Wednesday, April 10, 2013

Complementary food helps to make Cambodia’s children strong, healthy and clever

Complementary feeding campaign promotes nutritious porridge for children 6 – 24 months.
Vath Ngim (C), her neighbour Roeun Heourn (L), and her aunt Oum Kheng prepare ingredients.
©UNICEF Cambodia/2013/Khoy
It is eight in the morning in Ponleak village, Kampong Thom (central Cambodia) and the sun is already high in the sky as a line of oxen amble down the dry dirt road past Vath Ngim’s house on stilts. She is chatting and laughing with her neighbour Roeun Heourn as they sit on a large wood-slatted bed in the shade beneath her home, chopping ingredients for their babies’ morning meal. Along with Ngim’s aunt, Oum Kheng, they are making Bobor Khab Krub Kroeung, a thick rice porridge made with vegetables and oil, and either meat, fish or eggs.

Ngim’s son, Chanreah is 13 months old and Heourn’s son Tith is 7 months old. They both breastfeed their youngsters and complement the breastmilk with Bobor Khab Krub Kroeung.

As hot water for rice boils on a clay stove in the open air, Ngim describes how she first learned about Bobor Khab Krub Kroeung. “I heard about it from my mother who is a health volunteer. She took me to see the food cooking demonstration at the pagoda [Buddhist temple].I feed my baby three times a day and breastfeed him. When I give him Bobor Khab Krub Kroeung he likes it and eats a lot, and he’s more active,” she says.

Cambodian children at risk of malnutrition
Heourn, who is mashing pre-boiled pumpkin to add to the pot, says she also saw the food demonstrations and heard about Bobor Khab Krub Kroeung on TV and radio. ”The radio [messages] explained that it can make children strong, healthy and clever, and build the body to protect it from being sick. It is different to the porridge we used to give babies with just rice, water and salt. I remember from the TV that we have to give them green vegetables, yellow vegetables, meat, fish, eggs and oil, and it showed us how to cook them,” says Heourn.
Data from the Cambodia Demographic and Health Survey 2010 shows that only 24 per cent of Cambodian children aged between 6 and 23 months are appropriately fed. Without a variety of complementary foods with the right micronutrients, the other 76 per cent of children are at risk of malnutrition, which can have a permanent impact on their physical and cognitive development. More than one quarter of Cambodian children under the age of 5 are underweight and 4 out of every 10 are short for their age.
Watched by her neighbour Ngim, Heourn adds green vegetables to the ingredients cooking on the clay stove.
©UNICEF Cambodia/2013/Khoy
In April 2012, UNICEF, with funding from Spain through the Millennium Development Goals Joint Programme and the United States Agency for International Development (USAID), and in partnership with the Royal Government of Cambodia Ministry of Health, National Centre for Health Promotion (NCHP), the National Nutrition Programme, the World Health Organization (WHO), the Reproductive and Child Health Alliance (RACHA), and Helen Keller International launched a communication campaign to promote complementary feeding in Cambodia to change the way caregivers feed their children in order to improve child nutrition.

Communication campaign promotes complementary feeding
The campaign’s main objective is for caregivers to cook the multi-ingredient porridge Bobor Khab Krub Kroeung, for children aged between 6 and 24 months and ensure that they provide this food hygienically, with appropriate frequency and in the right quantity while interacting with their babies during feeding.

Heourn says she makes Bobor Khab Krub Kroeung for her baby every day but Ngim admits that sometimes when she’s very busy she may miss a day of making it. “Occasionally when my mother is away [Chanreah] gets rice and water but he looks unhappy and he doesn’t like it.”

When health volunteer, Sim Sray passes by Ngim’s house to see the mothers and their children, she points out that campaign has made a difference in Ponleak village where there are currently 42 babies under the age of 2. “Children are quite different from before,” she says, “Most used to be malnourished. Now many are healthy and we encourage families to start a house garden and grow vegetables to feed to their children. On my visits I try to motivate the mothers to cook for their children. In the rainy season there are many vegetables but when vegetables are hard to find in the dry season, I encourage them to cook together with each neighbour contributing something.” It is advice that Ngim and Heourn have obviously followed.
13 month old Chanreah enjoys nutritious Bobor Khab Krub Kroeung.
©UNICEF Cambodia/2013/Khoy
Heourn completes the cooking by folding eggs, greens and oil into the bubbling porridge. After stirring well, she takes another small spoon, tastes the food and nods with satisfaction. The mothers then ladle the mixture into small bowls to cool, before serving it to their babies. Mealtime is not just about feeding. As the mothers learned through the campaign, it is also an opportunity to talk and play with their babies so Ngim and Heourn use toy cars and rattles to make the children laugh between eagerly anticipated mouthfuls of food.  Says Heourn, “I feed him and play, and I don’t force him [to eat], but Bobor Khab Krub Kroeung has a good taste and he likes it.”

By Denise Shepherd-Johnson

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