Observation of Traditional Caregiver-Infant Feeding Behaviours and Porridge and Energy Intakes during One Meal to Define Key Messages for Promoting Responsive Feeding in the Amparafaravola District, Rural Madagascar.

Undernutrition is highly prevalent in young children in Madagascar and insufficient intake per meal could be one of the main causes. A cross-sectional survey of infant feeding practices including video-recorded meal observations was carried out with 101 caregiver-infant pairs in the Amparafaravola district, Northeast Madagascar. The objective was to quantify the porridge/energy intake of 9-11-month-old children and assess its association with the caregiver-infant feeding behaviours. Then, key messages for promoting responsive feeding (RF) were developed and tested through focus group discussions. The mean porridge intake was 12.8 ± 7.5 g/kg body weight (BW)/meal, corresponding to hardly one-third of the 300 kcal recommended from complementary foods for 9-11-month-old children. Analysis of meal videos suggested that mothers practiced the five positive feeding behaviours (self-feeding, responsive, active, social, and distraction), and rarely the negative ones. Only 6.9% of mothers used positive RF "very frequently", although it was associated with higher intakes (p < 0.05), with mean intake reaching 21 g/kg BW. In focus groups, caregivers approved the six RF messages and related counselling cards. They suggested some modifications to improve their understanding, and counselling cards were revised accordingly. The long-term impact of RF-promoting card use on the meal intakes and the nutritional status of young children must now be assessed.

Recipes and nutritional value of dishes prepared from green-leafy vegetables in an urban district of Antananarivo (Madagascar).

The recipes of 50 multi-ingredient dishes consumed by the population in an urban district were noted down. The nutritional value was determined as well as the cook value of the dishes in order to evaluate the severity of the thermal treatment. The recipes were simple and involved steps such as boiling, mixing, and cutting. Fibre contents were rather low except when the leaf stems were included. All the dishes had very high beta-carotene content (15.8-25.0 mg/100 g dry matter) and retinol activity equivalent (RAE) (1.3-2.3 mg RAE/100 g dry matter) because of the high proportion of fresh leafy vegetables (from 41.2% to 58.8% of the total dry matter of the ingredients). When meat was added to the preparation, the micronutrient content (iron, zinc, and retinol) was not increased significantly. In three dishes, a positive correlation was found between the thermal treatment severity and the 13-cis-beta-carotene amount.