Undernutrition in the first two years does damage that is not fully recovered later: it shows up as stunting, more infections, and less learning at school. Feeding well in that window is the highest-value thing available, and it does not require expensive food.
By age
- 0 to 6 months: breast milk only.
- 6 to 8 months: continue breastfeeding, plus soft food two to three times a day, thick enough to stay on a spoon.
- 9 to 23 months: continue breastfeeding, plus family food three to four times a day, with one or two snacks.
- After two years: family food, five small meals a day, with breastfeeding for as long as both want.
What makes a good plate here
A staple (fufu, rice, plantain, yam, maize) is the base but not the meal. Every plate should also carry a protein and something coloured: groundnut paste, beans, egg, fish (including small dried fish eaten whole, bones and all, for calcium), liver once a week, and dark green leaves such as ndole, huckleberry or okra leaves. Add a spoon of red palm oil or groundnut oil to a child’s food: the energy is concentrated and red palm oil carries vitamin A.
The cheap foods that do the most
- Small dried fish, ground and stirred in: protein, calcium and iron.
- Beans and groundnuts: protein at a fraction of the cost of meat.
- Eggs: one a day makes a measurable difference to growth.
- Liver, once a week: the densest source of iron and vitamin A available.
- Dark green leaves and orange-fleshed foods: pawpaw, mango, yellow sweet potato, carrot.
Signs a child is not getting enough
- Not gaining weight, or losing it, over two visits.
- Visible wasting: ribs and shoulder bones showing, very thin upper arms.
- Swelling of both feet. This is severe malnutrition and it is urgent even though the child looks full.
- Hair turning pale or reddish, and coming out easily.
- Very pale palms and inner eyelids.
- A child who is listless and does not play.
- Repeated infections or diarrhoea that keeps returning.
During and after illness
Keep feeding a sick child; do not stop food during diarrhoea or fever. Offer smaller amounts more often, and keep breastfeeding. After the illness, give one extra meal a day for two weeks to catch up. Most weight loss in small children happens during these episodes.
What to avoid
- Watery pap as the main food after six months. It fills the stomach without the energy or protein.
- Sugary drinks and sweets, which take the place of food and damage teeth.
- Feeding a small child only from the adult plate leftovers. Small stomachs need dense food, not the remains.
- Stopping food during illness.
Alongside the food
Vitamin A every six months, deworming from 12 months, vaccinations on schedule, safe water and soap. Undernutrition and infection feed each other, so the two are treated together.
