Impact of ritual pollution on lactation and breastfeeding practices in rural West Bengal, India
Tóm tắt
Breastfeeding in India is universal and prolonged. Several cultural practices are associated with lactation and breastfeeding in India, mainly revolving around the concept of ritual purity and 'hot and cold' foods, food avoidance, restricted diet after childbirth, and remaining in seclusion for a certain time period because of the polluting effects of childbirth. This study on breastfeeding practices explored how the concept of ritual pollution influenced practices after delivery, including during lactation and breastfeeding. The study was conducted in four villages of West Bengal State in India, representing different levels of socioeconomic development, religion, and caste/tribe from September 1993 to April 1994. One hundred households with one woman respondent from each household were selected from each village. Both qualitative and quantitative methods were employed for data collection. A survey questionnaire was administered to 402 respondents and in-depth interviews were conducted with 30 women in the reproductive age group (13–49 years), and 12 case studies were documented with women belonging to different caste, religious, and tribal groups. Belief in 'impurity and polluting effects of childbirth' necessitated seclusion and confinement of mothers after childbirth in the study villages. Breastfeeding was universal and prolonged, and food proscriptions were followed by mothers after childbirth to protect the health of their newborn. Initiation of breastfeeding was delayed after birth because of the belief that mother's milk is 'not ready' until two-to-three days postpartum. Generally, colostrum was discarded before putting the infant to the breast in the study villages. Breastfeeding lasted up to five years, and the majority of women in the sample introduced supplementary food before six months. Most infants in the study villages were given a prelacteal feed immediately after birth, only a small number of women (35) exclusively breastfed – after giving a prelacteal feed – until six months in the study villages. Cultural and traditional practices have considerable implications on lactation and breastfeeding, and in the overall well-being and health of mothers and infants. Breastfeeding programs should take into account traditional beliefs and concepts when communicating with families about practices such as food restriction and food avoidance.
Tài liệu tham khảo
Anandaiah R, Choe MK: Are the WHO guidelines on breastfeeding appropriate for India?. National Family Health Survey Subject Reports Number 16. Mumbai, India and Honolulu, Hawaii, USA: International Institute for Population Sciences and East-West Centre, Population Health Studies, 2000, 1-23.
Khan ME: Breast-feeding and weaning practices in India. Asia-Pacific Population Journal. 1990, 5 (1): 71-88.
Tiwari R, Mahajan PC, Lahariya C: The determinants of exclusive breast feeding in urban slums: a community based study. Journal of Tropical Pediatrics. 2008, 1-6.
Winch P, Ashraful Alam M, Akther A, Afroz D, Ashraf Ali N, Ellis AA, Baqui AH, Darmstadt GL, El Arifeen S, Seraji MHR: Local understandings of vulnerability and protection during the neonatal period in Sylhet district, Bangladesh: a qualitative study. Lancet. 2005, 366: 478-485. 10.1016/S0140-6736(05)66836-5.
MacCormack CP: Health and the social power of women. Social Science and Medicine. 1988, 26: 677-683. 10.1016/0277-9536(88)90059-7.
Reissland N, Burghart R: The quality of a mother's milk and the health of her child: Beliefs and practices of the women of Mithila. Social Science and Medicine. 1988, 27 (5): 461-469. 10.1016/0277-9536(88)90369-3.
Khan ME: Inequalities between men and women in nutrition and family welfare services: an in-depth inquiry in an Indian village. Population and labour policies program: Working paper no 158. 1987, Geneva: ILO
Gopalan C: The mother and child in India. Economic and Political Weekly. 1985, 20 (4): 162-
Manderson L: Roasting, smoking and dieting in response to birth: Malay confinement in cross-cultural perspective. Soc Sci Med [B. 1981, 15 (4): 509-520.
Horta BL, Bahl R, Martines J, Victora C: Evidence on the long-term effects of breastfeeding: systematic reviews and meta-analyses. World Health Organization, Geneva, 2007.
Goldman AS: The immune system in human milk and the developing infant. Breastfeeding Medicine. 2007, 2 (4): 195-204. 10.1089/bfm.2007.0024.
León-Cava N, Lutter C, Ross J, Martin L: Quantifying the benefits of breastfeeding: a summary of the evidence. Food and Nutrition Program/Health Promotion and Protection Division, Pan American Health Organization; Washington DC, 2002.
Prasad B, Costello AMdL: Impact and sustainability of a "baby friendly" health education intervention at a district hospital in Bihar, India. British Medical Journal. 1995, 310: 621-623.
Hanson LA: Immunobiology of Human Milk: How Breastfeeding Protects Babies. Amarillo, TX, USA: Pharmasoft Publishing, 2004.
Rasheed S, Siddiqui I, Baig LA: Decline in breast feeding, who is to be blamed?!! A study of knowledge, attitude and practice of breast feeding amongst nurses. J Pak Med Assoc. 2000, 50 (1): 8-11.
Chye JK, Lim CT: Breastfeeding at 6 months and effects on infection. Singapore Medical Journal. 1998, 39: 551-556.
Hoyer S, Horvat L: Successful breast-feeding as a result of a health education programme for mother. Journal of Advanced Nursing. 2000, 32 (5): 1158-1167. 10.1046/j.1365-2648.2000.01553.x.
Bauer DF, Karp I: Ritual aspects of medical practice. Pennsylvania Association of Sociological Society (PASS). 1979
Mines DP: Hindu periods of death 'impurity'. Contributions to Indian Sociology – New Series. 1989, 23 (1): 103-130. 10.1177/006996689023001007.
Thompson C: The power to pollute and the power to preserve: perceptions of female power in a Hindu village. Social Science and Medicine. 1985, 21 (6): 701-711. 10.1016/0277-9536(85)90210-2.
Katona-Apte J: The relevance of nourishment on the reproductive cycle of the female in India. Being Female Reproduction, Power, and Change. Edited by: Raphael D. The Hauge: Mouton, 1975, 46-47.
Mudiraj GNR: Spatial differentiation of castes: analysis of a regional pattern. Man in India. 1973, 33 (1): 13-18.
Lawrence DL: Reconsidering the menstrual taboo: a Portuguese case. Anthropological Quarterly. 1982, 55 (2): 84-98. 10.2307/3318155.
McCarthy J, Maine D: A framework for analysing the determinants of maternal mortality. Studies in Family Planning. 1992, 23 (1): 23-33. 10.2307/1966825.
Bandyopadhyay M, MacPherson S: Women and Health: Tradition and Culture in Rural India. Aldershot, UK: Ashgate Publishing Ltd, 1998.
Pope C, Mays N: Qualitative Research in Health Care. 2nd edition. London: BMJ Books, 2000.
Grbich C: Qualitative Research in Health. 1999, Sydney: Allen & Unwin
Jeffery PM, Jeffery R, Lyon A: Contaminating States and Women's Status. New Delhi: Indian Social Institute, 1985.
Wray JD: Maternal nutrition, breast-feeding and infant survival. Nutrition and Human Reproduction. Edited by: Mosley WH. New York: Plenum Press, 1978.
Costello AM: Perinatal health in developing countries. Transactions of the Royal Society of Tropical Medicine and Hygiene. 1993, 87 (1): 1-2. 10.1016/0035-9203(93)90395-7.
National Family Health Survey (NFHS-2), 1998–1999. International Institute for Population Sciences and ORC MACRO; Calverton, Maryland, USA, 2000.
UNICEF Global Database on Breastfeeding (2000–2006). ChildInfo monitoring the situation of children and women. [http://www.childinfo.org/breastfeeding_countrydata.php]
Mahadevan K, Reddy PR, Murthy MSR, Reddy PJ, Gowri V, Raju SS: Culture, nutrition and mortality in South Central India. Journal of Family Welfare. 1986, 32 (3): 36-58.
Mishra V, Roy TK, Retherford RD: Sex differentials in childhood feeding, health care, and nutritional status in India. Population and Development Review. 2004, 30 (2): 269-295. 10.1111/j.1728-4457.2004.013_1.x.
Choudhry UK: Traditional practices of women from India: pregnancy, childbirth, and newborn care. Journal of Obstetric, Gynaecologic, & Neonatal Nursing (JOGNN). 1997, 26 (5): 533-539. 10.1111/j.1552-6909.1997.tb02156.x.
Acsadi GT, Johnson-Acsadi G: Social and cultural factors influencing maternal and child mortality in Sub-Saharan Africa. The Effects of Maternal Mortality on Children in Africa. Washington DC: Defence for Children International – USA, 1991.