A Simple Tool to Improve Child Nutrition

A persistent problem: insufficient food quantity

An enduring problem in improving young child feeding (YCF) is caregivers’ reluctance to increase the amount of food they feed their young children. Even when other practices improve, food quantity remains poor. Qualitative studies indicate that caregivers are often unaware of how much a child should eat.


In response to this problem, The Manoff Group developed a specially marked child feeding bowl, featuring measurements denoting the appropriate amount of food for each age. This bowl was tested with caregivers in rural Bolivia through the PROCOSI Network Technical Assistance Project in June–July 2008 to measure behavior change in YCF practices. See the presentation on this work given at the 2009 Global Health Conference.


Mother with child holding bowl reporting to interviewer on young child feedingUsing TIPs to Test the Solution

The Manoff Group used its innovative research technique, Trials of Improved Practices (TIPs), to test the bowl’s effectiveness with 82 mothers of children 6–23 months in 15 communities.


Mothers were interviewed three times: The first interview identified current feeding practices to learn what issues would need to be addressed. In the second interview, the caregiver selected and agreed to try new recommended behaviors for about two weeks. The third interview assessed the trial period to learn what worked and what didn’t. Outcomes of each interview session were recorded.


Of the 82 mothers who participated in TIPs, 28 were offered the feeding bowl as a tool to improve their YCF practices, as their children often had the poorest food intakes. All of the caregivers who were offered the bowl for trial accepted. Other practices that were negotiated with caregivers included continued breastfeeding, improved food quality and quantity, and increased feeding frequency. Trial outcomes were tabulated and analyzed along with the content of the interviews.


Results: Beyond Improved Feeding

Mothers who used the feeding bowls were successful in improving YCF through increasing food quantity to the amount indicated by the bowl. Use of the bowl seemed to motivate other practices as well, such as feeding more frequently, separating the child’s food from the rest of the family’s food, and continued feeding during illness. Older children took ownership of their bowls and asked for food. 


The results illustrate the effectiveness of the child feeding bowl in facilitating mothers’ ability to improve their YCF practices. The feeding bowl technology is not unique to Bolivia: it has been introduced in Nicaragua and El Salvador with anecdotal reports of subsequent improved feeding. Given that this technology is simple, low-cost, and offers a solution to a persistent problem, it should become an invaluable tool for public health nutrition programs.