By Lydia Atieno
Because of a tight working schedule of many families today, parents have embraced services offered at Early Childhood Development Centres (ECDC).
Early Childhood Development Centres are places that provide care and act as recreation facilities for children who are mostly under the age of six.
Their primary role is to provide a safe and secure environment availed by quality caregivers.
Rwanda developed a policy around Early Childhood Development with an aim of ensuring that all Rwandan children achieve their potential, are healthy, well-nourished and safe, and their mothers, fathers and communities become nurturing caregivers through receiving integrated early childhood development services.
But most importantly, the policy aims at reducing under-5 child mortality and morbidity; reduce the incidence of childhood illnesses and ensure that child rights are respected and children are safe and secure.
This is why, among other aspects, it is imperative for these centres to have quality hygienic and feeding practices.
Why is this important?
Private Kamanzi, a nutritionist at Amazon Cabinet Clinic in Remera, Kigali, says if the nutrition of these young ones is compromised, it means that they might have long-term effects on their overall health.
Through his consultancy with some centres, he observes that the component of quality nutrition hasn’t been attained fully.
This he says is not as a result of lack food but a lack of nutritional knowledge on the best practices and how the kids should be fed.
Apart from that, Kamanzi says the quality of food served to these children should matter as well.
“For instance, for breakfast, if you are to make porridge, it should be thick. Children in this age group are supposed to be given thick porridge made from different cereals as recommended by nutritionists,” he explains.
He insists that the flour from which the porridge is made should be composed of different grains and should be blended in measured quantities as well, highlighting that the main cereals should dominate others.
“Some caregivers tend to put more wheat than other cereals yet too much wheat is not good for a child at this age because it’s not easy for their tract to digest it. This age is critical and it requires special nutrition to ensure the child grows up healthily,” he cautions.
Joseph Uwiragiye, head of nutrition department at University Teaching Hospital (CHUK) notes that meals served to these children should be balanced with carbohydrates, proteins, vitamins as well as fruits and vegetables.
He insists on vegetables especially when it comes to the way they are prepared noting that this matters a lot for them to not be overcooked.
“When they are overcooked, they lose nutrients, therefore, making it difficult for a child to get what is required when it comes to nutrition intake,” he says.
Uwiragiye gives similar caution when serving fruits to children.
“They shouldn’t be given in form of juice, because when this is done, it’s easier to dilute them with water thus adding more sugar to make it tasty, this is not recommended.”
He hence says that given that children tend to spend a lot of time at these centres, poor nutrition would definitely have a serious impact on their health noting that they can for instance become stunted.
The nutritionist advises caregivers at the centres to always device means of handling children with bad eating habits.
He says, in cases where some children refuse food not because they aren’t hungry or the food is not tasty, but because of a low appetite; there should be skills on how to handle this.
And with this, he adds that children should be fed in a specific area other than entertaining those who choose to feed while running or playing.
This, he explains that it’s important because it builds good eating habits hence a good appetite.
Hygiene matters too
Adeline Ufitinema, food and nutrition specialist at NECDP explains that children under the age of two must be exclusively breastfed for the first 6 months of life, expressed breast milk should be left at daycare centers and parents must also ensure breast milk is kept well in a safe and clean environment.
When it comes to complementary feeding, she says children from 6 to 24 months should be fed on complementary food which is balanced.
She adds that it’s important for caregivers to take care of the frequency of feeding, the quantity of food they are fed, variety of food, yet attention and hygiene should be ensured.
For instance, she says children from 6 months must be fed at least two times a day with 2 to 3 tablespoons at each feeding.
She says from 9 to 12 months: the child should be fed three to four times a day with 250 ml each feeding. It’s better to introduce new types of food for the children to be familiar with a variety of food. While from 12 to 24 months, she says a child must be fed five times a day and the food must be mixed with micronutrient powder.
Till the age of five, children should be continued to be fed a well-balanced diet. When they are not fed properly, it can lead to poor nutrition and acute malnutrition as well, Ufitinema says.
Freya Zaninka De Clercq, head of the department early learning, parenting education and child protection at National Early Childhood Development Program (NECDP) says sanitation matters because even if a child is given enough food and a balanced diet but with poor hygiene- the nutrition of this child will not be attained.
She notes that poor hygiene is also another cause of child stunting thus aiming at improving it is really encouraged at all centers, she says.
Ufitinema also highlights that caregivers should wash their hands before feeding children.
What’s being done to achieve quality care?
Zaninka says sensitization is being carried out at different levels.
She notes that they carry out a cooking demonstration in home-based ECD and rural areas for parents to get that knowledge of what a child needs to be fed on while they are out of the centers.
Zaninka adds that they also count a lot of community health workers who sensitize pregnant mothers on the importance of proper feeding.
“And after delivery, they help them understand the importance of exclusive feeding and a balanced diet for the child below the age of two years.”
For the centres, Zaninka says, apart from accrediting those that abide by the rules and regulations of ECD policy, they as well make personal visits to ensure the guidelines are taken into considerations.