Foods to Fill the Iron and

Vitamin A Gaps
Session 30
 30/1
Objectives
After completing this session
participants will be able to:
• list the local foods that can fill the nutrient
gaps for iron and vitamin A
• explain the importance of animal-source
foods
• explain the importance of legumes
• explain the use of processed
complementary foods
• explain the fluid needs of the young child
• list the Key Messages from this session
Important point:
• The young child needs iron to make new
blood, to assist in growth and
development and to help the body to
fight infections
Gap for iron 30/2

Absorbed iron needed and amount provided

1.2 Iron gap
Absorbed iron

0.8 Iron from

(mg/day)

birth
stores
Iron from
0.4 breast
milk

0
0-2 m 3-5 m 6-8 m 9-11 m 12-23 m
Age (months)
Important points:
• The young child grows faster in the first
year than in the second year. This is
why the need for iron is higher when the
child is younger.

• However, the iron stores are gradually

used up over the first six months. So,
after that time we see a gap between
the child’s iron needs and what they
receive from breast milk. This gap
needs to be filled by complementary
foods.
Question:

What happens if the child does not have

enough intake of iron to fill this gap?
• If the child does not have enough iron, the
child will become anemic, will be more
likely to get infections and to recover
slowly from infections. The child will also
grow and develop slowly.

• Zinc is another nutrient that helps children

to grow and stay healthy. It is usually
found in the same foods as iron, so we
assume that if they are eating foods rich in
iron they are also receiving zinc.
Your goals, as health workers are:

– To identify local foods and food

preparations that are rich sources
of iron
– To assist families to use these iron
rich foods to feed their young
children
Important points:
• Foods from animals, the flesh (meat)
and organs such as liver and heart as
well as milk, yoghurt, cheese and eggs
are rich sources of many nutrients.
• The flesh and organs of animals, birds
and fish (including shell fish and tinned
fish) are the best sources of iron and
zinc.
• Liver is not only a good source of iron
but also of Vitamin A
Important points:
• Animal source foods should be eaten
daily or as often as possible. This is
especially important for the non-
breastfed child
• Some families do not give meat to their
young children because they think it is
too hard for the children to eat. Or they
may be afraid there will be bones in fish
that would make the child choke.
Question:

What are some ways of making these

foods easier for the young child to eat?
Important points:
• Some ways of making these foods easier
to eat for young children are to:
• Cook chicken liver or other meat with rice or
other staple or vegetables and then mash them
together.
• Scrape meat with a knife to make soft small
pieces
• Pound dried fish so bones are crushed to powder
and then sieve before mixing with other foods.
• Milk and eggs are good for children
because they are high in protein and other
nutrients. However, milk and milk
products, such as cheese and yoghurt, are
not good sources of iron.
• Milk fat (cream) contains vitamin A.
Therefore, foods made form whole milk
are good sources of vitamin A
• Foods made from milk (whole milk or
skimmed or powdered) and any food
containing bones, such as pounded dried
fish, are good sources of calcium to help
bones to grow strong.
• Egg yolk - rich in vitamin A.
• Fortified or enriched foods such as
fortified flours, pasta, cereals or instant
foods made for children, help to meet
these nutrient needs.
• Some children may need supplements if
they do not eat enough iron-containing
foods or if they have particularly high
needs for iron.
Key Message 4 30/3

Animal-source foods are especially

good for children, to help them grow
strong and lively
poultry fish

meat
liver

cheese

eggs
yoghurt
• Legumes or pulses such as beans, peas
and lentils as well as nuts and seeds are
good sources of protein. Legumes are a
source of iron as well.
 30/4
Key Message 5
Peas, beans, lentils, and nuts and
seeds are also good for children

seeds

lentils Groundnut
paste

beans

peas nuts
Questions:

What types of legumes are used in the

area?

What are ways that legumes, nuts and

seeds could be prepared that would
be easier for the child to eat and
digest?
Some ways these foods can be prepared:

• Soak beans before cooking and throw away the

soaking water.
• Remove skins by soaking raw seeds and then
rubbing the skins off before cooking.
• Boil beans then sieve to remove coarse skins.
• Toast or roast nuts and seeds and pound to a
paste.
• Add beans/lentils to soups or stews.
• Mash cooked beans well.
• Eating a variety of foods at the same
meal can improve the way body uses the
nutrients. For example, combining a
cereal with a pulse (rice and beans), or
adding a milk product to a cereal or
grain (maize meal with milk)
Iron Absorption
The amount of iron that a child absorbs
from food depends on:
– The amount of iron in the food.
– The type of iron (iron from meat and fish
is better absorbed than iron from plants
and eggs)
– The types of other foods present in the
same meal (some increase iron
absorption and others reduce
absorption)
– Whether the child has anemia (more
iron is absorbed if anemic).
Iron Absorption:

Eating these foods at the same meal increases

the amount of iron absorbed from eggs and
plant foods such as cereals, pulses, seeds
and vegetables:
– Foods rich in vitamin C such as tomato, broccoli,
guava, mango, pineapple, papaya, orange, lemon
and other citrus fruits.
– Small amounts of the flesh or organs of animals,
birds, fish and other sea foods.
• Iron absorption is decreased by
– Drinking teas and coffee
– Foods high in fiber such as bran
Gap for vitamin A 30/5

Vitamin A needed and amount provided

400
Vitamin A
Vitamin A (µg RE/day)

gap
300
Vitamin A
from birth
200 stores
Vitamin A
from
100 breast milk

0
0-2 m 3-5 m 6-8 m 9-11 m 12-23 m
Age (months)
Important points:
• Good foods to fill this gap are dark-
green leaves and yellow colored
vegetables and fruits.
• Other sources of Vitamin A that we
mentioned already were:
• Organ foods/offal (liver) from animals
• Milk and foods made from milk such as butter,
cheese and yoghurt egg yolks
• Margarine, dried milk powder and other foods,
fortified with vitamin A.
Important points:
• Vitamin A can be stored in a child’s body
for a few months. Encourage families to
feed foods rich in vitamin A as often as
possible when these food s are
available, ideally every day. A variety of
vegetables and fruits in the child’s diet
help to meet many nutrient needs.
• Remember breast milk supplies much of
the vitamin A required. A child that is
not breastfed needs a diet rich in
vitamin A.
 30/6
Key Message 6
Dark-green leaves and yellow-coloured
fruits and vegetables help a child to
have healthy eyes and fewer infections

carrot

pumpki yellow sweet

n potato

mango
papaya spinac
h
Use of Fortified Complementary Foods

• In some areas, there are fortified

complementary foods available. For
example flour or a cereal product with
added iron and zinc
• Fortified processed complementary
foods may be sold in packets, cans, jars
or from food stalls. These may be
produced by international companies
and imported or they may be made
locally. They may also be available
through food programmes for young
children
Question:

What products do you see in your area

that are fortified?
Fluid needs of the young child
• The baby who is exclusively breastfeeding
receives all the liquids he needs in the breast
milk and does not require extra water.
• However, when other foods are added to the
diet, the baby may need extra fluids.
• How much extra fluid to give depends on
what foods are eaten, how much breast milk
is taken and the child’s activity and
temperature. Offer fluid when the child
seems thirsty
• Extra fluid is needed if the child has a fever or
diarrhea.
Question:

What types of drinks are given to

young children between six and 24
months old?
Exercise 30.a: What is in the Bowl?
• Now we will put these
recommendations or key messages into
foods. Each group has a picture of a
mother feeding a child from a bowl. In
your group, think of the foods available
to families in your area that could be
used to form one meal for a young
child.
Exercise 30.a: What is in the Bowl?
• Although we talk about types of foods
such as staples, legumes, foods from
animals, dark-green leaves and yellow-
colored fruits and vegetables and so on,
it is easier and more natural for
caregivers to think in terms of the meals
they usually prepare or foods that taste
good together.
Important points:
• Families may give complementary foods
that are:
– Especially prepared foods
– The usual family foods that are modified to
make them easy to eat and provide enough
nutrients.
• For example, a caregiver may specially
prepare a porridge for the baby while the
rest of the family eat rice and bean stew.
Or the caregiver may take some suitable
foods out of the family meal and mash
these foods to a soft consistency that is
easy for the young child to eat.