Both encouraging feeding style and high energy density may increase energy intakes from fermented millet gruels eaten by infants and toddlers in Ouagadougou.

Traditional fermented millet gruel is frequently eaten by children in Burkina Faso as a complementary food or for breakfast. The effects of gruel energy density and feeding style on intakes (amounts and energy) were assessed in children in Ouagadougou. Twenty-three young children (11 infants and 12 toddlers) were given two meals of gruel per day for two periods of 11 consecutive days, first, the traditional fermented gruel (TFG), and second, an improved high energy density fermented gruel (IFG). On the first 10 days of each period, the children were fed as usual, while on the 11th day, the mothers were asked to use encouraging feeding. Intakes of TFG and IFG were also measured once a day for nine days in 25 preschoolers (2-5 years-old). After adjustment for the subject effect, IFG intakes did not significantly differ from TFG intakes in the groups of infants and toddlers, meaning there was a significant increase in energy intakes, which almost doubled. Encouraging feeding increased TFG intakes in both age groups, but IFG intakes only increased in toddlers, whose energy intake tripled compared to that from TFG with the usual feeding style. In preschoolers, mean IFG intakes were lower than TFG intakes and there were no increase in mean energy intakes. Improving fermented gruel and training the mothers to encourage their young children during feeding are two possible strategies to improve food intakes, and hence to better satisfy the children's nutritional needs.

A sustainable food support for non-breastfed infants: implementation and acceptability within a WHO mother-to-child HIV transmission prevention trial in Burkina Faso.

OBJECTIVE: To provide HIV-positive mothers who opted for exclusive breastfeeding or formula feeding from birth to 6 months postpartum as a means of prevention of mother-to-child transmission (PMTCT) of HIV with a sustainable infant food support programme (FSP) from 6 to 12 months postpartum. We describe the implementation and assessment of this pilot initiative. DESIGN: The FSP included a 6-month provision of locally produced infant fortified mix (IFM; 418 kJ/100 g of gruel) for non-breastfed infants coupled with infant-feeding and psychosocial counselling and support. Acceptability and feasibility were assessed in a subsample of sixty-eight mother-infant pairs. SETTING: The FSP was developed in collaboration with local partners to support participants in a PMTCT prevention study. Formula was provided for free from 0 to 6 months postpartum. Cessation by 6 months was recommended for breastfeeding mothers. RESULTS: The FSP was positively received and greatly encouraged breastfeeding mothers to cease by 6 months. As recommended, most infants were given milk as an additional replacement food, mainly formula subsidised by safety networks. Among daily IFM consumers, feeding practices were satisfactory overall; however, the IFM was shared within the family by more than one-third of the mothers. Cessation of IFM consumption was observed among twenty-two infants, seventeen of whom were fed milk and five neither of these. CONCLUSIONS: Without any food support most mothers would have been unable to provide appropriate replacement feeding. The food security of non-breastfed infants urgently needs to be addressed in HIV PMTCT programmes. Our findings on a simple cost-effective pioneer intervention provide an important foundation for this process.