The session
covering nutrition focused on the causes of malnutrition, preparing nutrient-rich
food using local ingredients, and preparing food in the proper quantity,
consistency and frequency according to the child’s age. It is surprising to find
After reviewing the
causes of malnutrition and advice for preparing food in a hygienic manner, I
presented the new food categories recently adopted by Peru’s national Ministry
of Health, which separates food into three groups:
1)
Foods that
Give Us Energy-Energizers (carbohydrates
and fats)
2)
Foods that
Make Us Grow – Constructors (animal
proteins and legumes)
3)
Foods that
Protect Us Against Illness – Protectors
(fruits and vegetables)
To liven up the
presentation, I engaged the group in an activity in which I gave each person a
card with a picture representing a common food and each person had to tell me
into which group it fell.
Then we discussed
each group and the importance of eating a balance diet to make sure the child
is getting the proper mix of vitamins, minerals, carbohydrates, proteins and
fats to help kids grow properly. In the
baseline survey given to 135 members of my community during the Community
Diagnostic, many mothers had trouble naming foods that contain protein, which
indicate a lack of information as a contributing barrier to change. Therefore, we carefully reviewed the foods
that contain iron and encouraged mothers to serve iron-rich foods with lime
juice to aid in absorption of iron and prevent anemia.
In addition, we
covered the importance of including fruits and vegetables in every meal, as the
common practice is to not include fruits and vegetables in meals, as they are
not considered adequate nourishment, but might be consumed between meals as a
snack. A typical lunch is chicken soup
with a heaping plate of rice, potatoes, noodles (or beans) and fried fish or
stewed meat on top and a few extra tablespoons of oil drizzled over top. Witnessing the social pressure to prepare
meals that conform to a narrow definition leads me to conclude that a barrier
to change revolves around social acceptance.
We stressed that fruits and vegetables contain vitamins and minerals
that do not exist in other foods and help protect our bodies from illness, such
as cancer. The cancer comment was likely
quite convincing given the recent deaths of several well-known members of our
community due to cancer, and will hopefully push at least a few moms over the
barrier to change and include fresh fruits and veggies in meals.
Next, my
co-presenter described the proper quantity, consistency and frequency of food
to prepare for each age group. For
children under 6 months of age, it recommended that they exclusively receive
breast milk. Most mothers are aware of
this but give their child tea or other home remedies to soothe the child. My counterpart explained how dangerous it is
for the child to be deprived of nutritious breast milk.
For children in the
other age groups, the recommendations from the Ministry of Health have been
confusing and evolving, with new recommendations disseminated each year. These have been the recommendations
previously provided by the Ministry of Health:
Age Group
|
Quantity
|
Consistency
|
Frequency
|
Plus
|
6-8
months
|
3
to 5 Tbsp.
Including
1 Tbsp. protein or ½ liver or ½ egg once per day
|
Creamy
|
3x
day
|
Add
1 Tbsp. oil to food and continue breastfeeding 4x per day
|
9-11
months
|
5
to 7 Tbsp.
Including
1 Tbsp. protein or ¾ liver or ¾ egg once per day
|
Diced
|
4x
day
|
Add 1 Tbsp.
oil to food and continue breastfeeding 4x per day
|
1
year+
|
7-10
Tbsp.
Including
2 Tbsp. protein or 1 liver or 1 egg once per day
|
Normal
|
5x
day
|
Add 1 Tbsp.
oil to food and continue breastfeeding 4x per day
|
Clearly, these are
good recommendations for a healthy diet, but the numbers can be very confusing,
especially for a mother who cannot read and therefore cannot refer to the chart
above to determine the correct specifications for feeding her child.
My co-facilitator
explained the chart above while the mothers patiently listened, and afterwards
she brought the numbers into reality by assigning participants to prepare a
meal for a specific age group. She brought
various local foods to the demonstration and different sized plates to indicate
portion size. The mothers were tasked
with preparing meals in the correct quantity, consistency, with the additional
recommendations for including protein, adding extra oil, and balancing the
plate with the three different food groups.
It was clear that the participants had a difficult time pushing aside
the rice to make room for the vegetables, but it was good practice.
Please click here to read about Educational Session #4: Early Childhood Development
