Traditional postpartum dietary practices and maternal nutritional status

Introduction: In Malaysia, new mothers commonly practise traditional postpartum dietary restrictions, which generally involve food proscriptions and prescriptions. These practices may affect the success of breastfeeding as it may impact the ability to meet the increased nutritional requirements during lactation period. Objectives: This review examines the postpartum dietary practices of different cultures in Malaysia. It also intends to assess maternal nutritional status during the confinement period. Methodology: A literature search was conducted through Mendeley software and PubMed (from year 2001 to 2016) by the keywords postpartum, practices, dietary, beliefs, culture, and nutritional status. Search by bibliography was also done. Results: A total of 30 literatures were examined in this review which included quantitative and qualitative studies. Typically, mothers in Eastern cultures avoid intake of particular foods perceived to have properties of “cold”, “gassy”, “itchy”, etc. A study found that women in confinement have 19% lower mean energy intake as compared to Malaysian Recommended Nutrients Intake (RNI) and more than 90% of mothers did not meet nutritional requirements for some micronutrients and minerals. As lactating mother needs higher energy and nutrients intake, food restrictions practiced during this period may impact their ability to meet these nutritional requirements. Consequently, the lactation process may be affected. Conclusion: More investigations are needed to determine the potential effects of dietary postnatal restrictions on maternal nutritional status and lactation practices. This is necessary to optimize the effectiveness of breastfeeding, which would enhance the intermediate as well as the future health of the country’s next generations

Perception on postpartum dietary practices among Malay women in Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang

Traditional postpartum practices generally involve food proscriptions and prescriptions. Certain foods are prohibited due to their properties such as “windy”, “cold” and “hot”. As lactating mother needs higher energy and protein intake, this practice may impact their ability to meet their nutritional requirements. Consequently, their health may not be fully restored, wound healing would be slowed, and lactation success may be interfered. This study was conducted in Hospital Tengku Ampuan Afzan (HTAA) to investigate Malay mothers’ perception on confinement dietary practices during postpartum period. A total of 80 respondents aged between 23-43 years old were interviewed using a questionnaire which consisted of an extensive list of food items. It was found that 100% of respondents mentioned that they do observe the traditional postpartum practices after childbirth with most of them (63.0%) chose to confine for up to 44 days. Flavored rice, roti canai and various types of noodle were generally avoided during postpartum period due to their ‘oily/fatty’ property. Tubers, and most fruits and vegetables were also avoided due to their ‘cold’ property. Moreover, the famous ‘reason’ for exclusion of fish was ‘bisa’ and ‘causing itchiness’ for seafood. Milk and dairy products were included in majority of respondents’ diet. Out of 80, 43 (53.8%) respondents avoided soy sauce because it was believed to give negative effect on wound healing. Other than that, iced drink, tea and sugarcane drink were avoided due to their ‘cold’ and ‘sharp/sour’ properties. In addition, statistical tests of all food items show that there is no difference in terms of level of acceptance for each food between women delivered via normal delivery or caesarean section. It is concluded that postpartum food taboo beliefs are still prevalent among Malay women. Extensive food prohibition and restriction causes limited food choices which may affect mothers’ nutritional intake. Thus, a more balanced diet should be recommended for Malay mothers during postpartum period to ensure adequate nutrient intake, as much as culturally acceptabl

Assessment of prophetic foods consumption among lactating mothers: Combining quantitative & qualitative approaches

Introduction: The phrase ‘Prophetic food and medicine’ reflects the words and actions of the Holy Prophet Muhammad (PBUH) with the bearing of disease, treatment of disease, and care of patients. Among plants mentioned in the Al-Quran, Al-Hadith and Islamic literature are dates, pomegranates, figs, olive and black cumin seeds. These plants are widely used for medicinal purposes, as functional foods and industrial products. However, there are limited studies found regarding their effect on human milk quality and quantity. Thus, this paper aims to describe the methodology to assess knowledge, attitude, and practice of prophetic foods consumption among lactating mothers in Kuantan, Pahang. Methodology: Pregnant Malay mothers aged 18 to 40 years old, at a gestational duration of ≥ 32 weeks, are recruited. During the lactation period, their dietary intake (specifically the consumption of prophetic foods) are assessed using a quantitative method which is food frequency questionnaire. A subsample of these mothers is then interviewed using semi-structured interview method on the prophetic food consumption. Quantitative and qualitative data are analysed using SPSS and NVivo software, respectively. Result: Reports of positive effects of prophetic food consumption on lactation experience namely improving human milk production is anticipated from this study. In addition, it will provide a foundation for further exploration of the role of prophetic food consumption in the lactation process. Conclusion: This research is at the forefront to provide the data on potential practice and application of prophetic foods in positively influencing lactation experience and quality of human milk

The prophetic foods consumption among exclusively breastfeeding mothers in Kuantan, Pahang: An exploratory study

The World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) strongly advocate exclusive breastfeeding for the first six months after birth as the optimal way of feeding infants. Nutritional inadequacy during breastfeeding period may lead to breastfeeding problems such as inadequate milk production which is a common reason to early breastfeeding termination. Galactagogue is one of the solutions seek by breastfeeding mothers to overcome this problem. Within the topic of prophetic medicine, scholars discussed the foods consumed by Prophet Muhammad (P.B.U.H) and their health benefits. Among the plants mentioned in Islamic literature are F.carica (figs), O.europea (olive), P.granatum (pomegranate) and N.sativa (habbatussauda). Studies on prophetic foods consumption among lactating mothers is limited in the literature. Thus, the aims of this study to explore on prophetic food consumption, among Malay mothers during exclusive breastfeeding period. Ten subjects are interviewed by in-depth semistructured interview guide. Inclusion criteria include Malay mothers aged 18 to 40 years, deliver full term babies and were exclusively breastfeeding. Audio-recorded interviews were transcribed verbatim in Malay and translated into English. Translated transcripts were then analysed thematically with the help of NVivo software. Thematic analysis revealed three themes that represents participants’ knowledge, attitude and practice on prophetic foods consumption. The themes were 1) prophetic diet is related to Prophet Muhammad (P.B.U.H)’s practice on foods and eating manners, 2) perceived benefits and effectiveness of prophetic foods consumption, and 3) Practice of prophetic foods consumption during exclusive breastfeeding period. This study provides an insight to the understanding and perception on prophetic foods consumption during exclusive breastfeeding period among breastfeeding mothers. It is acknowledged that prophetic foods, particularly dates may have lactogenic function. Further studies should be carried out to investigate the relationship between prophetic foods consumption and lactogenic activity

The knowledge, attitude and practice of prophetic foods consumption among exclusively breastfeeding mothers in Kuantan, Pahang: an exploratory study

The World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) strongly advocate exclusive breastfeeding for the first six months after birth as the optimal way of feeding infants. Nutritional inadequacy during breastfeeding period may lead to breastfeeding problems such as inadequate milk production which is a common reason to early breastfeeding termination. Galactagogue is one of the solutions seek by breastfeeding mothers to overcome this problem. Within the topic of prophetic medicine, scholars discussed the foods consumed by Prophet Muhammad (P.B.U.H) and their health benefits. Among the plants mentioned in Islamic literature are F.carica (figs), O.europea (olive), P.granatum (pomegranate) and N.sativa (habbatussauda). Studies on prophetic foods consumption among lactating mothers is limited in the literature. Thus, the aims of this study to explore the knowledge, attitude, and practice (KAP) of prophetic food consumption, among Malay mothers during exclusive breastfeeding period. Ten subjects are interviewed by in-depth semi-structured interview guide. Inclusion criteria include Malay mothers aged 18 to 40 years, deliver full term babies and were exclusively breastfeeding. Audio-recorded interviews were transcribed verbatim in Malay and translated into English. Translated transcripts were then analysed thematically with the help of NVivo software. Thematic analysis revealed three themes that represents participants’ knowledge, attitude and practice on prophetic foods consumption. The themes were 1) prophetic diet is related to Prophet Muhammad (P.B.U.H)’s practice on foods and eating manners, 2) perceived benefits and effectiveness of prophetic foods consumption, and 3) Practice of prophetic foods consumption during exclusive breastfeeding period. This study provides an insight to the understanding and perception on prophetic foods consumption during exclusive breastfeeding period among breastfeeding mothers. It is acknowledged that prophetic foods, particularly dates may have lactogenic function. Further studies should be carried out to investigate the relationship between prophetic foods consumption and lactogenic activity

Description of a Hybrid Mindfulness-Integrated Multidisciplinary Workplace Weight Management Intervention Module ‘Mind-SLIMSHAPE’ Using the TIDieR Checklist

Published reports of workplace-based weight management interventions are often poorly described and are focused on dietary, physical, and behavioral management. These strategies are often unsustainable and only have short-term effectiveness. The Mind-SLIMSHAPETM is a mindfulness-integrated multidisciplinary intervention developed to address overweight and obesity problems among desk-bound employees while improving weight-related behavior through mindfulness meditation and mindful eating exercises. The integration of mindfulness and mindful eating aims to improve the individual’s focus on the present and heighten their sensitivity towards internal and external eating cues. The aim of this article is to describe the Mind-SLIMSHAPETM intervention program using The Template for Intervention Description and Replication (TIDieR) checklist. The Mind-SLIMSHAPETM module is a 24-week intervention program that was delivered in a quasi-experimental study among employees with BMI ≥ 25.0 kg/m² in a selected higher learning institution. The module was delivered via hybrid sessions that included both face-to-face and virtual online sessions. The novelty of our description includes summaries of each intervention component with its intensity, details of the theory grounded for this program, and the rationale for the intervention components. The Mind-SLIMSHAPETM module is ready to be implemented and replicated in a similar setting with possible refinement and enhancement of the mindfulness and mindful eating elements

The Challenges and Strategies towards Healthy Eating during COVID-19 Home Confinement Period among Working Adults with BMI ≥ 25 kg/m2 Enrolled in a Weight Loss Program: Qualitative Findings

The COVID-19 pandemic has been affecting our lifestyles, such as work, living, and health. In Malaysia, the Restriction of Movement Order (RMO) was first announced in March 2020 to curb the spread of the virus. Since then, many Malaysians have been confined to their own home. This new lifestyle can cause a change of eating habits where healthy eating may be a challenge. Hence, our qualitative study explored the challenges and strategies for healthy eating during the first wave of the COVID-19 home confinement period among working adults overweight and obese in Malaysia. Eleven participants were individually interviewed through phone calls. The interviews were audio-recorded, transcribed verbatim, and then coded with NVIVO 12 based on thematic analysis. We found that social pressure, changes in the social setting, more free time to access food, and extra stock of unhealthy foods at home were among the challenges to healthy eating. Some participants countered these perceived challenges by reducing unhealthy food stock, limiting kitchen visits, and utilizing self-monitoring apps to monitor their calorie intake. Social media was not consistently perceived to influence their eating behavior during this period. We conclude that COVID-19 home confinement has created challenges to healthy eating habits among overweight and obese adults with overweight and obesity. Our study provides evidence that vulnerable groups such as overweight and obese individuals require specific nutritional support during pandemic-related confinement to enhance eating self-efficacy

The gadget generation: BMI, physical activity & screen viewing durations of pre-school children in Kuantan, Pahang

According to recent figures by WHO, the prevalence of overweight or obese children under five (almost 50% of whom live in Asia) increased by >30% since 1990. Sedentary lifestyle especially due to physical inactivity and increased screen viewing (SV) duration is identified as one of the risk factors of childhood obesity. This study aimed to investigate body mass index (BMI), SV and physical activity (PA) duration of pre-school children in Kuantan, Pahang. Information regarding duration of SV and PA was collected via a self-administered questionnaire, completed by the parents of 4-6 years old children attending 11 KEMAS kindergartens (categorized according to urban or rural areas). Height and weight of subjects were measured using a SECA stadiometer. This study included 284 subjects. The mean (±SD) of BMI was 15.1±2.5 kg/m2. Overall, 58.5% subjects have normal BMI, 25.3% were underweight and 16.2% were overweight/obese. A total of 87% of subjects reported to be using gadgets. In addition, 96% of the subjects reported >2 hours/day of total SV (which included television viewing & gadgets usage) duration, exceeding the international recommendation of <2 hours/day of screen time and Malaysian Dietary Guideline’s recommendation of <2 hours/day of sedentary activity. A total of 67% of the subjects met the recommended 1 hour/day of moderate PA. There were no significant differences of BMI, SV and PA durations between urban and rural areas. Preschoolers in Kuantan are largely found to have higher than recommended SV duration and only two thirds meet the recommended PA duration, regardless of urban or rural locations. This suggests that, the trend of sedentary lifestyle (particularly spending a lot time watching television and using tech devices) which may contribute to obesity among this Gadget Generation, is found to be prevalent across different geographical areas in this state capital of Pahang

Assessment of prophetic foods consumption among lactating mothers: Combining quantitative and qualitative approaches.

Introduction: The phrase ‘Prophetic food and medicine’ reflects the words and actions of the Holy Prophet Muhammad (PBUH) with the bearing of disease, treatment of disease, and care of patients. Among plants mentioned in the Al-Quran, Al-Hadith and Islamic literature are dates, pomegranates, figs, olive and black cumin seeds. These plants are widely used for medicinal purposes, as functional foods and industrial products. However, there are limited studies found regarding their effect on human milk quality and quantity. Thus, this paper aims to describe the methodology to assess knowledge, attitude, and practice of prophetic foods consumption among lactating mothers in Kuantan, Pahang. Methodology: Pregnant Malay mothers aged 18 to 40 years old, at a gestational duration of ≥ 32 weeks, are recruited. During the lactation period, their dietary intake (specifically the consumption of prophetic foods) are assessed using a quantitative method which is food frequency questionnaire. A subsample of these mothers is then interviewed using semi-structured interview method on the prophetic food consumption. Quantitative and qualitative data are analysed using SPSS and NVivo software, respectively. Result: Reports of positive effects of prophetic food consumption on lactation experience namely improving human milk production is anticipated from this study. In addition, it will provide a foundation for further exploration of the role of prophetic food consumption in the lactation process. Conclusion: This research is at the forefront to provide the data on potential practice and application of prophetic foods in positively influencing lactation experience and quality of human milk

Dietary status of exclusively breastfeeding mothers: The Influence of traditional postpartum dietary practices

Human milk is recognized as the normative standard for infant feeding (Moretti, 2012; WHO, 2011). It is a unique food that contains both nutrients and non-nutritive bio-active factors suited to human infants. The World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) strongly advocate exclusive breastfeeding for the first six months after birth as the optimal way of feeding infants based on evidence which showed beneficial effects on child health, growth and development as well as positive implications on maternal wellbeing (WHO, 2009; UNICEF, 2016). The Malaysian government has consequently adopted this recommendation in its Malaysian Dietary Guidelines (MDG) which encourage mothers to practise breastfeeding from birth until six months and continue to breastfeed for two years (Key Message 1, MDG, 2013). The aim of this review was to discuss the potential influence of traditional postpartum dietary practices on maternal dietary status during exclusive breastfeeding period. Besides duration, the nutritional quality of human milk is also an important aspect of breastfeeding. One of the factors that may influence this is the maternal diet.Lactation comes with a higher nutritional demand and greater than that of pregnancy. Thus, there is a need to optimize maternal food intake during lactation period in order to meet the elevated energy and micronutrients requirements. However, among Asian populations, maternal nutritional intake during this crucial period may be affected by the common traditional postpartum practices which involve dietary restrictions and prohibitions. These practices, however, may impact mothers’ ability to meet the increased energy and nutrients needs during breastfeeding period. Inadequate dietary intake during lactation may compromise the nutritional status of the mother, her recovery back to health, and her human milk production. Consequently, inadequate amounts of human milk may pose malnutrition risk for the infant. Thus, it is crucial for the mother to maintain good nutritional intake especially during the confinement period in order to ensure optimal recovery, breastfeeding success, and satisfactory nutritional status of her baby