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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

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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

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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.

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Table of Contents Page

Section I: Ethiopian Infant & Young Child Feeding Recommendations A. Feeding infants 0-5 months old . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 B. Feeding children 6-23 months old . . . . . . . . . . . . . . . . . . . . . . . . . . 3 C. Responsive feeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Section II: Complementary Feeding of Infants 6-11 months of age A. Ethiopian Feeding Guidelines: infants 6-11 months . . . . . . . . . . . 6 B. Recipes for Three Staple Groups: Group 1: maize and enset Recipe 1: Bulla porridge enriched with milk, carrots and

oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7 Recipe 2: Maize porridge enriched with kidney beans,

tomato and oil/butter . . . . . . . . . . . . . . . . . . . . . . .

8 Recipe 3: Bulla porridge enriched with milk, tomato and

oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9 Recipe4: Mashed potato enriched with kale, carrot milk and

oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10 Recipe 5: Bulla and pea porridge enriched with pumpkin and

oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11 Recipe 6: Maize porridge enriched with milk, tomato and

oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13 Recipe 8: Enjera with shiro, onion and tomato . . . . . . . . . . . . 14 Group 2: teff, wheat and barley Recipe 9: Teff porridge enriched with milk, carrot, tomato

and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15 Recipe 10: Wheat porridge enriched with milk, pumpkin

and 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 . . . . . . . . . . . . . . . .

18 Recipe 13: Enjera with shiro, onion, carrot and tomato . . . . 19 Recipe 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

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Recipe 16: Maize porridge enriched with pumpkin, milk and

oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

22 Recipe 17: Sorghum porridge enriched with Tomato, carrot

and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

23 Recipe 18: Mashed potato enriched with carrot, milk and

oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

24 Recipe 19: Sorghum porridge enriched with pea flour, kale

and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25 Recipe 20: Maize porridge enriched with pumpkin, tomato

and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26 Recipe 21: Potato porridge enriched with carrot, egg and

oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

27

Section III: Complementary Feeding of Children 12-23 months of age A. Ethiopian Feeding Guidelines: children 12-23 months . . . . . . . . . 29 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 . . . . . . . . . . . . . . . . . . . . . . . . .

30 Recipe 23: Enjera with potato, carrot, kale and egg, with

milk to drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

31 Recipe 24: Bulla porridge enriched with kale, milk and

oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

32 Recipe 25: Enjera with meat and kale, with milk to drink. . . 33 Group 2: teff, wheat and barley Recipe 26: Teff porridge enriched with pea flour, carrot

milk and oil/butter, with milk to drink . . . . . . . . .

34 Recipe 27: Barley porridge enriched with kale, egg, milk and

oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35 Recipe 28: Enjera with lentile and carrot sauce, with milk

to drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36 Group 3: maize and sorghum Recipe 29: Sorghum porridge enriched with pea flour,

carrot and oil/butter, and milk to drink . . . . . . .

37 Recipe 30: Enjera with potato and carrots, with milk to

drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

39 Recipe 32: Enjera with meat and kale sauce, with milk to

drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

40

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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

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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

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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. 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 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.

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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.

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1

Section I

Ethiopian Infant & Young Child Feeding

Recommendations

0 to 23 months

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1

A. Ethiopian Feeding Guidelines: birth to 6 months

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1

B. Ethiopian Feeding Guidelines: 6 to 23 months

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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.

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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 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 **

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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 stirring 4. 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 Amount Weight 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 0.7 Carrot 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 Iodized salt

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!

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Staple Food Group 1: maize/enset

5

RECIPE 2: MAIZE PORRIDGE ENRICHED WITH KIDNEY BEANS, TOMATO AND OIL/BUTTER How to prepare the enriched porridge:

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 salt 5. 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 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. 3. Feed the baby with spoon.

Ingredients Amount Weight 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 Kidney beans

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 Iodized salt

for taste 0 0 0 0

Ripe avocado

½ medium sized 50 gram 55 0.8 0.8

Total Amount 341 6.8 5.2

In one day, along with breast milk, your 6-11 month old baby can eat:

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

Feed even more food if baby wants to eat more!

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Staple Food Group 1: maize/enset

6

RECIPE 3: BULLA PORRIDGE ENRICHED WITH MILK, TOMATO AND OIL/BUTTER

How to prepare the enriched porridge:

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.

Cooked amount: 3 Coffee cups. Preparation and cooking time: 30 minutes. Ripe mango for mekses 1. Wash and peel mango 2. Mashed it by clean spoon & cup.

3. Feed the baby with spoon

Ingredients Amount Weight 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 Iodized salt

for taste 0 0 0

Ripe mango ½ medium sized 50 gram 22 0.2 0.3 Total Amount 310 4.9 7.1

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 ripe mango as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 1: maize/enset

7

RECIPE 4: MASHED POTATO ENRICHED WITH KALE, CARROT, MILK AND OIL/BUTTER

How to prepare the enriched porridge:

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 banana 2. Mashed in clean cup with spoon.

3. Feed the baby with spoon.

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Potato 1 medium size potato 80 grams

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 (boiled and cooled)

More than one coffee cup 75ml 56 2.6 0.8

Butter/oil 1½ teaspoon 7 ml 63 0 0 Iodized salt

for taste 0 0 0

Banana ½ medium sized 25 gram 22 0.2 0.1 Total Amount 327 5.6 4.1

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 banana as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 1: maize/enset

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RECIPE 5: BULLA AND PEA PORRIDGE ENRICHED WITH PUMPKIN AND OIL/BUTTER

How to prepare the enriched porridge:

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 mixture 7. Feed the baby with spoon, using patience and encouragement.

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

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

Avocado for mekses 1. Wash and peel avocado 2. Mashed with spoon in a clean cup.

3. Feed baby with spoon

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Bulla flour More than half a coffee cup

55 gram 108 0.5 5.5

Pea or beans 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 Lemon 1 medium size 15ml 7 0.1 0.1 Water 5 coffee cups 350ml 0 0 0 Iodized salt

for taste 0 0 0

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

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 ripe avocado as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 1: maize/enset

9

RECIPE 6: MAIZE PORRIDGE ENRICHED WITH MILK, TOMATO AND OIL/BUTTER

How to prepare the enriched porridge:

1. Mix the maize flour with water and milk & put it on the heat 2. 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 Banana 2. Mashed it in clean cup with spoon.

3. Feed the baby with spoon.

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Maize flour More than half coffee cup

55 gram 208 4.9 3.9

Tomato 1 small size 20 gram 6 0.3 0.2 Milk More than half coffee

cup 50ml 37 1.7 0.5

Butter/oil 1 teaspoon 5 ml 45 0 0 Iodized salt

for taste 0 0 0 0

Water 4 coffee cups 280ml 0 0 0 Banana 1 medium sized 50 gram 44 0.4 0.3

Total Amount 340 7.3 4.9

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 banana as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 1: maize/enset

10

RECIPE 7: MASHED BEEF HEART WITH POTATO, CARROT, KALE, EGG AND OIL/BUTTER

How to prepare the enriched porridge:

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.

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Potato 1 small sized potato 50 gram 100 1.0 0.9 Carrot 1 small sized carrot 20 gram 6 0.1 0.1 Egg 1 small egg 35 gram 54 4.0 1.5 Heart of beef

2 teaspoons 10 gram 22 2.9 0.8

Kale 3 leaves 40 gram 18 1.1 1.6 Butter/oil 2 teaspoons 10 ml 90 0 0 Iodized salt

for taste 0 0 0

Ripe papaya ¼ small size 60 gram 21 0.4 0.3 Total Amount 311 9.5 5.2

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 ripe papaya as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 1: maize/enset

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.

Cooked amount: 3 coffee cups. Preparation and cooking time: 35 minutes.

Orange for mekses

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

Ingredients Amount Weight 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 Butter/oil 3 teaspoons 15 ml 134 0 0 Water 4 coffee cups 280 ml 0 0 0 Iodized salt

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

Total Amount 314 5.8 8.5

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 orange as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 2: teff/wheat/barley

15

RECIPE 9: TEFF PORRIDGE ENRICHED WITH MILK, CARROT, TOMATO AND OIL/BUTTER

How to prepare the enriched porridge:

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

Cooked amount: 3 coffee cups. Preparation and cooking time: 25 minutes

Ripe 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 Weight Gram

Calories kcal

Protein gram

Iron mg

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 Butter/oil 1½ teaspoon 7 ml 63 0 0 Water 4 ½ coffee cups 315 ml 0 0 0 Iodized salt

for taste 0 0 0

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

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 ripe papaya as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 2: teff/wheat/barley

16

RECIPE 10: WHEAT PORRIDGE ENRICHED WITH MILK, PUMPKIN AND OIL/BUTTER

How to prepare the enriched porridge:

1. Mix the wheat flour with water and milk. 2. Heat and add iodized salt 3. 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 Preparation and cooking time: 30 minutes Orange for mekses 1. Wash and squeeze the orange 2. Feed the baby with spoon.

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Wheat flour

More than half coffee cup

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 Butter/oil 1½ teaspoon 7 ml 63 0 0 Water 4 ½ coffee cups 315 ml 0 0 0 Iodized salt

for taste 0 0 0

Orange

1 medium sized orange 50 gram 17 0.4 0.4

Total Amount 306 8.2 3.3

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 orange as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 2: teff/wheat/barley

17

RECIPE 11: MASHED POTATO PORRIDGE ENRICHED WITH TOMATO, MILK AND OIL/BUTTER

How to prepare the enriched porridge:

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 pieces 5. 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. Cooked amount: 3 coffee cups. Preparation and cooking time: 40 minutes. Avocado for mekses 1. Wash and peel the avocado. 2. Mashed it by clean spoon & cup.

3. Feed the baby with spoon.

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

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

gram 30 1.4 1.0

Carrot 1 small sized carrot 20 gram 6 0.1 0.1 Milk More than half coffee

cup 50 ml 37 1.7 0.5

Oil 1 ½ tea spoon 7 ml 63 0 0 Iodized salt

For taste 0 0 0 0

Ripe avocado

½ medium sized 50 gram 55 0.8 0.9

Total Amount 350 5.5 3.9

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 ripe avocado as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 2: teff/wheat/barley

18

RECIPE 12: BARLEY PORRIDGE ENRICHED WITH MILK, PEA/BEAN FLOUR, CARROTS AND OIL/BUTTER

How to prepare the enriched porridge:

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 mash 5. 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 Preparation and cooking time: 35 minutes. Banana for mekses

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

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Barley flour

More than half coffee cup

40 gram 147 3.4 2.5

Pea or beans 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 Water 4 coffee cups 280 ml 0 0 0 Iodized salt

For taste - 0 0 0

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

In one day, along with breast milk, your 6-11 month old baby can eat:

• 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

Feed even more food if baby wants to eat more!

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Staple Food Group 2: teff/wheat/barley

19

RECIPE 13: ENJERA WITH SHIRO, ONION, CARROT AND TOMATO

How to prepare the enriched porridge:

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 Preparation and cooking time: 30 minutes

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

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Roasted pea 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 Carrot 1 small sized carrot 20 gram 6 0.1 0.1 Butter/oil 3 teaspoons 15 ml 134 0 0 Water 5 coffee cups 350ml 0 0 0 Iodized salt

for taste 0 0 0

enjera 1/5 of one enjera 60 gram 100 2.9 33.6 Ripe papaya ¼ small size 60 gram 21 0.4 0.3

Total Amount 316 5.9 35.8

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 ripe papaya as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 2: teff/wheat/barley

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 mixture 4. 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 cool 9. Finely chop mixture and feed to child with spoon, using encouragement and

patience.

Cooked amount: 3 coffee cups 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.

Ingredients Amount Weight 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 0.4 Kale 3 leaves 40 gram 18 1.1 1.6 Onion ½ onion 20 gram 14 0.2 0.2 Oil 2 tea spoons 10 gram 90 0 enjera 1/5 enjera 60 gram 100 2.9 33.6 Water 6 coffee cups 420 ml 0 0 0 Iodized salt

For taste - 0 0 0

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

In one day, along with breast milk, your 6-11 month old baby can eat:

• 3 coffee cups of finely chopped enjera with meat, potato and kale fed over 2-3 feedings

• 1 orange as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 3: maize/sorghum

21

RECIPE 15: SORGHUM PORRIDGE ENRICHED WITH TOMATO, CARROT, MILK AND OIL/BUTTER

How to prepare the enriched porridge:

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 Weight gram

Calories kcal

Protein gram

Iron mg

Sorghum flour

Almost one coffee cup 60gram 225 4.9 5.3

Tomato 1 Tomato 30 gram 9 0.5 0.3 Butter/oil 1½ teaspoon 7 ml 63 0 0 Carrot 1 small sized carrot 20 gram 6 0.1 0.1 Water 4 coffee cups 240 ml 0 0 0 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 Total Amount 348 7.2 6.5

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 orange as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 3: maize/sorghum

22

RECIPE 16: MAIZE PORRIDGE ENRICHED WITH PUMPKIN, MILK AND OIL/BUTTER

How to prepare the enriched porridge:

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 sorghum

flour instead.

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

Orange for mekses

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

Ingredients Amount Weight 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 Milk More than half coffee

cup 50 ml 37 1.7 0.5

Butter/oil 1½ teaspoon 15 ml 63 0 0 Water 4 ½ coffee cups 315 ml 0 0 0 Iodized salt

for the taste 0 0 0

Orange 1medium size 50gram 17 0.4 0.4 Total Amount 350 2.9 5.4

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 orange as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 3: maize/sorghum

23

RECIPE 17: SORGHUM PORRIDGE ENRICHED WITH TOMATO, CARROT AND OIL/BUTTER

How to prepare the enriched porridge:

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 carrot 4. 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.

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

Ripe papaya for mekses

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

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Sorghum flour

Almost one coffee cup 60 gram 225 4.8 5.4

Tomato 1 Tomato 30 gram 9 0.5 0.3 Carrot 1 small sized carrot 20 gram 6 0.1 0.1 Butter/oil 1½ teaspoon 7 ml 63 0 0 Iodized salt

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

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 ripe papaya as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 3: maize/sorghum

24

RECIPE 18: MASHED POTATO ENRICHED WITH CARROT, MILK AND OIL/BUTTER

How to prepare the enriched porridge:

1. Peel carrot and potato, wash, chop and boil 2. When cooked well take potatoes and carrots off the fire, and mash well 3. Add the milk into the potato and carrot mixture 4. 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.

Cooked amount: 3 coffee cups. Preparation and cooking time: 45 minutes. Mango for mekses: 1. Wash and peel the Mango 2. Mashed it by clean spoon & cup. 3. Feed the baby with spoon

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Potato 1 medium size potato 80 grams

159 1.5 1.4

Carrot 3 small carrots 60 gram 17 0.3 0.3 Milk (boiled and cooled)

1½ coffee cup 105 ml 78 3.6 1.1

Butter/oil 1½ teaspoon 7 ml 63 0 0 Iodized salt

for the taste 0 0 0

Ripe mango ½ medium size 50 gram 22 0.2 0.3 Total Amount 339 5.6 3.1

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 ripe mango as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 3: maize/sorghum

25

RECIPE 19: SORGHUM PORRIDGE ENRICHED WITH PEA FLOUR, KALE AND OIL/BUTTER:

How to prepare the enriched porridge:

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. Cooked amount: 3 coffee cups. Preparation and cooking time: 50 minutes.

Ripe papaya for mekses

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

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Sorghum flour

Almost one coffee cup 60 gram 225 4.9 5.3

Pea or bean flour

1 teaspoon 5 gram 18 1.0 0.7

Butter/oil 1 teaspoon 5 ml 45 0 0 Kale 3 leaves 40

gram 16 1.0 1.6

Water 4 coffee cups 280 ml 0 0 0 Iodized salt

for the taste 0 0 0

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

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 ripe papaya as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 3: maize/sorghum

26

RECIPE 20: MAIZE PORRIDGE ENRICHED WITH PUMPKIN, TOMATO AND OIL/BUTTER

How to prepare the enriched porridge:

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 flour instead of maize flour.

Cooked amount: 3 coffee cups Preparation and cooking time: 40 minutes

Ripe avocado for mekses 1. Wash and peel avocado. 2. Cut in to small pieces & give to the child to eat.

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Maize flour Almost one coffee cup 60 gram 227 5.4 4.2 Pumpkin 1 slice 10 gram 4 0.1 0.2 Butter/oil 1 teaspoon 5 ml 45 0 0 Iodized salt

for the taste 0 0 0

Water 4 coffee cups 280 ml 0 0 0 Ripe avocado

½ medium size 50 gram 55 0.8 0.9

Total Amount 331 6.3 5.3

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 ripe avocado as mekses

Feed even more food if baby wants to eat more!

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Staple Food Group 3: maize/sorghum

27

RECIPE 21: POTATO PORRIDGE ENRICHED WITH CARROT, EGG AND OIL/BUTTER

How to prepare the enriched porridge:

1. Wash, peel, chop and boil the potato and carrot 2. When cooked, take the carrot and potato off the fire, mash and mix them up 3. Beat the egg and add to the mashed carrot and potato mixture 4. Add butter/oil and iodized salt and warm by stirring. 5. Allow to cool and feed with spoon, using encouragement and patience. Cooked amount: 3 coffee cups. Preparation and cooking time: 55 minutes.

Papaya for mekses 1. Wash and cut papaya & remove the seeds.

2. Cut into small pieces and give to child to eat.

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Potato 1 big size potato 100 gram

199 1.9 1.7

Carrot 2 small carrots 40 gram 11 0.2 0.2 Egg 1 small egg 35 gram 54 4.1 1.5 Butter/oil 1 teaspoon 5 ml 45 0 0 Iodized salt

for taste 0 0 0

Ripe papaya ¼ small size 50 gram 17 0.5 1.4 Total Amount 326 6.7 4.8

In one day, along with breast milk, your 6-11 month old baby can eat:

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

• 1 ripe papaya as mekses

Feed even more food if baby wants to eat more!

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28

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 **

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Staple Food Group 1: maize/enset

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

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Kale 3 leaves 40 gram 18 1.1 1.6 Potato 1 medium sized potato 80

grams 159 1.5 1.4

Egg 1 small egg 35 gram 53 4.1 1.5 Butter/oil 2 teaspoons 10 ml 90 0 0 Iodized Iodized salt

for the taste 0 0 0

enjera of maize

1/4 of enjera 75 gram 119 3.3 7.4

Milk to drink

1 coffee cup 70ml 52 1.8 0.7

Ripe avocado

1 medium sized 100 gram

110 1.6 1.7

Total Amount 601 13.4 14.3

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!

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Staple Food Group 1: maize/enset

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 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. 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

Ingredients Amount Weight 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 11 0.2 0.2 Onion ½ onion 20 gram 14 0.2 0.2 Butter/oil 2 teaspoons 10 ml 90 0 0 Kale 3 leaves 40 gram 18 1.1 1.6 Egg 1 small egg 35 gram 53 4.6 1.5 Water 7 coffee cups 490ml 0 0 0 Iodized salt

for the taste 0 0 0

enjera of maize

¼ of enjera 75 gram 119 3.3 7.4

Milk to drink

1 coffee cup 70ml 52 1.8 0.7

Banana 1 big size 100 gram

87.8 0.8 0.5

Total Amount 603.8 13.5 13.5

In one day, along with breast milk, your 12-23 month old child can eat:

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

• 1 banana as mekses

Feed even more food if child wants to eat more!

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Staple Food Group 1: maize/enset

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RECIPE 24: BULLA PORRIDGE ENRICHED WITH KALE, MILK AND OIL/BUTTER

How to prepare the enriched porridge:

1. Wash, chop and boil the kale 2. When it is cooked take it off fire and mash it. 3. Mix the bulla with milk and put it on the fire 4. Add butter/oil and iodized salt & cook while stirring. 5. Add the kale and stir adding a little water for further cooking 6. 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.

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Maize flour 1 coffee cups

70 gram 265 6.3 4.9

Kale 3 leaves 40 gram 18 1.1 1.6 Butter/oil 3 teaspoons 15 gram 134 0 0 Milk 2 coffee cups 140ml 103 4.7 2.8 Water 4 coffee cups 280ml 0 0 0 Iodized salt

for the taste 0 0 0

Ripe papaya ½ small sized 100 gram

35 0.7 0.5

Total Amount 555 12.8 9.8

In one day, along with breast milk, your 12-23 month old child can eat:

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

• 1 ripe papaya as mekses

Feed even more food if child wants to eat more!

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Staple Food Group 1: maize/enset

33

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

How to prepare the enjera meal:

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

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Finely minced meat

4 teaspoons 20 gram 23 4.0 0.7

Kale 4 ½ leaves 60 gram 27 1.7 2.5 Onion ½ of one onion 20 gram 14 0.2 0.2 Butter/oil 2 teaspoons 10 ml 90 0 0 Water 7 coffee cups 490ml 0 0 0 Iodized salt

for the taste - 0 0 0

'Enjera' of Maize

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 200 gram

174 1.6 1.0

Total Amount 550 15.5 13.2

In one day, along with breast milk, your 12-23 month old child can eat:

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

• 1 banana as mekses

Feed even more food if child wants to eat more!

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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

How to prepare the enriched porridge: 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 cups Preparation and cooking time: 35 minutes.

Ripe avocado for mekses

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

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Teff Flour More than one coffee cups

80 gram 284 7.2 120.0

Peas flour 1 tea spoons 5 gram 18 1.0 0.7 Carrot 1 small size 20 gram 6 0.1 0.1 Milk 1 coffee cup 70 ml 56 2.3 0.7 Oil 2 tea spoons 10 ml 90 0 0 Water 6 coffee cups 420ml 0 0 0 Iodized salt

For the test 0 0 0

Milk to drink

1 coffee cup 70ml 52 1.8 0.7

Ripe avocado

1 medium size 100gram 110 1.6 1.7

Total Amount 616 14 123.9

In one day, along with breast milk, your 12-23 month old child can 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

Feed even more food if child wants to eat more!

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Staple Food Group 2: teff/wheat/barley

35

RECIPE 27: BARLEY PORRIDGE ENRICHED WITH KALE, EGG, MILK AND OIL/BUTTER:

How to prepare the enriched porridge:

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 Cooked Amount: 4 coffee cups Preparation and cooking time: 35 minutes

Banana for mekses 1. Wash and peel the Banana 2. Cut in to small pieces & give to the child to eat.

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Barley flour

More than one coffee cups

80 gram 294 6.8 5.0

Kale 3 leaves 40 gram 18 1.1 1.6 Milk 1 ½ coffee cups 100ml 74 3.4 1.0 Egg 1 small egg 35 gram 53 4.6 1.5 Oil 2 tea spoons 10 ml 90 0 0 Lemon 1 medium size 15ml 7 0.1 0.1 Water 5 coffee cups 350ml 0 0 0 Iodized salt

For the test 0 0 0

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

In one day, along with breast milk, your 12-23 month old child can eat:

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

• 1 banana as mekses

Feed even more food if child wants to eat more!

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Staple Food Group 2: teff/wheat/barley

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 onion 3. 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

Cooked Amount: 4 coffee cups Preparation and cooking time: 1 hour

Ripe avocado for mekses

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

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Lentil split 2 1/2 medium sized table spoons

30 gram 107 6.9 12.9

Carrot 1 small size 20 gram 6 0.1 0.1 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 Water 8 coffee cups 560ml 0 0 0 Iodized salt

For the test - 0 0 0

Milk to drink

1 coffee cup 70ml 52 1.8 0.7

Ripe avocado

1 medium size 100 gram

110 1.6 1.7

Total Amount 630 14.2 57.5

In one day, along with breast milk, your 12-23 month old child can eat:

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

• 1 ripe avocado as mekses

Feed even more food if child wants to eat more!

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Staple Food Group 3: maize/sorghum

37

RECIPE 29: SORGHUM PORRIDGE ENRICHED WITH PEA FLOUR, CARROT AND OIL/BUTTER, AND MILK TO DRINK

How to prepare the enriched porridge:

1. Clean the flour by sieving into a pot 2. Mix the flour with water and milk.. 3. Add iodized salt and put it on the fire 4. 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. Preparation and cooking time: 35 minutes. Ripe avocado for mekses 1. Wash & peel off the Avocado. 2. Cut in to small pieces & give to the child to eat.

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Sorghum flour

More than one coffee cups

80 gram 300 6.5 7.1

Pea or bean flour

1 tea spoon 5 gram 18 1.0 0.7

Carrot 1 small size 20 gram 6 0.1 0.1 Butter/oil 3 teaspoons 15 ml 134 0 0 Water 7 coffee cups 490 ml 0 0 0 Iodized salt

for the taste 0 0 0

Milk to drink

1 coffee cup 70ml 52 1.8 0.7

Ripe avocado

1 medium size 100 gram

110 1.6 1.7

Total Amount 620 11 10.3

In one day, along with breast milk, your 12-23 month old child can eat:

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

• 1 ripe avocado as mekses

Feed even more food if child wants to eat more!

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Staple Food Group 3: maize/sorghum

38

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

How to prepare the enriched porridge:

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

Banana for mekses 1. Wash and peel banana 2. Cut in to small pieces & give to the child to eat.

Ingredients Amount Weight 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 Butter/oil 3 teaspoons 15 ml 134 0 0 Water 7 big coffee cups 490 ml 0 0 0 Iodized salt

for the taste 0 0 0

enjera from Sorghum

A quarter of one enjera 75 gram 168 4.4 5.6

Milk to drink

1 coffee cup 70ml 52 1.8 0.7

Banana 1 big size 100 gram

88 0.8 0.5

Total Amount 625 9.3 8.5

In one day, along with breast milk, your 12-23 month old child can eat:

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

• 1 banana as mekses

Feed even more food if child wants to eat more!

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Staple Food Group 3: maize/sorghum

39

RECIPE 31: SORGHUM PORRIDGE ENRICHED WITH KALE, MILK AND OIL/BUTTER

How to prepare the enriched porridge:

1. Wash, chop and boil the kale in a pot 2. When it is cooked take off the fire and mash it. 3. Mix the sorghum flour with milk and water & put it on the fire 4. Add butter/oil and iodized salt & cook by stirring. 5. Add the kale and stir adding little water for further cooking 6. 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.

Ripe avocado for mekses

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

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Sorghum flour

More than one coffee cups

80 gram 300 6.5 7.1

Kale 3 leaves 40 gram 18 1.1 1.6 Butter/oil 2 teaspoons 10 gram 90 0 0 Milk 1 coffee cup 70 ml 52 2.4 0.7 Water 6 coffee cups 420ml 0 0 0 Iodized salt

for the taste 0 0 0

Ripe avocado

1 medium size 100 gram

110 1.6 1.7

Total Amount 570 11.6 11.1

In one day, along with breast milk, your 12-23 month old child can eat:

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

• 1 ripe avocado as mekses

Feed even more food if child wants to eat more!

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Staple Food Group 3: maize/sorghum

40

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

How to prepare the enriched porridge:

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

Ripe mango for mekses

1. Wash, peel and cut up mango 2. Give to the child to eat.

Ingredients Amount Weight gram

Calories kcal

Protein gram

Iron mg

Finely minced meat

3 teaspoons 15 gram 17 3.0 0.5

Kale 3 leaves 40 gram 18 1.1 1.6 Potato ½ big size 50 gram 100 0.9 0.9 Carrot 2 small size 40 gram 11 0.2 0.2 Onion ½ onion 20 gram 14 0.2 0.2 Butter/oil 4 teaspoons 20 ml 179 0 0 Water 6 coffee cups 420 ml 0 0 0 Iodized salt

for the taste 0 0 0

‘Enjera of Sorghum

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

Milk to drink

1 coffee cup 70ml 52 1.8 0.7

Ripe mango 1 medium size 100 gram

44 0.3 0.6

Total Amount 603 11.9 10.3

In one day, along with breast milk, your 12-23 month old child can 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

Feed even more food if child wants to eat more!

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41

References 1. Complementary Food for Children Prepared for Communities where their

Staple 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 their 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

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Annex 1: Key Messages for Ethiopia on Optimal Breastfeeding 0 to 6 months

WHO? ACTION WHY? This first yellow milk (colostrum) is the mother’s natural butter and will help to expel your baby’s first dark stool.

1. Mother Give the first yellow milk made especially for the new born as it will protect your baby from illness.

Colostrum contains many important factors which will protect your new baby from disease. Immediate breastfeeding within one hour of birth will help to expel the placenta and reduce post-partum bleeding.

2. Mother Put your baby on the breast immediately after birth, even before the placenta is expelled, to stimulate your production of milk.

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. 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.

3. Mother Feed your baby only breast milk for the first six months, not even giving water, for it to grow healthy and strong.

Even during very hot weather, breastmilk will satisfy all your baby’s thirst for liquids during the first six months.

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WHO? ACTION WHY? 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.

4. Mother 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.

Advise mothers with nipple and breast problems to seek immediate care from a Health Worker. Foremilk quenches thirst because it is more watery.

5. Mother Empty one breast first before switching to the second for your baby to get the most nutritious hind milk to grow strong and healthy.

Hind milk is richer and satisfies the baby’s hunger so that it will not cry as much.

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

6. Husband Ensure that your wife who is breastfeeding has two extra meals a day to maintain her health and the health of the baby.

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

7. Mother During illness, increase the frequency of breastfeeding for your baby to recover faster.

Sick mothers can continue to breastfeed their baby.

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WHO? ACTION WHY? Each time a baby is sick, it will loose weight so it is important to breastfeed as often as possible.

8. Mother After each illness increase the frequency of breast feeding for the baby to regain health and weight.

Your breast milk is the safest and most important food you can offer your baby to regain its health and weight.

Ask a Health Worker for Vitamin A supplementation after the birth of the baby.

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

Taking a Vitamin A capsule will enrich the mother’s breastmilk with important nutrients to keep the baby healthy and strong.

Malaria causes anemia which will make members of your family unwell and very tired.

10.All family

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

Family members with fever need to be taken to a health facility for immediate 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, and 3. if the baby is less than 6 months

LAM is a modern family planning method, effective to 98% if the 3 conditions are met

12. Mother

and

father

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? ACTION WHY?

Mother

and

father

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

Exposure to sunshine will help ensure your baby has adequate Vitamin D which is important for bone growth and good health.

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Annex 2: Key Messages for Ethiopia on Complementary Feeding with Breastfeeding 6 to 24 months

WHO? ACTION 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.

1. Mother

and

father

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.

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

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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.

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.

3. Mother

and

father

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.

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

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WHO? ACTION WHY? 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

4. Mother

and

father

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.

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.

5. Mother

and

father

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.

Foods given to the child must be stored in hygienic conditions to avoid diarrhea and illness.

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WHO? ACTION WHY?

6. Mothers

and

fathers

As your baby grows older, feed more food at each meal in order to ensure that they are eating enough to maintain healthy growth.

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.

7. Mother Be patient and actively encourage your baby to eat all its food in order to grow healthy.

Even when older, young children should be supervised during mealtime to make sure they eat all the food put on their plate. Fluid and food requirements are higher during illness. Take time to patiently encourage your 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.

8. Mother

and

father

During illness, increase the frequency of breastfeeding and offer additional food to your child to help it recover faster.

It is important to keep breastfeeding and feeding complementary foods to your child during illness to maintain its strength and reduce the weight loss.

9. Mother

and

father

When your child has recovered from an illness, give one additional meal of solid food each day during the two weeks that follow to help it recover quickly.

Children who have been sick need extra food and should be breastfed more frequently to regain the strength and weight lost during the illness.

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Take enough time to actively encourage your child to eat this extra food as they still may not appear hungry due to the 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 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.

11. Mother

and

all family

members

Wash your hands with soap and water before preparing food, before eating, and before feeding young children to avoid diarrhea.

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.

Foods given to the child must be stored in hygienic conditions to avoid diarrhea and illness.

12. Mother

and

father

When your baby is 6 months old, make sure it receives Vitamin A supplementation every six months to make it strong.

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.

13. Mother

and

father

Find ripe orange/yellow fruits and vegetables or liver to feed your child to keep it healthy.

These foods are good sources of Vitamin A and other nutrients that will help your child grow strong and healthy.

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Children should eat these foods as often as possible.

14. Mother

and

father

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

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.

15. All family

members Sleep under a insecticide treated net (INT), especially pregnant women and children, to prevent getting sick with 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.

16. Mother

and

father

Ensure that all family food is cooked using iodized iodized salt so that family members remain healthy.

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? ACTION WHY?

Mother

and

father

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

Exposure to sunshine will help ensure your child has adequate Vitamin D which is important for bone growth and good health.

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ANNEX 3

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

Food items

Calories

Protein in grams

Iron in milligrams

1 Bulla 196.0 0.9 10.1 2 Maize flour 378.2 9.0 7.0 3 Pea flour [shiro] 352.2 20.1 13.9 4 Enjera of maize 159.0 4.4 9.8 5 Meat 114.8 19.8 3.3 6 Milk 73.7 3.4 1.0 7 Egg 152.9 11.6 4.3 8 Kale 46.0 2.8 4.1 9 Potato 199.0 1.9 1.7 10 Carrot 27.8 0.40 0.50 11 Onion 71.3 1.06 0.80 12 Papaya 34.9 0.70 0.50 13 Lemon 48.5 0.40 0.50 14 Orange 33.9 0.70 0.80 15 Banana 87.8 0.80 0.50 16 Oil 896.4 0 0 17 Heart, beef 219.7 28.8 8.2 18 Kidney beans 170.3 9.1 3.3 19 Sugar 385.0 0 0 20 Human breast milk 70.0 1.0 0.006[absorbed] 21 Avocado 110.1 1.6 1.7 22 Mango 43.8 0.3 0.6 23 Bread of bulla 186.1 0.3 4.6 24 Tomato 30.7 1.3 0.9 25 Pumpkin 42.6 1.2 1.8 26 Wheat Flour 362.9 10.9 5.7 27 Barley Flour 368.0 8.5 6.3 28 Teff Flour 355.1 9.0 150 29 Enjera of teff 166.0 4.9 56 30 Bread of Wheat 251 7.8 7.1 31 Lentil Spilt 355.1 23 43.1 32 Sorghum Flour 374.8 8.1 8.9 33 Enjera of sorghum 224 5.8 7.4

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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

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Coffee cup in some parts of Oromia

Coffee cup in some parts of Oromia

Coffee cup of konso

=

=

=