1/2 coffee cup
1 full coffee cup
1 carrot
3 teaspoons
4 1/2 coffee cups
for taste
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
53 gram
70 ml
30 gram
15 gram
315 ml
0
104
52
9
134
0
0
0.5
2.4
0.2
0
0
0
5.3
0.7
0.2
0
0
0
1 medium size
1 small size
15ml
7
0.1
0.
35 gram
31
0.3
0.2
Total Amount
337
3.5
6.4
Mix the bulla flour with water and milk, add iodized salt and put on the fire.
Peel, boil and mash carrot.
To porridge, add mashed carrot and butter/oil and continue to cook well with
continuous stirring
Cool porridge, squeeze the lemon into it and mix
Feed the baby with spoon, using patience and encouragement.
Cooked amount: 3 coffee cups.
Total preparation and cooking time: 25 minutes.
Banana for mekses
1. Wash and peel the banana.
2. Mash with spoon into clean cup.
3. Feed the baby with spoon.
Staple Food Group 1: maize/enset
RECIPE 2: MAIZE PORRIDGE ENRICHED WITH KIDNEY BEANS,
TOMATO AND OIL/BUTTER
•
•
3 coffee cups of enriched maize porridge fed over 2-3 feedings
1 ripe avocado as mekses
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
53 gram
198
4.8
3.8
7 ml
7 gram
63
19
0
0.7
0
0.3
1 tomato
5 ½ coffee cups
for taste
30 gram
385 ml
0
6
0
0
0.5
0
0
0.3
0
0
½ medium sized
50 gram
55
0.8
0.8
Ingredients
Amount
Maize flour
just over half a coffee
cup
Butter/oil
Kidney
beans
Tomato
Water
Iodized
salt
Ripe
avocado
1 ½ teaspoon
1 ½ teaspoon
1.
2.
3.
4.
5.
6.
Total Amount
341
6.8
5.2
Soak kidney beans overnight in water.
Boil beans in water, remove skin and mash.
Boil, peel off skin and chop tomato.
Mix maize flour into water, bring to boil and add iodized salt
Mix in tomato, butter/oil and mashed beans & stir until cooked properly.
Cool porridge and feed the baby with spoon using patience and encouragement.
Note: Whenever available use teff, barley, wheat or sorghum flour instead of
maize flour.
Cooked amount: 3 Coffee cups.
Preparation and cooking time: 25 minutes.
Ripe avocado for mekses
1. Wash and peel the avocado.
2. Mashed it by clean spoon & cup.
5
RECIPE 3: BULLA PORRIDGE ENRICHED WITH MILK, TOMATO AND
OIL/BUTTER
•
•
3 coffee cups of bulla porridge enriched with milk, tomato and
oil/butter fed over 2-3 feedings
1 ripe mango as mekses
Ingredients
Bulla
Tomato
Butter/oil
Milk
Lemon
Water
Iodized
salt
Ripe mango
1.
2.
3
4.
5.
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
53 gram
104
0.5
5.3
30 gram
10 ml
105ml
15ml
315ml
9
90
78
7
0
0
0.5
0
3.6
0.1
0
0
0.3
0
1.1
0.1
0
0
50 gram
Total Amount
22
310
0.2
4.9
0.3
7.1
Amount
More than half coffee
cup
1 tomato
2 teaspoon
1½ coffee cup
1 medium size
4 ½ coffee cups
for taste
½ medium sized
Mix bulla flour with water and milk, add iodized salt and put on the fire.
Boil, peel and chop the tomato.
Add the tomato, butter/oil and stir it till properly cooked.
Allow to cool and squeeze the lemon on it & mix.
Feed baby with spoon using patience and encouragement.
Ripe mango for mekses
1. Wash and peel mango
3. Feed the baby with spoon
6
RECIPE 4: MASHED POTATO ENRICHED WITH KALE, CARROT,
MILK AND OIL/BUTTER
•
•
3 coffee cups of mashed potato with kale, carrot, milk and oil/butter
fed over 2-3 feedings
1 banana as mekses
Ingredients
Amount
Potato
1 medium size potato
Carrot
Kale
Milk (boiled
and cooled)
Butter/oil
Iodized
salt
Banana
1 carrot
3 leaves
More than one coffee cup
1.
2.
3.
4.
5.
6.
7.
1½ teaspoon
for taste
½ medium sized
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
80
grams
30 gram
40 gram
75ml
159
1.5
1.4
9
18
56
0.2
1.1
2.6
0.2
1.6
0.8
7 ml
63
0
0
0
0
22
327
0.2
5.6
0.1
4.1
25 gram
Total Amount
0
Wash, chop and boil the kale.
Peel carrot and potato, wash, chop and boil.
When properly cooked, take the kale, carrot and potato off the fire and mash.
Mix the milk into the mashed potato, kale and carrot.
Add butter/oil and iodized salt and put the cooking pan on the fire.
Stir the mixed ingredients till properly heated.
Cool mashed mixture and feed baby with spoon using patience and
encouragement.
Cooked amount: 3 Coffee Cups.
Preparation and cooking time: 1 hour.
Banana for mekses
1. Wash and peel banana
2. Mashed in clean cup with spoon.
7
RECIPE 5: BULLA AND PEA PORRIDGE ENRICHED WITH PUMPKIN
AND OIL/BUTTER
•
•
3 coffee cups of bulla and pea porridge enriched with pumpkin and
Ingredients
Bulla flour
Pea or
beans flour
Pumpkin
Butter/oil
Lemon
Water
Iodized
salt
Avocado
1.
2.
3.
4.
5.
6.
7.
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
More than half a coffee
cup
3 teaspoons
55 gram
108
0.5
5.5
15 gram
53
3.0
2.1
1 slice
2 teaspoons
1 medium size
5 coffee cups
for taste
10 gram
10 ml
15ml
350ml
4
90
7
0
0
0.1
0
0.1
0
0
0.2
0
0.1
0
0
Amount
½ medium sized
50 gram
55
0.8
Total Amount
317
4.5
Mix the bulla with the beans or pea flour.
Pour water into the mixed flour, add iodized salt and put on the fire.
Peel pumpkin, remove the seed and chop; then boil in water.
Once cooked, mash pumpkin well.
Add oil/butter to pumpkin, and cook with stirring.
Allow to cool and squeeze the lemon into mixture
Feed the baby with spoon, using patience and encouragement.
0.9
8.8
Note: Whenever available use 45 gram finely minced meat instead of pea flour.
Avocado for mekses
1. Wash and peel avocado
2. Mashed with spoon in a clean cup.
3. Feed baby with spoon
8
RECIPE 6: MAIZE PORRIDGE ENRICHED WITH MILK, TOMATO AND
OIL/BUTTER
•
•
3 coffee cups of maize porridge enriched with milk, tomato and
oil/butter over 2-3 feedings
1 banana as mekses
Ingredients
Amount
Maize flour
cup
1 small size
cup
1 teaspoon
for taste
Tomato
Milk
Butter/oil
Iodized
salt
Water
Banana
1.
2.
3.
4.
5.
4 coffee cups
1 medium sized
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
55 gram
208
4.9
3.9
20 gram
50ml
6
37
0.3
1.7
0.2
0.5
5 ml
0
45
0
0
0
0
0
0
44
340
0
0.4
7.3
0
0.3
4.9
280ml
50 gram
Total Amount
Mix the maize flour with water and milk & put it on the heat
Add iodized salt.
Add the tomato, butter or oil & stir until cooked properly.
Allow the porridge to cool and feed the baby with spoon with encouragement
and patience.
Note: If maize flour not available, then use teff, barley, wheat or sorghum flour.
Cooked amount : 3 coffee cups
Preparation and cooking time: 30 minutes
Banana for mekses
1. Wash and peel the Banana
2. Mashed it in clean cup with spoon.
9
RECIPE 7: MASHED BEEF HEART WITH POTATO, CARROT, KALE,
EGG AND OIL/BUTTER
•
•
3 coffee cups of mashed beef heart with potato, carrot, kale and egg
1 ripe papaya as mekses
Ingredients
Potato
Carrot
Egg
Heart of
beef
Kale
Butter/oil
Iodized
salt
Ripe papaya
1.
2.
3.
4.
5.
6.
7.
8.
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
1 small sized potato
1 small sized carrot
1 small egg
2 teaspoons
50 gram
20 gram
35 gram
10 gram
100
6
54
22
1.0
0.1
4.0
2.9
0.9
0.1
1.5
0.8
3 leaves
2 teaspoons
for taste
40 gram
10 ml
18
90
0
1.1
0
0
1.6
0
0
¼ small size
60 gram
Total Amount
21
311
0.4
9.5
0.3
5.2
Amount
Chop beef heart into very small pieces and fry in oil.
Wash and chop the kale and add to heart.
Wash, peel, chop and boil carrots and potatoes in water.
Cook carrots and potatoes thoroughly, take off the fire and mash..
Add to beef heart mixture, mashing together well.
Beat egg and add to the mashed mixture.
Add iodized salt and continue to cook and stir.
Cool and feed baby with patience and encouragement using a spoon.
Cooked amount: = 3 coffee cups.
Preparation and cooking time = 1 hour and 15 minutes.
Ripe papaya for mekses
1. Wash papaya,, cut open and remove seeds.
2. Mash and feed baby with spoon.
10
RECIPE 8: ENJERA WITH SHIRO, ONION AND TOMATO
•
•
3 coffee cups of finely chopped enjera with shiro, onion and tomato
1 orange as mekses
How to prepare the chopped enjera and shiro:
Amount
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
1medium size table spoon
10 gram
35
2.0
1.4
¼ onion
1 medium size
3 teaspoons
4 coffee cups
for taste
10 gram
30 gram
15 ml
280 ml
7
9
134
0
0
0.1
0.4
0
0
0
0.1
0.3
0
0
0
enjera
1/5 of one enjera
60 gram
95
2.6
5.9
Orange
1 big size
100gram
Total Amount
34
314
0.7
5.8
0.8
8.5
Ingredients
Roasted
pea flour
Onion
Tomato
Butter/oil
Water
Iodized
salt
1
2.
3.
4.
5.
6.
Chop and fry onion in oil.
Add the tomato to water and boil.
Add pea flour and iodized salt and cook by stirring.
When the shiro is properly cooked, add enjera and mix.
Allow to cool and feed with spoon using encouragement and patience.
Note: Whenever available, use 30 gram finely minced meat instead of pea flour.
Orange for mekses
1. Wash & peel off the orange.
2. Cut in to small pieces, remove the seeds & give to the child to eat.
11
Staple Food Group 2: teff/wheat/barley
RECIPE 9: TEFF PORRIDGE ENRICHED WITH MILK, CARROT,
TOMATO AND OIL/BUTTER
•
•
3 coffee cups of teff porridge enriched with milk, carrot, tomato
and oil/butter fed over 2-3 feedings
Ingredients
Teff flour
Tomato
Carrot
Milk
Butter/oil
Water
Iodized
salt
Ripe papaya
1.
2.
3.
4.
5.
Amount
More half coffee cup
1 Tomato
More one coffee cup
1½ teaspoon
4 ½ coffee cups
for taste
Weight
Gram
Calories
kcal
Protein
gram
Iron
mg
45 gram
30 gram
20 gram
75 ml
7 ml
315 ml
161
9
6
56
63
0
0
4.1
0.5
0.1
2.6
0
0
0
67.5
0.3
0.1
0.8
0
0
0
¼ Small size
50 gram
17
0.5
1.4
Total Amount
312
7.8
70.1
Mix the teff flour with milk and water, add iodized salt and put on the fire.
Peel, boil and mash carrot.
Add carrot, tomato, butter or oil to porridge and cook by continuously stirring.
Wait until mixture cools and feed the baby with spoon using encouragement
and patience
1. Wash, cut and remove the seeds of papaya.
2. Mash in a clean cup with spoon.
3. Feed the child with spoon.
15
RECIPE 10: WHEAT PORRIDGE ENRICHED WITH MILK, PUMPKIN
AND OIL/BUTTER
•
•
3 coffee cups of wheat porridge enriched with milk, pumpkin and
1 orange as mekses
Ingredients
Wheat
flour
Pumpkin
Milk
Butter/oil
Water
Iodized
salt
Orange
1.
2.
3.
4.
5.
6.
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
cup
1½ slice
Just over 1 coffee cup
1½ teaspoon
4 ½ coffee cups
for taste
45 gram
164
5.0
1.8
15 gram
75 ml
7 ml
315 ml
6
56
63
0
0
0.2
2.6
0
0
0
0.3
0.8
0
0
0
1 medium sized orange
50 gram
17
0.4
0.4
Amount
Total Amount
306
8.2
3.3
Mix the wheat flour with water and milk.
Heat and add iodized salt
Peel pumpkin, remove the seed, chop and boil in water.
When cooked, remove from heat, and mash pumpkin.
Add pumpkin and oil/butter to porridge and stir until cooked.
Allow the porridge to cool and feed the baby with spoon using encouragement
and patience.
Note: If wheat flour is not available use teff, barley, maize or sorghum flour
instead.
Cooked amount: 3 coffee cups
Orange for mekses
1. Wash and squeeze the orange
16
RECIPE 11: MASHED POTATO PORRIDGE ENRICHED WITH TOMATO,
MILK AND OIL/BUTTER
•
•
3 coffee cups of mashed potato enriched with tomato, milk and oil
Ingredients
Potato
Tomato
Carrot
Milk
Oil
Iodized
salt
Ripe
avocado
Calories
kcal
Protein
gram
Iron
mg
80 gram
100
gram
20 gram
More than half coffee 50 ml
cup
1 ½ tea spoon
7 ml
For taste
0
159
30
1.5
1.4
1.4
1.0
6
37
0.1
1.7
0.1
0.5
63
0
0
0
0
0
½ medium sized
55
0.8
0.9
350
5.5
3.9
Amount
Weight
gram
1 medium size
2 medium sized
50 gram
Total Amount
1.
2.
3.
4.
5.
Wash potato and carrots, peel, chop and boil.
When potato and carrots are cooked, remove from heat and mash.
Boil water and add tomato.
Remove tomato and chop into small pieces
Mix mashed potato, carrot and tomato with milk, add oil & iodized salt and
warm it.
6. Allow the preparation to cool and feed the baby with spoon, using
encouragement and patience.
Avocado for mekses
1. Wash and peel the avocado.
17
RECIPE 12: BARLEY PORRIDGE ENRICHED WITH MILK, PEA/BEAN
FLOUR, CARROTS AND OIL/BUTTER
•
•
3 coffee cups of barley porridge enriched with milk, pea/bean flour,
carrots and oil/butter fed over 2-3 feedings
1 banana as mekses
Ingredients
Barley
flour
Pea or
beans flour
Carrot
Milk
Butter/oil
Water
Iodized
salt
Banana
1.
2
3.
4.
5.
6.
Amount
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
40 gram
147
3.4
2.5
cup
1 teaspoon
5 gram
18
1.0
0.7
1 small size
½ coffee cup
2 teaspoon
4 coffee cups
For taste
20 gram
35ml
10ml
280 ml
-
6
26
90
0
0
0.1
1.2
0
0
0
0.1
0.4
0
0
0
44
331
0.4
6.1
0.3
4
1 medium size
50 gram
Total Amount
Mix the barley with the pea flour.
Add water, milk and iodized salt into the mixed flour and put on the fire.
Wash, peel, chop, and boil carrot in water.
Take off fire and mash
Add the mashed carrot and butter/oil to porridge, and cook by stirring.
Allow to cool and feed with spoon, using encouragement and patience.
Cooked amount: 3 coffee cup
Banana for mekses
2. Cut in to small pieces & give to the child to eat
18
RECIPE 13: ENJERA WITH SHIRO, ONION, CARROT AND
TOMATO
•
•
3 coffee cups of finely chopped enjera with shiro, onion, carrot, and
tomato fed over 2-3 feedings
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
1 medium table spoon
10gram
35
2.0
1.4
1 small size
½ onion
3 teaspoons
5 coffee cups
for taste
20 gram
20 gram
20 gram
15 ml
350ml
6
14
6
134
0
0
0.3
0.2
0.1
0
0
0
0.2
0.2
0.1
0
0
0
enjera
1/5 of one enjera
60 gram
100
2.9
33.6
Ripe papaya
¼ small size
60 gram
Total Amount
21
316
0.4
5.9
0.3
35.8
Ingredients
Roasted
pea flour
Tomato
Onion
Carrot
Butter/oil
Water
Iodized
salt
1.
2.
3.
4.
5.
6.
7.
8.
Amount
Roast the onion with oil.
Wash, peel, boil and mash carrot.
Add the tomato to water and boil.
Add pea flour and iodized salt and cook by stirring.
When the shiro is cooked, add the enjera and chop.
Also add mashed carrot to mixture.
Allow to cool and feed with spoon using encouragement and patience.
Cooked Amount: 3 coffee cups
1. Wash, cut the papaya & remove the seeds.
2. Cut in to small pieces & give the child to eat
19
RECIPE 14: ENJERA WITH MEAT, POTATO, KALE AND OIL/BUTTER
•
•
3 coffee cups of finely chopped enjera with meat, potato and kale
1 orange as mekses
How to prepare the enjera dish:
Ingredients
Meat
Potato
Kale
Onion
Oil
enjera
Water
Iodized
salt
Orange
1.
2.
3.
4.
5.
6.
7.
8.
9.
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
15 gram
25 gram
40 gram
20 gram
10 gram
60 gram
420 ml
-
17
50
18
14
90
100
0
0
2.9
0.5
1.1
0.2
0
2.9
0
0
0.5
0.4
1.6
0.2
33.6
0
0
100gram
Total Amount
34
323
0.7
8.3
0.8
34.4
Amount
3 tea spoons
½ small size
3 leaves
½ onion
2 tea spoons
1/5 enjera
6 coffee cups
For taste
1 big size
Clean, chop and boil potato in water.
In separate pan, fry onion in oil and add finely minced meat.
Wash, chop and add kale to the fried onion and meat mixture
Add small quantity of water and cook.
Add boiled potato to onion and meat mixture.
Add iodized salt and the remaining water and cook properly.
Take the pan off the fire and add enjera.
Allow to cool
Finely chop mixture and feed to child with spoon, using encouragement and
patience.
Preparation and cooking time: 1 hour
Orange for mekses
1. Wash & peel off the orange.
2. Cut in to small pieces, remove the seeds.
3. Give to the child to eat.
20
Staple Food Group 3: maize/sorghum
RECIPE 15: SORGHUM PORRIDGE
CARROT, MILK AND OIL/BUTTER
ENRICHED
WITH
TOMATO,
•
•
3 coffee cups of sorghum porridge enriched with tomato, carrot, milk
1 orange as mekses
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
Almost one coffee cup
60gram
225
4.9
5.3
1 Tomato
1½ teaspoon
4 coffee cups
Just over 1/2 coffee cup
for the taste
30 gram
7 ml
20 gram
240 ml
35 ml
-
9
63
6
0
28
0
0.5
0
0.1
0
1.3
0
0.3
0
0.1
0
.4
0
Ingredients
Sorghum
flour
Tomato
Butter/oil
Carrot
Water
Milk
Iodized
salt
Orange
1.
2.
3.
4.
5.
Amount
1 medium size
50 gram
17
0.4
0.4
Total Amount
348
7.2
6.5
Mix sorghum flour with water, milk and iodized salt and put on the fire.
Clean, peel, boil and mash carrot.
To the porridge, add tomato, mashed carrot, oil/butter and cook well by
continuously stirring.
Wait until it gets cool and feed baby with spoon, using encouragement and
patience.
Orange for mekses
1. Wash and peel orange.
2. Cut in to very small pieces & give to child to eat.
21
RECIPE 16: MAIZE PORRIDGE ENRICHED WITH PUMPKIN, MILK
AND OIL/BUTTER
•
•
3 coffee cups of maize porridge enriched with pumpkin, milk and
1 orange as mekses
Ingredients
Amount
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
Maize flour
60 gram
227
0.6
4.2
Pumpkin
Milk
1½ slice
cup
1½ teaspoon
4 ½ coffee cups
for the taste
15 gram
50 ml
6
37
0.2
1.7
0.3
0.5
15 ml
315 ml
63
0
0
0
0
0
0
0
0
17
350
0.4
2.9
0.4
5.4
Butter/oil
Water
Iodized
salt
Orange
1.
2.
3.
4.
5.
6.
1medium size
50gram
Total Amount
Mix maize flour with milk and water.
Put it on fire, add iodized salt, and heat.
Peel, remove seed, chop and boil the pumpkin in water.
Take off heat and mash pumpkin.
To the pumpkin mixture, add the oil/butter and stir until cooked.
Allow to cool and feed the baby with spoon, using encouragement and patience.
Note: If maize flour is not available, use teff, barley, and wheat or sorghum
flour instead.
Orange for mekses
1. Wash & peel orange.
2. Cut in to small pieces & give to the child to eat.
22
RECIPE 17:
SORGHUM PORRIDGE ENRICHED WITH TOMATO,
CARROT AND OIL/BUTTER
•
•
3 coffee cups of sorghum porridge enriched with tomato, carrot and
Ingredients
Sorghum
flour
Tomato
Carrot
Butter/oil
Iodized
salt
Water
Lemon
Ripe papaya
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
60 gram
225
4.8
5.4
1 Tomato
1½ teaspoon
for the taste
30 gram
20 gram
7 ml
9
6
63
0
0.5
0.1
0
0
0.3
0.1
0
0
0
7
17
327
0
0.1
0.5
6
0
0.1
1.5
7.4
Amount
4 ½ coffee cups
1 medium sized
¼ small size
315ml
15ml
50gram
Total Amount
1.
2.
3.
4.
Pour water into the flour, add iodized salt and put on the fire.
Clean, peel, boil and mash carrot
To the porridge add the tomato, carrot and butter/oil and stir it till properly
cooked
5. Allow to cool and wash, squeeze the lemon into porridge and mix.
6. Feed the baby with spoon, using encouragement and patience.
1. Wash papaya, cut and remove seeds.
2. Cut in to small pieces give to the child to eat.
23
RECIPE 18: MASHED POTATO ENRICHED WITH CARROT, MILK
AND OIL/BUTTER
•
•
3 coffee cups of mashed potato enriched with carrot, milk and
1 ripe mango as mekses
Ingredients
Potato
Carrot
Milk (boiled
and cooled)
Butter/oil
Iodized
salt
Ripe mango
Amount
3 small carrots
1½ coffee cup
1½ teaspoon
for the taste
½ medium size
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
80
grams
60 gram
105 ml
159
1.5
1.4
17
78
0.3
3.6
0.3
1.1
7 ml
63
0
0
0
0
22
339
0.2
5.6
0.3
3.1
50 gram
Total Amount
0
1.
2.
3.
4.
Peel carrot and potato, wash, chop and boil
When cooked well take potatoes and carrots off the fire, and mash well
Add the milk into the potato and carrot mixture
Add butter/oil and iodized salt and warm on the fire, stirring mixture
together.
5. Take pan off fire, allow to cool and feed with spoon, using encouragement and
patience.
Mango for mekses:
1. Wash and peel the Mango
3. Feed the baby with spoon
24
RECIPE 19: SORGHUM PORRIDGE ENRICHED WITH PEA FLOUR,
KALE AND OIL/BUTTER:
•
•
3 coffee cups of sorghum porridge enriched with pea flour, kale and
Ingredients
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
60 gram
225
4.9
5.3
1 teaspoon
5 gram
18
1.0
0.7
1 teaspoon
3 leaves
5 ml
40
gram
280 ml
45
16
0
1.0
0
1.6
0
0
0
0
0
0
21
325
0.4
7.3
0.3
7.9
Amount
Sorghum
flour
Pea or bean
flour
Butter/oil
Kale
Water
Iodized
salt
Ripe papaya
4 coffee cups
for the taste
1.
2.
3.
4.
5.
¼ small sized
60 gram
Total Amount
Wash, chop and boil the kale.
Mix sorghum flour with bean (or pea) flour.
Pour water into the mixed flour add iodized salt and put on fire.
Add butter/oil and kale & cook by stirring.
1. Wash, cut the papaya & remove the seeds.
25
RECIPE 20: MAIZE PORRIDGE ENRICHED WITH PUMPKIN, TOMATO
AND OIL/BUTTER
•
•
3 coffee cups of sorghum porridge enriched with pumpkin, tomato
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
1 slice
1 teaspoon
for the taste
60 gram
10 gram
5 ml
227
4
45
0
5.4
0.1
0
0
4.2
0.2
0
0
4 coffee cups
½ medium size
280 ml
50 gram
0
55
0
0.8
0
0.9
Total Amount
331
6.3
5.3
Ingredients
Amount
Maize flour
Pumpkin
Butter/oil
Iodized
salt
Water
Ripe
avocado
1.
2.
3.
4.
5.
Pour water into maize flour, add iodized salt and put it on the fire.
Peel, remove the seed, chop and boil pumpkin.
Take off the fire and mash it.
Add the pumpkin and oil/butter to maize porridge, and cook by stirring.
Note: Whenever available you can use teff, barely, wheat or sorghum flour
instead of maize flour.
1. Wash and peel avocado.
26
RECIPE 21: POTATO PORRIDGE ENRICHED WITH CARROT, EGG AND
OIL/BUTTER
•
•
3 coffee cups of potato porridge enriched with carrot, egg and
Ingredients
Amount
Potato
1 big size potato
Carrot
Egg
Butter/oil
Iodized
salt
Ripe papaya
2 small carrots
1 small egg
1 teaspoon
for taste
1.
2.
3.
4.
5.
¼ small size
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
100
gram
40 gram
35 gram
5 ml
199
1.9
1.7
11
54
45
0
0.2
4.1
0
0
0.2
1.5
0
0
50 gram
Total Amount
17
326
0.5
6.7
1.4
4.8
Wash, peel, chop and boil the potato and carrot
When cooked, take the carrot and potato off the fire, mash and mix them up
Beat the egg and add to the mashed carrot and potato mixture
Add butter/oil and iodized salt and warm by stirring.
Papaya for mekses
1. Wash and cut papaya & remove the seeds.
2. Cut into small pieces and give to child to eat.
27
Section III
Complementary Feeding of
Children 12-23 months of age
The first part of this section presents a “field tool” for field workers to use with mothers to
counsel on the feeding of children 12 to 23 months of age. This field tood emphasizes i.)
continued breastfeeding, ii.) types and amounts of complementary foods to give, as well as iii.) key
practices for the nutritional care of sick children. A complete list of all messages related to the
complementary feeding of children 12 to 23 months of age is contained in Annex 2.
The second part of the section contains practical recipes using locally available foods that
mothers can use to prepare nutritious meals for their children. These recipes are based on the
assumption that children are still being breastfed, and thus aim to provide the additional
nutritional requirements from complementary foods needed by breastfed children in this age
group. Recipes are presented for each of the three major staple food eating groups. It is
recognized that the iron content of local foods and its bioavailability is limited, thus, iron
supplements or foods fortified with iron should be used whenever available.
** Encourage families to add meat each day to the following recipes when possible **
28
28
RECIPE 22: ENJERA WITH KALE, POTATO, EGG AND OIL/BUTTER,
WITH MILK TO DRINK
In one day, along with breast milk, your 12-23 month old child can
eat:
• 4 coffee cups of enjera with kale, potato, egg and oil/butter fed
over 3-4 feedings, with milk to drink
• 1 ripe avocadoe as mekses
Feed even more food if child wants to eat more!
How to prepare the enriched meals:
Ingredients
Amount
Kale
Potato
3 leaves
1 medium sized potato
Egg
Butter/oil
Iodized
Iodized
salt
enjera of
maize
Milk to
drink
Ripe
avocado
1 small egg
2 teaspoons
for the taste
1/4 of enjera
1 coffee cup
1 medium sized
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
40 gram
80
grams
35 gram
10 ml
18
159
1.1
1.5
1.6
1.4
53
90
0
4.1
0
0
1.5
0
0
75 gram
119
3.3
7.4
70ml
52
1.8
0.7
110
1.6
1.7
601
13.4
14.3
100
gram
Total Amount
1. Wash, chop and boil the kale.
2. Peel, wash, chop and add in potato.
3. When cooked properly take the kale & potato off the fire and mash.
4. Add the beaten egg to the mashed kale & potato.
5. Add butter/oil and iodized salt and cook while stirring.
6. Allow to cool and feed with enjera, assisting child to eat.
Note: Whenever available you can use 65 gram bulla bread instead of enjera.
Preparation and cooking time: 1hour and 10 minutes.
1. Wash avocado and peel off skin.
30
RECIPE 23: ENJERA WITH POTATO, CARROT, KALE AND EGG,
WITH MILK TO DRINK
eat:
• 4 coffee cups of enjera with potato, carrot, kale and egg fed over 34 feedings, with milk to drink
• 1 banana as mekses
How to prepare the enjera meal:
Ingredients
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
80
grams
40 gram
20 gram
10 ml
40 gram
35 gram
490ml
159
1.5
1.4
11
14
90
18
53
0
0
0.2
0.2
0
1.1
4.6
0
0
0.2
0.2
0
1.6
1.5
0
0
¼ of enjera
75 gram
119
3.3
7.4
1 coffee cup
70ml
52
1.8
0.7
87.8
0.8
0.5
603.8
13.5
13.5
Amount
Potato
Carrot
Onion
Butter/oil
Kale
Egg
Water
Iodized
salt
enjera of
maize
Milk to
drink
Banana
2 small size carrots
½ onion
2 teaspoons
3 leaves
1 small egg
7 coffee cups
for the taste
1 big size
100
gram
Total Amount
1. Chop & fry onion in oil.
2. Wash, chop and add the kale
3. Wash, peel, chop & boil carrots and potatos in same pan.
4. Mash carrots and potatoes together and add beaten egg.
5. Add remaining water, iodized salt and boil further.
6. When cooked take off fire and mix with enjera.
7. Allow to cool and assist child to eat, using encouragement and patience.
Note: Whenever available use 135 gram finely minced meat instead of potato.
Banana for mekses
1. Wash & peel banana
2. Cut up in small pieces and feed child
31
RECIPE 24: BULLA PORRIDGE ENRICHED WITH KALE, MILK AND
OIL/BUTTER
eat:
• 4 coffee cups of bulla porridge enriched with kale, milk and
• 1 ripe papaya as mekses
Ingredients
Amount
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
Maize flour
1 coffee cups
70 gram
265
6.3
4.9
Kale
Butter/oil
Milk
Water
Iodized
salt
Ripe papaya
3 leaves
3 teaspoons
2 coffee cups
4 coffee cups
for the taste
40 gram
15 gram
140ml
280ml
18
134
103
0
0
1.1
0
4.7
0
0
1.6
0
2.8
0
0
100
gram
Total Amount
35
0.7
0.5
555
12.8
9.8
1.
2.
3.
4.
5.
6.
½ small sized
Wash, chop and boil the kale
When it is cooked take it off fire and mash it.
Mix the bulla with milk and put it on the fire
Add butter/oil and iodized salt & cook while stirring.
Add the kale and stir adding a little water for further cooking
Allow to cool and assist child to eat, using encouragement and patience
Cooked amount = 4 coffee cups
Prepation and cooking time = 40 minutes.
Papaya for mekses
1. Wash & cut the papaya & remove the seeds.
32
RECIPE 25:
DRINK
ENJERA WITH MEAT AND KALE, WITH MILK TO
eat:
• 4 coffee cups of enjera with meat and kale fed over 3-4 feedings,
with milk to drink
How to prepare the enjera meal:
Ingredients
Finely
minced
meat
Kale
Onion
Butter/oil
Water
Iodized
salt
'Enjera' of
Maize
Milk to
drink
Banana
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
4 teaspoons
20 gram
23
4.0
0.7
4 ½ leaves
½ of one onion
2 teaspoons
7 coffee cups
for the taste
60 gram
20 gram
10 ml
490ml
-
27
14
90
0
0
1.7
0.2
0
0
0
2.5
0.2
0
0
0
A quarter of one 'Enjera'
75 gram
119
3.3
7.4
140ml
103
4.7
1.4
174
1.6
1.0
Amount
2 coffee cups
2 big bananas
200
gram
Total Amount
550
15.5
13.2
1. Chop and fry onion in oil
2. Add the minced meat to the roasted onion and cook by adding small quantity
of water
3. Wash and chop kale and add to meat mixture.
4. Add iodized salt and keep on cooking adding small quantity of water frequently
5. Take the preparation off the fire and mix it with the enjera.
6. Allow to cool and assist child to eat, using encouragement and patience.
Cooked Amount= 4 coffee cups.
Preparation and cooking time= 1hour and 10 minutes.
Banana for mekses
33
RECIPE 26: TEFF PORRIDGE ENRICHED WITH PEA FLOUR, CARROT,
MILK AND OIL/BUTTER, WITH MILK TO DRINK
eat:
• 4 coffee cups of teff porridge enriched with pea flour, carrot, milk
and oil/butter fed over 3-4 feedings, with milk to drink
• 1 ripe avocado as mekses
1. Sieve the flours and mix in a pot.
Ingredients
Teff Flour
Peas flour
Carrot
Milk
Oil
Water
Iodized
salt
Milk to
drink
Ripe
avocado
2.
3.
4.
5.
6.
Amount
More than one coffee
cups
1 tea spoons
1 small size
1 coffee cup
2 tea spoons
6 coffee cups
For the test
1 coffee cup
1 medium size
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
80 gram
284
7.2
120.0
5 gram
20 gram
70 ml
10 ml
420ml
18
6
56
90
0
0
1.0
0.1
2.3
0
0
0
0.7
0.1
0.7
0
0
0
70ml
52
1.8
0.7
100gram
110
1.6
1.7
Total Amount
616
14
123.9
Pour water & milk into the mixed flour and put it on the fire.
Peel, wash and boil the carrot.
Add the mashed carrot, iodized salt & butter/oil to porridge and cook while
stirring.
1. Wash & peel off the Avocado.
34
RECIPE 27: BARLEY PORRIDGE ENRICHED WITH KALE, EGG, MILK
AND OIL/BUTTER:
eat:
• 4 coffee cups of barley porridge enriched with kale, egg, milk and
Ingredients
Barley
flour
Kale
Milk
Egg
Oil
Lemon
Water
Iodized
salt
Banana
1.
2.
3.
4.
5.
6.
7.
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
80 gram
294
6.8
5.0
40 gram
100ml
35 gram
10 ml
15ml
350ml
18
74
53
90
7
0
0
1.1
3.4
4.6
0
0.1
0
0
1.6
1.0
1.5
0
0.1
0
0
100gram
Total Amount
88
571
0.8
12.2
0.5
8.2
Amount
cups
3 leaves
1 ½ coffee cups
1 small egg
2 tea spoons
1 medium size
5 coffee cups
For the test
1 big size bananas
Mix the flour with water & milk.
Add iodized salt & put it on the fire.
Wash and boil the kale.
Take off the fire and chop.
Add the kale & butter/oil to porridge and cook while stirring.
Allow to cool and squeeze lemon on it.
Banana for mekses
1. Wash and peel the Banana
35
RECIPE 28: ENJERA WITH LENTIL AND CARROT SAUCE, WITH MILK
TO DRINK
eat:
• 4 coffee cups of enjera with lentil and carrot sauce fed over 3-4
feedings, and milk to drink
How to prepare the enriched meals:
Ingredients
Amount
Lentil split
2 1/2 medium sized table
spoons
1 small size
5 teaspoons
¼ onion
¼ Enjera
8 coffee cups
For the test
Carrot
Oil
Onion
Enjera
Water
Iodized
salt
Milk to
drink
Ripe
avocado
1.
2.
3.
4.
5.
6.
7.
1 coffee cup
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
30 gram
107
6.9
12.9
20 gram
25 ml
10 gram
75 gram
560ml
-
6
224
7
124
0
0
0.1
0
0.1
3.7
0
0
0.1
0
0.1
42.0
0
0
70ml
52
1.8
0.7
1 medium size
100
110
1.6
gram
Total Amount
630
14.2
Chop roasted the onion with the oil.
Wash, chop and add the carrot in to the roasted onion
Cook by adding small quantity of water.
Add the lentil split and.
Add iodized salt and the remaining water and cook properly.
Take the preparation off the fire and mix it with enjera.
1.7
57.5
36
RECIPE 29: SORGHUM PORRIDGE ENRICHED WITH PEA FLOUR,
CARROT AND OIL/BUTTER, AND MILK TO DRINK
eat:
• 4 coffee cups of sorghum porridge enriched with pea flour, carrots
and oil/butter fed over 3-4 feedings, with milk to drink
Ingredients
Sorghum
flour
Pea or bean
flour
Carrot
Butter/oil
Water
Iodized
salt
Milk to
drink
Ripe
avocado
1.
2.
3.
4.
5.
6.
7.
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
cups
1 tea spoon
80 gram
300
6.5
7.1
5 gram
18
1.0
0.7
1 small size
3 teaspoons
7 coffee cups
for the taste
20 gram
15 ml
490 ml
6
134
0
0
0.1
0
0
0
0.1
0
0
0
70ml
52
1.8
0.7
Amount
1 coffee cup
1 medium size
100
110
1.6
gram
Total Amount
620
11
Clean the flour by sieving into a pot
Mix the flour with water and milk..
Add iodized salt and put it on the fire
Peel, wash and boil the carrot.
Add the carrot & butter/oil and cook by stirring.
1.7
10.3
Note: When available use barley, wheat or teff flour instead of sorghum flour.
37
RECIPE 30: ENJERA WITH POTATO AND CARROTS, WITH MILK TO
DRINK
eat:
• 4 coffee cups of enjera with potato and carrots fed over 3-4
feedings, with milk to drink
Ingredients
Amount
Potato
Carrot
Onion
Butter/oil
Water
Iodized
salt
2 small size carrots
A quarter of one onion
3 teaspoons
7 big coffee cups
for the taste
enjera
from
Sorghum
Milk to
drink
Banana
A quarter of one enjera
1 coffee cup
1 big size
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
80
grams
40 gram
10 gram
15 ml
490 ml
159
1.5
1.4
17
7
134
0
0
0.7
0.1
0
0
0
0.2
0.1
0
0
0
75 gram
168
4.4
5.6
70ml
52
1.8
0.7
88
0.8
0.5
625
9.3
8.5
100
gram
Total Amount
1.
2.
3.
4.
Chop and fry the onion in oil.
Peel, cop & wash the carrot and potato.
Put little water and add the carrot. Cook for a while and then add the potato.
Add the remaining water and iodized salt and keep on the fire for further
boiling.
5. When it is cooked takes it off the fire and mix with enjera.
6. Assist child to eat, using encouragement and patience
Banana for mekses
38
RECIPE 31: SORGHUM PORRIDGE ENRICHED WITH KALE, MILK AND
OIL/BUTTER
eat:
• 4 coffee cups of sorghum porridge enriched with kale, milk and
Ingredients
Sorghum
flour
Kale
Butter/oil
Milk
Water
Iodized
salt
Ripe
avocado
1.
2.
3.
4.
5.
6.
Amount
cups
3 leaves
2 teaspoons
1 coffee cup
6 coffee cups
for the taste
1 medium size
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
80 gram
300
6.5
7.1
40 gram
10 gram
70 ml
420ml
18
90
52
0
0
1.1
0
2.4
0
0
1.6
0
0.7
0
0
100
gram
Total Amount
110
1.6
1.7
570
11.6
11.1
Wash, chop and boil the kale in a pot
When it is cooked take off the fire and mash it.
Mix the sorghum flour with milk and water & put it on the fire
Add butter/oil and iodized salt & cook by stirring.
Add the kale and stir adding little water for further cooking
Preparation and cooking time: 1 hours and 20 minutes.
39
RECIPE 32: ENJERA WITH MEAT & KALE SAUCE, WITH MILK TO DRINK
eat:
• 4 coffee cups of enjera with meat and kale sauce fed over 3-4
feedings, with milk to drink
• 1 ripe mango as mekses
Ingredients
Finely
minced
meat
Kale
Potato
Carrot
Onion
Butter/oil
Water
Iodized
salt
‘Enjera of
Sorghum
Milk to
drink
Ripe mango
Weight
gram
Calories
kcal
Protein
gram
Iron
mg
3 teaspoons
15 gram
17
3.0
0.5
3 leaves
½ big size
2 small size
½ onion
4 teaspoons
6 coffee cups
for the taste
40 gram
50 gram
40 gram
20 gram
20 ml
420 ml
18
100
11
14
179
0
0
1.1
0.9
0.2
0.2
0
0
0
1.6
0.9
0.2
0.2
0
0
0
A quarter of one ‘Enjera’
75 gram
168
4.4
5.6
70ml
52
1.8
0.7
44
0.3
0.6
603
11.9
10.3
Amount
1 coffee cup
1 medium size
100
gram
Total Amount
1. Chop and fry onion in oil
2. Add minced meat to fried onion and cook in small quantity of water
3. Wash and chop kale, and add to the meat mixture.
4. Add iodized salt and keep on cooking adding small quantity of water frequently
5. Take off the fire and mix with enjera.
6. Assist child to eat, using encouragement and patience
Ripe mango for mekses
1. Wash, peel and cut up mango
2. Give to the child to eat.
40
References
1. Complementary Food for Children Prepared for Communities where their
Staple Food is Maize & Enset [Amharic; Prepared By EHNRI]
Staple Food is Teff, Wheat & Barley [Amharic; Prepared By EHNRI]
Staple Food is Maize & Sorghum [Amharic; Prepared By EHNRI]
4. Key Messages on the Essential Nutrition Action to Improve the Nutrition of
Women & Young Children in Ethiopia, January, 2005.
5. Food Composition Table for Use in Ethiopia Part III
6. Food Composition Table for Use In Ethiopia Part IV
7. Guiding Principles for Complementary Feeding of the Breastfed Child.
Pan
American Health organization, World Health Origination, Division of Health
Promotion and protection, Food and Nutrition Program. 2002
41
Annex 1: Key Messages for Ethiopia on
Optimal Breastfeeding 0 to 6 months
WHO?
1. Mother
ACTION
WHY?
Give the first yellow milk made especially
for the new born as it will protect your
baby from illness.
This first yellow milk (colostrum) is
the mother’s natural butter and will
help to expel your baby’s first dark
stool.
Colostrum contains many important
factors which will protect your new
baby from disease.
2. Mother
Put your baby on the breast immediately
after birth, even before the placenta is
expelled, to stimulate your production of
milk.
Immediate breastfeeding within one
hour of birth will help to expel the
placenta and reduce post-partum
bleeding.
Pre-lacteal feeds (such as sugar
water, water, butter, ersho) are not
necessary and may interfere with
establishing good breastfeeding
practices during the first days of the
baby’s life.
3. Mother
Feed your baby only breast milk for the
first six months, not even giving water,
for it to grow healthy and strong.
Feeding the baby only breastmilk
provides the best nourishment
possible for the baby and will protect
it from diseases such as diarrhea and
respiratory infections.
Giving the baby water or other liquids
may make your baby sick with
diarrhea.
If the baby takes water or other
liquids, its appetite for breastmilk
may decrease meaning it sucks less on
the breast leading to poor growth.
Even during very hot weather,
breastmilk will satisfy all your baby’s
thirst for liquids during the first six
months.
42
WHO?
4. Mother
ACTION
WHY?
Breast feed your baby on demand, at
least 10 times day and night, to produce
enough milk and provide your baby enough
food to grow healthy.
Frequent breastfeeding helps the milk
to flow.
Increases bonding between mother
and child.
Ensure proper positioning and
attachment of the baby on the breast
to ensure it gets enough breastmilk
and also to avoid breast problems such
as sore and cracked nipples.
Advise mothers with nipple and breast
problems to seek immediate care from
a Health Worker.
5. Mother
6. Husband
Empty one breast first before switching
to the second for your baby to get the
most nutritious hind milk to grow strong
and healthy.
Foremilk quenches thirst because it is
more watery.
Ensure that your wife who is
breastfeeding has two extra meals a day
to maintain her health and the health of
the baby.
To maintain their health,
breastfeeding women need to eat a
wide variety of foods, particularly
animal products (meat, milk, eggs, etc),
fruits and vegetables.
Hind milk is richer and satisfies the
baby’s hunger so that it will not cry as
much.
Ripe papaya, orange, carrot, pumpkin,
mango and liver are especially good for
the mother.
7. Mother
During illness, increase the frequency of
breastfeeding for your baby to recover
faster.
Continue
to
breastfeed
during
diarrhea,
even
increasing
the
frequency, to replace the liquid lost.
Breastfeeding more during illness will
help your baby to fight the sickness
and not loose weight.
Breastfeeding also provides comfort
to a sick baby.
Sick mothers can continue to
breastfeed their baby.
43
WHO?
8. Mother
ACTION
After each illness increase the frequency of
breast feeding for the baby to regain health
and weight.
WHY?
Each time a baby is sick, it will
loose weight so it is important to
breastfeed as often as possible.
Your breast milk is the safest and
most important food you can offer
your baby to regain its health and
weight.
9. Mother
Take Vitamin A supplementation within 45
days of delivery for the baby’s health and
strength.
Ask a Health Worker for Vitamin
A supplementation after the birth
of the baby.
Taking a Vitamin A capsule will
enrich the mother’s breastmilk
with important nutrients to keep
the baby healthy and strong.
10.All family
members
Sleep under an insecticide treated net
(INT), especially pregnant women and
children, to prevent getting malaria.
Malaria causes anemia which will
make members of your family
unwell and very tired.
Family members with fever need to
be taken to a health facility for
immediate treatment.
11. Mother
and
father
12. Mother
and
father
Use LAM as a family planning method:
1. if the mother does not have her menses,
2. if the baby is exclusively breastfeed, and
LAM is a modern family planning
method, effective to 98% if the 3
conditions are met
3. if the baby is less than 6 months
When your baby is older than 6 months, or if
one of the conditions of LAM does not exist,
visit the health facility or Community Based
Reproductive Health Agent to obtain
another Family Planning method
Don’t wait until the baby is 6
months to decide on which family
planning method you want to have.
Additional nutrition message for infants 0 to 6 months on Vitamin D
WHO?
Mother
and
father
ACTION
Expose your baby to sunlight for 20 to 30
minutes daily to ensure it grows well
WHY?
Exposure to sunshine will help
ensure your baby has adequate
Vitamin D which is important for
bone growth and good health.
44
Annex 2: Key Messages for Ethiopia on
Complementary Feeding with Breastfeeding 6 to 24 months
WHO?
1. Mother
and
father
ACTION
Introduce complementary foods at
six months of age, such as soft
porridge 2-3 times a day, for your
baby to grow healthy and strong.
WHY?
Porridge can be made from many different
types of cereals and tubers (e.g. potatoes,
enset).
The consistency of the porridge should be
thick enough to be fed by hand.
Thicken the porridge as the baby grows
older, making sure that it is still able to
easily swallow without choking.
Thin gruels made with water are not
healthy for your baby as they do not
provide enough of the nutrients it needs
to grow strong and healthy.
When possible use milk instead of water
to prepare the porridge.
Foods given to the child must be stored in
hygienic conditions to avoid diarrhea and
illness.
First types of complementary foods, such
as porridges, found in different regions
that can be used to feed babies 6 to 12
months of age include:
SNNPR:
- husifa (Sidama)
- bulla, genfo (Gurage/Cheha)
- uncha shandra (N. Omo/Konta)
- boru-de-libajun (Bench and
Majil/Menit)
- boru-de-wedida (Bench and
Majil/Menit)
Oromia:
- shura (E. Marage/Kersa Jurso)
- merqa (E. Wellega)
Amhara:
- genfo
45
WHO?
ACTION
WHY?
2. Mother
Continue to breast feed your child on
demand, at least 8 times, day and night
until two years and beyond to maintain
its strength.
During the first and second year,
breastmilk is still an important source
of nutrients for your baby.
3. Mother
Enrich your baby’s porridge with 2 to 3
different types of foods at each meal
(such as butter, oil, peanuts, meat, eggs,
lentils, vegetables and fruits) for it to
grow and get strong.
From 6 months onwards, feed your
child 2-3 types of different
enrichment foods with the porridge at
each meal, in addition to breastmilk.
Try to feed different foods each time.
Mash and soften the enrichment foods
so the baby can easily chew and swallow
without choking.
Cow’s milk can be offered to your child
in addition to the enrichment foods
given, however, not to replace the
enrichment foods.
Add butter and oil every time.
Animal foods (meat, liver, fish, eggs)
are especially good for your baby and
will keep it healthy and strong.
Ripe orange/yellow fruits (papaya,
mangos) and vegetables (carrots) are
good sources of Vitamin A.
Dark green leaves (kale, chard,
shiferaw)
and
legumes
contain
important nutrients such as iron and
will help your baby grow strong.
Types of enrichment foods that can be
given with the porridge include:
Oil and butter
Meat and fish
Eggs
Peanuts, beans, peas or lentils
Ripe papaya or mangoes
Carrots
Avocados
Dark green leafy vegetables
and
father
46
WHO?
4. Mother
and
father
5. Mother
and
father
ACTION
WHY?
From 6 to 12 months of age, in addition
to the 2-3 servings of enriched porridge,
also feed your baby 1-2 other solid
foods (mekses) each day to ensure
healthy growth.
Babies have small stomachs and can
only eat small amounts at each meal so
it important to feed them frequently
throughout the day.
By 8 months the baby should be able to
begin eating finger foods such as
pieces of ripe mango & papaya, avocado,
banana, other fruits & vegetables,
fresh & fried bread products, boiled
potato, sweet potato, kita (unleavened
bread), etc.
Feed these finger foods as snacks
(mekses) at least 1-2 times each day
Foods given to the child must be stored
in hygienic conditions to avoid diarrhea
and illness.
It is very important that the family’s
meals are also enriched with a variety
of foods and that the child eats a
variety of foods.
Young children have small stomachs and
can only eat small amounts at each meal
so it important to feed them
frequently throughout the day.
Other solid foods (mekses) can be
given as many times as possible each
day and can include ripe mango &
papaya, avocado, banana, other fruits &
vegetables, fresh & fried bread
products, boiled potato, sweet potato,
kita (unleavened bread), etc.
and illness.
From 12 to 24 months of age, feed your
child at least 3-4 times a day using
family foods, along with 1-2 other solid
foods (mekses) each day to ensure
healthy growth.
47
WHO?
6. Mothers
and
fathers
7. Mother
8. Mother
and
father
9. Mother
and
father
ACTION
As your baby grows older, feed more
food at each meal in order to ensure
that they are eating enough to maintain
healthy growth.
WHY?
Change recipes each day using a variety
of different foods remembering to
encourage your child to eat more at
each meal as they get older
At first the baby may need time to get
used to eating foods other than
breastmilk so have patience and take
enough time to feed them, even using
play to help them eat. Make the time
for eating special.
Use a separate plate to feed the child
to make sure it eats all the food given.
Forced feeding will discourage babies
and young children from eating.
As they are too little to feed
themselves, babies need to be fed
directly to make sure they eat all the
food given to them.
Even when older, young children should
be supervised during mealtime to make
sure they eat all the food put on their
plate.
During illness, increase the frequency of Fluid and food requirements are higher
breastfeeding and offer additional food during illness.
Take time to patiently encourage your
to your child to help it recover faster.
sick child to eat as their appetite may
be decreased because of the illness.
It is easier for a sick child to eat small
frequent meals so feed the child foods
it likes in small quantities throughout
the day.
It is important to keep breastfeeding
and feeding complementary foods to
your child during illness to maintain its
strength and reduce the weight loss.
Children who have been sick need extra
When your child has recovered from an
food and should be breastfed more
illness, give one additional meal of solid
frequently to regain the strength and
food each day during the two weeks
weight lost during the illness.
that follow to help it recover quickly.
Be patient and actively encourage your
baby to eat all its food in order to grow
healthy.
48
10. Mother
and
father
11. Mother
and
all family
members
12. Mother
and
father
13. Mother
and
father
Feed your baby using a clean cup and
spoon, never a bottle as this may cause
your baby to get diarrhea.
Wash your hands with soap and water
before preparing food, before eating,
and before feeding young children to
avoid diarrhea.
When your baby is 6 months old, make
sure it receives Vitamin A
supplementation every six months to
make it strong.
Find ripe orange/yellow fruits and
vegetables or liver to feed your child to
keep it healthy.
Take enough time to actively encourage
your child to eat this extra food as
they still may not appear hungry due to
the illness.
Nutritious porridges for children
should be thick enough to be fed by
hand. Porridge that is too watery and
can be fed with a bottle will not help
your baby to grow.
Bottles are very difficult to keep clean
and can make your baby sick with
diarrhea.
Cups can be used to feed your baby,
are easy to keep clean and are cheaper
to buy than a bottle.
Touching food with unclean hands can
cause diarrhea.
Utensils for feeding the baby also have
to be clean.
Use a cup to feed a baby or a young
child never a bottle which can cause
diarrhea.
and illness.
Ask a Health Worker to give Vitamin A
supplementation two times a year to
your child between 6 to 59 months of
age.
Vitamin A is important for your child’s
eyesight as well as will help your child
fight illness.
Be sure to bring your child to Vitamin A
supplementation sessions during Child
Health Days.
These foods are good sources of
Vitamin A and other nutrients that will
help your child grow strong and
healthy.
49
14. Mother
and
father
15. All family
members
16. Mother
and
father
When your child is two years old, it has
to receive de-worming medicine every
six months to maintain healthy growth.
Sleep under a insecticide treated net
(INT), especially pregnant women and
children, to prevent getting sick with
malaria.
Ensure that all family food is cooked
using iodized iodized salt so that family
members remain healthy.
Children should eat these foods as
often as possible.
Ask a Health Worker for de-worming
medicine to be given two times a year
to your child between the ages of 2 to
5 years.
Intestinal parasites cause young
children to become anemic which will
make your child unwell and tired.
Malaria causes anemia which will make
members of your family unwell and very
tired.
Family members with fever need to be
taken to a health facility for immediate
treatment.
Iodized iodized salt is not available
everywhere, but should be used when
available.
Pregnant women need to use iodized
iodized salt to ensure the health of
their new baby.
Additional nutrition message for children 6 to 12 months on Vitamin D
WHO?
Mother
and
father
ACTION
Expose your child to sunlight for 20 to
30 minutes daily to ensure it grows well
WHY?
Exposure to sunshine will help ensure
your child has adequate Vitamin D
which is important for bone growth and
good health.
50
ANNEX 3
Foods used to prepare these recipes and their nutrient composition
per 100 gram edible portion.
Food items
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
Bulla
Maize flour
Pea flour [shiro]
Enjera of maize
Meat
Milk
Egg
Kale
Potato
Carrot
Onion
Papaya
Lemon
Orange
Banana
Oil
Heart, beef
Kidney beans
Sugar
Human breast milk
Avocado
Mango
Bread of bulla
Tomato
Pumpkin
Wheat Flour
Barley Flour
Teff Flour
Enjera of teff
Bread of Wheat
Lentil Spilt
Sorghum Flour
Enjera of sorghum
Calories
Protein in
grams
Iron in
milligrams
196.0
378.2
352.2
159.0
114.8
73.7
152.9
46.0
199.0
27.8
71.3
34.9
48.5
33.9
87.8
896.4
219.7
170.3
385.0
70.0
110.1
43.8
186.1
30.7
42.6
362.9
368.0
355.1
166.0
251
355.1
374.8
224
0.9
9.0
20.1
4.4
19.8
3.4
11.6
2.8
1.9
0.40
1.06
0.70
0.40
0.70
0.80
0
28.8
9.1
0
1.0
1.6
0.3
0.3
1.3
1.2
10.9
8.5
9.0
4.9
7.8
23
8.1
5.8
10.1
7.0
13.9
9.8
3.3
1.0
4.3
4.1
1.7
0.50
0.80
0.50
0.50
0.80
0.50
0
8.2
3.3
0
0.006[absorbed]
1.7
0.6
4.6
0.9
1.8
5.7
6.3
150
56
7.1
43.1
8.9
7.4
51
ANNEX 4
Different Types of Coffee Cups Observed During Community
Assessment
[
Coffee cup commonly used in almost all communities and we used as
standard (70 ml)
Coffee cup used in few house holds
=
52
Coffee cup in some parts of Oromia
=
Coffee cup in some parts of Oromia
=
Coffee cup of konso
=
53

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