Feeding of lactic acid-fermented high nutrient density weaning formula in paediatric settings in Ghana and Nigeria: Acceptance by mother and infant and performance during recovery from acute diarrhoea

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Abstract
A period of acute diarrhoea in infants is often associated with anorexia and weight loss. Catch-up growth is, therefore, necessary and this depends very much on the type of food, in terms of nutrient density, protein quality and digestibility, given to the child. Fermented (F) and non-fermented (NF) maize–soybean porridges of increased nutrient density were formulated and compared with traditionally fermented maize-only porridge (P) for acceptability using mothers in peri-urban Ghana as well as urban Nigeria as subjects. Subsequently, infants hospitalised in paediatric wards for acute diarrhoea, from the same communities in both countries, were assigned randomly to one or other of the three porridges. Infant subjects in all cases fell within the ages of 6–15 months. Complementary to regular breast-feeding, infants could consume as much porridge as they wanted and their total daily consumption was interpreted as an indication of acceptance. Although mothers in both the environments of Ghana and Nigeria rated P as more acceptable than F and NF, no significant difference was recorded in the quantitative intake by infants of the three formula groups. By adding enzyme-rich cereal malt flour (at the 1–5% level by weight) as a viscosity-thinning agent to F and NF porridges, it was possible to feed these porridges to infants at total solids concentration levels of 20–25% (wet basis) which is approximately double the solid matter content of the P porridge. Consequently, the daily nutrient intake by infants consuming F and NF porridges was considerably higher compared to the P porridge group. It is concluded that the concept of high nutrient density weaning foods is a feasible vehicle for an improvement of nutrient supply to infants.