Complementary Feeding Recipes for Ethiopian Children 6-23 Months Old

A Practical Cooking and Feeding Guide

AUGUST 2006

Contains daily recipes for Staple Group 1: maize/enset Staple Group 2: teff/wheat/barley Staple Group 3: maize/sorghum

Federal Democratic Republic of Ethiopia Ministry of Health

This publication is supported by

This publication was developed by LINKAGES: Breastfeeding, LAM, Related Complementary Feeding, and Maternal Nutrition Program, and was made possible through funding from the United States Agency for International Development (USAID) provided to the Academy for Educational Development (AED) under the terms of Cooperative Agreement No. HRN-A-00-97-00007-00. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the USAID or AED.

Table of Contents
Section I: Ethiopian Infant & Young Child Feeding Recommendations A. Feeding infants 0-5 months old . . . . . . . . . . . . . . . . . . . . . . . . . . . . B. Feeding children 6-23 months old . . . . . . . . . . . . . . . . . . . . . . . . . . C. Responsive feeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section II: Complementary Feeding of Infants 6-11 months of age A. Ethiopian Feeding Guidelines: infants 6-11 months . . . . . . . . . . . B. Recipes for Three Staple Groups: Group 1: maize and enset Recipe 1: Bulla porridge enriched with milk, carrots and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 2: Maize porridge enriched with kidney beans, tomato and oil/butter . . . . . . . . . . . . . . . . . . . . . . . Recipe 3: Bulla porridge enriched with milk, tomato and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe4: Mashed potato enriched with kale, carrot milk and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 5: Bulla and pea porridge enriched with pumpkin and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 6: Maize porridge enriched with milk, tomato and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 7: Mashed beef heart with potato, carrot, kale, egg and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 8: Enjera with shiro, onion and tomato . . . . . . . . . . . . Group 2: teff, wheat and barley Recipe 9: Teff porridge enriched with milk, carrot, tomato and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 10: Wheat porridge enriched with milk, pumpkin and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 11: Mashed potato porridge enriched with tomato, milk and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 12: Barley porridge enriched with milk, pea/bean flour, carrots and oil/butter . . . . . . . . . . . . . . . . Recipe 13: Enjera with shiro, onion, carrot and tomato . . . . Recipe 14: Enjera with meat, potato, kale and oil/butter. . . . Group 3: maize and sorghum Recipe 15: Sorghum porridge enriched with tomato, carrot, milk and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . Page 2 3 4

7 8 9 10 11 12 13 14

15 16 17 18 19 20

21

Recipe 16: Maize porridge enriched with pumpkin, milk and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 17: Sorghum porridge enriched with Tomato, carrot and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 18: Mashed potato enriched with carrot, milk and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 19: Sorghum porridge enriched with pea flour, kale and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 20: Maize porridge enriched with pumpkin, tomato and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 21: Potato porridge enriched with carrot, egg and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section III: Complementary Feeding of Children 12-23 months of age A. Ethiopian Feeding Guidelines: children 12-23 months . . . . . . . . . B. Recipes for Three Staple Groups: Group 1: maize and enset Recipe 22: Enjera with kale, potato, egg and oil/butter, with milk to drink . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 23: Enjera with potato, carrot, kale and egg, with milk to drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 24: Bulla porridge enriched with kale, milk and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 25: Enjera with meat and kale, with milk to drink. . . Group 2: teff, wheat and barley Recipe 26: Teff porridge enriched with pea flour, carrot milk and oil/butter, with milk to drink . . . . . . . . . Recipe 27: Barley porridge enriched with kale, egg, milk and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 28: Enjera with lentile and carrot sauce, with milk to drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Group 3: maize and sorghum Recipe 29: Sorghum porridge enriched with pea flour, carrot and oil/butter, and milk to drink . . . . . . . Recipe 30: Enjera with potato and carrots, with milk to drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 31: Sorghum porridge enriched with kale, milk and oil/butter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipe 32: Enjera with meat and kale sauce, with milk to drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

22 23 24 25 26 27

29

30 31 32 33

34 35 36

37 38 39 40

References Annex 1: Key Essential Nutrition Action Messages for Feeding Infants 0-5 months Annex 2: Key Essential Nutrition Action Messages for Feeding Children 6-23 months Annex 3: Food Composition Table Annex 4: Different types of cups used to measure quantities in different localities

Acknowledgments
This book focuses on how to adequately feed young children 6-23 months and was adopted from materials originally developed by Ethiopian Health and Nutrition Research Institute, all of which are listed in the reference section. We are grateful to have had this valuable technical background on which to develop this present document. We would like to give special thanks to Dr. Victoria Quinn, Dr. Agnes B. Guyon Dr.Hana NekaTebeb and Ms Mulu G/medhin for their encouragement in the preparation and production of this book on how to feed children 6-23 months of age in Ethiopia. Special thanks are also given to Aster Mekonen for her help in the LINKAGES/Ethiopia kitchen during the testing of the recipes. Appreciation is also extended to other members of the LINKAGES team and colleagues from other organizations, foremost the Federal Ministry of Health, for their input and support.

LINKAGES/Ethiopia

August 2006

Introduction
Studies show that malnutrition is a significant health problem for infants and young children in Ethiopia. Though poverty is the underlining cause of malnutrition, inadequate food security, sup-optimal infant caring practice and limited access to water and sanitation services are also important causes of child malnutrition. Improved child care and infant feeding practices are important interventions for reducing infant and young child malnutrition. The purpose of this book is to provide service providers with information necessary for counseling mothers and child caretakers on how to feed their children 6-23 months, specifically on aspects of complementary feeding in addition to continued breastfeeding. Complementary feeding means giving other foods in addition to breast milk starting when an infant is 6 months old since at this time breastmilk alone is not sufficient to meet a growing infants 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 Ethiopias Essential Nutrition Action Messages). Techniques for mothers and child caretakers to more effectively feed children using a responsive feeding approach are also presented.

The recipes contained also assume that there will be about food losses during cooking. Thus ingredient amounts have been adjusted upwards to account for expected losses and provide the calories needed by a breastfed child from complementary foods, roughly 300 calories at 6-11 months of age and 550 calories at 12-23 months of age.
1

For all the recipes contained in this book, a commonly found measuring unit, a 70 ml bunna coffee cup, was used. Using this type and size coffee cup allows for standardization of recipes, nutrition messages and IEC tools. Annex 4 shows some other cups occasionally used in certain localities in the country. The equivalent number of 70 ml coffee cups is shown for each of these other types of measuring cups so that appropriate conversions can be made by service providers working in these localities of the country.

Section I Ethiopian Infant & Young Child Feeding Recommendations 0 to 23 months

A. Ethiopian Feeding Guidelines: birth to 6 months

B. Ethiopian Feeding Guidelines: 6 to 23 months

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.

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

The first part of this section presents a field tool for field workers to use with mothers to counsel on the feeding of infants 6 to 11 months of age. This field tool emphasizes i.) continued breastfeeding, ii.) types and amounts of complementary foods to give, as well as iii.) key practices for the nutritional care of sick children. A complete list of all messages related to the complementary feeding of infants 6-11 months of age is contained in Annex 2. The second part of the section contains practical recipes based on locally available foods that mothers can use to prepare nutritious meals for their infants. These recipes are based on the assumption that infants are still being breastfed, and thus aim to provide the additional nutritional requirements from complementary foods needed by breastfed infants in this age group. Recipes are presented for each of the three major staple food eating groups. It is recognized that the iron content of local foods and its bioavailability is limited, thus, iron supplements or foods fortified with iron should be used whenever available.

** Encourage families to add meat each day to the following recipes when possible ** 2

RECIPE 1: BULLA PORRIDGE ENRICHED WITH MILK, CARROTS AND OIL/BUTTER In one day, along with breast milk, your 6-11 month old baby can eat: 3 coffee cups of enriched bulla porridge fed over 2-3 feedings 1 banana as mekses

Feed even more food if baby wants to eat more!

How to prepare the enriched porridge: Weight gram 53 gram 70 ml 30 gram 15 gram 315 ml 0 Calories kcal 104 52 9 134 0 0 Protein gram 0.5 2.4 0.2 0 0 0 Iron mg 5.3 0.7 0.2 0 0 0

Ingredients Bulla flour Milk Carrot Butter/oil Water Iodized salt Lemon Banana 1. 2. 3. 4. 5.

Amount just over 1/2 coffee cup 1 full coffee cup 1 carrot 3 teaspoons 4 1/2 coffee cups for taste 1 medium size 1 small size

15ml 7 0.1 0. 35 gram 31 0.3 0.2 Total Amount 337 3.5 6.4 Mix the bulla flour with water and milk, add iodized salt and put on the fire. Peel, boil and mash carrot. To porridge, add mashed carrot and butter/oil and continue to cook well with continuous stirring Cool porridge, squeeze the lemon into it and mix Feed the baby with spoon, using patience and encouragement.

Cooked amount: 3 coffee cups. Total preparation and cooking time: 25 minutes. Banana for mekses 1. Wash and peel the banana. 2. Mash with spoon into clean cup. 3. Feed the baby with spoon.

Staple Food Group 1: maize/enset

RECIPE 2: MAIZE PORRIDGE ENRICHED WITH KIDNEY BEANS, TOMATO AND OIL/BUTTER 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!

How to prepare the enriched porridge: Ingredients Maize flour Amount just over half a coffee cup 1 teaspoon 1 teaspoon 1 tomato 5 coffee cups for taste medium sized Weight gram 53 gram Calories kcal 198 Protein gram 4.8 Iron mg 3.8

Butter/oil Kidney beans Tomato Water Iodized salt Ripe avocado 1. 2. 3. 4. 5. 6.

7 ml 7 gram 30 gram 385 ml 0 50 gram

63 19 6 0 0 55

0 0.7 0.5 0 0 0.8

0 0.3 0.3 0 0 0.8

Total Amount 341 6.8 5.2 Soak kidney beans overnight in water. Boil beans in water, remove skin and mash. Boil, peel off skin and chop tomato. Mix maize flour into water, bring to boil and add iodized salt Mix in tomato, butter/oil and mashed beans & stir until cooked properly. Cool porridge and feed the baby with spoon using patience and encouragement.

Note: Whenever available use teff, barley, wheat or sorghum flour instead of maize flour. Cooked amount: 3 Coffee cups. Preparation and cooking time: 25 minutes. Ripe avocado for mekses 1. Wash and peel the avocado. 2. Mashed it by clean spoon & cup. 3. Feed the baby with spoon.

Staple Food Group 1: maize/enset

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

How to prepare the enriched porridge:
Ingredients Bulla Tomato Butter/oil Milk Lemon Water Iodized salt Ripe mango Amount More than half coffee cup 1 tomato 2 teaspoon 1 coffee cup 1 medium size 4 coffee cups for taste medium sized Weight gram 53 gram 30 gram 10 ml 105ml 15ml 315ml Calories kcal 104 9 90 78 7 0 0 22 310 Protein gram 0.5 0.5 0 3.6 0.1 0 0 0.2 4.9 Iron mg 5.3 0.3 0 1.1 0.1 0 0 0.3 7.1

50 gram Total Amount

1. 2. 3 4. 5.

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

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

Staple Food Group 1: maize/enset

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

How to prepare the enriched porridge: Ingredients Potato Carrot Kale Milk (boiled and cooled) Butter/oil Iodized salt Banana 1. 2. 3. 4. 5. 6. 7. Amount 1 medium size potato 1 carrot 3 leaves More than one coffee cup 1 teaspoon for taste medium sized Weight gram 80 grams 30 gram 40 gram 75ml 7 ml Calories kcal 159 9 18 56 63 0 22 327 Protein gram 1.5 0.2 1.1 2.6 0 0 0.2 5.6 Iron mg 1.4 0.2 1.6 0.8 0 0 0.1 4.1

25 gram Total Amount

Wash, chop and boil the kale. Peel carrot and potato, wash, chop and boil. When properly cooked, take the kale, carrot and potato off the fire and mash. Mix the milk into the mashed potato, kale and carrot. Add butter/oil and iodized salt and put the cooking pan on the fire. Stir the mixed ingredients till properly heated. Cool mashed mixture and feed baby with spoon using patience and encouragement.

Cooked amount: 3 Coffee Cups. Preparation and cooking time: 1 hour. Banana for mekses 1. Wash and peel banana 2. Mashed in clean cup with spoon. 3. Feed the baby with spoon.

Staple Food Group 1: maize/enset

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

How to prepare the enriched porridge: Ingredients Bulla flour Pea or beans flour Pumpkin Butter/oil Lemon Water Iodized salt Avocado 1. 2. 3. 4. 5. 6. 7. Amount More than half a coffee cup 3 teaspoons 1 slice 2 teaspoons 1 medium size 5 coffee cups for taste medium sized Weight gram 55 gram 15 gram 10 gram 10 ml 15ml 350ml Calories kcal 108 53 4 90 7 0 0 Protein gram 0.5 3.0 0.1 0 0.1 0 0 Iron mg 5.5 2.1 0.2 0 0.1 0 0 0.9 8.8

50 gram 55 0.8 Total Amount 317 4.5 Mix the bulla with the beans or pea flour. Pour water into the mixed flour, add iodized salt and put on the fire. Peel pumpkin, remove the seed and chop; then boil in water. Once cooked, mash pumpkin well. Add oil/butter to pumpkin, and cook with stirring. Allow to cool and squeeze the lemon into mixture Feed the baby with spoon, using patience and encouragement.

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

Staple Food Group 1: maize/enset

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

How to prepare the enriched porridge: Ingredients Maize flour Tomato Milk Butter/oil Iodized salt Water Banana Amount More than half coffee cup 1 small size More than half coffee cup 1 teaspoon for taste 4 coffee cups 1 medium sized Weight gram 55 gram 20 gram 50ml 5 ml 0 Calories kcal 208 6 37 45 0 0 44 340 Protein gram 4.9 0.3 1.7 0 0 0 0.4 7.3 Iron mg 3.9 0.2 0.5 0 0 0 0.3 4.9

280ml 50 gram Total Amount

1. 2. 3. 4. 5.

Mix the maize flour with water and milk & put it on the heat Add iodized salt. Boil, peel and chop the tomato. Add the tomato, butter or oil & stir until cooked properly. Allow the porridge to cool and feed the baby with spoon with encouragement and patience.

Note: If maize flour not available, then use teff, barley, wheat or sorghum flour. Cooked amount : 3 coffee cups Preparation and cooking time: 30 minutes Banana for mekses 1. Wash and peel the Banana 2. Mashed it in clean cup with spoon. 3. Feed the baby with spoon.

Staple Food Group 1: maize/enset

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

How to prepare the enriched porridge: Ingredients Potato Carrot Egg Heart of beef Kale Butter/oil Iodized salt Ripe papaya Amount 1 small sized potato 1 small sized carrot 1 small egg 2 teaspoons 3 leaves 2 teaspoons for taste small size Weight gram 50 gram 20 gram 35 gram 10 gram 40 gram 10 ml Calories kcal 100 6 54 22 18 90 0 21 311 Protein gram 1.0 0.1 4.0 2.9 1.1 0 0 0.4 9.5 Iron mg 0.9 0.1 1.5 0.8 1.6 0 0 0.3 5.2

60 gram Total Amount

1. 2. 3. 4. 5. 6. 7. 8.

Chop beef heart into very small pieces and fry in oil. Wash and chop the kale and add to heart. Wash, peel, chop and boil carrots and potatoes in water. Cook carrots and potatoes thoroughly, take off the fire and mash.. Add to beef heart mixture, mashing together well. Beat egg and add to the mashed mixture. Add iodized salt and continue to cook and stir. Cool and feed baby with patience and encouragement using a spoon.

Cooked amount: = 3 coffee cups. Preparation and cooking time = 1 hour and 15 minutes. Ripe papaya for mekses 1. Wash papaya,, cut open and remove seeds. 2. Mash and feed baby with spoon.

10

Staple Food Group 1: maize/enset

RECIPE 8: ENJERA WITH SHIRO, ONION AND TOMATO 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!

How to prepare the chopped enjera and shiro: Ingredients Roasted pea flour Onion Tomato Butter/oil Water Iodized salt Amount 1medium size table spoon onion 1 medium size 3 teaspoons 4 coffee cups for taste 1/5 of one enjera 1 big size Weight gram 10 gram 10 gram 30 gram 15 ml 280 ml Calories kcal 35 7 9 134 0 0 95 34 314 Protein gram 2.0 0.1 0.4 0 0 0 2.6 0.7 5.8 Iron mg 1.4 0.1 0.3 0 0 0 5.9 0.8 8.5

enjera

60 gram 100gram Total Amount

Orange 1 2. 3. 4. 5. 6.

Chop and fry onion in oil. Boil, peel and chop the tomato. Add the tomato to water and boil. Add pea flour and iodized salt and cook by stirring. When the shiro is properly cooked, add enjera and mix. Allow to cool and feed with spoon using encouragement and patience.

Note: Whenever available, use 30 gram finely minced meat instead of pea flour. 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.

11

Staple Food Group 2: teff/wheat/barley

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

How to prepare the enriched porridge: Weight Gram 45 gram 30 gram 20 gram 75 ml 7 ml 315 ml Calories kcal 161 9 6 56 63 0 0 Protein gram 4.1 0.5 0.1 2.6 0 0 0 Iron mg 67.5 0.3 0.1 0.8 0 0 0

Ingredients Teff flour Tomato Carrot Milk Butter/oil Water Iodized salt Ripe papaya 1. 2. 3. 4. 5.

Amount More half coffee cup 1 Tomato 1 small sized carrot More one coffee cup 1 teaspoon 4 coffee cups for taste Small size

50 gram 17 0.5 1.4 Total Amount 312 7.8 70.1 Mix the teff flour with milk and water, add iodized salt and put on the fire. Peel, boil and mash carrot. Boil, peel and chop the tomato. Add carrot, tomato, butter or oil to porridge and cook by continuously stirring. Wait until mixture cools and feed the baby with spoon using encouragement and patience

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.

15

Staple Food Group 2: teff/wheat/barley

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

How to prepare the enriched porridge: Ingredients Wheat flour Pumpkin Milk Butter/oil Water Iodized salt Orange Amount More than half coffee cup 1 slice Just over 1 coffee cup 1 teaspoon 4 coffee cups for taste 1 medium sized orange Weight gram 45 gram 15 gram 75 ml 7 ml 315 ml Calories kcal 164 6 56 63 0 0 17 Protein gram 5.0 0.2 2.6 0 0 0 0.4 Iron mg 1.8 0.3 0.8 0 0 0 0.4

50 gram

1. 2. 3. 4. 5. 6.

Total Amount 306 8.2 3.3 Mix the wheat flour with water and milk. Heat and add iodized salt Peel pumpkin, remove the seed, chop and boil in water. When cooked, remove from heat, and mash pumpkin. Add pumpkin and oil/butter to porridge and stir until cooked. Allow the porridge to cool and feed the baby with spoon using encouragement and patience.

Note: If wheat flour is not available use teff, barley, maize or sorghum flour instead. Cooked amount: 3 coffee cups Preparation and cooking time: 30 minutes Orange for mekses 1. Wash and squeeze the orange 2. Feed the baby with spoon.

16

Staple Food Group 2: teff/wheat/barley

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

How to prepare the enriched porridge: Ingredients Potato Tomato Carrot Milk Oil Iodized salt Ripe avocado 1. 2. 3. 4. 5. Amount 1 medium size 2 medium sized Weight gram Calories kcal 159 30 6 37 63 0 55 350 Protein gram 1.5 1.4 0.1 1.7 0 0 0.8 5.5 Iron mg 1.4 1.0 0.1 0.5 0 0 0.9 3.9

80 gram 100 gram 1 small sized carrot 20 gram More than half coffee 50 ml cup 1 tea spoon 7 ml For taste 0 medium sized 50 gram Total Amount

Wash potato and carrots, peel, chop and boil. When potato and carrots are cooked, remove from heat and mash. Boil water and add tomato. Remove tomato and chop into small pieces Mix mashed potato, carrot and tomato with milk, add oil & iodized salt and warm it. 6. Allow the preparation to cool and feed the baby with spoon, using encouragement and patience. 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.

17

Staple Food Group 2: teff/wheat/barley

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

How to prepare the enriched porridge: Ingredients Barley flour Pea or beans flour Carrot Milk Butter/oil Water Iodized salt Banana Amount More than half coffee cup 1 teaspoon 1 small size coffee cup 2 teaspoon 4 coffee cups For taste 1 medium size Weight gram 40 gram 5 gram 20 gram 35ml 10ml 280 ml 50 gram Total Amount Calories kcal 147 18 6 26 90 0 0 44 331 Protein gram 3.4 1.0 0.1 1.2 0 0 0 0.4 6.1 Iron mg 2.5 0.7 0.1 0.4 0 0 0 0.3 4

1. 2 3. 4. 5. 6.

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

Cooked amount: 3 coffee cup 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

18

Staple Food Group 2: teff/wheat/barley

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

How to prepare the enriched porridge: Ingredients Roasted pea flour Tomato Onion Carrot Butter/oil Water Iodized salt Amount 1 medium table spoon 1 small size onion 1 small sized carrot 3 teaspoons 5 coffee cups for taste 1/5 of one enjera small size Weight gram 10gram 20 gram 20 gram 20 gram 15 ml 350ml Calories kcal 35 6 14 6 134 0 0 100 21 316 Protein gram 2.0 0.3 0.2 0.1 0 0 0 2.9 0.4 5.9 Iron mg 1.4 0.2 0.2 0.1 0 0 0 33.6 0.3 35.8

enjera

60 gram 60 gram Total Amount

Ripe papaya

1. 2. 3. 4. 5. 6. 7. 8.

Roast the onion with oil. Wash, peel, boil and mash carrot. Boil, peel and chop the tomato. Add the tomato to water and boil. Add pea flour and iodized salt and cook by stirring. When the shiro is cooked, add the enjera and chop. Also add mashed carrot to mixture. Allow to cool and feed with spoon using encouragement and patience.

Cooked Amount: 3 coffee cups 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

19

Staple Food Group 2: teff/wheat/barley

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

How to prepare the enjera dish: Ingredients Meat Potato Kale Onion Oil Amount 3 tea spoons small size 3 leaves onion 2 tea spoons 1/5 enjera 6 coffee cups For taste 1 big size Weight gram 15 gram 25 gram 40 gram 20 gram 10 gram 60 gram 420 ml 100gram Total Amount Calories kcal 17 50 18 14 90 100 0 0 34 323 Protein gram 2.9 0.5 1.1 0.2 0 2.9 0 0 0.7 8.3 Iron mg 0.5 0.4 1.6 0.2 33.6 0 0 0.8 34.4

enjera

Water Iodized salt Orange

1. 2. 3. 4. 5. 6. 7. 8. 9.

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

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.

20

Staple Food Group 3: maize/sorghum

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

ENRICHED

WITH

TOMATO,

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!

How to prepare the enriched porridge: Weight gram 60gram 30 gram 7 ml 20 gram 240 ml 35 ml Calories kcal 225 9 63 6 0 28 0 Protein gram 4.9 0.5 0 0.1 0 1.3 0 Iron mg 5.3 0.3 0 0.1 0 .4 0

Ingredients Sorghum flour Tomato Butter/oil Carrot Water Milk Iodized salt Orange 1. 2. 3. 4. 5.

Amount Almost one coffee cup 1 Tomato 1 teaspoon 1 small sized carrot 4 coffee cups Just over 1/2 coffee cup for the taste 1 medium size

50 gram 17 0.4 0.4 Total Amount 348 7.2 6.5 Mix sorghum flour with water, milk and iodized salt and put on the fire. Boil, peel and chop the tomato. Clean, peel, boil and mash carrot. To the porridge, add tomato, mashed carrot, oil/butter and cook well by continuously stirring. Wait until it gets cool and feed baby with spoon, using encouragement and patience.

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.

21

Staple Food Group 3: maize/sorghum

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

How to prepare the enriched porridge: Ingredients Maize flour Pumpkin Milk Butter/oil Water Iodized salt Orange Amount Almost one coffee cup 1 slice More than half coffee cup 1 teaspoon 4 coffee cups for the taste 1medium size Weight gram 60 gram 15 gram 50 ml 15 ml 315 ml Calories kcal 227 6 37 63 0 0 17 350 Protein gram 0.6 0.2 1.7 0 0 0 0.4 2.9 Iron mg 4.2 0.3 0.5 0 0 0 0.4 5.4

50gram Total Amount

1. 2. 3. 4. 5. 6.

Mix maize flour with milk and water. Put it on fire, add iodized salt, and heat. Peel, remove seed, chop and boil the pumpkin in water. Take off heat and mash pumpkin. To the pumpkin mixture, add the oil/butter and stir until cooked. Allow to cool and feed the baby with spoon, using encouragement and patience.

Note: If maize flour is not available, use teff, barley, and wheat or sorghum flour instead. 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.

22

Staple Food Group 3: maize/sorghum

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

How to prepare the enriched porridge: Ingredients Sorghum flour Tomato Carrot Butter/oil Iodized salt Water Lemon Ripe papaya Amount Almost one coffee cup 1 Tomato 1 small sized carrot 1 teaspoon for the taste 4 coffee cups 1 medium sized small size Weight gram 60 gram 30 gram 20 gram 7 ml Calories kcal 225 9 6 63 0 0 7 17 327 Protein gram 4.8 0.5 0.1 0 0 0 0.1 0.5 6 Iron mg 5.4 0.3 0.1 0 0 0 0.1 1.5 7.4

315ml 15ml 50gram Total Amount

1. 2. 3. 4.

Pour water into the flour, add iodized salt and put on the fire. Boil, peel and chop the tomato. Clean, peel, boil and mash carrot To the porridge add the tomato, carrot and butter/oil and stir it till properly cooked 5. Allow to cool and wash, squeeze the lemon into porridge and mix. 6. Feed the baby with spoon, using encouragement and patience. 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.

23

Staple Food Group 3: maize/sorghum

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

How to prepare the enriched porridge: Ingredients Potato Carrot Milk (boiled and cooled) Butter/oil Iodized salt Ripe mango Amount 1 medium size potato 3 small carrots 1 coffee cup 1 teaspoon for the taste medium size Weight gram 80 grams 60 gram 105 ml 7 ml Calories kcal 159 17 78 63 0 22 339 Protein gram 1.5 0.3 3.6 0 0 0.2 5.6 Iron mg 1.4 0.3 1.1 0 0 0.3 3.1

50 gram Total Amount

1. 2. 3. 4.

Peel carrot and potato, wash, chop and boil When cooked well take potatoes and carrots off the fire, and mash well Add the milk into the potato and carrot mixture Add butter/oil and iodized salt and warm on the fire, stirring mixture together. 5. Take pan off fire, allow to cool and feed with spoon, using encouragement and patience.

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

24

Staple Food Group 3: maize/sorghum

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

How to prepare the enriched porridge: Ingredients Sorghum flour Pea or bean flour Butter/oil Kale Water Iodized salt Ripe papaya Amount Almost one coffee cup 1 teaspoon 1 teaspoon 3 leaves 4 coffee cups for the taste small sized Weight gram 60 gram 5 gram 5 ml 40 gram 280 ml Calories kcal 225 18 45 16 0 0 21 325 Protein gram 4.9 1.0 0 1.0 0 0 0.4 7.3 Iron mg 5.3 0.7 0 1.6 0 0 0.3 7.9

60 gram Total Amount

1. 2. 3. 4. 5.

Wash, chop and boil the kale. Mix sorghum flour with bean (or pea) flour. Pour water into the mixed flour add iodized salt and put on fire. Add butter/oil and kale & cook by stirring. 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.

25

Staple Food Group 3: maize/sorghum

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

How to prepare the enriched porridge: Ingredients Maize flour Pumpkin Butter/oil Iodized salt Water Ripe avocado Amount Almost one coffee cup 1 slice 1 teaspoon for the taste 4 coffee cups medium size Weight gram 60 gram 10 gram 5 ml Calories kcal 227 4 45 0 0 55 331 Protein gram 5.4 0.1 0 0 0 0.8 6.3 Iron mg 4.2 0.2 0 0 0 0.9 5.3

280 ml 50 gram Total Amount

1. 2. 3. 4. 5.

Pour water into maize flour, add iodized salt and put it on the fire. Peel, remove the seed, chop and boil pumpkin. Take off the fire and mash it. Add the pumpkin and oil/butter to maize porridge, and cook by stirring. 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.

26

Staple Food Group 3: maize/sorghum

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

How to prepare the enriched porridge: Ingredients Potato Carrot Egg Butter/oil Iodized salt Ripe papaya Amount 1 big size potato 2 small carrots 1 small egg 1 teaspoon for taste small size Weight gram 100 gram 40 gram 35 gram 5 ml Calories kcal 199 11 54 45 0 17 326 Protein gram 1.9 0.2 4.1 0 0 0.5 6.7 Iron mg 1.7 0.2 1.5 0 0 1.4 4.8

50 gram Total Amount

1. 2. 3. 4. 5.

Wash, peel, chop and boil the potato and carrot When cooked, take the carrot and potato off the fire, mash and mix them up Beat the egg and add to the mashed carrot and potato mixture Add butter/oil and iodized salt and warm by stirring. 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.

27

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

The first part of this section presents a field tool for field workers to use with mothers to counsel on the feeding of children 12 to 23 months of age. This field tood emphasizes i.) continued breastfeeding, ii.) types and amounts of complementary foods to give, as well as iii.) key practices for the nutritional care of sick children. A complete list of all messages related to the complementary feeding of children 12 to 23 months of age is contained in Annex 2. The second part of the section contains practical recipes using locally available foods that mothers can use to prepare nutritious meals for their children. These recipes are based on the assumption that children are still being breastfed, and thus aim to provide the additional nutritional requirements from complementary foods needed by breastfed children in this age group. Recipes are presented for each of the three major staple food eating groups. It is recognized that the iron content of local foods and its bioavailability is limited, thus, iron supplements or foods fortified with iron should be used whenever available.

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

28

28

Staple Food Group 1: maize/enset

RECIPE 22: ENJERA WITH KALE, POTATO, EGG AND OIL/BUTTER, WITH MILK TO DRINK In one day, along with breast milk, your 12-23 month old child can eat: 4 coffee cups of enjera with kale, potato, egg and oil/butter fed over 3-4 feedings, with milk to drink 1 ripe avocadoe as mekses

Feed even more food if child wants to eat more!

How to prepare the enriched meals: Ingredients Kale Potato Egg Butter/oil Iodized Iodized salt enjera of maize Milk to drink Ripe avocado Amount 3 leaves 1 medium sized potato 1 small egg 2 teaspoons for the taste Weight gram 40 gram 80 grams 35 gram 10 ml Calories kcal 18 159 53 90 0 Protein gram 1.1 1.5 4.1 0 0 Iron mg 1.6 1.4 1.5 0 0

1/4 of enjera 1 coffee cup 1 medium sized

75 gram 70ml 100 gram Total Amount

119 52 110 601

3.3 1.8 1.6 13.4

7.4 0.7 1.7 14.3

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.

30

Staple Food Group 1: maize/enset

RECIPE 23: ENJERA WITH POTATO, CARROT, KALE AND EGG, WITH MILK TO DRINK In one day, along with breast milk, your 12-23 month old child can eat: 4 coffee cups of enjera with potato, carrot, kale and egg fed over 34 feedings, with milk to drink 1 banana as mekses

Feed even more food if child wants to eat more!

How to prepare the enjera meal: Ingredients Potato Carrot Onion Butter/oil Kale Egg Water Iodized salt enjera of maize Milk to drink Banana Amount 1 medium size potato 2 small size carrots onion 2 teaspoons 3 leaves 1 small egg 7 coffee cups for the taste of enjera 1 coffee cup 1 big size Weight gram 80 grams 40 gram 20 gram 10 ml 40 gram 35 gram 490ml Calories kcal 159 11 14 90 18 53 0 0 119 52 87.8 603.8 Protein gram 1.5 0.2 0.2 0 1.1 4.6 0 0 3.3 1.8 0.8 13.5 Iron mg 1.4 0.2 0.2 0 1.6 1.5 0 0 7.4 0.7 0.5 13.5

75 gram 70ml 100 gram Total Amount

1. Chop & fry onion in oil. 2. Wash, chop and add the kale 3. Wash, peel, chop & boil carrots and potatos in same pan. 4. Mash carrots and potatoes together and add beaten egg. 5. Add remaining water, iodized salt and boil further. 6. When cooked take off fire and mix with enjera. 7. Allow to cool and assist child to eat, using encouragement and patience. Note: Whenever available use 135 gram finely minced meat instead of potato. 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

31

Staple Food Group 1: maize/enset

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

How to prepare the enriched porridge: Ingredients Maize flour Kale Butter/oil Milk Water Iodized salt Ripe papaya Amount 1 coffee cups 3 leaves 3 teaspoons 2 coffee cups 4 coffee cups for the taste small sized Weight gram 70 gram 40 gram 15 gram 140ml 280ml Calories kcal 265 18 134 103 0 0 35 555 Protein gram 6.3 1.1 0 4.7 0 0 0.7 12.8 Iron mg 4.9 1.6 0 2.8 0 0 0.5 9.8

100 gram Total Amount

1. 2. 3. 4. 5. 6.

Wash, chop and boil the kale When it is cooked take it off fire and mash it. Mix the bulla with milk and put it on the fire Add butter/oil and iodized salt & cook while stirring. Add the kale and stir adding a little water for further cooking Allow to cool and assist child to eat, using encouragement and patience

Cooked amount = 4 coffee cups Prepation and cooking time = 40 minutes. Papaya for mekses 1. Wash & cut the papaya & remove the seeds. 2. Cut in to small pieces & give to the child to eat.

32

Staple Food Group 1: maize/enset

RECIPE 25: DRINK

ENJERA WITH MEAT AND KALE, WITH MILK TO

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!

How to prepare the enjera meal:
Ingredients Finely minced meat Kale Onion Butter/oil Water Iodized salt 'Enjera' of Maize Milk to drink Banana Amount 4 teaspoons Weight gram 20 gram Calories kcal 23 Protein gram 4.0 Iron mg 0.7

4 leaves of one onion 2 teaspoons 7 coffee cups for the taste A quarter of one 'Enjera' 2 coffee cups 2 big bananas

60 gram 20 gram 10 ml 490ml 75 gram 140ml 200 gram Total Amount

27 14 90 0 0 119 103 174

1.7 0.2 0 0 0 3.3 4.7 1.6

2.5 0.2 0 0 0 7.4 1.4 1.0

550 15.5 13.2 1. Chop and fry onion in oil 2. Add the minced meat to the roasted onion and cook by adding small quantity of water 3. Wash and chop kale and add to meat mixture. 4. Add iodized salt and keep on cooking adding small quantity of water frequently 5. Take the preparation off the fire and mix it with the enjera. 6. Allow to cool and assist child to eat, using encouragement and patience.

Cooked Amount= 4 coffee cups.

Preparation and cooking time= 1hour and 10 minutes. Banana for mekses 1. Wash and peel banana 2. Cut in to small pieces & give to the child to eat.

33

Staple Food Group 2: teff/wheat/barley

RECIPE 26: TEFF PORRIDGE ENRICHED WITH PEA FLOUR, CARROT, MILK AND OIL/BUTTER, WITH MILK TO DRINK In one day, along with breast milk, your 12-23 month old child can eat: 4 coffee cups of 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!

How to prepare the enriched porridge: 1. Sieve the flours and mix in a pot. Ingredients Teff Flour Peas flour Carrot Milk Oil Water Iodized salt Milk to drink Ripe avocado 2. 3. 4. 5. 6. Amount More than one coffee cups 1 tea spoons 1 small size 1 coffee cup 2 tea spoons 6 coffee cups For the test 1 coffee cup 1 medium size Weight gram 80 gram 5 gram 20 gram 70 ml 10 ml 420ml Calories kcal 284 18 6 56 90 0 0 52 110 Protein gram 7.2 1.0 0.1 2.3 0 0 0 1.8 1.6 Iron mg 120.0 0.7 0.1 0.7 0 0 0 0.7 1.7

70ml 100gram

Total Amount 616 14 123.9 Pour water & milk into the mixed flour and put it on the fire. Peel, wash and boil the carrot. Take off the fire and mash it. Add the mashed carrot, iodized salt & butter/oil to porridge and cook while stirring. 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.

34

Staple Food Group 2: teff/wheat/barley

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

How to prepare the enriched porridge: Ingredients Barley flour Kale Milk Egg Oil Lemon Water Iodized salt Banana Amount More than one coffee cups 3 leaves 1 coffee cups 1 small egg 2 tea spoons 1 medium size 5 coffee cups For the test 1 big size bananas Weight gram 80 gram 40 gram 100ml 35 gram 10 ml 15ml 350ml Calories kcal 294 18 74 53 90 7 0 0 88 571 Protein gram 6.8 1.1 3.4 4.6 0 0.1 0 0 0.8 12.2 Iron mg 5.0 1.6 1.0 1.5 0 0.1 0 0 0.5 8.2

100gram Total Amount

1. 2. 3. 4. 5. 6. 7.

Mix the flour with water & milk. Add iodized salt & put it on the fire. Wash and boil the kale. Take off the fire and chop. Add the kale & butter/oil to porridge and cook while stirring. Allow to cool and squeeze lemon on it. 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.

35

Staple Food Group 2: teff/wheat/barley

RECIPE 28: ENJERA WITH LENTIL AND CARROT SAUCE, WITH MILK TO DRINK In one day, along with breast milk, your 12-23 month old child can eat: 4 coffee cups of enjera with 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!

How to prepare the enriched meals: Ingredients Lentil split Carrot Oil Onion Enjera Water Iodized salt Milk to drink Ripe avocado 1. 2. 3. 4. 5. 6. 7. Amount 2 1/2 medium sized table spoons 1 small size 5 teaspoons onion Enjera 8 coffee cups For the test 1 coffee cup 1 medium size Weight gram 30 gram 20 gram 25 ml 10 gram 75 gram 560ml 70ml Calories kcal 107 6 224 7 124 0 0 52 Protein gram 6.9 0.1 0 0.1 3.7 0 0 1.8 Iron mg 12.9 0.1 0 0.1 42.0 0 0 0.7 1.7 57.5

100 110 1.6 gram Total Amount 630 14.2 Chop roasted the onion with the oil. Wash, chop and add the carrot in to the roasted onion Cook by adding small quantity of water. Add the lentil split and. Add iodized salt and the remaining water and cook properly. Take the preparation off the fire and mix it with enjera. 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

36

Staple Food Group 3: maize/sorghum

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

How to prepare the enriched porridge: Ingredients Sorghum flour Pea or bean flour Carrot Butter/oil Water Iodized salt Milk to drink Ripe avocado 1. 2. 3. 4. 5. 6. 7. Amount More than one coffee cups 1 tea spoon 1 small size 3 teaspoons 7 coffee cups for the taste 1 coffee cup 1 medium size Weight gram 80 gram 5 gram 20 gram 15 ml 490 ml Calories kcal 300 18 6 134 0 0 52 Protein gram 6.5 1.0 0.1 0 0 0 1.8 Iron mg 7.1 0.7 0.1 0 0 0 0.7 1.7 10.3

70ml

100 110 1.6 gram Total Amount 620 11 Clean the flour by sieving into a pot Mix the flour with water and milk.. Add iodized salt and put it on the fire Peel, wash and boil the carrot. Take off the fire and mash it. Add the carrot & butter/oil and cook by stirring. 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.

37

Staple Food Group 3: maize/sorghum

RECIPE 30: ENJERA WITH POTATO AND CARROTS, WITH MILK TO DRINK In one day, along with breast milk, your 12-23 month old child can eat: 4 coffee cups of enjera with 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!

How to prepare the enriched porridge: Ingredients Potato Carrot Onion Butter/oil Water Iodized salt Amount 1 medium size potato 2 small size carrots A quarter of one onion 3 teaspoons 7 big coffee cups for the taste A quarter of one enjera Weight gram 80 grams 40 gram 10 gram 15 ml 490 ml Calories kcal 159 17 7 134 0 0 168 Protein gram 1.5 0.7 0.1 0 0 0 4.4 Iron mg 1.4 0.2 0.1 0 0 0 5.6

enjera

75 gram

from Sorghum Milk to drink Banana

1 coffee cup 1 big size

70ml 100 gram Total Amount

52 88 625

1.8 0.8 9.3

0.7 0.5 8.5

1. 2. 3. 4.

Chop and fry the onion in oil. Peel, cop & wash the carrot and potato. Put little water and add the carrot. Cook for a while and then add the potato. Add the remaining water and iodized salt and keep on the fire for further boiling. 5. When it is cooked takes it off the fire and mix with enjera. 6. Assist child to eat, using encouragement and patience 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.

38

Staple Food Group 3: maize/sorghum

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

How to prepare the enriched porridge: Ingredients Sorghum flour Kale Butter/oil Milk Water Iodized salt Ripe avocado Amount More than one coffee cups 3 leaves 2 teaspoons 1 coffee cup 6 coffee cups for the taste 1 medium size Weight gram 80 gram 40 gram 10 gram 70 ml 420ml Calories kcal 300 18 90 52 0 0 110 570 Protein gram 6.5 1.1 0 2.4 0 0 1.6 11.6 Iron mg 7.1 1.6 0 0.7 0 0 1.7 11.1

100 gram Total Amount

1. 2. 3. 4. 5. 6.

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

39

Staple Food Group 3: maize/sorghum

RECIPE 32: ENJERA WITH MEAT & KALE SAUCE, WITH MILK TO DRINK In one day, along with breast milk, your 12-23 month old child can eat: 4 coffee cups of enjera with 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!

How to prepare the enriched porridge: Ingredients Finely minced meat Kale Potato Carrot Onion Butter/oil Water Iodized salt Enjera of Sorghum Milk to drink Ripe mango Amount 3 teaspoons Weight gram 15 gram Calories kcal 17 Protein gram 3.0 Iron mg 0.5

3 leaves big size 2 small size onion 4 teaspoons 6 coffee cups for the taste A quarter of one Enjera 1 coffee cup 1 medium size

40 gram 50 gram 40 gram 20 gram 20 ml 420 ml

18 100 11 14 179 0 0 168 52 44 603

1.1 0.9 0.2 0.2 0 0 0 4.4 1.8 0.3 11.9

1.6 0.9 0.2 0.2 0 0 0 5.6 0.7 0.6 10.3

75 gram 70ml

100 gram Total Amount

1. Chop and fry onion in oil 2. Add minced meat to fried onion and cook in small quantity of water 3. Wash and chop kale, and add to the meat mixture. 4. Add iodized salt and keep on cooking adding small quantity of water frequently 5. Take off the fire and mix with enjera. 6. Assist child to eat, using encouragement and patience 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.

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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?
1. Mother

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

WHY?
This first yellow milk (colostrum) is the mothers natural butter and will help to expel your babys first dark stool. Colostrum contains many important factors which will protect your new baby from disease.

2. Mother

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

Immediate breastfeeding within one hour of birth will help to expel the placenta and reduce post-partum bleeding. Pre-lacteal feeds (such as sugar water, water, butter, ersho) are not necessary and may interfere with establishing good breastfeeding practices during the first days of the babys life.

3. Mother

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

Feeding the baby only breastmilk provides the best nourishment possible for the baby and will protect it from diseases such as diarrhea and respiratory infections. Giving the baby water or other liquids may make your baby sick with diarrhea. If the baby takes water or other liquids, its appetite for breastmilk may decrease meaning it sucks less on the breast leading to poor growth. Even during very hot weather, breastmilk will satisfy all your babys thirst for liquids during the first six months.

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WHO?
4. Mother

ACTION
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.

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. Advise mothers with nipple and breast problems to seek immediate care from a Health Worker.

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.

Foremilk quenches thirst because it is more watery. Hind milk is richer and satisfies the babys 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. Ripe papaya, orange, carrot, pumpkin, mango and liver are especially good for the mother.

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.

7. Mother

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

Continue to breastfeed during diarrhea, even increasing the frequency, to replace the liquid lost. Breastfeeding more during illness will help your baby to fight the sickness and not loose weight. Breastfeeding also provides comfort to a sick baby. Sick mothers can continue to breastfeed their baby.

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WHO?
8. Mother

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

WHY?
Each time a baby is sick, it will loose weight so it is important to breastfeed as often as possible. Your breast milk is the safest and most important food you can offer your baby to regain its health and weight.

9. Mother

Take Vitamin A supplementation within 45 days of delivery for the babys health and strength.

Ask a Health Worker for Vitamin A supplementation after the birth of the baby. Taking a Vitamin A capsule will enrich the mothers breastmilk with important nutrients to keep the baby healthy and strong.

10.All family members

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

Malaria causes anemia which will make members of your family unwell and very tired. Family members with fever need to be taken to a health facility for immediate treatment.

11. Mother and father 12. Mother and father

Use LAM as a family planning method: 1. if the mother does not have her menses, 2. if the baby is exclusively breastfeed, and 3. if the baby is less than 6 months When your baby is older than 6 months, or if one of the conditions of LAM does not exist, visit the health facility or Community Based Reproductive Health Agent to obtain another Family Planning method

LAM is a modern family planning method, effective to 98% if the 3 conditions are met Dont wait until the baby is 6 months to decide on which family planning method you want to have.

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

WHO?
Mother and father

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

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

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Annex 2: Key Messages for Ethiopia on Complementary Feeding with Breastfeeding 6 to 24 months
WHO?
1. Mother and father

ACTION
Introduce complementary foods at six months of age, such as soft porridge 2-3 times a day, for your baby to grow healthy and strong.

WHY?
Porridge can be made from many different types of cereals and tubers (e.g. potatoes, enset). The consistency of the porridge should be thick enough to be fed by hand. Thicken the porridge as the baby grows older, making sure that it is still able to easily swallow without choking. Thin gruels made with water are not healthy for your baby as they do not provide enough of the nutrients it needs to grow strong and healthy. When possible use milk instead of water to prepare the porridge. Foods given to the child must be stored in hygienic conditions to avoid diarrhea and illness. First types of complementary foods, such as porridges, found in different regions that can be used to feed babies 6 to 12 months of age include: SNNPR:

- husifa (Sidama) - bulla, genfo (Gurage/Cheha) - uncha shandra (N. Omo/Konta) - boru-de-libajun (Bench and - boru-de-wedida (Bench and
Majil/Menit)

Majil/Menit) Oromia: - shura (E. Marage/Kersa Jurso) - merqa (E. Wellega) Amhara:

- genfo

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WHO?
2. Mother

ACTION
Continue to breast feed your child on demand, at least 8 times, day and night until two years and beyond to maintain its strength. Enrich your babys 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.

WHY?
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. Cows milk can be offered to your child in addition to the enrichment foods given, however, not to replace the enrichment foods. Add butter and oil every time. Animal foods (meat, liver, fish, eggs) are especially good for your baby and will keep it healthy and strong. Ripe orange/yellow fruits (papaya, mangos) and vegetables (carrots) are good sources of Vitamin A. Dark green leaves (kale, chard, shiferaw) and legumes contain important nutrients such as iron and will help your baby grow strong. Types of enrichment foods that can be given with the porridge include: Oil and butter Meat and fish Eggs Peanuts, beans, peas or lentils Ripe papaya or mangoes Carrots Avocados Dark green leafy vegetables

3. Mother and father

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WHO?
4. Mother and father

ACTION
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.

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 Foods given to the child must be stored in hygienic conditions to avoid diarrhea and illness. It is very important that the familys 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. Foods given to the child must be stored in hygienic conditions to avoid diarrhea and illness.

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.

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WHO?
6. Mothers and fathers 7. Mother

ACTION
As your baby grows older, feed more food at each meal in order to ensure that they are eating enough to maintain healthy growth. Be patient and actively encourage your baby to eat all its food in order to grow healthy.

WHY?
Change recipes each day using a variety of different foods remembering to encourage your child to eat more at each meal as they get older

8. Mother and father

9. Mother and father

At first the baby may need time to get used to eating foods other than breastmilk so have patience and take enough time to feed them, even using play to help them eat. Make the time for eating special. Use a separate plate to feed the child to make sure it eats all the food given. Forced feeding will discourage babies and young children from eating. As they are too little to feed themselves, babies need to be fed directly to make sure they eat all the food given to them. Even when older, young children should be supervised during mealtime to make sure they eat all the food put on their plate. During illness, increase the frequency of Fluid and food requirements are higher breastfeeding and offer additional food during illness. Take time to patiently encourage your to your child to help it recover faster. sick child to eat as their appetite may be decreased because of the illness. It is easier for a sick child to eat small frequent meals so feed the child foods it likes in small quantities throughout the day. It is important to keep breastfeeding and feeding complementary foods to your child during illness to maintain its strength and reduce the weight loss. Children who have been sick need extra When your child has recovered from an food and should be breastfed more illness, give one additional meal of solid frequently to regain the strength and food each day during the two weeks weight lost during the illness. that follow to help it recover quickly.

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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.

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.

Take enough time to actively encourage your child to eat this extra food as they still may not appear hungry due to the illness. Nutritious porridges for children should be thick enough to be fed by hand. Porridge that is too watery and can be fed with a bottle will not help your baby to grow. Bottles are very difficult to keep clean and can make your baby sick with diarrhea. Cups can be used to feed your baby, are easy to keep clean and are cheaper to buy than a bottle. Touching food with unclean hands can cause diarrhea.

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.

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. 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 childs eyesight as well as will help your child fight illness. Be sure to bring your child to Vitamin A supplementation sessions during Child Health Days. These foods are good sources of Vitamin A and other nutrients that will help your child grow strong and healthy.

13. Mother and father

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

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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.

15. All family members

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

Children should eat these foods as often as possible. Ask a Health Worker for de-worming medicine to be given two times a year to your child between the ages of 2 to 5 years. Intestinal parasites cause young children to become anemic which will make your child unwell and tired. Malaria causes anemia which will make members of your family unwell and very tired. Family members with fever need to be taken to a health facility for immediate treatment. Iodized iodized salt is not available everywhere, but should be used when available. Pregnant women need to use iodized iodized salt to ensure the health of their new baby.

16. Mother and father

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

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

WHO?
Mother and father

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

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

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ANNEX 3
Foods used to prepare these recipes and their nutrient composition per 100 gram edible portion. Food items
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 Bulla Maize flour Pea flour [shiro] Enjera of maize Meat Milk Egg Kale Potato Carrot Onion Papaya Lemon Orange Banana Oil Heart, beef Kidney beans Sugar Human breast milk Avocado Mango Bread of bulla Tomato Pumpkin Wheat Flour Barley Flour Teff Flour Enjera of teff Bread of Wheat Lentil Spilt Sorghum Flour Enjera of sorghum

Calories
196.0 378.2 352.2 159.0 114.8 73.7 152.9 46.0 199.0 27.8 71.3 34.9 48.5 33.9 87.8 896.4 219.7 170.3 385.0 70.0 110.1 43.8 186.1 30.7 42.6 362.9 368.0 355.1 166.0 251 355.1 374.8 224

Protein in grams
0.9 9.0 20.1 4.4 19.8 3.4 11.6 2.8 1.9 0.40 1.06 0.70 0.40 0.70 0.80 0 28.8 9.1 0 1.0 1.6 0.3 0.3 1.3 1.2 10.9 8.5 9.0 4.9 7.8 23 8.1 5.8

Iron in milligrams
10.1 7.0 13.9 9.8 3.3 1.0 4.3 4.1 1.7 0.50 0.80 0.50 0.50 0.80 0.50 0 8.2 3.3 0 0.006[absorbed] 1.7 0.6 4.6 0.9 1.8 5.7 6.3 150 56 7.1 43.1 8.9 7.4

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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

53