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| LETTER TO THE EDITOR |
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| Ahead of print publication |
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Culturally coherent nutrition to promote lactating mothers' health
Kavita Thakur, Shweta Gangurde, Hetal Rathod, Prerna Verma
Department of Community Medicine, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| Date of Submission | 06-Jan-2022 |
| Date of Decision | 10-Apr-2022 |
| Date of Acceptance | 15-Apr-2022 |
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Correspondence Address:
Shweta Gangurde,
A1 703 Genesis CHS, Wadmukhwadi, Near Sai Mandir, Pune, Maharashtra - 412 105
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/mjdrdypu.mjdrdypu_17_22
Breast feeding is the safest and healthiest food for baby. It provides complete nutrition for the baby in first 6 months of life. It is also called the first vaccine for a baby. Babies who are exclusively breastfed grow better physically and mentally. They have better Intelligent Quotient level. They also develop better jaws and teeth. Breastfeeding also reduces infant mortality and decreases disease burden. Early weaning can put the child into vicious cycle of malnutrition and infection. It is said that dietary intake of mother affects breast milk composition.[1],[2],[3]
The amount of variation in human milk that can be attributed to nutrition is unknown. Caffeine travels in small amounts from mother to infant through breast milk; however, when the mother takes low to moderate levels, the infant is usually unaffected (equal to 300 milligrams or less per day). Irritability, poor sleeping patterns, fussiness and jitteriness have been reported in infants of mothers with very high intakes of caffeine, about 10 cups of coffee or more per day.[4] Use of galactogogues like Shatavari Kalp and Fenugreek seeds is not quite uncommon in India.[5] Various cultural practices allow women to eat or avoid certain food items. Culture can have positive and negative influence on the diet of breast-feeding mothers. Lactation and nursing customs in India are essentially based on the concepts of ritual purity and 'hot and cold' foods, food avoidance, and a restricted diet following childbirth and remaining in seclusion for a period of time due to the polluting effects of childbirth.[6],[7],[8]
We conducted an observational study on 150 post natal women who had children <12 months in rural field practice area of a medical college. This study was designed to look at the impact of culture on dietary modification in the postnatal period, specifically in terms of awareness, prelacteal feeding, and the use of galactogogues supplements to increase breast milk supply in breastfeeding mothers. Spicy foods should be avoided during lactation, according to almost 40% of women. Another 40% believe that lactating women should avoid sour foods. When enquired about a lactating mother's daily milk intake, 112 (73%) believed that less than 500 mL of milk was beneficial, whereas 21.6 percent were unaware of the importance of milk intake in breastfeeding.
On being asked about the beneficial food items to increase breast milk supply during lactation, the responses received are summarized in [Table 1]. | Table 1: Various food items taken by lactating mothers to increase milk supply
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Only 41 participants had taken supplements during lactation as summarized in [Figure 1].
ShatavariKalp was taken by 22 (53.6%) of participants followed by multivitamin syrup and Ayurvedic supplements.
The most important concern a lactating mother have is regarding breast milk sufficiency. 87.9% of participants were confident enough about their breast milk production and consider sufficient for their baby. Seventy-seven (58.77%) participants believed that her dietary intake affects breast milk 4 to 6 months of age, and 23 (17.55%) believed it to be till 12 months of age. Breastfeeding mothers should eat for two, according to 43.24% mothers. In this study, 87.25% mothers were not aware of effect of coffee on the breastfeeding. It is recommended that health care workers should educate them during antenatal and postnatal visits.
About 73% mothers felt that inclusion of milk in their diet was important for improving the breast milk. 86% mothers felt that Laddus made of dry fruits; jaggery and ginger are beneficial in breastfeeding. These positive cultural habits which encourages inclusion of Iron and calcium containing food items can be encouraged by counselling by healthcare workers.
One hundred and sixteen (77.3%) participants had not given prelacteal to their babies. Thirty-four (22.67%) participants gave prelacteal to their babies. The most common prelacteal given to babies was honey (85.29 percent), followed by sugar water.
Although most of the mothers in the present study restricted at least one type of food without scientific rationale while breastfeeding, the woman who did not restrict or included special food items did not face any problems in lactation. Restriction of certain food items may interfere with mothers to continue exclusive breastfeeding.
Deeper understanding of how the cultural beliefs and practices affect the diet of lactating mother is very important to plan and prescribe appropriate dietary prescriptions to them. Counseling during postnatal visits should be used to change negative cultural dietary modifications such as restricting a few foods, raw foods, and cold foods that have no scientific basis. It is very important to understand how culture and traditions affect the diet of lactating mothers.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Huang Z, Hu Y-M. Dietary patterns and their association with breast milk macronutrient composition among lactating women. Int Breastfeed J 2020;15:52.  |
| 2. | Bravi F, Di Maso M, Eussen SR, Agostoni C, Salvatori G, Profeti C, et al.; On Behalf of the Medidiet Working Group. Dietary patterns of breastfeeding mothers and human milk composition: Data from the Italian MEDIDIET study. Nutrients 2021;13:1722. |
| 3. | Bravi F, Wiens F, Decarli A, Dal Pont A, Agostoni C, Ferraroni M. Impact of maternal nutrition on breast-milk composition: A systematic review. Am J Clin Nutr 2016;104:646-62. |
| 4. | CDC. Do mothers need more calories while breastfeeding? Available from: cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/maternal-diet.html. [Last Accessed on 10 July 2021]. |
| 5. | Forinash AB, Yancey AM, Barnes KN, Myles TD. The use of galactogogues in the breastfeeding mother. Ann Pharmacother 2012;46:1392-404. |
| 6. | Protecting, promoting and supporting breastfeeding: The special role of maternity services. A joint WHO/UNICEF statement. Int J Gynaecol Obstet 1990;31(Suppl 1):171-83. |
| 7. | Paine P, Dorea JG. Gender role attitudes and other determinants of breast feeding intentions in Brazilian women. Child Care Health Dev 2001;27:61-72. |
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[Figure 1]
[Table 1]
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