complementary feeding recipebook

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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, RelatedComplementary Feeding, and Maternal Nutrition Program, and was made possible throughfunding from the United States Agency for International Development (USAID) providedto the Academy for Educational Development (AED) under the terms of CooperativeAgreement No. HRN-A-00-97-00007-00. The opinions expressed herein are those of theauthors and do not necessarily reflect the views of the USAID or AED.



Table of ContentsPage

Section I: Ethiopian Infant & Young Child Feeding Recommendations

A. Feeding infants 0-5 months old . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2B. Feeding children 6-23 months old . . . . . . . . . . . . . . . . . . . . . . . . . . 3C. Responsive feeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Section II: Complementary Feeding of Infants 6-11 months of age

A. Ethiopian Feeding Guidelines: infants 6-11 months . . . . . . . . . . . 6B. Recipes for Three Staple Groups: Group 1: maize and enset

Recipe 1: Bulla porridge enriched with milk, carrots andoil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Recipe 2: Maize porridge enriched with kidney beans,

tomato and oil/butter . . . . . . . . . . . . . . . . . . . . . . . 8Recipe 3: Bulla porridge enriched with milk, tomato andoil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Recipe4: Mashed potato enriched with kale, carrot milk andoil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Recipe 5: Bulla and pea porridge enriched with pumpkin andoil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Recipe 6: Maize porridge enriched with milk, tomato andoil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Recipe 7: Mashed beef heart with potato, carrot, kale, egg

and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Recipe 8: Enjera with shiro, onion and tomato . . . . . . . . . . . . 14

Group 2: teff, wheat and barley

Recipe 9: Teff porridge enriched with milk, carrot, tomatoand oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Recipe 10: Wheat porridge enriched with milk, pumpkinand oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Recipe 11: Mashed potato porridge enriched with tomato,milk and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . 17

Recipe 12: Barley porridge enriched with milk, pea/bean

flour, carrots and oil/butter . . . . . . . . . . . . . . . . 18Recipe 13: Enjera with shiro , onion, carrot and tomato . . . . 19Recipe 14: Enjera with meat, potato, kale and oil/butter. . . . 20

Group 3: maize and sorghum

Recipe 15: Sorghum porridge enriched with tomato, carrot,milk and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . 21



Recipe 16: Maize porridge enriched with pumpkin, milk andoil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Recipe 17: Sorghum porridge enriched with Tomato, carrotand oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Recipe 18: Mashed potato enriched with carrot, milk andoil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Recipe 19: Sorghum porridge enriched with pea flour, kaleand oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Recipe 20: Maize porridge enriched with pumpkin, tomatoand oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Recipe 21: Potato porridge enriched with carrot, egg andoil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Section III: Complementary Feeding of Children 12-23 months of age

A. Ethiopian Feeding Guidelines: children 12-23 months . . . . . . . . . 29B. Recipes for Three Staple Groups:Group 1: maize and enset

Recipe 22: Enjera with kale, potato, egg and oil/butter,with milk to drink . . . . . . . . . . . . . . . . . . . . . . . . . 30

Recipe 23: Enjera with potato, carrot, kale and egg, withmilk to drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

Recipe 24: Bulla porridge enriched with kale, milk andoil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Recipe 25: Enjera with meat and kale, with milk to drink. . . 33Group 2: teff, wheat and barley

Recipe 26: Tef f porridge enriched with pea flour, carrotmilk and oil/butter, with milk to drink . . . . . . . . . 34

Recipe 27: Barley porridge enriched with kale, egg, milk andoil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Recipe 28: Enjera with lentile and carrot sauce, with milkto drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Group 3: maize and sorghum

Recipe 29: Sorghum porridge enriched with pea flour,

carrot and oil/butter, and milk to drink . . . . . . . 37Recipe 30: Enjera with potato and carrots, with milk to

drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38Recipe 31: Sorghum porridge enriched with kale, milk and

oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39Recipe 32: Enjer a with meat and kale sauce, with milk to

drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40



References

Annex 1: Key ‘Essential Nutrition Action’ Messages for Feeding Infants 0-5 monthsAnnex 2: Key ‘Essential Nutrition Action’ Messages for Feeding Children

6-23 months

Annex 3: Food Composition TableAnnex 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 monthsand was adopted from materials originally developed by Ethiopian Health and

Nutrition Research Institute, all of which are listed in the referencesection. We are grateful to have had this valuable technical background onwhich 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 encouragementin the preparation and production of this book on how to feed children 6-23months of age in Ethiopia. Special thanks are also given to Aster Mekonenfor her help in the LINKAGES/Ethiopia kitchen during the testing of therecipes. Appreciation is also extended to other members of the LINKAGES

team and colleagues from other organizations, foremost the FederalMinistry of Health, for their input and support.

LINKAGES/Ethiopia

August 2006



Introduction

Studies show that malnutrition is a significant health problem for infantsand young children in Ethiopia. Though poverty is the underlining cause of

malnutrition, inadequate food security, sup-optimal infant caring practiceand limited access to water and sanitation services are also important causesof child malnutrition. Improved child care and infant feeding practices areimportant interventions for reducing infant and young child malnutrition.

The purpose of this book is to provide service providers with informationnecessary for counseling mothers and child caretakers on how to feed theirchildren 6-23 months, specifically on aspects of complementary feeding inaddition to continued breastfeeding. Complementary feeding means givingother 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 growinginfant’s nutritional needs. Complementary foods are needed to fill thecalorie, protein and micronutrient gap between the total nutritional needs ofthe child and the amount provided by breast milk.

The book contains simple nutritious complementary feeding recipes that canbe prepared from locally available foods for three major staple eating areasof the country, including (1) maize/enset /teff , (2) wheat/barley, and (3)sorghum/maize. The recipes have been developed to meet the changingnutritional needs of children in two age groups, 6-11 months and 12-23

months, in terms of calories, consistency and thickness. It is assumed thatchildren are still receiving breast milk, thus the amounts and types of foodshave been determined to provide the additional nutrients needed fromcomplementary foods1. These amounts conform to the recommendationscontained in the internationally accepted Guiding Principles on the

Complementary Feeding of the Breastfed Child (PAHO 2002) as well as wellas take into account the adaptation of these principles by the FederalMinistry of Health in Ethiopia (see Annex 2 for Ethiopia’s EssentialNutrition Action Messages). Techniques for mothers and child caretakersto more effectively feed children using a ‘responsive feeding approach’ arealso presented.

1 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 andprovide the calories needed by a breastfed child from complementary foods, roughly 300calories at 6-11 months of age and 550 calories at 12-23 months of age.



For all the recipes contained in this book, a commonly found measuring unit, a70 ml ‘bunna’ coffee cup, was used. Using this type and size coffee cupallows for standardization of recipes, nutrition messages and IEC tools.Annex 4 shows some other cups occasionally used in certain localities in thecountry. The equivalent number of 70 ml coffee cups is shown for each of

these other types of measuring cups so that appropriate conversions can bemade by service providers working in these localities of the country.



1

Section I

Ethiopian Infant & Young Child FeedingRecommendations

0 to 23 months



A. Ethiopian Feeding Guidelines: birth to 6 months



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 canuse 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 easilydistracted. Therefore he/she needs help. When a child does not eatenough, he/she will become malnourished.

• Let the child eat from his/her own plate (caregiverthen knows how much the child is eating)

• Sit down with the child and encourage him/her ifneeded.

• Offer food the child can take and hold; the youngchild often wants to feed him/herself. Encourage him/her to, but makesure 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 withthe family in order to create an atmospherepromoting his/her psycho-affectivedevelopment.

• 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.



2

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 tocounsel 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 practicesfor 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 thatmothers 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. Recipesare 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 foodsfortified with iron should be used whenever available.

** Encourage families to add meat each day to the following recipes when possible **



RECIPE 1: BULLA PORRIDGE ENRICHED WITH MILK, CARROTS

AND OIL/BUTTER

How to prepare the enriched porridge:

1. Mix the bulla flour with water and milk, add iodized salt and put on the fire.

2. Peel, boil and mash carrot.3. To porridge, add mashed carrot and butter/oil and continue to cook well with

continuous stirring4. Cool porridge, squeeze the lemon into it and mix 5. 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.

Ingredients AmountWeight

gram

Calories

kcal

Protein

gram

Iron

mg

Bulla flour just over 1/2 coffee cup 53 gram 104 0.5 5.3

Milk 1 full coffee cup 70 ml 52 2.4 0.7Carrot 1 carrot 30 gram 9 0.2 0.2

Butter/oil 3 teaspoons 15 gram 134 0 0

Water 4 1/2 coffee cups 315 ml 0 0 0

Iodizedsalt

for taste 0 0 0 0

Lemon 1 medium size 15ml 7 0.1 0.

Banana 1 small size 35 gram 31 0.3 0.2

Total Amount 337 3.5 6.4

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!



Staple Food Group 1: maize/enset

5

RECIPE 2: MAIZE PORRIDGE ENRICHED WITH KIDNEY BEANS,

TOMATO AND OIL/BUTTER


1. Soak kidney beans overnight in water.2. Boil beans in water, remove skin and mash.3. Boil, peel off skin and chop tomato.4. Mix maize flour into water, bring to boil and add iodized salt5. Mix in tomato, butter/oil and mashed beans & stir until cooked properly.6. Cool porridge and feed the baby with spoon using patience and encouragement.

Note: Whenever available use teff, barley, wheat or sorghum flour instead ofmaize 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.3. Feed the baby with spoon.


gram

Calories

kcal

Protein

gram

Iron

mg

Maize flour just over half a coffee

cup

53 gram 198 4.8 3.8

Butter/oil 1 ½ teaspoon 7 ml 63 0 0

Kidneybeans

1 ½ teaspoon 7 gram 19 0.7 0.3

Tomato 1 tomato 30 gram 6 0.5 0.3

Water 5 ½ coffee cups 385 ml 0 0 0

Iodizedsalt

for taste 0 0 0 0

Ripeavocado

½ medium sized 50 gram 55 0.8 0.8



• 3 coffee cups of enriched maize porridge fed over 2-3 feedings• 1 ripe avocado as mekses





6

RECIPE 3: BULLA PORRIDGE ENRICHED WITH MILK, TOMATO AND

OIL/BUTTER


1. Mix bulla flour with water and milk, add iodized salt and put on the fire.2. Boil, peel and chop the tomato.3 Add the tomato, butter/oil and stir it till properly cooked.4. Allow to cool and squeeze the lemon on it & mix.5. Feed baby with spoon using patience and encouragement.



Ripe mango for mekses

1. Wash and peel mango2. Mashed it by clean spoon & cup.3. Feed the baby with spoon


gram

Calories

kcal

Protein

gram

Iron

mg

Bulla More than half coffee

cup

53 gram 104 0.5 5.3

Tomato 1 tomato 30 gram 9 0.5 0.3

Butter/oil 2 teaspoon 10 ml 90 0 0

Milk 1½ coffee cup 105ml 78 3.6 1.1

Lemon 1 medium size 15ml 7 0.1 0.1

Water 4 ½ coffee cups 315ml 0 0 0

Iodizedsalt

for taste 0 0 0

Ripe mango ½ medium sized 50 gram 22 0.2 0.3



• 3 coffee cups of bulla porridge enriched with milk, tomato andoil/butter fed over 2-3 feedings

• 1 ripe mango as mekses





7

RECIPE 4: MASHED POTATO ENRICHED WITH KALE, CARROT,

MILK AND OIL/BUTTER


1. Wash, chop and boil the kale.2. Peel carrot and potato, wash, chop and boil.3. When properly cooked, take the kale, carrot and potato off the fire and mash.4. Mix the milk into the mashed potato, kale and carrot.5. Add butter/oil and iodized salt and put the cooking pan on the fire.6. Stir the mixed ingredients till properly heated.7. 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 banana2. Mashed in clean cup with spoon.3. Feed the baby with spoon.


gram

Calories

kcal

Protein

gram

Iron

mg

Potato 1 medium size potato 80grams 159 1.5 1.4

Carrot 1 carrot 30 gram 9 0.2 0.2

Kale 3 leaves 40 gram 18 1.1 1.6

Milk (boiledand cooled)

More than one coffee cup 75ml 56 2.6 0.8

Butter/oil 1½ teaspoon 7 ml 63 0 0

Iodizedsalt

for taste 0 0 0

Banana ½ medium sized 25 gram 22 0.2 0.1



• 3 coffee cups of mashed potato with kale, carrot, milk and oil/butterfed over 2-3 feedings

• 1 banana as mekses





8

RECIPE 5: BULLA AND PEA PORRIDGE ENRICHED WITH PUMPKIN

AND OIL/BUTTER


1. Mix the bulla with the beans or pea flour.2. Pour water into the mixed flour, add iodized salt and put on the fire.3. Peel pumpkin, remove the seed and chop; then boil in water.4. Once cooked, mash pumpkin well.5. Add oil/butter to pumpkin, and cook with stirring.6. Allow to cool and squeeze the lemon into mixture7. Feed the baby with spoon, using patience and encouragement.

Note: Whenever available use 45 gram finely minced meat instead of pea flour.



Avocado for mekses

1. Wash and peel avocado2. Mashed with spoon in a clean cup.3. Feed baby with spoon


gram

Calories

kcal

Protein

gram

Iron

mg

Bulla flour More than half a coffeecup

55 gram 108 0.5 5.5

Pea orbeans flour

3 teaspoons 15 gram 53 3.0 2.1

Pumpkin 1 slice 10 gram 4 0.1 0.2

Butter/oil 2 teaspoons 10 ml 90 0 0


Water 5 coffee cups 350ml 0 0 0

Iodizedsalt

for taste 0 0 0

Avocado ½ medium sized 50 gram 55 0.8 0.9Total Amount 317 4.5 8.8


• 3 coffee cups of bulla and pea porridge enriched with pumpkin andoil/butter fed over 2-3 feedings

• 1 ripe avocado as mekses





9

RECIPE 6: MAIZE PORRIDGE ENRICHED WITH MILK, TOMATO AND

OIL/BUTTER


1. Mix the maize flour with water and milk & put it on the heat2. Add iodized salt.3. Boil, peel and chop the tomato.4. Add the tomato, butter or oil & stir until cooked properly.5. 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 Banana2. Mashed it in clean cup with spoon.3. Feed the baby with spoon.


gram

Calories

kcal

Protein

gram

Iron

mgMaize flour More than half coffee

cup55 gram 208 4.9 3.9

Tomato 1 small size 20 gram 6 0.3 0.2

Milk More than half coffeecup

50ml 37 1.7 0.5


Iodizedsalt

for taste 0 0 0 0


Banana 1 medium sized 50 gram 44 0.4 0.3



• 3 coffee cups of maize porridge enriched with milk, tomato andoil/butter over 2-3 feedings






10

RECIPE 7: MASHED BEEF HEART WITH POTATO, CARROT, KALE,

EGG AND OIL/BUTTER


1. Chop beef heart into very small pieces and fry in oil.2. Wash and chop the kale and add to heart.3. Wash, peel, chop and boil carrots and potatoes in water.4. Cook carrots and potatoes thoroughly, take off the fire and mash..5. Add to beef heart mixture, mashing together well.6. Beat egg and add to the mashed mixture.7. Add iodized salt and continue to cook and stir.8. 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.


gram

Calories

kcal

Protein

gram

Iron

mg

Potato 1 small sized potato 50 gram 100 1.0 0.9Carrot 1 small sized carrot 20 gram 6 0.1 0.1

Egg 1 small egg 35 gram 54 4.0 1.5

Heart ofbeef




Iodizedsalt

for taste 0 0 0

Ripe papaya ¼ small size 60 gram 21 0.4 0.3



• 3 coffee cups of mashed beef heart with potato, carrot, kale and eggfed over 2-3 feedings

• 1 ripe papaya as mekses





11

RECIPE 8: ENJERA WITH SHIRO, ONION AND TOMATO

How to prepare the chopped enjera and shiro :

1 Chop and fry onion in oil.2. Boil, peel and chop the tomato.3. Add the tomato to water and boil.4. Add pea flour and iodized salt and cook by stirring.5. When the shiro is properly cooked, add enjera and mix.6. 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 mekses1. Wash & peel off the orange.2. Cut in to small pieces, remove the seeds & give to the child to eat.


gram

Calories

kcal

Protein

gram

Iron

mg

Roasted

pea flour

1medium size table spoon 10 gram 35 2.0 1.4

Onion ¼ onion 10 gram 7 0.1 0.1

Tomato 1 medium size 30 gram 9 0.4 0.3


Water 4 coffee cups 280 ml 0 0 0

Iodizedsalt

for taste 0 0 0

enjera 1/5 of one enjera 60 gram 95 2.6 5.9

Orange 1 big size 100gram 34 0.7 0.8



• 3 coffee cups of finely chopped enjera with shiro , onion and tomato

fed over 2-3 feedings• 1 orange as mekses




Staple Food Group 2: teff /wheat/barley

15

RECIPE 9: TEFF PORRIDGE ENRICHED WITH MILK, CARROT,

TOMATO AND OIL/BUTTER


1. Mix the teff flour with milk and water, add iodized salt and put on the fire.2. Peel, boil and mash carrot.3. Boil, peel and chop the tomato.4. Add carrot, tomato, butter or oil to porridge and cook by continuously stirring.5. Wait until mixture cools and feed the baby with spoon using encouragement

and patience


Preparation and cooking time: 25 minutesRipe papaya for mekses

1. Wash, cut and remove the seeds of papaya.2. Mash in a clean cup with spoon.3. Feed the child with spoon.

Ingredients Amount WeightGram

Calorieskcal

Proteingram

Ironmg

Teff flour More half coffee cup 45 gram 161 4.1 67.5

Tomato 1 Tomato 30 gram 9 0.5 0.3

Carrot 1 small sized carrot 20 gram 6 0.1 0.1

Milk More one coffee cup 75 ml 56 2.6 0.8



Iodizedsalt

for taste 0 0 0

Ripe papaya ¼ Small size 50 gram 17 0.5 1.4Total Amount 312 7.8 70.1


• 3 coffee cups of teff porridge enriched with milk, carrot, tomatoand oil/butter fed over 2-3 feedings






16

RECIPE 10: WHEAT PORRIDGE ENRICHED WITH MILK, PUMPKIN

AND OIL/BUTTER


1. Mix the wheat flour with water and milk.2. Heat and add iodized salt3. Peel pumpkin, remove the seed, chop and boil in water.4. When cooked, remove from heat, and mash pumpkin.5. Add pumpkin and oil/butter to porridge and stir until cooked.6. 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 orange2. Feed the baby with spoon.


gram

Calories

kcal

Protein

gram

Iron

mgWheatflour

More than half coffeecup

45 gram 164 5.0 1.8

Pumpkin 1½ slice 15 gram 6 0.2 0.3

Milk Just over 1 coffee cup 75 ml 56 2.6 0.8



Iodizedsalt

for taste 0 0 0

Orange

1 medium sized orange 50 gram 17 0.4 0.4



• 3 coffee cups of wheat porridge enriched with milk, pumpkin andoil/butter fed over 2-3 feedings

• 1 orange as mekses





17

RECIPE 11: MASHED POTATO PORRIDGE ENRICHED WITH TOMATO,

MILK AND OIL/BUTTER


1. Wash potato and carrots, peel, chop and boil.2. When potato and carrots are cooked, remove from heat and mash.3. Boil water and add tomato.4. Remove tomato and chop into small pieces5. 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.2. Mashed it by clean spoon & cup.3. Feed the baby with spoon.


gram

Calories

kcal

Protein

gram

Iron

mg

Potato 1 medium size 80 gram 159 1.5 1.4Tomato 2 medium sized 100

gram30 1.4 1.0



50 ml 37 1.7 0.5

Oil 1 ½ tea spoon 7 ml 63 0 0

Iodizedsalt

For taste 0 0 0 0

Ripe

avocado

½ medium sized 50 gram 55 0.8 0.9



• 3 coffee cups of mashed potato enriched with tomato, milk and oilfed over 2-3 feedings






18

RECIPE 12: BARLEY PORRIDGE ENRICHED WITH MILK, PEA/BEAN

FLOUR, CARROTS AND OIL/BUTTER


1. Mix the barley with the pea flour.2 Add water, milk and iodized salt into the mixed flour and put on the fire.3. Wash, peel, chop, and boil carrot in water.4. Take off fire and mash5. Add the mashed carrot and butter/oil to porridge, and cook by stirring.6. Allow to cool and feed with spoon, using encouragement and patience.

Cooked amount: 3 coffee cup


Banana for mekses

1. Wash and peel banana2. Cut in to small pieces & give to the child to eat


gram

Calories

kcal

Protein

gram

Iron

mg

Barleyflour

More than half coffeecup

40 gram 147 3.4 2.5

Pea orbeans flour

1 teaspoon 5 gram 18 1.0 0.7

Carrot 1 small size 20 gram 6 0.1 0.1

Milk ½ coffee cup 35ml 26 1.2 0.4

Butter/oil 2 teaspoon 10ml 90 0 0


Iodizedsalt

For taste - 0 0 0

Banana 1 medium size 50 gram 44 0.4 0.3Total Amount 331 6.1 4


• 3 coffee cups of barley porridge enriched with milk, pea/bean flour,carrots and oil/butter fed over 2-3 feedings






19

RECIPE 13: ENJERA WITH SHIRO, ONION, CARROT AND

TOMATO


1. Roast the onion with oil.2. Wash, peel, boil and mash carrot.3. Boil, peel and chop the tomato.4. Add the tomato to water and boil.5. Add pea flour and iodized salt and cook by stirring.6. When the shiro is cooked, add the enjera and chop.7. Also add mashed carrot to mixture.8. 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


gram

Calories

kcal

Protein

gram

Iron

mg

Roastedpea flour 1 medium table spoon 10gram 35 2.0 1.4

Tomato 1 small size 20 gram 6 0.3 0.2

Onion ½ onion 20 gram 14 0.2 0.2




Iodizedsalt

for taste 0 0 0

enjera 1/5 of one enjera 60 gram 100 2.9 33.6




• 3 coffee cups of finely chopped enjera with shiro, onion, carrot, andtomato fed over 2-3 feedings






20

RECIPE 14: ENJERA WITH MEAT, POTATO, KALE AND OIL/BUTTER

How to prepare the enjera dish:

1. Clean, chop and boil potato in water.2. In separate pan, fry onion in oil and add finely minced meat.3. Wash, chop and add kale to the fried onion and meat mixture4. Add small quantity of water and cook.5. Add boiled potato to onion and meat mixture.6. Add iodized salt and the remaining water and cook properly.7. Take the pan off the fire and add enjera .8. Allow to cool9. Finely chop mixture and feed to child with spoon, using encouragement and

patience.

Cooked amount: 3 coffee cupsPreparation 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.


gram

Calories

kcal

Protein

gram

Iron

mg

Meat 3 tea spoons 15 gram 17 2.9 0.5

Potato ½ small size 25 gram 50 0.5 0.4Kale 3 leaves 40 gram 18 1.1 1.6


Oil 2 tea spoons 10 gram 90 0

enjera 1/5 enjera 60 gram 100 2.9 33.6


Iodizedsalt

For taste - 0 0 0

Orange 1 big size 100gram 34 0.7 0.8Total Amount 323 8.3 34.4


• 3 coffee cups of finely chopped enjera with meat, potato and kale

fed over 2-3 feedings• 1 orange as mekses




Staple Food Group 3: maize/sorghum

21

RECIPE 15: SORGHUM PORRIDGE ENRICHED WITH TOMATO,

CARROT, MILK AND OIL/BUTTER


1. Mix sorghum flour with water, milk and iodized salt and put on the fire.2. Boil, peel and chop the tomato.3. Clean, peel, boil and mash carrot.4. To the porridge, add tomato, mashed carrot, oil/butter and cook well by

continuously stirring.5. Wait until it gets cool and feed baby with spoon, using encouragement and

patience.

Cooked amount: 3 coffee cups.Preparation and cooking time: 30 minutes.

Orange for mekses

1. Wash and peel orange.2. Cut in to very small pieces & give to child to eat.

Ingredients Amount Weightgram

Calorieskcal

Proteingram

Ironmg

Sorghumflour

Almost one coffee cup 60gram 225 4.9 5.3





Milk Just over 1/2 coffee cup 35 ml 28 1.3 .4

Iodized

salt

for the taste - 0 0 0

Orange 1 medium size 50 gram 17 0.4 0.4



• 3 coffee cups of sorghum porridge enriched with tomato, carrot, milkand oil/butter fed over 2-3 feedings






22

RECIPE 16: MAIZE PORRIDGE ENRICHED WITH PUMPKIN, MILK

AND OIL/BUTTER


1. Mix maize flour with milk and water.2. Put it on fire, add iodized salt, and heat.3. Peel, remove seed, chop and boil the pumpkin in water.4. Take off heat and mash pumpkin.5. To the pumpkin mixture, add the oil/butter and stir until cooked.6. 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 sorghumflour instead.



Orange for mekses

1. Wash & peel orange.2. Cut in to small pieces & give to the child to eat.


gram

Calories

kcal

Protein

gram

Iron

mg

Maize flour Almost one coffee cup 60 gram 227 0.6 4.2

Pumpkin 1½ slice 15 gram 6 0.2 0.3


50 ml 37 1.7 0.5



Iodizedsalt

for the taste 0 0 0

Orange 1medium size 50gram 17 0.4 0.4



• 3 coffee cups of maize porridge enriched with pumpkin, milk andoil/butter fed over 2-3 feedings






23

RECIPE 17: SORGHUM PORRIDGE ENRICHED WITH TOMATO,

CARROT AND OIL/BUTTER


1. Pour water into the flour, add iodized salt and put on the fire.2. Boil, peel and chop the tomato.3. Clean, peel, boil and mash carrot4. To the porridge add the tomato, carrot and butter/oil and stir it till properly

cooked5. 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.


gram

Calories

kcal

Protein

gram

Iron

mg

Sorghumflour

Almost one coffee cup 60 gram 225 4.8 5.4




Iodizedsalt

for the taste 0 0 0

Water 4 ½ coffee cups 315ml 0 0 0

Lemon 1 medium sized 15ml 7 0.1 0.1

Ripe papaya ¼ small size 50gram 17 0.5 1.5

Total Amount 327 6 7.4


• 3 coffee cups of sorghum porridge enriched with tomato, carrot andoil/butter fed over 2-3 feedings






24

RECIPE 18: MASHED POTATO ENRICHED WITH CARROT, MILK

AND OIL/BUTTER


1. Peel carrot and potato, wash, chop and boil2. When cooked well take potatoes and carrots off the fire, and mash well3. Add the milk into the potato and carrot mixture4. 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 Mango2. Mashed it by clean spoon & cup.3. Feed the baby with spoon


gram

Calories

kcal

Protein

gram

Iron

mgPotato 1 medium size potato 80

grams159 1.5 1.4

Carrot 3 small carrots 60 gram 17 0.3 0.3

Milk (boiledand cooled)

1½ coffee cup 105 ml 78 3.6 1.1


Iodizedsalt

for the taste 0 0 0

Ripe mango ½ medium size 50 gram 22 0.2 0.3



• 3 coffee cups of mashed potato enriched with carrot, milk andoil/butter fed over 2-3 feedings






25

RECIPE 19: SORGHUM PORRIDGE ENRICHED WITH PEA FLOUR,

KALE AND OIL/BUTTER:


1. Wash, chop and boil the kale.2. Mix sorghum flour with bean (or pea) flour.3. Pour water into the mixed flour add iodized salt and put on fire.4. Add butter/oil and kale & cook by stirring.5. Allow to cool and feed with spoon, using encouragement and patience.




1. Wash, cut the papaya & remove the seeds.2. Cut in to small pieces & give to the child to eat.


gram

Calories

kcal

Protein

gram

Iron

mg

Sorghumflour

Almost one coffee cup 60 gram 225 4.9 5.3

Pea or beanflour

1 teaspoon 5 gram 18 1.0 0.7


Kale 3 leaves 40gram

16 1.0 1.6


Iodizedsalt

for the taste 0 0 0

Ripe papaya ¼ small sized 60 gram 21 0.4 0.3Total Amount 325 7.3 7.9


• 3 coffee cups of sorghum porridge enriched with pea flour, kale andoil/butter fed over 2-3 feedings






26

RECIPE 20: MAIZE PORRIDGE ENRICHED WITH PUMPKIN, TOMATO

AND OIL/BUTTER


1. Pour water into maize flour, add iodized salt and put it on the fire.2. Peel, remove the seed, chop and boil pumpkin.3. Take off the fire and mash it.4. Add the pumpkin and oil/butter to maize porridge, and cook by stirring.5. Allow to cool and feed with spoon, using encouragement and patience.

Note: Whenever available you can use teff, barely, wheat or sorghum flourinstead of maize flour.

Cooked amount: 3 coffee cups


Ripe avocado for mekses1. Wash and peel avocado.2. Cut in to small pieces & give to the child to eat.


gram

Calories

kcal

Protein

gram

Iron

mg

Maize flour Almost one coffee cup 60 gram 227 5.4 4.2Pumpkin 1 slice 10 gram 4 0.1 0.2


Iodizedsalt

for the taste 0 0 0


Ripeavocado

½ medium size 50 gram 55 0.8 0.9



• 3 coffee cups of sorghum porridge enriched with pumpkin, tomatoand oil/butter fed over 2-3 feedings






27

RECIPE 21: POTATO PORRIDGE ENRICHED WITH CARROT, EGG AND

OIL/BUTTER


1. Wash, peel, chop and boil the potato and carrot2. When cooked, take the carrot and potato off the fire, mash and mix them up3. Beat the egg and add to the mashed carrot and potato mixture4. Add butter/oil and iodized salt and warm by stirring.5. Allow to cool and feed with spoon, using encouragement and patience.



Papaya for mekses

1. Wash and cut papaya & remove the seeds.2. Cut into small pieces and give to child to eat.


gram

Calories

kcal

Protein

gram

Iron

mgPotato 1 big size potato 100

gram199 1.9 1.7

Carrot 2 small carrots 40 gram 11 0.2 0.2



Iodizedsalt

for taste 0 0 0




• 3 coffee cups of potato porridge enriched with carrot, egg andoil/butter fed over 2-3 feedings





28

Section III

Complementary Feeding ofChildren 12-23 months of age

The first part of this section presents a “field tool” for field workers to use with mothers tocounsel 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.) keypractices 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 thatmothers 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 agegroup. Recipes are presented for each of the three major staple food eating groups. It isrecognized 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 **




30

RECIPE 22: ENJERA WITH KALE, POTATO, EGG AND OIL/BUTTER,

WITH MILK TO DRINK

How to prepare the enriched meals:

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 .

Cooked amount: 4 coffee cups.Preparation and cooking time: 1hour and 10 minutes.


1. Wash avocado and peel off skin.2. Cut in to small pieces & give to the child to eat.


gram

Calories

kcal

Protein

gram

Iron

mg


Potato 1 medium sized potato 80grams

159 1.5 1.4



IodizedIodizedsalt

for the taste 0 0 0

enjera ofmaize

1/4 of enjera 75 gram 119 3.3 7.4

Milk to

drink

1 coffee cup 70ml 52 1.8 0.7

Ripeavocado

1 medium sized 100gram

110 1.6 1.7


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 fedover 3-4 feedings, with milk to drink

• 1 ripe avocadoe as mekses

Feed even more food if child wants to eat more!




31

RECIPE 23: ENJERA WITH POTATO, CARROT, KALE AND EGG,

WITH MILK TO DRINK

How to prepare the enjera meal:

1. Chop & fry onion in oil.2. Wash, chop and add the kale3. 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.Cooked amount: 4 coffee cups.

Preparation and cooking time: 1hour and 20 minutes.

Banana for mekses

1. Wash & peel banana

2. Cut up in small pieces and feed child


gram

Calories

kcal

Protein

gram

Iron

mg

Potato 1 medium size potato 80grams

159 1.5 1.4

Carrot 2 small size carrots 40 gram 11 0.2 0.2Onion ½ onion 20 gram 14 0.2 0.2





Iodizedsalt

for the taste 0 0 0

enjera ofmaize

¼ of enjera 75 gram 119 3.3 7.4

Milk todrink 1 coffee cup 70ml 52 1.8 0.7

Banana 1 big size 100gram

87.8 0.8 0.5

Total Amount 603.8 13.5 13.5


eat:

• 4 coffee cups of enjera with potato, carrot, kale and egg fed over 3-4 feedings, with milk to drink






32

RECIPE 24: BULLA PORRIDGE ENRICHED WITH KALE, MILK AND

OIL/BUTTER


1. Wash, chop and boil the kale2. When it is cooked take it off fire and mash it.3. Mix the bulla with milk and put it on the fire4. Add butter/oil and iodized salt & cook while stirring.5. Add the kale and stir adding a little water for further cooking6. 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.2. Cut in to small pieces & give to the child to eat.


gram

Calories

kcal

Protein

gram

Iron

mg

Maize flour 1 coffee cups 70 gram 265 6.3 4.9



Milk 2 coffee cups 140ml 103 4.7 2.8


Iodizedsalt

for the taste 0 0 0

Ripe papaya ½ small sized 100gram

35 0.7 0.5



eat:

• 4 coffee cups of bulla porridge enriched with kale, milk andoil/butter fed over 3-4 feedings






33

RECIPE 25: ENJERA WITH MEAT AND KALE, WITH MILK TO

DRINK

How to prepare the enjera meal:

1. Chop and fry onion in oil2. Add the minced meat to the roasted onion and cook by adding small quantity

of water3. Wash and chop kale and add to meat mixture.4. Add iodized salt and keep on cooking adding small quantity of water frequently5. 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

1. Wash and peel banana2. Cut in to small pieces & give to the child to eat.


gram

Calories

kcal

Protein

gram

Iron

mg

Finely

mincedmeat


Kale 4 ½ leaves 60 gram 27 1.7 2.5

Onion ½ of one onion 20 gram 14 0.2 0.2



Iodizedsalt

for the taste - 0 0 0

'Enjera' ofMaize

A quarter of one 'Enjera' 75 gram 119 3.3 7.4

Milk to

drink

2 coffee cups 140ml 103 4.7 1.4

Banana 2 big bananas 200gram

174 1.6 1.0



eat:

• 4 coffee cups of enjera with meat and kale fed over 3-4 feedings,with milk to drink





Staple Food Group 2: teff/wheat/barley

34

RECIPE 26: TEFF PORRIDGE ENRICHED WITH PEA FLOUR, CARROT,

MILK AND OIL/BUTTER, WITH MILK TO DRINK


1. Sieve the flours and mix in a pot.

2. Pour water & milk into the mixed flour and put it on the fire.3. Peel, wash and boil the carrot.4. Take off the fire and mash it.5. Add the mashed carrot, iodized salt & butter/oil to porridge and cook while

stirring.6. Allow to cool and assist child to eat, using encouragement and patience

Cooked amount: 4 coffee cupsPreparation and cooking time: 35 minutes.


1. Wash & peel off the Avocado.2. Cut in to small pieces & give to the child to eat.


gram

Calories

kcal

Protein

gram

Iron

mg

Teff Flour More than one coffeecups

80 gram 284 7.2 120.0

Peas flour 1 tea spoons 5 gram 18 1.0 0.7


Milk 1 coffee cup 70 ml 56 2.3 0.7

Oil 2 tea spoons 10 ml 90 0 0


Iodizedsalt

For the test 0 0 0

Milk to

drink

1 coffee cup 70ml 52 1.8 0.7

Ripeavocado

1 medium size 100gram 110 1.6 1.7



eat:

• 4 coffee cups of teff porridge enriched with pea flour, carrot, milkand oil/butter fed over 3-4 feedings, with milk to drink






35

RECIPE 27: BARLEY PORRIDGE ENRICHED WITH KALE, EGG, MILK

AND OIL/BUTTER:


1. Mix the flour with water & milk.2. Add iodized salt & put it on the fire.3. Wash and boil the kale.4. Take off the fire and chop.5. Add the kale & butter/oil to porridge and cook while stirring.6. Allow to cool and squeeze lemon on it.7. Allow to cool and assist child to eat, using encouragement and patience



Banana for mekses

1. Wash and peel the Banana2. Cut in to small pieces & give to the child to eat.


gram

Calories

kcal

Protein

gram

Iron

mg

Barleyflour

More than one coffeecups

80 gram 294 6.8 5.0


Milk 1 ½ coffee cups 100ml 74 3.4 1.0


Oil 2 tea spoons 10 ml 90 0 0



Iodizedsalt

For the test 0 0 0

Banana 1 big size bananas 100gram 88 0.8 0.5Total Amount 571 12.2 8.2


eat:

• 4 coffee cups of barley porridge enriched with kale, egg, milk andoil/butter fed over 3-4 feedings






36

RECIPE 28: ENJERA WITH LENTIL AND CARROT SAUCE, WITH MILK

TO DRINK

How to prepare the enriched meals:

1. Chop roasted the onion with the oil.2. Wash, chop and add the carrot in to the roasted onion3. Cook by adding small quantity of water.4. Add the lentil split and.5. Add iodized salt and the remaining water and cook properly.6. Take the preparation off the fire and mix it with enjera .7. Allow to cool and assist child to eat, using encouragement and patience


Preparation and cooking time: 1 hour


1. Wash & peel off the Avocado.2. Cut in to small pieces & give to the child to eat


gram

Calories

kcal

Protein

gram

Iron

mg

Lentil split 2 1/2 medium sized tablespoons 30 gram 107 6.9 12.9


Oil 5 teaspoons 25 ml 224 0 0

Onion ¼ onion 10 gram 7 0.1 0.1

Enjera ¼ Enjera 75 gram 124 3.7 42.0


Iodizedsalt

For the test - 0 0 0

Milk todrink

1 coffee cup 70ml 52 1.8 0.7

Ripeavocado

1 medium size 100gram

110 1.6 1.7



eat:

• 4 coffee cups of enjera with lentil and carrot sauce fed over 3-4feedings, and milk to drink






37

RECIPE 29: SORGHUM PORRIDGE ENRICHED WITH PEA FLOUR,

CARROT AND OIL/BUTTER, AND MILK TO DRINK


1. Clean the flour by sieving into a pot2. Mix the flour with water and milk..3. Add iodized salt and put it on the fire4. Peel, wash and boil the carrot.5. Take off the fire and mash it.6. Add the carrot & butter/oil and cook by stirring.7. Allow to cool and assist child to eat, using encouragement and patience

Note: When available use barley, wheat or teff flour instead of sorghum flour. Cooked amount: 4 coffee cups.



1. Wash & peel off the Avocado.2. Cut in to small pieces & give to the child to eat.


gram

Calories

kcal

Protein

gram

Iron

mg

Sorghum

flour

More than one coffee

cups

80 gram 300 6.5 7.1

Pea or beanflour

1 tea spoon 5 gram 18 1.0 0.7




Iodizedsalt

for the taste 0 0 0

Milk todrink

1 coffee cup 70ml 52 1.8 0.7

Ripeavocado


110 1.6 1.7



eat:

• 4 coffee cups of sorghum porridge enriched with pea flour, carrotsand oil/butter fed over 3-4 feedings, with milk to drink






38

RECIPE 30: ENJERA WITH POTATO AND CARROTS, WITH MILK TO

DRINK


1. Chop and fry the onion in oil.2. Peel, cop & wash the carrot and potato.3. Put little water and add the carrot. Cook for a while and then add the potato.4. 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 patienceCooked amount: 4 coffee cups.

Preparation and cooking time: 1 hour

Banana for mekses

1. Wash and peel banana2. Cut in to small pieces & give to the child to eat.


gram

Calories

kcal

Protein

gram

Iron

mg

Potato 1 medium size potato 80

grams

159 1.5 1.4

Carrot 2 small size carrots 40 gram 17 0.7 0.2

Onion A quarter of one onion 10 gram 7 0.1 0.1


Water 7 big coffee cups 490 ml 0 0 0

Iodizedsalt

for the taste 0 0 0

enjera fromSorghum

A quarter of one enjera 75 gram 168 4.4 5.6

Milk todrink

1 coffee cup 70ml 52 1.8 0.7

Banana 1 big size 100gram

88 0.8 0.5



eat:

• 4 coffee cups of enjera with potato and carrots fed over 3-4feedings, with milk to drink






39

RECIPE 31: SORGHUM PORRIDGE ENRICHED WITH KALE, MILK AND

OIL/BUTTER


1. Wash, chop and boil the kale in a pot2. When it is cooked take off the fire and mash it.3. Mix the sorghum flour with milk and water & put it on the fire4. Add butter/oil and iodized salt & cook by stirring.5. Add the kale and stir adding little water for further cooking6. Allow to cool and assist child to eat, using encouragement and patience

Cooked amount: 4 coffee cups

Preparation and cooking time: 1 hours and 20 minutes.


1. Wash & peel off the Avocado.2. Cut in to small pieces & give to the child to eat


gram

Calories

kcal

Protein

gram

Iron

mg

Sorghumflour

More than one coffeecups

80 gram 300 6.5 7.1



Milk 1 coffee cup 70 ml 52 2.4 0.7


Iodizedsalt

for the taste 0 0 0

Ripeavocado


110 1.6 1.7



eat:

• 4 coffee cups of sorghum porridge enriched with kale, milk andoil/butter fed over 3-4 feedings






40

RECIPE 32: ENJERA WITH MEAT & KALE SAUCE, WITH MILK TO DRINK


1. Chop and fry onion in oil2. Add minced meat to fried onion and cook in small quantity of water3. Wash and chop kale, and add to the meat mixture.4. Add iodized salt and keep on cooking adding small quantity of water frequently5. Take off the fire and mix with enjera .6. Assist child to eat, using encouragement and patience

Cooked amount: 4 coffee cups.Preparation and cooking time: 1hour and 35 minutes.

Ripe mango for mekses

1. Wash, peel and cut up mango2. Give to the child to eat.


gram

Calories

kcal

Protein

gram

Iron

mg

Finelymincedmeat


Kale 3 leaves 40 gram 18 1.1 1.6Potato ½ big size 50 gram 100 0.9 0.9





Iodizedsalt

for the taste 0 0 0

‘Enjera ofSorghum

A quarter of one ‘Enjera’ 75 gram 168 4.4 5.6

Milk todrink

1 coffee cup 70ml 52 1.8 0.7

Ripe mango 1 medium size 100gram

44 0.3 0.6



eat:

• 4 coffee cups of enjera with meat and kale sauce fed over 3-4feedings, with milk to drink





41

References

1. Complementary Food for Children Prepared for Communities where theirStaple Food is Maize & Enset [Amharic; Prepared By EHNRI]

2. Complementary Food for Children Prepared for Communities where their

Staple Food is Teff, Wheat & Barley [Amharic; Prepared By EHNRI]

3. Complementary Food for Children Prepared for Communities where theirStaple Food is Maize & Sorghum [Amharic; Prepared By EHNRI]

4. Key Messages on the Essential Nutrition Action to Improve the Nutrition ofWomen & 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. PanAmerican Health organization, World Health Origination, Division of HealthPromotion and protection, Food and Nutrition Program. 2002



42

Annex 1: Key Messages for Ethiopia on

Optimal Breastfeeding 0 to 6 months

WHO? ACTION WHY?

This first yellow milk (colostrum) isthe mother’s natural butter and willhelp to expel your baby’s first darkstool.

1. Mother Give the first yellow milk made especiallyfor the new born as it will protect yourbaby from illness.

Colostrum contains many importantfactors which will protect your newbaby from disease.

Immediate breastfeeding within onehour of birth will help to expel the

placenta and reduce post-partumbleeding.

2. Mother Put your baby on the breast immediatelyafter birth, even before the placenta is

expelled, to stimulate your production ofmilk.

Pre-lacteal feeds (such as sugarwater, water, butter, ersho ) are notnecessary and may interfere withestablishing good breastfeedingpractices during the first days of thebaby’s life.

Feeding the baby only breastmilkprovides the best nourishment

possible for the baby and will protectit from diseases such as diarrhea andrespiratory infections.

Giving the baby water or other liquidsmay make your baby sick withdiarrhea.

If the baby takes water or otherliquids, its appetite for breastmilkmay decrease meaning it sucks less onthe breast leading to poor growth.

3. Mother Feed your baby only breast milk for thefirst six months, not even giving water,

for it to grow healthy and strong.

Even during very hot weather,

breastmilk will satisfy all your baby’sthirst for liquids during the first sixmonths.



43

WHO? ACTION WHY?

Frequent breastfeeding helps the milkto flow.

Increases bonding between motherand child.

Ensure proper positioning andattachment of the baby on the breastto ensure it gets enough breastmilkand also to avoid breast problems suchas sore and cracked nipples.

4. Mother Breast feed your baby on demand, atleast 10 times day and night, to produceenough milk and provide your baby enough

food to grow healthy.

Advise mothers with nipple and breastproblems to seek immediate care froma Health Worker.

Foremilk quenches thirst because it ismore watery.

5. Mother Empty one breast first before switching

to the second for your baby to get themost nutritious hind milk to grow strongand healthy.

Hind milk is richer and satisfies thebaby’s hunger so that it will not cry asmuch.

To maintain their health,breastfeeding women need to eat awide variety of foods, particularlyanimal products (meat, milk, eggs, etc),fruits and vegetables.

6. Husband Ensure that your wife who isbreastfeeding has two extra meals a dayto maintain her health and the health ofthe baby.

Ripe papaya, orange, carrot, pumpkin,mango and liver are especially good forthe mother.

Continue to breastfeed duringdiarrhea, even increasing thefrequency, to replace the liquid lost.

Breastfeeding more during illness willhelp your baby to fight the sicknessand not loose weight.

Breastfeeding also provides comfortto a sick baby.

7. Mother During illness, increase the frequency ofbreastfeeding for your baby to recoverfaster.

Sick mothers can continue tobreastfeed their baby.



44

WHO? ACTION WHY?

Each time a baby is sick, it willloose weight so it is important tobreastfeed as often as possible.

8. Mother After each illness increase the frequency ofbreast feeding for the baby to regain healthand weight.

Your breast milk is the safest andmost important food you can offer

your baby to regain its health andweight.

Ask a Health Worker for VitaminA supplementation after the birthof the baby.

9. Mother Take Vitamin A supplementation within 45days of delivery for the baby’s health andstrength.

Taking a Vitamin A capsule willenrich the mother’s breastmilkwith important nutrients to keepthe baby healthy and strong.

Malaria causes anemia which willmake members of your familyunwell and very tired.

10.All family

members

Sleep under an insecticide treated net(INT), especially pregnant women andchildren, to prevent getting malaria.

Family members with fever need tobe taken to a health facility forimmediate treatment.

11. 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, and3. if the baby is less than 6 months

LAM is a modern family planningmethod, effective to 98% if the 3

conditions are met

12. Mother

and

father

When your baby is older than 6 months, or ifone of the conditions of LAM does not exist,visit the health facility or Community BasedReproductive Health Agent to obtainanother Family Planning method

Don’t wait until the baby is 6months to decide on which familyplanning method you want to have.

Additional nutrition message for infants 0 to 6 months on Vitamin D

WHO? ACTION WHY?

Mother

and

father

Expose your baby to sunlight for 20 to 30minutes daily to ensure it grows well

Exposure to sunshine will helpensure your baby has adequateVitamin D which is important forbone growth and good health.



45

Annex 2: Key Messages for Ethiopia on

Complementary Feeding with Breastfeeding 6 to 24 months

WHO? ACTION WHY?

Porridge can be made from many differenttypes of cereals and tubers (e.g. potatoes,enset ).

The consistency of the porridge should bethick enough to be fed by hand.

Thicken the porridge as the baby growsolder, making sure that it is still able toeasily swallow without choking.

Thin gruels made with water are nothealthy for your baby as they do notprovide enough of the nutrients it needs

to grow strong and healthy.When possible use milk instead of waterto prepare the porridge.

Foods given to the child must be stored inhygienic conditions to avoid diarrhea andillness.

1. Motherand

father

Introduce complementary foods atsix months of age, such as softporridge 2-3 times a day, for yourbaby to grow healthy and strong.

First types of complementary foods, suchas porridges, found in different regionsthat can be used to feed babies 6 to 12months 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



46

WHO? ACTION WHY?

2. Mother Continue to breast feed your child ondemand, at least 8 times, day and nightuntil two years and beyond to maintainits strength.

During the first and second year,breastmilk is still an important sourceof nutrients for your baby.

From 6 months onwards, feed yourchild 2-3 types of differentenrichment foods with the porridge ateach meal, in addition to breastmilk.

Try to feed different foods each time.

Mash and soften the enrichment foodsso the baby can easily chew and swallowwithout choking.

Cow’s milk can be offered to your child

in addition to the enrichment foodsgiven, however, not to replace theenrichment foods.

Add butter and oil every time.

Animal foods (meat, liver, fish, eggs)are especially good for your baby andwill keep it healthy and strong.

Ripe orange/yellow fruits (papaya,mangos) and vegetables (carrots) aregood sources of Vitamin A.

Dark green leaves (kale, chard,shiferaw ) and legumes containimportant nutrients such as iron andwill help your baby grow strong.

3. Mother

and

father

Enrich your baby’s porridge with 2 to 3different types of foods at each meal(such as butter, oil, peanuts, meat, eggs,lentils, vegetables and fruits) for it togrow and get strong.

Types of enrichment foods that can begiven with the porridge include:

Oil and butterMeat and fishEggsPeanuts, beans, peas or lentilsRipe papaya or mangoes

CarrotsAvocadosDark green leafy vegetables



47

WHO? ACTION WHY?

Babies have small stomachs and canonly eat small amounts at each meal soit important to feed them frequentlythroughout the day.

By 8 months the baby should be able tobegin eating finger foods such aspieces of ripe mango & papaya, avocado,banana, other fruits & vegetables,fresh & fried bread products, boiledpotato, sweet potato, kita (unleavenedbread), etc.

Feed these finger foods as snacks(mekses ) at least 1-2 times each day

4. Mother

and

father

From 6 to 12 months of age, in additionto the 2-3 servings of enriched porridge,also feed your baby 1-2 other solid

foods (mekses ) each day to ensurehealthy growth.

Foods given to the child must be stored

in hygienic conditions to avoid diarrheaand illness.

It is very important that the family’smeals are also enriched with a varietyof foods and that the child eats avariety of foods.

Young children have small stomachs andcan only eat small amounts at each mealso it important to feed themfrequently throughout the day.

Other solid foods (mekses) can be

given as many times as possible eachday and can include ripe mango &papaya, avocado, banana, other fruits &vegetables, fresh & fried breadproducts, boiled potato, sweet potato,kita (unleavened bread), etc.

5. Mother

and

father

From 12 to 24 months of age, feed yourchild at least 3-4 times a day usingfamily foods, along with 1-2 other solidfoods (mekses ) each day to ensurehealthy growth.

Foods given to the child must be storedin hygienic conditions to avoid diarrheaand illness.



48

WHO? ACTION WHY?

6. Mothers

andfathers

As your baby grows older, feed morefood at each meal in order to ensurethat they are eating enough to maintainhealthy growth.

Change recipes each day using a varietyof different foods remembering to

encourage your child to eat more ateach meal as they get older

At first the baby may need time to getused to eating foods other thanbreastmilk so have patience and takeenough time to feed them, even usingplay to help them eat. Make the timefor eating special.

Use a separate plate to feed the childto make sure it eats all the food given.

Forced feeding will discourage babiesand young children from eating.

As they are too little to feedthemselves, babies need to be feddirectly to make sure they eat all thefood given to them.

7. Mother Be patient and actively encourage yourbaby to eat all its food in order to growhealthy.

Even when older, young children shouldbe supervised during mealtime to makesure they eat all the food put on theirplate.

Fluid and food requirements are higherduring illness.

Take time to patiently encourage yoursick child to eat as their appetite maybe decreased because of the illness.

It is easier for a sick child to eat smallfrequent meals so feed the child foodsit likes in small quantities throughoutthe day.

8. Motherand

father

During illness, increase the frequency ofbreastfeeding and offer additional foodto your child to help it recover faster.

It is important to keep breastfeedingand feeding complementary foods to

your child during illness to maintain itsstrength and reduce the weight loss.

9. Mother

and

father

When your child has recovered from anillness, give one additional meal of solidfood each day during the two weeksthat follow to help it recover quickly.

Children who have been sick need extrafood and should be breastfed morefrequently to regain the strength andweight lost during the illness.



49

Take enough time to actively encourage your child to eat this extra food asthey still may not appear hungry due tothe illness.

10. Mother

and

father

Feed your baby using a clean cup and

spoon, never a bottle as this may cause your baby to get diarrhea.

Nutritious porridges for children

should be thick enough to be fed byhand. Porridge that is too watery andcan be fed with a bottle will not help

your baby to grow.

Bottles are very difficult to keep cleanand can make your baby sick withdiarrhea.

Cups can be used to feed your baby,are easy to keep clean and are cheaperto buy than a bottle.

11. Mother

and

all family

members

Wash your hands with soap and waterbefore preparing food, before eating,and before feeding young children toavoid diarrhea.

Touching food with unclean hands can

cause diarrhea.

Utensils for feeding the baby also haveto be clean.

Use a cup to feed a baby or a youngchild never a bottle which can causediarrhea.

Foods given to the child must be stored

in hygienic conditions to avoid diarrheaand illness.

12. Mother

and

father

When your baby is 6 months old, makesure it receives Vitamin Asupplementation every six months tomake it strong.

Ask a Health Worker to give Vitamin Asupplementation two times a year to

your child between 6 to 59 months ofage.

Vitamin A is important for your child’seyesight as well as will help your childfight illness.

Be sure to bring your child to Vitamin A

supplementation sessions during ChildHealth Days.

13. Mother

and

father

Find ripe orange/yellow fruits andvegetables or liver to feed your child tokeep it healthy.

These foods are good sources ofVitamin A and other nutrients that willhelp your child grow strong andhealthy.



50

Children should eat these foods asoften as possible.

14. Mother

and

father

When your child is two years old, it hasto receive de-worming medicine everysix months to maintain healthy growth.

Ask a Health Worker for de-wormingmedicine to be given two times a yearto your child between the ages of 2 to

5 years.Intestinal parasites cause youngchildren to become anemic which willmake your child unwell and tired.

15. All family

members

Sleep under a insecticide treated net(INT), especially pregnant women andchildren, to prevent getting sick withmalaria.

Malaria causes anemia which will makemembers of your family unwell and verytired.

Family members with fever need to betaken to a health facility for immediate

treatment.16. Mother

and

father

Ensure that all family food is cookedusing iodized iodized salt so that familymembers remain healthy.

Iodized iodized salt is not availableeverywhere, but should be used whenavailable.

Pregnant women need to use iodizediodized salt to ensure the health oftheir new baby.

Additional nutrition message for children 6 to 12 months on Vitamin D

WHO? ACTION WHY?

Mother

and

father

Expose your child to sunlight for 20 to30 minutes daily to ensure it grows well

Exposure to sunshine will help ensure your child has adequate Vitamin Dwhich is important for bone growth andgood health.



51

ANNEX 3

Foods used to prepare these recipes and their nutrient compositionper 100 gram edible portion.

Food items Calories

Protein in

grams

Iron in

milligrams1 Bulla 196.0 0.9 10.12 Maize flour 378.2 9.0 7.03 Pea flour [shiro] 352.2 20.1 13.94 Enjera of maize 159.0 4.4 9.85 Meat 114.8 19.8 3.36 Milk 73.7 3.4 1.07 Egg 152.9 11.6 4.38 Kale 46.0 2.8 4.19 Potato 199.0 1.9 1.7

10 Carrot 27.8 0.40 0.5011 Onion 71.3 1.06 0.8012 Papaya 34.9 0.70 0.5013 Lemon 48.5 0.40 0.5014 Orange 33.9 0.70 0.8015 Banana 87.8 0.80 0.5016 Oil 896.4 0 017 Heart, beef 219.7 28.8 8.218 Kidney beans 170.3 9.1 3.319 Sugar 385.0 0 020 Human breast milk 70.0 1.0 0.006[absorbed]

21 Avocado 110.1 1.6 1.722 Mango 43.8 0.3 0.623 Bread of bulla 186.1 0.3 4.624 Tomato 30.7 1.3 0.925 Pumpkin 42.6 1.2 1.826 Wheat Flour 362.9 10.9 5.727 Barley Flour 368.0 8.5 6.328 Teff Flour 355.1 9.0 15029 Enjera of teff 166.0 4.9 5630 Bread of Wheat 251 7.8 7.1

31 Lentil Spilt 355.1 23 43.132 Sorghum Flour 374.8 8.1 8.933 Enjera of sorghum 224 5.8 7.4



52

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

=



Coffee cup in some parts of Oromia

Coffee cup in some parts of Oromia

Coffee cup of konso

=

=

=

complementary feeding recipebook

Documents