show the extremes and that even with the best diets, some deficiencies exist. Similarly, if women’s time is a severely limiting factor, offering examples of women’s time allocation would allow more insight into the issue than simply summarizing how many hours women work each day. These types of ‘callouts’ should be planned, and daily briefings of the field workers should always include their observations about interesting deviations, new relationships, or patterns they have observed during the course of their interviews or visits. Formative research reports should go beyond a descriptive report of the information collected by method or participant group. The insights come from the researcher’s synthesis looking across the findings from the various methods and participant groups. Box 10 suggests some tips for synthesizing findings. Box 10. Tips for synthesizing formative research results Synthesis What Tips and formats Summarize and compare findings from all methods by participant group Summarize and compare findings by practice across participant groups · Highlight majority practices and/or opinions. · Note the range of opinions and practices by characteristic of person. · Reasons why. · By comparing responses across methods and participant groups, it is possible to triangulate to find the most reliable answer to what is being practiced, by whom, and why. · Look for contradictions between what was said and what was observed and offer insights. Example: Finding: Mothers report giving their children animal-source foods but none are observed on interview day. Interpretation: They know the foods are important, but they are not a daily staple. Clarify and summarize processes, unspoken decision algorithms, or classifications · Highlight patterns and trends. · Insights into decision-making. · Specific examples. · Use diagrams to show the usual sequence of practices and others to show significant deviations. · Develop taxonomies to describe feeding problems, their symptoms, causes, and remedies. · Develop decision charts or algorithms for different participant groups and compare. Example: A taxonomy of mothers’ beliefs about breastfeeding problems and how to resolve them. A decision tree about what to feed a child with diarrhea depending on the child’s appetite and appearance of diarrhea. 14 Synthesis What Tips and formats Interpret the findings to develop recommendations · Action recommendations are formulated for each major finding or group of findings related to a specific topic or question. The recommendations must flow from the findings. · Mention when a particular, expected recommendation is not offered because it is not supported by the research. · Use ‘therefore’ statements after each small set of findings as a transition to the recommendations. Example: Finding: Caregivers add water to adult porridge so it is easy for their child to swallow; children drink, not eat, their first foods. Therefore: First foods lack energy density because they are diluted to make them easy to feed and easy for the child to swallow. Recommendation: Counseling should stress using the adult porridge, but softened with a spoon of sour milk. Children are ready to learn to swallow and will not choke on the soft food. 15 Annex A. Infant and young child feeding guiding principles for the breastfed and non-breastfed child Topic Guiding principle summary—for breastfed children Modifications for non-breastfed children Early initiation of breastfeeding The baby is placed at the breast and is allowed to suckle within the first hour of being delivered. · Commercial infant formula milk as long as home conditions include safe water and sanitation; the mother/caregiver can reliably provide sufficient infant formula milk to support normal growth and development; the mother/caregiver can prepare it cleanly and frequently enough so that it is safe; and the mother/ caregiver can exclusively give infant formula milk. · Expressed, heat-treated breastmilk. · Home-modified animal milk is not recommended for the first six months. Exclusive breastfeeding for the first six months Practice exclusive breastfeeding from birth to 6 months of age, and introduce complementary foods at 6 months (180 days) while continuing to breastfeed. Maintenance of breastfeeding Continue frequent, on-demand breastfeeding until 2 years of age or beyond. Animal milk (boiled for infants younger than 12 months), as part of a diet providing adequate micronutrient intake. Responsive feeding Practice responsive feeding, applying the principles of psychosocial care: Feed infants directly and assist older children when they feed themselves; feed slowly and patiently; experiment with different food combinations, tastes, and textures; minimize distractions during meals; talk to children during feeding, with eye-to-eye contact. Safe preparation and storage of complementary foods Practice good hygiene and proper food handling: Wash caregivers’ and children’s hands before food preparation and eating; store foods safely and serve immediately after preparation; use clean utensils, cups, and bowls; and avoid using baby bottles. Amount of complementary food needed Start at 6 months of age with small amounts of food and increase the quantity as the child gets older, while maintaining frequent breastfeeding. Amounts should be approximately: 200 kcal/day at 6–8 months, 300 kcal/day at 9–11 months, and 550 kcal/day at 12–23 months. Start at 6 months of age with small amounts of food and increase the quantity as the child gets older, offering at least 200 kcal/day of milk. Complementary foods would make up the rest of the diet, depending on milk intake. Ranges for food could be: 200–400 kcal/day at 6–8 months, 300–500 kcal/day at 9–11 months, and 550– 700 kcal/day at 12–23 months. Food consistency Gradually increase food consistency and variety as the infant gets older, adapting to the infant’s requirements and abilities. Infants can eat pureed, mashed, or semisolid foods starting at 6 months; by 8 months, most can eat finger foods; and by 12 months, most can eat family foods, bearing in mind nutrient density and