essential nutrition, hygiene and care during early...

Essential Nutrition, Hygiene and Care

During Early Childhood

Leader Mother Flipchart Module 4 of 5

2

Essential Nutrition, Hygiene, and Care during Early Childhood

Table of Contents

Lesson 1: Child Feeding: 6-8 months .......................................... 4

Lesson 2: Child Feeding: 9-11 months ...................................... 12

Lesson 3: Child Feeding: 12-23 months .................................... 20

Lesson 4: Porridge Recipes: CSB and Local Foods ....................... 28

Lesson 5: Vitamin A: Foods and Supplements ............................ 36

Lesson 6: Worms and Deworming ............................................ 44

Lesson 7: Preparing, Cooking and Storing Foods ........................ 52

Lessons, stories, and activities in the Essential Nutrition, Hygiene, and Care during Early Childhood Lesson Plan complements the information provided in Essential Nutrition, Hygiene, and Care during Early Childhood Leader Mother Flipchart.

Acknowledgements

Hanold, Mitzi J. (2010) Essential Nutrition, Hygiene, and Care during Early

Childhood Mother Leader Flipchart. Washington DC. Food for the Hungry (FH), made possible through support provided by the Office of Food for Peace, Bureau of Democracy, Conflict, and Humanitarian Assistances, and

the U.S. Agency for International Development under the terms AID-FFP-09-00004-00. The opinions expressed herein are those of the authors and do not necessarily reflect the view of the U.S. Agency for International Development.

Many thanks to our illustrators including Ocatvio Gonzales and Gatabo

Edgar. Ababitosoye nabo barimwo Dr. Dieudonne Bikorimana (FH), Megan Parker (IFPRI), (CRS), Isaac Kilimushi-Hamuli (IMC), and Regine Pachis Nihoreho (CRS). For questions or comments, please contact the authors at [email protected].

4

Lesson 1: Child Feeding: 6-8 months

Materials:

1. Attendance Registers

2. One cup of water*

3. Two pieces of chewy food like dried fish

4. One handful of crunchy food like peanuts

1. Game: The Hand Washing Song

2. Attendance and Troubleshooting

3. Story: Mvuyekure Refuses his First Foods (Picture 1.1)

Barumwete followed the advice of Karorero and began exclusively breastfeeding Mvuyekure. Mvuyekure gained weight. Now he is six

months old. Barumwete offers him a thick porridge. He coughs and turns away. Barumwete tries again. Mvuyekure won’t eat it.

4. Ask

? Why isn’t Mvuyekure eating?

? At what age, should a mother offer food to

her infant?

? When did you give your last child his first

taste of porridge?

Let’s compare your ideas with the messages on the following pages.

Story: Mvuyekure Refuses his First Foods (Picture 1.1)

Barumwete followed the advice of Karorero and began exclusively breastfeeding Mvuyekure. Mvuyekure gained weight. Now he is six months

old. Barumwete offers him a thick porridge. He coughs and turns away.

Barumwete tries again. Mvuyekure won’t eat it.

6

First Foods at Six Months (Picture 1.2)

5. Show

? What do you think these pictures mean?

6. Explain

At six months of age, offer soft porridge after breastfeeding.

o Breast milk is still the most important source of food.

o Always breastfeed before giving foods.

o Breastfeed whenever the child shows signs of hunger.

Prepare porridge using CSB and oil.

o Add oil after cooking.

o Uncooked oil is better for the child than cooked oil.

o Porridge can also be made with taro, maize or sorghum.

Porridge should be soft: not too thick or too thin.

o Thick porridge may block the child’s throat.

o Thin porridge will slip out of the child’s mouth.

o Soft porridge is easy for the child to swallow.

? If the infant refuses new foods, what should the mother do?

o Try again tomorrow.

o Add breast milk to the porridge.

o Talk to the child, encouraging him to eat.

o Offer porridge made from a different food.

First foods at Six Months (Picture 1.2)

At six months of age, offer soft porridge after breastfeeding.

Prepare porridge with CSB and oil. Porridge should be soft: not too thick or too thin.

8

Quantity and Frequency of Feeding: 6-8 months (Picture 1.3)

7. Show


8. Explain

Offer porridge three times a day. Offer a little less than half of an Agasabasaba cup at each feeding (up to 6 spoonfuls at each

feeding).

o Offer porridge in the morning, at noon and in the evening.

o The first week of feeding, offer 2 or 3 spoonfuls each day.

o Increase each day as the child appetite increases until the child is able to eat 5 or 6 spoonfuls at each feeding.

Feed children slowly and patiently.

o Encourage the child to eat, but do not force them.

o Sing or talk to the child to encourage them.

o Add breast milk to porridge to encourage them to eat.

Breastfeed whenever the child is hungry day and night.

o Breastfeed whenever the child shows signs of hunger.

o Always breastfeed before offering foods.

? Why do you think that Karorero and her husband spend so much time helping Biguvu to eat?

o They know that Biguvu must eat to grow well.

o Without encouragement he will not eat enough.

o They value their child. They do all they can to help him

grow.


Offer porridge three times a day. Offer a little less than half of an Agasabasaba cup at each feeding (up to 6 spoonfuls at each feeding).

Feed infants slowly and patiently. Breastfeed whenever the child is hungry day and night.

10

Increased Food Variety: 6-8 months (Picture 1.4)

9. Show


10. Explain

Slowly add new foods to the child’s porridge.

o After four days of plain porridge, add one new food.

o Offer the new food for four days.

o Then add another new food to the porridge.

Porridge with petite pois, cajun peas and oil will make the blood

strong.

o CSB and peas are rich in iron.

o Oil gives children energy.

Porridge with fish, peanuts and oil will build strong muscles and bones.

o Use fresh fish since it is soft. Remove the skin and bones.

o CSB, fish and peanuts are rich in protein.


Porridge with mashed pumpkin, carrots and oil will help prevent sickness.

o CSB, pumpkin and carrots are rich in vitamin A.


11. Activity: Soft Porridge

12. Probe 13.Inform 14.Practice and

Coaching 15.Request 16.Examine

Increased Food Variety: 6-8 months (Picture 1.4)

Slowly add new foods to the child’s porridge. Porridge with, petit pois, cajun peas and oil will make the blood strong.

Porridge with fish, peanuts, and oil will build strong muscles and bones.

Porridge with mashed pumpkin, carrots and oil will help prevent sickness.

12


Materials:


1. Game: Making Porridge


3. Story: Mvuyekure is Always Hungry (Picture 3.1)

Mvuyekure is now 9 months old. Barumwete prepares porridge for Mvuyekure three times a day. But he often grows hungry between

meals. Barumwete is tired of making porridge. She doesn’t have time to cook five times each day. Her husband says, “Why aren’t

you feeding Mvuyekure? You are starving my son.”

4. Ask

? Why isn’t Mvuyekure satisfied?

? How can Barumwete satisfy her child’s hunger without cooking all day?

? How often do you feed your 9-11 month

old child each day?


Story: Mvuyekure is Always Hungry (Picture 2.1)

Mvuyekure is now 9 months old. Barumwete prepares porridge for Mvuyekure three times a day. But he grows hungry between meals.

Barumwete is tired of making porridge. She doesn’t have time to cook five

times each day. Her husband says, “Why aren’t you feeding Mvuyekure? You are starving my son.”

14

Complementary Feeding: 9-11 months (Picture 2.2)

5. Show


6. Explain

Breastfeed day and night whenever the child shows signs of hunger. Offer foods to your child after breastfeeding.

o Breast milk is the most important food for the child.

o Breast milk is better than animal milk or water.

o Continue to breastfeed for two or more years.

o Always breastfeed before giving foods.

At nine months offer finely chopped foods and chunky, mashed

foods. Offer foods the child can eat with his fingers.

o Chunky foods help the child to learn to chew.

o The pieces should be small so they won’t get stuck in the

child’s throat.

o Encourage the child to pick up foods with his fingers.

o This helps them to strengthen their fingers.

? How would you describe the texture of the foods that you fed

your 9-11 month old child yesterday?

? What finger foods did you offer your 9-11 month old child

yesterday?

Complementary Feeding: 9-11 months (Picture 2.2)

Breastfeed day and night whenever the child shows signs of hunger.

Offer foods to your child after breastfeeding.

At nine months offer finely chopped foods and chunky, mashed foods. Offer foods the child can eat with his fingers.

16


7. Show


8. Explain

For children 9 to 11 months, offer food four times each day.

o Offer food in the early morning, mid-day, afternoon and evening.

o Offer chunky porridges and finely chopped foods.

o Offer snacks once or twice a day.

Offer 8 spoonfuls of food at each feeding.

o This is the same as half of an Agasabasaba cup.

o You will be able to see how much the child eats.

o If the child is still hungry, offer more foods.

Children who are not fed four times a day suffer from

malnutrition.

o This father only offers his child family foods twice a day.

o The child is two years old, but growing very ill.

o He is malnourished and is too weak to walk.

? Karorero feeds Biguvu many times a day. Why does she do this?

o She doesn’t want Biguvu to suffer from malnutrition.

o She wants Biguvu to live a long healthy life.

o She must feed him many times each day so he will grow

tall and strong.


For children 9 to 11 months, offer food four times each day.

Offer 8 spoonfuls of food at each feeding.

Children who are not fed four times a day suffer from malnutrition.

18

Snacks for Children: 9-11 months (Picture 2.4)

9. Show


10. Explain

Offer raw foods like tomato, mango, guava, papaya, prune de

japon, pineapple, orange, banana, maracuja and avocado.

o Uncooked snacks are easier for mothers to prepare.

o Carry snacks with you when you are away from home.

Offer boiled foods like taro, egg, potato, carrot and pumpkin.

o Prepare boiled foods in the morning.

o Offer these foods to the child on the same day.

Offer wheat, maize or manioc bread.

Offer foods of many different colors.

o Foods of different colors have different vitamins inside.

o Children who eat foods of many different colors are tall and strong.

? What snacks can you offer to your child this week?

11. Activity: Child Feeding Song

12. Probe 13. Inform 14. Practice and

Coaching 15. Request 16. Examine

Snacks for Children: 9-11 months (Picture 2.4)

Offer raw foods like tomato, mango, guava,

papaya, prune de japon, pineapple, orange, banana,

maracuja and avocado.

Offer boiled foods like taro, egg, potato,

carrot, and pumpkin.

Offer wheat, maize or manioc bread.

Offer foods of

many different colors.

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Materials:


2. One Agasabasaba cup

3. One small bucket or cooking pot

4. A pile of soil (four cups of soil)

1. Game: Danger Sign Song


3. Story: Breast Milk Does Not Satisfy

Barumwete is talking with a friend and the children. When

Barumwete’s child cries, she offers him a piece of boiled banana.

When the neighbor’s child cries, the mother offers him her breast. “My breast milk doesn’t satisfy my child anymore.” The neighbor

complains. “Here.” Barumwete says. “She needs a snack. Your child is over a year old. Now she needs snacks to help satisfy her

hunger.”

4. Ask

? What does each mother offer her child?

? Which one of these mothers is doing the

right thing?

? When your one year old child cries, what

do you offer him?


Story: Breast Milk Does Not Satisfy (Picture 3.1)

Barumwete is talking with a friend and the children. When Barumwete’s child cries, she offers him a piece of boiled banana. When the neighbor’s child cries, the mother offers him her breast.

“My breast milk doesn’t satisfy my child anymore.” The neighbor complains.

“Here.” Barumwete says. “She needs a snack. Your child is over a year old. Now she needs snacks to help satisfy her hunger.”

22

Continued Breastfeeding: 1-2 years (Picture 3.2)

9. Show


10. Examine

After the child turns one, offer foods first then breastfeed. Continue to breastfeed for two or more years.

o Breastfeed whenever the child asks for it.

o Breast milk helps to prevent sickness.

o Breast milk is better for the child than animal milk or water.

o Children who continue to drink breast milk grow tall and strong.

Eat beans, organ meats, garlic, whole grain rice, red palm oil, peanuts, squash seeds, fish and eggs.

o These foods help the breastfeeding mother stay healthy.

o Mothers who eat these foods have healthier children.

o Eat two additional snacks each day.

? Why do some mothers stop breastfeeding before the child is two years of age?

? How can we help them to understand the importance of continuing to breastfeed?

Continued Breastfeeding: 1-2 years (Picture 3.2)

After the child turns one, offer foods first then breastfeed.

Continue to breastfeed for two or more years.

Eat beans, organ meats, garlic, whole grain rice, red palm oil, peanuts, squash seeds, fish and eggs.

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Quantity and Frequency of Feeding: 1-2 years (Picture 3.3)

7. Show


8. Examine

Offer food five times a day. Offer porridge, family foods and snacks.

o Offer family foods two or more times each day.

o Offer children the same foods others are eating.

o Feed children from a separate bowl.

Offer 17 tablespoons of food at each feeding.

o This is the same as one full Agasabasaba cup.

o Feed children from a separate plate so you can see how much they eat.

o Increase the food as the child grows.

o If the child is still hungry, offer more.

Chop or mash foods which are difficult to chew and swallow.

o Cut meat or dried fish into small pieces.

o Chop or mash foods that might cause choking.

? Why does Karorero feed her child out of a separate plate?

o She can make sure her child is eating enough each day.

o She knows exactly how much to prepare for him.

Quantity and Frequency of Feeding: 1-2 years (Picture 3.3)

Offer food five times each day. Offer porridge once or twice each day. Offer family foods and snacks.

Offer 17 tablespoons of food at each feeding.

Chop or mash foods which are difficult to chew or swallow.

26

Healthy Foods for Growing Children (Picture 3.4)

9. Show


10. Examine

Offer taro to your child. Taro helps children to grow well.

o Boil taro and offer it as porridge.

o Boil taro and mix with beans and fish.

o Boil taro and offer it as a snack.

Offer organ meats and fish to build strong blood, muscles and bones.

o These foods have iron for strong blood.

o These foods have protein for muscles and bones.

Add a sprinkle of iodized salt to family foods.

o Buy salt with the iodine label on it.

o Salt from Tanzania does not have iodine.

o Iodized salt helps children do well in school.

? What other foods are needed to help children grow?

o Energy foods like oils and grains.

o Fruits and vegetables.

11. Activity: A Child’s Stomach

12. Probe 13. Inform 14.Practice and


Healthy Foods for Growing Children (Picture 3.4)

Offer taro to your child.

Taro helps children to grow well.

Offer organ meats and fish to build strong blood, muscles and bones.

Add a sprinkle of iodized salt to family foods.

28

Lesson 4: Porridge Recipes: CSB and Local Foods

Materials:


2. Foods for the Taro and Sauce recipe

3. Cooking pots and materials needed for the fire.

4. Ask each mother to bring a small bowl to share the food.

1. Game: In the River


3. Story: Sharing Porridge (Picture 4.1)

Karorero adds five cups of CSB for porridge so that everyone in her

family can eat. She adds a ½ cup of mashed peanuts and a mashed and deboned fish. She adds water so that the porridge is soft and

thin for Biguvu. When the porridge is finished cooking, she adds oil. First she pours porridge for each of the children. She and her

husband eat after all the children are fed.

4. Ask

? Why does Karorero feed the children first?

? How much porridge should each person in

the family receive?

? How do you make sure that the children get

enough porridge each day?


Story: Sharing Porridge (Picture 4.1)

Karorero adds five cups of CSB for porridge so that everyone in her family

can eat. She adds a ½ cup of mashed peanuts and a mashed and deboned fish. She adds water so that the porridge is soft and thin for Biguvu. When the porridge is finished cooking, she adds oil.

First she pours porridge for each of the children. She and her husband eat after all the children are fed.

30

Rations for the Everyone (Picture 4.2)

5. Show


6. Explain

Pregnant and breastfeeding women use two cups of CSB and two

spoonfuls of oil each day.

o Fill the cup to the top of the circle design.

o Use one cup of CSB and one spoonful of oil for porridge each morning.

o Use one cup of CSB and one spoonful of oil for porridge in

the afternoon.

Use one cup of CSB and one spoonful of oil for children six to 24 months.

o Fill the cup to the top of the circle design.

o For children 6-8 months offer 1/3 cup of CSB porridge three

times each day.

o For children 9-11 months offer ½ cup of CSB porridge two times a day in addition to other foods.

o For children ages 1 to 2 years, offer one cup of porridge in addition to other foods.

Use four cups of CSB and 4 spoonfuls of oil for others in the family each day.

o Children older than 2 years and adults in the household share this porridge.

? How much water is mixed with each cup of CSB to prepare

porridge?

o Two full cups of water.

o To make thick porridge use less water.

o To make soft porridge add more water.

Rations for the Everyone (Picture 4.2)

Pregnant and breastfeeding women

use two cups of CSB

and two spoonfuls of oil each day.

Use one cup of CSB

and one spoonful of oil

for children 6-24 months

each day.

Use four cups of CSB and

4 spoonfuls of oil

for others in the family each day.

32

Sweet Porridge and Salty Porridge (Picture 4.3)

7. Show


8. Explain

To make sweet porridge:

o Mix 1 cup CSB. Fill the cup to the top of the circle design

o 2 cups of water

o 1 banana. If you do not have banana, add another fruit like mango or papaya.

Boil 5 minutes. Add more water is porridge is too thick.

Remove from the fire. Add one spoonful of oil. Add a sprinkle of iodized salt.

To make salty porridge:

o 1 cup CSB. Fill the cup to the top of the circle design.

o 2 cups of water

o 2 dried fish

o 2 spoons of beans

o If you don’t have fish, use mashed peanuts.

Cook beans and fish until soft. Mash. Boil CSB for 4 minutes. Add mashed beans and fish. Boil 1 minute.

Remove from the fire.

Add one spoonful of oil.

Add a sprinkle of iodized salt.

? What other foods have you added to your porridge?

Sweet Porridge and Salty Porridge (Picture 4.3)

To make sweet porridge:

Mix 1 cup CSB

2 cups of water

1 small banana

Boil 5 minutes.

Add more water if

the porridge is too thick.

Remove from the fire. Add one

spoonful of oil. Add a sprinkle of iodized salt.

To make salty porridge:

1 cup CSB

2 cups water

2 dried fish

2 spoons beans

Cook beans and fish until soft. Mash. Boil CSB for

4 minutes. Add mashed beans and fish. Boil 1 minute.

Remove from the fire. Add one spoonful of oil.

Add a sprinkle of iodized salt.

34

Taro and Sauce Recipe (Picture 4.4)

9. Show


10. Explain

You will need:

o 2 cups taro

o 4 cloves garlic

o 1 onion

o 1 cup organ meat

o 1 cups greens

o 2 cups pumpkin

o 4 cups beans

o 4 spoons of oil

o Sprinkle of iodized salt

Boil beans with water. When halfway done, add taro and squash

and amaranth. Cook until finished. Remove from the pot. Add salt.

In empty pot, add oil, onion, garlic and meat. Cook until finished.

Serve meat with the taro and bean mixture.

11. Activity: Taro and Sauce Recipe



Taro and Sauce Recipe (Picture 4.4)

You will need:

2 cups taro

4 cloves garlic

1 onion

1 cup organ meat

1 cups greens

2 cups pumpkin

4 cups beans

4 spoons of oil

Sprinkle of iodized salt

Boil beans with water. Add a sprinkle of salt.

When halfway

done, add taro and squash and amaranth.

Cook until

finished. Remove from the pot.

In empty pot, add oil, onion, garlic and meat. Cook until finished.

Serve meat with the bean and taro mixture.

36

Lesson 5: Vitamin A: Foods and Supplements

Materials:


2. Foods Rich in Vitamin A

1. Game: Child Feeding Song


3. Story: Stumbling in the Dark (Picture 5.1)

Barumwete’s son goes out to the latrine at night with a small light so

that he can see. “Uggh” (replace with an exclamation a boy might make when falling) she hears him say. She looks out the window

and see him falling to the ground. She runs outside. “What is wrong?” she asks her son. “I have trouble seeing, especially at

night, he says. “I must have tripped over these small rocks.” “How can this be?” She asks, “You are holding a candle. Didn’t you see

them?”

4. Ask

? What causes night blindness?

? What can be done to treat night

blindness?

? What would you do if your child suffered

from night blindness?


Story: Stumbling in the Dark (Picture 5.1)

Barumwete’s son goes out to the latrine at night with a small light so that he

can see. “Uggh” she hears him say. She looks out the window and see him falling to the ground. She runs outside. “What is wrong?” she asks her son. “I have trouble seeing, especially at night, he says. “I must have tripped over

these small rocks.” “How can this be?” She asks, “You are holding a candle. Didn’t you see them?”

38

Not Enough Vitamin A (Picture 5.2)

7. Show


8. Explain

Night blindness is a sign that the body does not have enough vitamin A.

o This child has trouble seeing at night.

o His eyes will grow worse if he is not treated.

o His eyes may become scarred and lumpy.

o Vitamin A protects children from blindness.

Frequent sickness is a sign that the body does not have enough

Vitamin A.

o This child is sick often.

o He does not have enough Vitamin A in his body.

o His body is not able to keep away sickness.

o Vitamin A protects children from severe illness.

? Why is it important for caregivers to take action if they see these signs?

o Blindness is a sign that the child needs help.

o Without immediate care, the child may lose their eyesight.

o Frequent sickness is a sign that the child needs help.

o Caregivers can make simple changes that will help their

children recover quickly.

Not Enough Vitamin A (Picture 5.2)

Night blindness is a

sign that the body does not have enough Vitamin A.

Frequent sickness is a

sign that the body does not have enough Vitamin A.

40

Foods Rich in Vitamin A (Picture 5.3)

7. Show


8. Explain

Offer children orange sweet potato, carrots, or liver twice each

month to provide enough vitamin A.

o These foods have the most vitamin A.

o Offer a ½ cup of one of these foods twice a month.

o White and gold flesh sweet potatoes do not have vitamin A.

Offer children pumpkin flesh, taro leaves or onion tops twice

each week to provide enough vitamin A.

o Pumpkin and taro leaves are rich in vitamin A.

o They are not as rich as orange sweet potato, carrots or liver.

o Offer a ½ cup of one of these foods twice a week.

Offer amaranth or pumpkin leaves each day to provide enough vitamin A.

o Children must eat these foods each day to have enough vitamin A.

o Offer a ½ cup of one of foods each day.

? Which of these foods can you offer to your child this week?

? How often do you need to provide this food so the child receives

enough vitamin A?

Foods Rich in Vitamin A (Picture 5.3)

Offer orange sweet potato, carrots and liver twice a month to provide enough vitamin A for the child.

Offer children pumpkin, taro leaves or onion tops twice each week to provide enough vitamin A.

Offer amaranth or pumpkin leaves each day to provide enough vitamin A.

42

Vitamin A Supplements (Picture 5.4)

9. Show


10. Explain

Within six weeks after delivery, go to the health center for

vitamin A.

o Vitamin A helps women recover after delivery.

o Vitamin A in the breast milk protects breastfeeding infants.

At six months of age, take your child to the health center for vitamin A. Return every six months for vitamin A.

o Vitamin A prevents severe illness.

o Vitamin A helps eyes to stay healthy.

o Offer children vitamin A every six months until they are five

years old.

Take children with measles or severe malnutrition for an additional treatment of Vitamin A.

o Vitamin A prevents death and helps the child recover quickly.

? When was the last time your child received Vitamin A?

11. Activity: Foods Rich in Vitamin A


coaching 15. Request 16.Examine

Vitamin A Supplements (Picture 5.4)

Within six weeks after delivery, go

to the health center for vitamin A.

At six months of age, take your

child to the health center for vitamin A.

Return every six

months for Vitamin A.

Take children with measles or severe

malnutrition for an additional treatment.

44

Lesson 6: Worms and Deworming

Materials:


1. Game: Pass the Worm


3. Story: Our Bellies are Full (Picture 6.1)

At dinner, Barumwete sees that her children are not eating well. “Why aren’t you eating?” she asks. “My stomach is already full” her

son says. “I’m just not hungry” say the girl. This continues for many days. Even though their bellies look full, Barumwete knows

they are not eating enough.

4. Ask

? Why aren’t the children eating?

? What sickness can cause this problem?

? What do you do when your children lose

their appetite?


Story: Our Bellies are Full (Picture 6.1)

At dinner, Barumwete sees that her children are not eating well. “Why aren’t

you eating?” she asks. “My stomach is already full” her son says. “I’m just not hungry” say the girl. This continues for many days. Even though their bellies look full, Barumwete knows they are not eating enough.

46

Worms and Malnutrition (Picture 6.2)

5. Show


6. Explain

A parasite is a small worm that lives in the body.

o Some worms are too small to see.

o Others can be several meters long inside the body.

o Parasites live off of food and blood in the body.

Children with worms do not eat well and become malnourished.

o Worms steal food from the child’s body.

o Worms steal blood from the child’s body.

o Children with worms do not grow well.

o Children with worms get sick easily.

? What are signs that a child has worms?

o Sometimes worms are seen in the child’s feces.

o The child’s belly may become round and large.

o The child may lose interest in eating.

Worms and Malnutrition (Picture 6.2)

A parasite is a small worm that lives in the body.

Children with worms do not eat well and become malnourished.

48

Worm Prevention (Picture 6.3)

7. Show


8. Explain

Worm eggs live in feces.

o This child has worms.

o His feces has eggs which are ready to hatch.

o The ground now has worm eggs on it.

o This child may have worm eggs on his hands and feet.

Always use a latrine. Keep feces and worms away from others.

o Don’t let worm eggs get onto the soil.

o Wash hands and child’s hands after using the latrine.

o Soap kills germs and worm eggs on hands.

Wash foods from the soil with boiled or purified water before eating them.

o Wash worm eggs off fruits and vegetables that are eaten without cooking.

o Use water that has been purified with Sur Eau.

o Use water that has been boiled.

Wear shoes. Stop worms from burrowing into your feet.

o Some worms hatch in the soil.

o The break through skin on the feet and enter the body.

o Always use a mat when sitting on the ground.

Worm Prevention (Picture6.3)

Always use a latrine. Keep feces away from others.

Wash foods from the soil with purified water.

Wear shoes. Stop worms from burrowing into your feet.

50

Deworming Children and Pregnant Women (Picture 6.4)

9. Show


10. Explain

Pregnant women, take a deworming pill in the fourth month of

pregnancy.

o Many pregnant women don’t know they have worms.

o Women who take deworming pills have healthier

pregnancies and infants.

o When a pregnant woman’s belly begins to show and she

feels movement inside, three months have passed.

o She is ready to take a deworming pill.

Beginning at the child’s first birthday, give a deworming pill every six months.

o Most children have worms and don’t know it.

o Worms prevent children from growing well.

o Worms give children weak blood.

o They are weak and are not able to do well in school.

11. Activity: Deworming Song



Deworming Children and Pregnant Women (Picture 6.4)

Pregnant women, take a deworming pill

in the fourth month of pregnancy.

Beginning at the child’s first birthday, give a

deworming pill every six months.

52

Lesson 7: Preparing, Cooking and Storing Foods

Materials:


1. Game: Rainstorm


3. Story: The Ruined Dinner (Picture 7.1)

After dinner, Barumwete puts cleans the dishes. “We have so much food leftover. I will save it for tomorrow” She says. She goes to

place it on the dish rack, but there are many things on the rack already. “I’ll just put it here under the rack until tomorrow,” she

says. Early in the morning, Mvuyekure wakes up and finds the food

on the floor. He starts to eat it. Soon his older brother sees him. “Stop Mvuyekure!” he says, “that food will make you sick!”

4. Ask

? Is this food good for Mvuyekure? Why

or why not?

? What did Barumwete do that was

wrong?

? How do you keep leftover foods?


Story: The Ruined Dinner (Picture 7.1)

After dinner, Barumwete puts cleans the dishes. “We have so much food

leftover. I will save it for tomorrow” She says. She goes to place it on the dish rack, but there are many things on the rack already. “I’ll just put it here under the rack until tomorrow,” she says.

Early in the morning, Mvuyekure wakes up and finds the food on the floor. He starts to eat it. Soon his older brother sees him. “Stop Mvuyekure!” he says, “that food will make you sick!”

54

Saving Leftover Foods (Picture 7.2)

9. Show


10. Explain

Flies, the hot sun, and sitting too long make food dangerous for children.

o Cooked food that sits for more than one day will cause sickness.

o Flies and other insects bring germs to foods.

o Heated food that sits all day in the hot sun will cause sickness.

Keep files away from leftover foods. Cover them.

o Use a woven cover or plate to cover food.

o Store foods up off the ground.

Do not keep cooked food for more than one day.

o Food prepared in the evening, should be eaten in the morning.

o Foods prepared in the morning should be eaten by the

evening.

o Germs multiply as the food sits.

o Always reheat food before eating.

? Is it a good idea to keep leftover porridge?

o No.

o Germs multiply more quickly in liquid food.

o Only make enough porridge for the child to eat at each feeding.

Saving Leftover Foods (Picture 7.2)

Flies, the hot

sun and sitting too long make food

dangerous for children.

Keep flies away from leftover foods. Cover them.

Do not keep cooked food for more than one day.

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Preparing Food (Picture 7.3)

5. Show


6. Explain

Wash your hands before preparing food.

o Wash with soap and water.

o If you do not have soap, use ash.

Wash knives, spoons and cooking surfaces before preparing

food.

o Flies on spoons and knives can add germs.

o Germs in foods can cause sickness.

Wash fruits and vegetables before cooking.

o Cleaning fruits and vegetables prevents sickness.

o If you don’t wash foods first, you are adding dirt to your cooking pot.

? Which of these things do you do already?

? Which of these things can you try to do to protect your family from sickness?

Preparing Food (Picture 7.3)

Wash your hands before preparing food.

Wash knives, spoons and cooking surfaces before preparing food.

Wash fruits

and vegetables with water

before cooking.

58

Before and After Eating (Picture 7.4)

7. Show


8. Explain

Cook foods until they are hot throughout. Always reheat leftover

foods until they are hot throughout.

o Heat meats until they are hot throughout.

o To kill germs, heat liquids until boiling.

o As leftover foods cool, germs multiply.

o Reheat left over foods until they are boiling.

Help everyone to wash their hands with soap before eating.

o Eating with dirty hands causes sickness.

o Soap kills germs on hands.

Clean dishes after eating. Let them dry in the hot sun.

o The heat from the sun helps to dry dishes quickly.

o The heat kills germs left on the dishes.

11. Activity: Most Important Behavior



Before and After Eating (Picture 7.4)

Cook foods until they are hot throughout.

Always

reheat leftover foods

until they are hot.

Help

everyone to wash their hands

with soap before eating.

Clean dishes after eating.

Let them

dry in the hot sun.

essential nutrition, hygiene and care during early...

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