An adolescent girl strikes a pose for Saskia Osendarp during a Growth Monitoring Promotion event in Tougan, Burkina FasoI am watching her while she is waiting at the community health centre with her 18- month-old son to get him measured, fed a specially prepared complementary food and receive a month supply of multiple micronutrient powders (MNPs).

She is 17, perhaps 18 years old and when I ask her if I can take her picture, she smiles, nods and strikes a pose. Just like any other teenage girl would do. It reminds me of my own teenage daughter, back home at school, having fun with her friends, going out for shopping, making plans for the summer, dreaming of her future.

What strikes me is the idea of “the lottery of birth”. If my daughter had been born here, in rural Burkina Faso, in the north-western province of Tougan, close to the border with Mali, I can’t help but think of how different her life would have been. Perhaps she, too, would have been waiting here with a young son, in the community health centre where the Growth Monitoring Promotion sessions take place.

It is the dry season now, sweltering heat, dust everywhere, no green in sight. How is anyone supposed to feed a young child under these circumstances? Especially after the age of 6 months, until the second birthday, when children need to start to consume other foods, in addition to breastmilk. And these complementary foods need to be dense enough in energy and nutrients, so that these young children can fulfill their nutrient requirements within the small portion sizes they can consume.

I’m in this remote area of Burkina Faso, working with Terre des Hommes (TdH) on an Infant and Young Child Nutrition (IYCN) demonstration project.

The TdH Community Health Worker shows mothers, including my new young friend, how to prepare an energy-dense complementary porridge from local grains, legumes, vegetable oil and some sugar. The mothers see how they can feed the porridge to their child and receive a month supply of MNPs to improve the micronutrient intakes of the children.

Health workers and mothers have a discussion about how to best feed their children using local available foods and commodities. They talk about hygiene and the use of clean water while feeding children, and the importance of good sanitation to prevent their children from falling sick with diarrhoea.

In addition, there are one-to-one personal counselling sessions with the mothers. During these sessions, mothers usually feel more open to talk about personal problems that may be obstacles for feeding their children adequately. The Community Health Worker listens, provides advice and sometimes refers the child to the nearest health post when necessary.

The children’s weight and lengths are measured and children who are identified as being malnourished are being taken into special community-care for more intensive management. The severe cases are referred to the health post where they will be treated with Plumpy-Nut.

This Micronutrient Initiative project is being supported by the Government of Canada, through the Department of Foreign Affairs, Trade and Development. Researchers from the Institut de Recherche en Sciences de la Santé (IRSS Burkina Faso) and the Institut de Médecine Tropicale (ITM) of Belgium are performing the external evaluation of the project.

It’s something I’ve been working on for the past three years, spending time with my dedicated MI colleagues and our TdH partners to support mothers, families and communities who are trying to improve the nutrition of their children under very difficult circumstances.

By empowering these mothers to feed their children adequately for the first two years of their lives, starting with exclusive breastfeeding for the first six months, we hope to prevent these children to fall into the malnutrition trap: vicious cycles of malnourishment, treatment, recovery, and relapse again.

We know that adequate breast- and complementary feeding can prevent growth faltering in these children, making them more resilient to infections, and allowing them to reach their full potential when they grow up. So that these children and their young mothers can start dreaming about a bright future as well….just like any teenage girl should do.

This piece was originally published in the Thousand Days Nutrition Newsroom Blog on 23/03/15

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