Abstract
Background
Traditional care practices play a significant role in shaping care provided to newborns across different ethnic groups. Understanding traditional care practices is crucial for integrating culturally sensitive approaches into modern healthcare systems. This study aims to fill the gap in the literature regarding the different traditional care practices across ethnic groups. The aim of this study was to determine the traditional beliefs and practices of women from different ethnic groups living in Mardin regarding newborn care.
Methods
This study is a descriptive cross-sectional study. The sample consisted of women from four ethnic groups who volunteered to participate in the study with at least one child living in Mardin, Turkey. Snowball and convenience sampling methods were used to recruit participants. The study was completed with 188 Assyrian, 197 Turkish, 181 Arab, and 175 Kurdish women. In total, 741 women participated in this study. Data were collected between 18 December 2023 and 14 June 2024. The data were collected face-to-face using a questionnaire. The data were analysed using SPSS for Windows 22.0.
Results
This study identified significant differences in traditional care practices across four ethnic groups (Assyrian, Turkish, Arab, and Kurdish). Traditional care practices regarding umbilical cord care, swaddling the baby, alleviating gas pain, preventing neonatal jaundice, care for canker sores, and alleviating diaper rash were identified. Assyrian participants were more likely to apply salt to the umbilical cord (14.9%), while Arab participants rarely used this practice (0.6%). Traditional practices for relieving gas pain included drinking herbal teas such as anise, fennel, linden, and cumin. Rubbing and rubbing breast milk on the abdomen, patting on the back, and massaging were other practices for alleviating gas pain. Arab participants were more likely to use anise tea to alleviate gas pain (75.1%), while Kurdish participants preferred fennel tea (22.3%). Practices regarding alleviating diaper rash included applying saturated fat, olive oil, and powder. Arab participants were more likely to apply olive oil for diaper rash (45.9%), while Assyrian participants commonly used dry earth ('Höllük'). These results highlight the cultural diversity in newborn care practices and underscore the importance of culturally sensitive healthcare interventions.
Conclusion
This study highlighted the significance of traditional care practices in newborn care across four ethnic groups. There are many differences between ethnic groups regarding traditional care practices during the postpartum period. Understanding such differences is crucial for developing culturally sensitive interventions that support maternal well-being and enhance health outcomes for both mothers and infants.
Supplementary Information
The online version contains supplementary material available at 10.1186/s12889-025-22176-7.
Keywords: Traditional practices, Newborn, Infant, Postpartum, Ethnic
Introduction
Particular care procedures should be followed throughout the postpartum period to protect the health of both the mother and newborn. Traditional care practices are defined as medical practices related to the belief, tradition, and value systems of societies [1, 2]. Individuals seek assistance from traditional healers, reliable individuals, and health professionals for their health concerns, depending on their culture, education, and beliefs. Cultural beliefs and practices regarding postpartum care for newborns have been studied in various regions [3]. While some traditional practices may be beneficial, others pose risks to the health of the mother and newborn. Investigating traditional care practices for newborns provides valuable insights into the cultural context [4]. Góes et al., [5] emphasised the importance of family dynamics in effective postnatal care practices. Based on research on newborn care practices in South Asia, communication strategies have been developed to enhance newborn health outcomes in resource-limited regions [6].
Assessing newborn care methods in different cultural contexts is crucial for designing training programmes and improving newborn health [7]. Misperceptions about newborn care contribute to neonatal mortality and illness severity [8]. Exploring traditional newborn care beliefs and practices is important for developing interventions to reduce neonatal morbidity and mortality [9]. Although different newborn care practices between ethnic groups may exist, however, efforts to minimise such differences are important for improving overall newborn health outcomes. Traditional and cultural practices have a significant influence on newborn care across different ethnic groups. Quality of care and neonatal health outcomes can be greatly enhanced during the postpartum period by recognising and integrating traditional and cultural practices into modern newborn care.
Recognising and integrating culturally specific traditional care practices can enhance newborn health outcomes. By understanding these traditional care practices, healthcare staff could provide effective care, ultimately leading to increased trust and cooperation between families and healthcare providers. Furthermore, such studies can highlight the potential benefits of traditional methods and encourage their incorporation into modern medical practices as appropriate. This approach could help reduce healthcare costs and improve patient outcomes, and provide a better understanding of how different cultures approach healthcare. Traditional care practices play a significant role in shaping the care provided to newborns from different ethnic groups. Understanding traditional care practices is crucial for integrating culturally sensitive approaches into modern healthcare systems [10]. This study aimed to fill the gap in the literature regarding the different traditional care practices across ethnic groups. The aim of this study was to determine the traditional beliefs and practices of women from different ethnic groups living in the city of Mardin regarding newborn care.
Methods
Background information about the study area (Mardin)
Mardin is a metropolitan city with a population of 840,000 and is located in southeast Turkey. Mardin is a multicultural city with diverse ethnic and religious communities. Mardin has a much more heterogeneous population in terms of culture and ethnicity than any other city in Turkey. Different ethnic groups, consisting mostly of Kurdish, Arab, Turkish, and Assyrian people, live peacefully in Mardin, where the official language is Turkish. The Kurdish, Arab, and Turkish ethnic groups are usually Muslims, while the Assyrians are usually Christians.
Design
This study is a descriptive cross-sectional study.
Participants, sampling, and setting
The population of this study consists of women from four ethnic groups (Assyrian, Turkish, Arab, and Kurdish) living in the multicultural city of Mardin. The sample of the study consisted of women from four different ethnic groups (Assyrian, Turkish, Arab, and Kurdish) who volunteered to participate, had at least one child, and were living in the multicultural city of Mardin, Turkey. Women who had communication skills and were willing to participate were included in the study. Women who did not meet the inclusion criteria (e.g., those without children or those living outside the city centre of Mardin) were excluded from the study. In addition, women who were unable to provide informed consent or complete the survey due to cognitive or language barriers were excluded. Since the universe of the study is unknown, the sample size was calculated using the Cochran formula. As a result of the calculations with a confidence level of 95% and a margin of error of 5%, the minimum sample size was determined as 384 individuals. The study was completed with 188 Assyrian, 197 Turkish, 181 Arab, and 175 Kurdish women. In total, 741 women participated in this study.
The study used a combination of convenience and snowball sampling techniques to recruit participants. Convenience sampling was used to identify initial participants from four ethnic groups (Assyrian, Turkish, Arab, and Kurdish) living in Mardin. The participants were approached through face-to-face interactions in community settings. After obtaining informed consent, the initial participants were asked to refer other women from their ethnic group who met the inclusion criteria (e.g., having at least one child and living in Mardin). This snowball sampling approach helped us reach a larger and more diverse group of participants within each ethnic group.
All participants in this study were able to provide informed consent themselves. No participants who could not complete the survey or provide consent were included in the study. The face-to-face data collection method was chosen to ensure that participants fully understood the questions and provide accurate responses. For participants who required assistance (e.g., due to literacy issues or language barriers), the researchers provided additional support to ensure that the questions were clearly understood. While this method required more time and effort, it helped ensure that all participants, including those who needed assistance, could provide clear and concise information.
Data collection
Data were collected between 18 December 2023 and 14 June 2024. The data were collected face-to-face using a questionnaire technique with a data collection form consisting of two parts (supplementary file). The questionnaire was designed based on a comprehensive review of the literature on traditional newborn care practices across different ethnic groups [11–15]. While expert opinions were not formally obtained during the development of the questionnaire, the questions were carefully designed based on a comprehensive review of the literature and pilot testing with a small group of participants. This approach ensured that the survey was relevant and comprehensive in capturing traditional newborn care practices. The questions were designed to capture a wide range of practices, including umbilical cord care, swaddling, alleviating gas pain, preventing neonatal jaundice, and postpartum rituals. The questionnaire was originally developed and administered in Turkish, as it is the official language of Turkey and is widely spoken in Mardin. The time taken to complete the questionnaire was approximately 20 min. Before starting to fill out the questionnaire, the women who volunteered to participate in the study were informed about the aim of the study, and consent forms were signed by the participants. Data collection form included two sections. Section 1 was the individual introduction form consisting of 15 questions on mother's age, income status, age at first pregnancy, and duration of marriage. Section 2 consisted of questions related to traditional practices for newborns (18 questions).
Data analysis
The data were analysed using SPSS (Statistical Package for Social Sciences) for Windows 22.0. In the data analysis, the number, percentage, mean, and standard deviation were used as descriptive statistical methods. The differences between the ratios of categorical variables in the independent groups were analysed by Chi-Square tests. One-Way Analysis of Variance (ANOVA) was applied to normally distributed variables. The results were evaluated using a 95% confidence interval and a significance level of p < 0.05.
Ethical considerations
Ethical approval was obtained from the Mardin Artuklu University Non-Interventional Research Ethics Committee (Date: 05.12.2023, REF: 2023/12–35). Informed consent forms were obtained from all participants. The research was conducted in accordance with the principles of the Declaration of Helsinki.
Results
There was a significant difference between the nationality groups in terms of the educational status of the participants (X2 = 36.036; p = 0.002 < 0.05). The percentage of illiterate people was 15.4% for Assyrians, 11.7% for Turks, 10.5% for Arabs, and 12.6% for Kurds. There was also a significant difference between nationality groups in terms of social security status (X2 = 89.557; p < 0.001 < 0.05). The proportion of those without social security was 37.8% for Assyrians, 51.3% for Turks, 85.1% for Arabs, and 54.9% for Kurds. The proportion of those with social security was 62.2% for Assyrians, 48.7% for Turks, 14.9% for Arabs, and 45.1% for Kurds. The proportion of Arabs without social security was quite high (Table 1).
Table 1.
Descriptive characteristics of the participants
| Descriptive characteristics of the participants | Assyrian | Turkish | Arab | Kurdish | p | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| n (188) | % | n (197) | % | n (181) | % | n (175) | % | |||
| Marital status | Married | 142 | 75.5 | 172 | 87.3 | 158 | 87.3 | 158 | 90.3 |
X2 = 32.407 p < 0.001 |
| Widow | 31 | 16.5 | 15 | 7.6 | 5 | 2.8 | 11 | 6.3 | ||
| Divorced | 15 | 8.0 | 10 | 5.1 | 18 | 9.9 | 6 | 3.4 | ||
| Education status | Illiterate | 29 | 15.4 | 23 | 11.7 | 19 | 10.5 | 22 | 12.6 |
X2 = 36.036 p = 0.002 |
| Literate | 32 | 17.0 | 33 | 16.8 | 14 | 7.7 | 21 | 12.0 | ||
| Primary school | 47 | 25.0 | 48 | 24.4 | 61 | 33.7 | 37 | 21.1 | ||
| High school | 62 | 33.0 | 51 | 25.9 | 46 | 25.4 | 50 | 28.6 | ||
| Bachelor’s degree | 17 | 9.0 | 37 | 18.8 | 39 | 21.5 | 38 | 21.7 | ||
| Postgraduate | 1 | 0.5 | 5 | 2.5 | 2 | 1.1 | 7 | 4.0 | ||
| Employment Status | Working | 48 | 25.5 | 61 | 31.0 | 43 | 23.8 | 40 | 22.9 |
X2 = 3.922 p = 0.270 |
| Not working | 140 | 74.5 | 136 | 69.0 | 138 | 76.2 | 135 | 77.1 | ||
| Income | Income equals expenditure | 74 | 39.4 | 74 | 37.6 | 84 | 46.4 | 72 | 41.1 |
X2 = 8.673 p = 0.193 |
| Income is more than expenses | 31 | 16.5 | 44 | 22.3 | 25 | 13.8 | 39 | 22.3 | ||
| Income is less than expenses | 83 | 44.1 | 79 | 40.1 | 72 | 39.8 | 64 | 36.6 | ||
| Social security status | Not available | 71 | 37.8 | 101 | 51.3 | 154 | 85.1 | 96 | 54.9 |
X2 = 89.557 p < 0.001 |
| Available | 117 | 62.2 | 96 | 48.7 | 27 | 14.9 | 79 | 45.1 | ||
| Duration of marriage | 1–5 years | 41 | 21.8 | 66 | 33.5 | 46 | 25.4 | 52 | 29.7 |
X2 = 18.045 p = 0.006 |
| 6–9 years | 51 | 27.1 | 64 | 32.5 | 42 | 23.2 | 53 | 30.3 | ||
| 10 years and more | 96 | 51.1 | 67 | 34.0 | 93 | 51.4 | 70 | 40.0 | ||
| Age at first pregnancy | 18 years and less | 38 | 20.2 | 46 | 23.4 | 55 | 30.4 | 39 | 22.3 |
X2 = 12.002 p = 0.062 |
| 19–29 years | 138 | 73.4 | 133 | 67.5 | 118 | 65.2 | 130 | 74.3 | ||
| 30 years or more | 12 | 6.4 | 18 | 9.1 | 8 | 4.4 | 6 | 3.4 | ||
| Family type | Extended family | 43 | 22.9 | 48 | 24.4 | 46 | 25.4 | 57 | 32.6 |
X2 = 7.886 p = 0.247 |
| Nuclear family | 140 | 74.5 | 138 | 70.1 | 125 | 69.1 | 111 | 63.4 | ||
| Separated family | 5 | 2.7 | 11 | 5.6 | 10 | 5.5 | 7 | 4.0 | ||
| Number of children | 1–2 | 69 | 36.7 | 98 | 49.7 | 82 | 45.3 | 103 | 58.9 |
X2 = 34.278 p < 0.001 |
| 3–4 | 56 | 29.8 | 68 | 34.5 | 63 | 34.8 | 33 | 18.9 | ||
| 5 and more | 63 | 33.5 | 31 | 15.7 | 36 | 19.9 | 39 | 22.3 | ||
| Initial response to health problems | Going to the doctor | 161 | 85.6 | 158 | 80.2 | 150 | 82.9 | 150 | 85.7 |
X2 = 2.857 p = 0.414 |
| Trying to solve it with traditional practices | 27 | 14.4 | 39 | 19.8 | 31 | 17.1 | 25 | 14.3 | ||
| Importance of traditional methods | Not important | 14 | 7.4 | 26 | 13.2 | 9 | 5.0 | 25 | 14.3 |
X2 = 39.284 p < 0.001 |
| Somewhat important | 103 | 54.8 | 141 | 71.6 | 134 | 74.0 | 109 | 62.3 | ||
| Very important | 71 | 37.8 | 30 | 15.2 | 38 | 21.0 | 41 | 23.4 | ||
| Source of information about traditional methods | Never received it | 8 | 4.3 | 36 | 18.3 | 17 | 9.4 | 40 | 22.9 |
X2 = 70.626 p < 0.001 |
| Internet, TV | 11 | 5.9 | 35 | 17.8 | 36 | 19.9 | 28 | 16.0 | ||
| Grandparents | 161 | 85.6 | 112 | 56.9 | 108 | 59.7 | 102 | 58.3 | ||
| Neighbours | 8 | 4.3 | 14 | 7.1 | 20 | 11.0 | 5 | 2.9 | ||
| Status of traditional practices after the baby is born | Yes | 150 | 79.8 | 174 | 88.3 | 157 | 86.7 | 168 | 96.0 |
X2 = 22,126 p = 0,001 |
| No | 38 | 20.2 | 23 | 11.7 | 24 | 13.3 | 7 | 4.0 | ||
| Total (n: 741) | 188 | 100.0 | 197 | 100.0 | 181 | 100.0 | 175 | 100.0 | ||
| Mean | SD | Mean | SD | Mean | SD | Mean | SD | F/p | ||
| Age | 40.910 | 11.416 | 35.560 | 10.925 | 33.730 | 9.733 | 34.120 | 11.409 | 17.172/0.001 | |
Chi-Square Analysis, One-Way Variance Analysis
Significant differences were found between nationality groups in terms of the number of children (X2 = 34.278; p < 0.001 < 0.05), in terms of the importance given to traditional methods (X2 = 39.284; p < 0.001 < 0.05), and in terms of the source from which information about traditional methods was obtained (X2 = 70 < 626; p < 0.0010.05). In our study, there was no significant difference between nationality groups in terms of employment status (X2 = 3.922; p = 0.270 > 0.05), income level (X2 = 8.673; p = 0.193 > 0.05), age at first pregnancy (X2 = 12.002; p = 0.062 > 0.05), family structure (X2 = 7.886; p = 0.247 > 0.05), or what was done primarily to address health problems (X2 = 2857; p = 0.414 > 0.05). These results demonstrate that the socioeconomic and cultural characteristics of different nationality groups differ in various aspects, and these differences are also effective for issues such as health and traditional practices. There was a significant difference between the nationality groups in terms of traditional practices after the baby was born (X2 = 22.126; p < 0.001 < 0.05). 79.8% of the Assyrian participants, 88.3% of the Turkish participants, 86.7% of the Arab participants, and 96.0% of the Kurdish participants stated that they were doing traditional practices. Traditional practice was seen at the highest rate among Kurdish participants (Table 1). Further characteristics of participants were provided in Table 1.
Tables 2 and 3 showed care practices for the umbilical cord to fall quickly and practices performed after the umbilical cord was dropped. There was a significant difference between ethnic groups in terms of performing practices after the umbilical cord was dropped (X2 = 8.334; p = 0.040 < 0.05). While this practice was most common among Kurdish participants (4.0%), it was almost never seen among Assyrian (1.1%), Turkish (1.0%), and Arab (0.6%) participants.
Table 2.
Care practices for rapid fall of the umbilical cord
| Care practices for rapid fall of the umbilical cord | Assyrian | Turkish | Arab | Kurdish | Total | p | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | |||
| Making a rag and placing it on the belly | Yes | 71 | 37.8 | 81 | 41.1 | 68 | 37.6 | 56 | 32.0 | 276 | 37.2 |
X2 = 3.353 p = 0.340 |
| No | 117 | 62.2 | 116 | 58.9 | 113 | 62.4 | 119 | 68.0 | 465 | 62.8 | ||
| Tying it tightly with an umbilical cord | Yes | 12 | 6.4 | 18 | 9.1 | 19 | 10.5 | 30 | 17.1 | 79 | 10.7 |
X2 = 11.817 p = 0.008 |
| No | 176 | 93.6 | 179 | 90.9 | 162 | 89.5 | 145 | 82.9 | 662 | 89.3 | ||
| Applying navel powder to the umbilical cord | Yes | 8 | 4.3 | 16 | 8.1 | 7 | 3.9 | 11 | 6.3 | 42 | 5.7 |
X2 = 4.143 p = 0.246 |
| No | 180 | 95.7 | 181 | 91.9 | 174 | 96.1 | 164 | 93.7 | 699 | 94.3 | ||
| Applying salt to the umbilical cord | Yes | 28 | 14.9 | 16 | 8.1 | 1 | 0.6 | 12 | 6.9 | 57 | 7.7 |
X2 = 26.948 p < 0.001 |
| No | 160 | 85.1 | 181 | 91.9 | 180 | 99.4 | 163 | 93.1 | 684 | 92.3 | ||
| Putting coffee on the umbilical cord | Yes | 32 | 17.0 | 22 | 11.2 | 1 | 0.6 | 17 | 9.7 | 72 | 9.7 |
X2 = 29.235 p < 0.001 |
| No | 156 | 83.0 | 175 | 88.8 | 180 | 99.4 | 158 | 90.3 | 669 | 90.3 | ||
| Applying cream to the umbilical cord | Yes | 19 | 10.1 | 22 | 11.2 | 6 | 3.3 | 18 | 10.3 | 65 | 8.8 |
X2 = 9.068 p = 0.028 |
| No | 169 | 89.9 | 175 | 88.8 | 175 | 96.7 | 157 | 89.7 | 676 | 91.2 | ||
| Applying powder to the umbilical cord | Yes | 54 | 28.7 | 23 | 11.7 | 81 | 44.8 | 51 | 29.1 | 209 | 28.2 |
X2 = 51.154 p < 0.001 |
| No | 134 | 71.3 | 174 | 88.3 | 100 | 55.2 | 124 | 70.9 | 532 | 71.8 | ||
| Applying an iodine tincture to the umbilical cord | Yes | 55 | 29.3 | 29 | 14.7 | 39 | 21.5 | 20 | 11.4 | 143 | 19.3 |
X2 = 22.165 p < 0.001 |
| No | 133 | 70.7 | 168 | 85.3 | 142 | 78.5 | 155 | 88.6 | 598 | 80.7 | ||
| Waiting for it to drop on its own | Yes | 0 | 0.0 | 1 | 0.5 | 0 | 0.0 | 7 | 4.0 | 8 | 1.1 |
X2 = 18.606 p < 0.001 |
| No | 188 | 100.0 | 196 | 99.5 | 181 | 100.0 | 168 | 96.0 | 733 | 98.9 | ||
Table 3.
Care practices performed after dropping the umbilical cord
| Care practices performed after dropping the umbilical cord | Assyrian | Turkish | Arab | Kurdish | Total | P | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | |||
| Practices performed after the umbilical cord is dropped | Yes | 2 | 1.1 | 2 | 1.0 | 1 | 0.6 | 7 | 4.0 | 12 | 1.6 |
X2 = 8.334 p = 0.040 |
| No | 186 | 98.9 | 195 | 99.0 | 180 | 99.4 | 168 | 96.0 | 729 | 98.4 | ||
| Burying umbilical cords in mosque yard | Yes | 96 | 51.6 | 51 | 26.2 | 108 | 60.0 | 63 | 37.5 | 318 | 43.6 |
X2 = 51.217 p < 0.001 |
| No | 90 | 48.4 | 144 | 73.8 | 72 | 40.0 | 105 | 62.5 | 411 | 56.4 | ||
| Burying the umbilical cord in the Schoolyard | Yes | 19 | 10.2 | 36 | 18.5 | 98 | 54.4 | 36 | 21.4 | 189 | 25.9 |
X2 = 107.563 p < 0.001 |
| No | 167 | 89.8 | 159 | 81.5 | 82 | 45.6 | 132 | 78.6 | 540 | 74.1 | ||
| Umbilical cords were buried in the hospital yard | Yes | 5 | 2.7 | 16 | 8.2 | 13 | 7.2 | 18 | 10.7 | 52 | 7.1 |
X2 = 9.141 p = 0.027 |
| No | 181 | 97.3 | 179 | 91.8 | 167 | 92.8 | 150 | 89.3 | 677 | 92.9 | ||
| Burying the umbilical cord in the garden | Yes | 15 | 8.1 | 23 | 11.8 | 11 | 6.1 | 17 | 10.1 | 66 | 9.1 |
X2 = 4.125 p = 0.248 |
| No | 171 | 91.9 | 172 | 88.2 | 169 | 93.9 | 151 | 89.9 | 663 | 90.9 | ||
| Hiding the umbilical cord at home | Yes | 59 | 31.7 | 85 | 43.6 | 101 | 56.1 | 64 | 38.1 | 309 | 42.4 |
X2 = 23.932 p < 0.001 |
| No | 127 | 68.3 | 110 | 56.4 | 79 | 43.9 | 104 | 61.9 | 420 | 57.6 | ||
| Throwing the umbilical cord into the water causes | Yes | 27 | 14.5 | 11 | 5.6 | 2 | 1.1 | 11 | 6.5 | 51 | 7.0 |
X2 = 26.350 p < 0.001 |
| No | 159 | 85.5 | 184 | 94.4 | 178 | 98.9 | 157 | 93.5 | 678 | 93.0 | ||
There was a significant difference between ethnic groups in terms of swaddling the baby (X2 = 20.202; p < 0.001 < 0.05). This practice was most common among Arab participants (96.7%), highly prevalent among Turkish (93.4%) and Kurdish (95.4%) participants, and less prevalent among Assyrian participants (85.6%) (Table 4).
Table 4.
Baby swaddling and reasons for swaddling the baby
| Baby swaddling and reasons for swaddling the baby | Assyrian | Turkish | Arab | Kurdish | Total | p | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | |||
| Status of swaddling the baby | Yes | 161 | 85.6 | 184 | 93.4 | 175 | 96.7 | 167 | 95.4 | 687 | 92.7 |
X2 = 20.202 p < 0.001 |
| No | 27 | 14.4 | 13 | 6.6 | 6 | 3.3 | 8 | 4.6 | 54 | 7.3 | ||
| To ensure that his legs were smooth | Yes | 55 | 34.2 | 54 | 29.3 | 111 | 63.4 | 69 | 41.3 | 289 | 42.1 |
X2 = 49.149 p < 0.001 |
| No | 106 | 65.8 | 130 | 70.7 | 64 | 36.6 | 98 | 58.7 | 398 | 57.9 | ||
| Making it harder than a razor | Yes | 28 | 17.4 | 40 | 21.7 | 93 | 53.1 | 24 | 14.4 | 185 | 26.9 |
X2 = 84.459 p < 0.001 |
| No | 133 | 82.6 | 144 | 78.3 | 82 | 46.9 | 143 | 85.6 | 502 | 73.1 | ||
| To ensure that the child stays warm | Yes | 94 | 58.4 | 39 | 21.2 | 105 | 60.0 | 40 | 24.0 | 278 | 40.5 |
X2 = 96.444 p < 0.001 |
| No | 67 | 41.6 | 145 | 78.8 | 70 | 40.0 | 127 | 76.0 | 409 | 59.5 | ||
| To allow the child to sleep comfortably | Yes | 50 | 31.1 | 100 | 54.3 | 120 | 68.6 | 92 | 55.1 | 362 | 52.7 |
X2 = 48.525 p < 0.001 |
| No | 111 | 68.9 | 84 | 45.7 | 55 | 31.4 | 75 | 44.9 | 325 | 47.3 | ||
| Because the child was scared when his hands moved | Yes | 0 | 0.0 | 6 | 3.3 | 1 | 0.6 | 12 | 7.2 | 19 | 2.8 |
X2 = 20.013 p < 0.001 |
| No | 161 | 100.0 | 178 | 96.7 | 174 | 99.4 | 155 | 92.8 | 668 | 97.2 | ||
| Other | Yes | 10 | 6.2 | 3 | 1.6 | 6 | 3.4 | 4 | 2.4 | 23 | 3.3 |
X2 = 6.228 p = 0.101 |
| No | 151 | 93.8 | 181 | 98.4 | 169 | 96.6 | 163 | 97.6 | 664 | 96.7 | ||
Among the practices of the participants to relieve gas pain; anise drinking (the most common among Arab participants with a rate of 75.1%, fennel drinking (the most common among Kurdish participants with 22.3%, linden drinking (similar rates in all groups), and cumin drinking (similar rates in all groups) were treated with herbal tea. Statistical significance was found between ethnic groups in terms of all these applications. In addition; rubbing and rubbing breast milk on the abdomen (most common among Arab participants with 45.9%, patting on the back (more common among Kurdish participants with 4.6%, massaging (more common among Kurdish participants with 5.1%, and statistically significant differences were found between the groups (Table 5).
Table 5.
Distribution of traditional practices for baby with gas pains
| Traditional practices for baby with gas pains | Assyrian | Turkish | Arab | Kurdish | Total | p | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | |||
| Drink anise | Yes | 102 | 54.3 | 65 | 33.0 | 136 | 75.1 | 64 | 36.6 | 367 | 49.5 |
X2 = 82.464 p < 0.001 |
| No | 86 | 45.7 | 132 | 67.0 | 45 | 24.9 | 111 | 63.4 | 374 | 50.5 | ||
| Drink fennel | Yes | 21 | 11.2 | 35 | 17.8 | 18 | 9.9 | 39 | 22.3 | 113 | 15.2 |
X2 = 14.031 p = 0.003 |
| No | 167 | 88.8 | 162 | 82.2 | 163 | 90.1 | 136 | 77.7 | 628 | 84.8 | ||
| Drink linden | Yes | 26 | 13.8 | 35 | 17.8 | 21 | 11.6 | 21 | 12.0 | 103 | 13.9 |
X2 = 3.788 p = 0.285 |
| No | 162 | 86.2 | 162 | 82.2 | 160 | 88.4 | 154 | 88.0 | 638 | 86.1 | ||
| Drink cumin | Yes | 17 | 9.0 | 35 | 17.8 | 29 | 16.0 | 29 | 16.6 | 110 | 14.8 |
X2 = 6.948 p = 0.074 |
| No | 171 | 91.0 | 162 | 82.2 | 152 | 84.0 | 146 | 83.4 | 631 | 85.2 | ||
| Rubbing and rubbing breast milk on the abdomen | Yes | 63 | 33.5 | 49 | 24.9 | 83 | 45.9 | 57 | 32.6 | 252 | 34.0 |
X2 = 18.828 p < 0.001 |
| No | 125 | 66.5 | 148 | 75.1 | 98 | 54.1 | 118 | 67.4 | 489 | 66.0 | ||
| Giving medication | Yes | 2 | 1.1 | 5 | 2.5 | 2 | 1.1 | 2 | 1.1 | 11 | 1.5 |
X2 = 2.041 p = 0.564 |
| No | 186 | 98.9 | 192 | 97.5 | 179 | 98.9 | 173 | 98.9 | 730 | 98.5 | ||
| Patting on the back | Yes | 1 | 0.5 | 1 | 0.5 | 0 | 0.0 | 8 | 4.6 | 10 | 1.3 |
X2 = 18.114 p < 0.001 |
| No | 187 | 99.5 | 196 | 99.5 | 181 | 100.0 | 167 | 95.4 | 731 | 98.7 | ||
| Massage | Yes | 0 | 0.0 | 6 | 3.0 | 1 | 0.6 | 9 | 5.1 | 16 | 2.2 |
X2 = 14.468 p = 0.002 |
| No | 188 | 100.0 | 191 | 97.0 | 180 | 99.4 | 166 | 94.9 | 725 | 97.8 | ||
| I will take the baby to the doctor | Yes | 7 | 3.7 | 1 | 0.5 | 0 | 0.0 | 3 | 1.7 | 11 | 1.5 |
X2 = 10.520 p = 0.015 |
| No | 181 | 96.3 | 196 | 99.5 | 181 | 100.0 | 172 | 98.3 | 730 | 98.5 | ||
Ethnic groups differed significantly in terms of the status of the newborn to avoid neonatal jaundice (X2 = 11.547; p = 0.009 < 0.05) (Table 6). 100% of Assyrians, 99.5% of Turks, 96.7% of Arabs, and 99.4% of Kurds practice to prevent jaundice in the baby.
Table 6.
Distribution of traditional practices to prevent neonatal jaundice
| Traditional practices to prevent neonatal jaundice | Assyrian | Turkish | Arab | Kurdish | Total | p | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | |||
| Practices status for the baby to prevent neonatal jaundice | Yes | 188 | 100.0 | 196 | 99.5 | 175 | 96.7 | 174 | 99.4 | 733 | 98.9 |
X2 = 11.547 p = 0.009 |
| No | 0 | 0.0 | 1 | 0.5 | 6 | 3.3 | 1 | 0.6 | 8 | 1.1 | ||
| Keeping light on | Yes | 59 | 31.4 | 75 | 38.3 | 126 | 72.0 | 64 | 36.8 | 324 | 44.2 |
X2 = 74.040 p < 0.001 |
| No | 129 | 68.6 | 121 | 61.7 | 49 | 28.0 | 110 | 63.2 | 409 | 55.8 | ||
| A gold engagement ring and 7 cloves of garlic are worn | Yes | 52 | 27.7 | 72 | 36.7 | 137 | 78.3 | 56 | 32.2 | 317 | 43.2 |
X2 = 118.211 p < 0.001 |
| No | 136 | 72.3 | 124 | 63.3 | 38 | 21.7 | 118 | 67.8 | 416 | 56.8 | ||
| The child’s heel is razed. and blood is drained | Yes | 8 | 4.3 | 32 | 16.3 | 6 | 3.4 | 26 | 14.9 | 72 | 9.8 |
X2 = 29.165 p < 0.001 |
| No | 180 | 95.7 | 164 | 83.7 | 169 | 96.6 | 148 | 85.1 | 661 | 90.2 | ||
| Covering child’s face with a yellow veil | Yes | 50 | 26.6 | 59 | 30.1 | 9 | 5.1 | 80 | 46.0 | 198 | 27.0 |
X2 = 75.160 p < 0.001 |
| No | 138 | 73.4 | 137 | 69.9 | 166 | 94.9 | 94 | 54.0 | 535 | 73.0 | ||
| Giving plenty of breast milk | Yes | 17 | 9.0 | 47 | 24.0 | 20 | 11.4 | 25 | 14.4 | 109 | 14.9 |
X2 = 19.564 p < 0.001 |
| No | 171 | 91.0 | 149 | 76.0 | 155 | 88.6 | 149 | 85.6 | 624 | 85.1 | ||
| Keep yellow away from the baby | Yes | 31 | 16.5 | 53 | 27.0 | 108 | 61.7 | 33 | 19.0 | 225 | 30.7 |
X2 = 109.469 p < 0.001 |
| No | 157 | 83.5 | 143 | 73.0 | 67 | 38.3 | 141 | 81.0 | 508 | 69.3 | ||
| Giving plenty of water | Yes | 1 | 0.5 | 2 | 1.0 | 0 | 0.0 | 1 | 0.6 | 4 | 0.5 |
X2 = 1.777 p = 0.620 |
| No | 187 | 99.5 | 194 | 99.0 | 175 | 100.0 | 173 | 99.4 | 729 | 99.5 | ||
| I will take the baby to the doctor | Yes | 19 | 10.1 | 3 | 1.5 | 11 | 6.1 | 2 | 1.1 | 35 | 4.7 |
X2 = 22.312 p < 0.001 |
| No | 169 | 89.9 | 194 | 98.5 | 170 | 93.9 | 173 | 98.9 | 706 | 95.3 | ||
Ethnic groups differ significantly in terms of the practice status of a baby with jaundice for the relief of jaundice (X2 = 7.909; p = 0.048 < 0.05) (Table 7). All Assyrians (100.0%) and Kurds (100.0%), and most of Turks (98.0%) and Arabs (99.4%) practice for preventing neonatal jaundice.
Table 7.
Distribution of traditional practices for alleviating neonatal jaundice
| Traditional practices for alleviating neonatal jaundice | Assyrian | Turkish | Arab | Kurdish | Total | p | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | |||
| The status of practising for alleviating neonatal jaundice | Yes | 188 | 100.0 | 193 | 98.0 | 180 | 99.4 | 175 | 100.0 | 736 | 99.3 |
X2 = 7.909 p = 0.048 |
| No | 0 | 0.0 | 4 | 2.0 | 1 | 0.6 | 0 | 0.0 | 5 | 0.7 | ||
| Cutting two eyebrows using a razor | Yes | 15 | 8.0 | 16 | 8.3 | 19 | 10.6 | 14 | 8.0 | 64 | 8.7 |
X2 = 1.053 p = 0.789 |
| No | 173 | 92.0 | 177 | 91.7 | 161 | 89.4 | 161 | 92.0 | 672 | 91.3 | ||
| The baby is left under the sun | Yes | 51 | 27.1 | 65 | 33.7 | 127 | 70.6 | 53 | 30.3 | 296 | 40.2 |
X2 = 92.916 p < 0.001 |
| No | 137 | 72.9 | 128 | 66.3 | 53 | 29.4 | 122 | 69.7 | 440 | 59.8 | ||
| Shining light on the surface of the crib | Yes | 25 | 13.3 | 53 | 27.5 | 109 | 60.6 | 29 | 16.6 | 216 | 29.3 |
X2 = 122.011 p < 0.001 |
| No | 163 | 86.7 | 140 | 72.5 | 71 | 39.4 | 146 | 83.4 | 520 | 70.7 | ||
| Removal of yellow-coloured items from the room | Yes | 15 | 8.0 | 39 | 20.2 | 109 | 60.6 | 34 | 19.4 | 197 | 26.8 |
X2 = 147.737 p < 0.001 |
| No | 173 | 92.0 | 154 | 79.8 | 71 | 39.4 | 141 | 80.6 | 539 | 73.2 | ||
| Tying a yellow cloth | Yes | 40 | 21.3 | 43 | 22.3 | 19 | 10.6 | 48 | 27.4 | 150 | 20.4 |
X2 = 16.587 p < 0.001 |
| No | 148 | 78.7 | 150 | 77.7 | 161 | 89.4 | 127 | 72.6 | 586 | 79.6 | ||
| Frequently breastfeeding | Yes | 0 | 0.0 | 15 | 7.8 | 5 | 2.8 | 23 | 13.1 | 43 | 5.8 |
X2 = 32.999 p < 0.001 |
| No | 188 | 100.0 | 178 | 92.2 | 175 | 97.2 | 152 | 86.9 | 693 | 94.2 | ||
| Yellow outfit and yellow light | Yes | 25 | 13.3 | 1 | 0.5 | 0 | 0.0 | 1 | 0.6 | 27 | 3.7 |
X2 = 66.354 p < 0.001 |
| No | 163 | 86.7 | 192 | 99.5 | 180 | 100.0 | 174 | 99.4 | 709 | 96.3 | ||
| Covering the face with a yellow cloth | Yes | 1 | 0.5 | 0 | 0.0 | 0 | 0.0 | 1 | 0.6 | 2 | 0.3 |
X2 = 2.066 p = 0.559 |
| No | 187 | 99.5 | 193 | 100.0 | 180 | 100.0 | 174 | 99.4 | 734 | 99.7 | ||
| I will take the baby to the doctor | Yes | 28 | 14.9 | 45 | 23.3 | 28 | 15.6 | 27 | 15.4 | 128 | 17.4 |
X2 = 6.423 p = 0.093 |
| No | 160 | 85.1 | 148 | 76.7 | 152 | 84.4 | 148 | 84.6 | 608 | 82.6 | ||
| Razor under the tongue | Yes | 16 | 8.5 | 0 | 0.0 | 1 | 0.6 | 1 | 0.6 | 18 | 2.4 |
X2 = 39.095 p < 0.001 |
| No | 172 | 91.5 | 193 | 100.0 | 179 | 99.4 | 174 | 99.4 | 718 | 97.6 | ||
| Putting 7 garlic cloves on the bedside and not keeping it warm | Yes | 0 | 0.0 | 1 | 0.5 | 0 | 0.0 | 2 | 1.1 | 3 | 0.4 |
X2 = 3.895 p = 0.273 |
| No | 188 | 100.0 | 192 | 99.5 | 180 | 100.0 | 173 | 98.9 | 733 | 99.6 | ||
| Putting amber on the baby's pillow | Yes | 0 | 0.0 | 1 | 0.5 | 0 | 0.0 | 1 | 0.6 | 2 | 0.3 |
X2 = 2.015 p = 0.569 |
| No | 188 | 100.0 | 192 | 99.5 | 180 | 100.0 | 174 | 99.4 | 734 | 99.7 | ||
| Wearing gold and garlic when there is jaundice and keeping it in light | Yes | 3 | 1.6 | 2 | 1.0 | 2 | 1.1 | 1 | 0.6 | 8 | 1.1 |
X2 = 0.891 p = 0.828 |
| No | 185 | 98.4 | 191 | 99.0 | 178 | 98.9 | 174 | 99.4 | 728 | 98.9 | ||
There was a significant difference between the ethnic groups in terms of the status of practices for babies with canker sores (X2 = 13.208; p = 0.004 < 0.05) (Table 8). 100% of the Assyrian participants, 94.4% of the Turkish participants, 97.8% of the Arab participants, and 94.3% of Kurdish participants applied this practice. There were practices such as applying the hair of an elderly woman or a woman with twin babies (more common among Kurdish participants), breast milk, flour, garlic, mixing and spreading (more common among Turkish participants), applying sugar (more common among Arab participants), applying baking soda (more common among Arab participants), and only breast milk (more common among Turkish participants), and significant differences were found between ethnic groups.
Table 8.
Distribution of traditional practices to baby with canker sores
| Traditional practices to baby with canker sores | Assyrian | Turkish | Arab | Kurdish | Total | p | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | |||
| Status of practicing to a baby with canker sores | Yes | 188 | 100.0 | 186 | 94.4 | 177 | 97.8 | 165 | 94.3 | 716 | 96.6 |
X2 = 13.208 p = 0.004 |
| No | 0 | 0.0 | 11 | 5.6 | 4 | 2.2 | 10 | 5.7 | 25 | 3.4 | ||
| Applying hair from an elderly woman or a woman with twins | Yes | 5 | 2.7 | 9 | 4.8 | 3 | 1.7 | 12 | 7.3 | 29 | 4.1 |
X2 = 8.169 p = 0.043 |
| No | 183 | 97.3 | 177 | 95.2 | 174 | 98.3 | 153 | 92.7 | 687 | 95.9 | ||
| Placing soda in the baby's mouth | Yes | 5 | 2.7 | 0 | 0.0 | 2 | 1.1 | 1 | 0.6 | 8 | 1.1 |
X2 = 6.540 p = 0.088 |
| No | 183 | 97.3 | 186 | 100.0 | 175 | 98.9 | 164 | 99.4 | 708 | 98.9 | ||
| Mixing breast milk, flour, garlic, and spreading | Yes | 30 | 16.0 | 46 | 24.7 | 20 | 11.3 | 36 | 21.8 | 132 | 18.4 |
X2 = 12.920 p = 0.005 |
| No | 158 | 84.0 | 140 | 75.3 | 157 | 88.7 | 129 | 78.2 | 584 | 81.6 | ||
| Applying sugar | Yes | 84 | 44.7 | 53 | 28.5 | 126 | 71.2 | 53 | 32.1 | 316 | 44.1 |
X2 = 80.668 p < 0.001 |
| No | 104 | 55.3 | 133 | 71.5 | 51 | 28.8 | 112 | 67.9 | 400 | 55.9 | ||
| Applying baking soda | Yes | 67 | 35.6 | 83 | 44.6 | 105 | 59.3 | 72 | 43.6 | 327 | 45.7 |
X2 = 21.277 p < 0.001 |
| No | 121 | 64.4 | 103 | 55.4 | 72 | 40.7 | 93 | 56.4 | 389 | 54.3 | ||
| Spreading starch | Yes | 26 | 13.8 | 15 | 8.1 | 13 | 7.3 | 23 | 13.9 | 77 | 10.8 |
X2 = 7.143 p = 0.067 |
| No | 162 | 86.2 | 171 | 91.9 | 164 | 92.7 | 142 | 86.1 | 639 | 89.2 | ||
| Cleaning the inside of the mouth with a clean cloth | Yes | 3 | 1.6 | 7 | 3.8 | 2 | 1.1 | 2 | 1.2 | 14 | 2.0 |
X2 = 4.403 p = 0.221 |
| No | 185 | 98.4 | 179 | 96.2 | 175 | 98.9 | 163 | 98.8 | 702 | 98.0 | ||
| Going to the doctor | Yes | 11 | 5.9 | 9 | 4.8 | 5 | 2.8 | 10 | 6.1 | 35 | 4.9 |
X2 = 2.484 p = 0.478 |
| No | 177 | 94.1 | 177 | 95.2 | 172 | 97.2 | 155 | 93.9 | 681 | 95.1 | ||
| Breast milk alone | Yes | 6 | 3.2 | 10 | 5.4 | 1 | 0.6 | 1 | 0.6 | 18 | 2.5 |
X2 = 11.764 p = 0.008 |
| No | 182 | 96.8 | 176 | 94.6 | 176 | 99.4 | 164 | 99.4 | 698 | 97.5 | ||
| Using special medication | Yes | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 1 | 0.6 | 1 | 0.1 |
X2 = 3.344 p = 0.342 |
| No | 188 | 100.0 | 186 | 100.0 | 177 | 100.0 | 164 | 99.4 | 715 | 99.9 | ||
It was determined that there was no significant difference between ethnic groups in terms of practices to the baby with diaper rash (X2 = 4.932; p = 0.177 > 0.05) (Table 9). 91% of Assyrians, 94.9% of Turks, 95.6% of Arabs, and 91.4% of Kurds have some practices to cure diaper rash. In the groups, practices such as applying saturated fat to diaper rash (more common in Arab participants), applying olive oil (more common in Arab participants), applying powder (more common in Arab participants), and laying dry sifted fine earth under the baby (‘Höllük’ in Turkish) (mostly in Assyrians) were determined, and there was a statistically significant difference between the groups for these practices.
Table 9.
Distribution of traditional practices to the baby with diaper rash
| Traditional practices to the baby with diaper rash | Assyrian | Turkish | Arab | Kurdish | Total | p | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | |||
| Status of practicing to the baby with diaper rash | Yes | 171 | 91.0 | 187 | 94.9 | 173 | 95.6 | 160 | 91.4 | 691 | 93.3 |
X2 = 4.932 p = 0.177 |
| No | 17 | 9.0 | 10 | 5.1 | 8 | 4.4 | 15 | 8.6 | 50 | 6.7 | ||
| Applying saturated fat | Yes | 21 | 12.3 | 34 | 18.2 | 94 | 54.3 | 40 | 25.0 | 189 | 27.4 |
X2 = 91.297 p < 0.001 |
| No | 150 | 87.7 | 153 | 81.8 | 79 | 45.7 | 120 | 75.0 | 502 | 72.6 | ||
| Applying olive oil | Yes | 75 | 43.9 | 70 | 37.4 | 124 | 71.7 | 60 | 37.5 | 329 | 47.6 |
X2 = 55.457 p < 0.001 |
| No | 96 | 56.1 | 117 | 62.6 | 49 | 28.3 | 100 | 62.5 | 362 | 52.4 | ||
| Applying powder | Yes | 83 | 48.5 | 85 | 45.5 | 128 | 74.0 | 75 | 46.9 | 371 | 53.7 |
X2 = 38.584 p < 0.001 |
| No | 88 | 51.5 | 102 | 54.5 | 45 | 26.0 | 85 | 53.1 | 320 | 46.3 | ||
| Laying dry sifted fine earth under the baby (“Höllük” in Turkish) | Yes | 23 | 13.5 | 18 | 9.6 | 7 | 4.0 | 14 | 8.8 | 62 | 9.0 |
X2 = 9.446 p = 0.024 |
| No | 148 | 86.5 | 169 | 90.4 | 166 | 96.0 | 146 | 91.2 | 629 | 91.0 | ||
| Using diaper rash cream | Yes | 15 | 8.8 | 47 | 25.1 | 30 | 17.3 | 27 | 16.9 | 119 | 17.2 |
X2 = 16.791 p < 0.001 |
| No | 156 | 91.2 | 140 | 74.9 | 143 | 82.7 | 133 | 83.1 | 572 | 82.8 | ||
| Going to the doctor | Yes | 0 | 0.0 | 0 | 0.0 | 1 | 0.6 | 5 | 3.1 | 6 | 0.9 |
X2 = 12.771 p = 0.005 |
| No | 171 | 100.0 | 187 | 100.0 | 172 | 99.4 | 155 | 96.9 | 685 | 99.1 | ||
| I use creams I make myself | Yes | 10 | 5.8 | 1 | 0.5 | 2 | 1.2 | 3 | 1.9 | 16 | 2.3 |
X2 = 13.221 p = 0.004 |
| No | 161 | 94.2 | 186 | 99.5 | 171 | 98.8 | 157 | 98.1 | 675 | 97.7 | ||
For the baby to be beautiful; there were practices such as squeezing the nose (more common in Assyrians), pressing on the cheeks and chin (more common in Arabs), tying the baby’s head (more common in Arabs), drawing eyebrows with kohl (more common in Arabs), applying breast milk to the face (more common in Arabs), tying the forehead tightly (more common in Assyrians), and tying the waist (more common in Assyrians). Significant differences were found among ethnic groups in terms of these practices (Table 10).
Table 10.
Distribution of traditional practices for the beauty of the baby
| Traditional practices for the beauty of the baby | Assyrian | Turkish | Arab | Kurdish | Total | p | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | |||
| Squeezing the nose | Yes | 103 | 54.8 | 73 | 37.1 | 61 | 33.7 | 83 | 47.4 | 320 | 43.2 |
X2 = 21.250 p < 0.001 |
| No | 85 | 45.2 | 124 | 62.9 | 120 | 66.3 | 92 | 52.6 | 421 | 56.8 | ||
| Pressing on the cheeks and chin | Yes | 60 | 31.9 | 65 | 33.0 | 115 | 63.5 | 60 | 34.3 | 300 | 40.5 |
X2 = 53.023 p < 0.001 |
| No | 128 | 68.1 | 132 | 67.0 | 66 | 36.5 | 115 | 65.7 | 441 | 59.5 | ||
| Tying the baby’s head | Yes | 39 | 20.7 | 32 | 16.2 | 72 | 39.8 | 36 | 20.6 | 179 | 24.2 |
X2 = 33.266 p < 0.001 |
| No | 149 | 79.3 | 165 | 83.8 | 109 | 60.2 | 139 | 79.4 | 562 | 75.8 | ||
| Tying the ears with a cloth | Yes | 25 | 13.3 | 31 | 15.7 | 22 | 12.2 | 28 | 16.0 | 106 | 14.3 |
X2 = 1.578 p = 0.665 |
| No | 163 | 86.7 | 166 | 84.3 | 159 | 87.8 | 147 | 84.0 | 635 | 85.7 | ||
| Drawing eyebrows with kohl | Yes | 24 | 12.8 | 29 | 14.7 | 76 | 42.0 | 23 | 13.1 | 152 | 20.5 |
X2 = 68.002 p < 0.001 |
| No | 164 | 87.2 | 168 | 85.3 | 105 | 58.0 | 152 | 86.9 | 589 | 79.5 | ||
| Applying breast milk to the face | Yes | 33 | 17.6 | 36 | 18.3 | 85 | 47.0 | 49 | 28.0 | 203 | 27.4 |
X2 = 52.265 p < 0.001 |
| No | 155 | 82.4 | 161 | 81.7 | 96 | 53.0 | 126 | 72.0 | 538 | 72.6 | ||
| Tying the forehead tightly | Yes | 35 | 18.6 | 15 | 7.6 | 4 | 2.2 | 12 | 6.9 | 66 | 8.9 |
X2 = 33.164 p < 0.001 |
| No | 153 | 81.4 | 182 | 92.4 | 177 | 97.8 | 163 | 93.1 | 675 | 91.1 | ||
| Tying the waist | Yes | 22 | 11.7 | 3 | 1.5 | 2 | 1.1 | 5 | 2.9 | 32 | 4.3 |
X2 = 33.959 p < 0.001 |
| No | 166 | 88.3 | 194 | 98.5 | 179 | 98.9 | 170 | 97.1 | 709 | 95.7 | ||
| Haircut | Yes | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 1 | 0.6 | 1 | 0.1 |
X2 = 3.239 p = 0.356 |
| No | 188 | 100.0 | 197 | 100.0 | 181 | 100.0 | 174 | 99.4 | 740 | 99.9 | ||
There was a significant difference between the ethnic groups in terms of the existence of the traditional method of the ritual of period ends on Day 40 (This is a ritual that waiting at home and not taking the baby out until the first 40 days passed from the birth) (X2 = 113.291; p < 0.001 < 0.05) (Table 11). 71.8% of the Assyrian participants, 99.0% of the Turkish participants, 96.1% of the Arab participants, and 97.1% of the Kurdish participants applied the traditional method of ritual of period ends on Day 40. This shows that the practice of this ritual is common, especially among Turkish and Arab participants. There were different practices such as not leaving the house for up to 40 days (most common in Arab participants), bathing with forty drops from a strainer with prayer water (most common in Arab participants), washing the baby’s face with 40 spoons of water (most common in Arab participants), not keeping the newborn in the same environment with another baby (most common in Arab participants), and not keeping the newborn in the same environment with newly married couples (most common in Arab participants). Significant differences were found between ethnic groups in terms of these practices.
Table 11.
Traditional method practices status and distribution of ritual of period ends on Day 40 (commonly referred to as ‘doing the month’)
| Traditional methods related to the ritual of period ends on Day 40 | Assyrian | Turkish | Arab | Kurdish | Total | p | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | |||
| Traditional methods related to the ritual of period ends on Day 40 | Yes | 135 | 71.8 | 195 | 99.0 | 174 | 96.1 | 170 | 97.1 | 674 | 91.0 |
X2 = 113.291 p < 0.001 |
| No | 53 | 28.2 | 2 | 1.0 | 7 | 3.9 | 5 | 2.9 | 67 | 9.0 | ||
| Not leaving home for up to 40 days | Yes | 79 | 58.5 | 71 | 36.4 | 136 | 78.2 | 111 | 65.3 | 397 | 58.9 |
X2 = 70.288 p < 0.001 |
| No | 56 | 41.5 | 124 | 63.6 | 38 | 21.8 | 59 | 34.7 | 277 | 41.1 | ||
| Bathing the baby with 40 drops of water from a strainer with holy water | Yes | 8 | 5.9 | 72 | 36.9 | 135 | 77.6 | 59 | 34.7 | 274 | 40.7 |
X2 = 169.474 p < 0.001 |
| No | 127 | 94.1 | 123 | 63.1 | 39 | 22.4 | 111 | 65.3 | 400 | 59.3 | ||
| Washing a baby’s face with 40 spoons of water | Yes | 14 | 10.4 | 52 | 26.7 | 120 | 69.0 | 26 | 15.3 | 212 | 31.5 |
X2 = 164.055 p < 0.001 |
| No | 121 | 89.6 | 143 | 73.3 | 54 | 31.0 | 144 | 84.7 | 462 | 68.5 | ||
| Not keeping a newborn in the same environment with another baby | Yes | 23 | 17.0 | 56 | 28.7 | 121 | 69.5 | 27 | 15.9 | 227 | 33.7 |
X2 = 143.174 p < 0.001 |
| No | 112 | 83.0 | 139 | 71.3 | 53 | 30.5 | 143 | 84.1 | 447 | 66.3 | ||
| Not staying in the same environment as newlywed couples | Yes | 35 | 25.9 | 44 | 22.6 | 127 | 73.0 | 25 | 14.7 | 231 | 34.3 |
X2 = 160.714 p < 0.001 |
| No | 100 | 74.1 | 151 | 77.4 | 47 | 27.0 | 145 | 85.3 | 443 | 65.7 | ||
Discussion
Traditional care practices regarding umbilical cord vary across ethnic groups, with many traditional methods aiming to promote faster cord separation while minimising infection risks. The umbilical cord care practices in this study focused on those that helped fall quickly and those performed after the umbilical cord was dropped. In many cultures, the umbilical cord has been perceived as a significant component of newborn health and identity [16]. Mukunya et al., [16] stated that the umbilical cord had a symbolic position in newborn care. The umbilical cord and the way it cared for played a part in the present and future survival of the baby, as well as the survival and well-being of the household. Persons other than the mother, such as older female relatives, were influential in the care of the umbilical cord [16]. In addition, the existing literature found that the application of unsterilised substances is associated with increased risks of infections [17, 18]. Furthermore, the existing literature found that some care practices for cord care included applying butter [19], applying saliva (mate), dirty door powder from old doors, hot knife, charcoal powder, shells, burning wood, banana steam, and fish bones [20]. Studies have demonstrated that chlorhexidine can reduce the incidence of infection compared to traditional practices that involve the use of potentially harmful substances [21].
The results of this study revealed that baby swaddling was common among all ethnic groups: Arabic participants (96.7%), Kurdish participants (95.4%), Turkish participants (93.4%), and Assyrian participants (85.6%). In other studies conducted in Turkey, the percentage of baby swaddling was between 20–90%, including 28.5% [22], 33.7% [23], 38% [24], 48% [25], and 89.7% [26]. Parents choose to swaddle their babies to enhance their sleep quality, keep them warm, and limit baby’s movements. In line with the existing literature, swaddled infants tend to sleep longer, which is attributed to the restriction of movement, thereby promoting more restful sleep [27]. Despite its benefits, swaddling is not without risks. Concerns arise about developmental dysplasia of the hip (DDH) in infants swaddled too restrictively, especially if their legs remained extended [28, 29]. The current literature indicates that traditional swaddling practices that restrict hip movement may contribute to an increased incidence of DDH, particularly in cultures where such practices are prevalent [30]. Swaddling continues to be a common infant care practice. Parents could be informed about risks to hip development. Healthcare providers could assist families in swaddling safely during their newborn care practices.
The results confirmed that some traditional practices were used to alleviate gas pain. Such practices included some drinks, rubbing, massaging, medication administration, and seeking care at healthcare services. In line with the results of this study, other studies found that parents use herbal remedies or teas, such as chamomile or fennel, which are believed to have carminative properties that can help expel gas [31]. These natural remedies are often preferred by parents seeking alternatives to pharmacological treatments. However, although some studies support the efficacy of certain herbal remedies in managing gas pain, it is crucial to approach this practice with caution due to potential adverse effects or allergies in infants [32]. Similarly, 30% of the infants were provided traditional drinks, such as gripe water, anise seed drink, and tea [33]. Traditional practices for alleviating gas pain in newborns, such as abdominal massage and the use of herbal remedies, reflect a blend of cultural beliefs and practical approaches. While these methods may offer comfort and relief, parents should remain informed about evidence-based practices and consult healthcare professionals when necessary.
This study found that parents applied some traditional practices in order to prevent and alleviate neonatal jaundice. Some of these practices included cutting between two eyebrows with a razor, leaving the baby under the sun, shining a light on the surface of your crib, removing yellow-coloured things from the room, tying a yellow cloth, breastfeeding frequently, yellow outfit, yellow light, covering the face with a yellow cloth, and using a razor under the tongue, putting 7 garlic cloves on the bedside, not keeping it warm, and putting them to sleep in a lighted environment. In contrast to the results of this study, Le, Partridge [34] found that a vast majority of participants avoided exposure to sunlight (n = 864, 88%), and some parents believed that sunlight is harmful (n = 320, 33%). In line with the results of this study, previous studies have shown that early initiation of breastfeeding helps prevent and alleviate neonatal jaundice [35]. Research has indicated that early breastfeeding can significantly reduce the incidence of severe neonatal jaundice. Traditional practices for preventing and alleviating neonatal jaundice are prevalent and culturally significant. Education and awareness among caregivers can enhance the management of neonatal jaundice. Improving caregivers' understanding of jaundice and its implications could lead to better health-seeking behaviours and timely interventions, ultimately reducing neonatal mortality associated with jaundice.
The results of this study showed practices to baby with canker sores included applying the hair of an elderly woman or a woman with twin babies, putting soda in the baby's mouth, mixing breast milk, flour, garlic, and spreading, applying sugar, applying baking soda, spreading starch, cleaning the inside of the mouth with a clean cloth, and breast milk. In line with the results of this study, 33.2% of participant reported any practice which can be used for babies with canker sores [15]. Such traditional practices included applying soda water, sugar, or breast milk on the mouth of the baby (30.3%, 17.1% and 16.0%; respectively) [15].
This study revealed some traditional practices regarding alleviating diaper rash. Such practices included applying saturated fat, olive oil, powder, and dry earth (‘Höllük’ in Turkish. It means laying dry, sifted fine earth under the baby). In line with the results of this study, Mulyani et al., [36] found that the application of olive oil improved the healing of diaper rashes in infants, suggesting that its moisturising properties may help to soothe irritated skin.
This study revealed some traditional practices that aim to make babies beautiful. Such practices included squeezing the nose, pressing on the cheeks and chin, tying the baby’s head, drawing eyebrows and eyes with kohl, applying breast milk to the face, tightening the forehead, and tying the waist. Concurring with these results, another study conducted in Turkey found that traditional practices regarding baby to be beautiful included covering the head of the baby with a cloth (58.1%), tying the forehead of the baby tightly (56.8%), and squeezing the nose of the baby (42.7%) [37].
This study identified some traditional practices following childbirth. This is a ritual of period ends on Day 40, and commonly referred to as ‘doing the month’. Such practices included that not leaving home for up to 40 days, bathing the baby with forty drops from a strainer with prayerful water, washing baby's face with 40 spoons of water, not keeping the newborn in the same environment with another baby, and not staying in the same environment with newlywed couples. Similarly, the ritual of period ends on Day 40 was more common (97.8%) in another study conducted in Turkey [26].
Strengths and limitations
One of the strengths of this study was to collect data from a large number of participants (n = 741) from four different ethnic groups. This allowed us to investigate the different care practices across four different ethnic groups. In contrast, this study was limited to Mardin, a city located in eastern Turkey. The results of this study may not be generalisable to the western Turkey and other contexts due to differences in cultural, religious and societal factors.
Implications for practice and recommendations
In contrast to some other studies conducted in Turkey [23], women commonly used traditional care practices for newborn care rather than seeking assistance from healthcare providers. Therefore, this study recommends that parents should be educated regarding the possible harms of traditional care practices and encourage them to seek assistance from healthcare providers. In addition, this study found that harmful traditional care practices were more common among the Arab population. Transcultural healthcare services could help reduce harmful traditional care practices.
Conclusion
This study highlights the significance of traditional care practices in newborn care across four ethnic groups. There are many differences between ethnic groups with respect to traditional care practices in the postpartum period. Understanding such differences is crucial for developing culturally sensitive interventions that support maternal well-being and enhance health outcomes for both mothers and infants. This approach could help identify potential opportunities for integrating traditional care practices into modern healthcare approaches. Future interventions should focus on educating parents about the risks of traditional practices and the advantages of following recommended guidelines to address the gap between cultural practices and current healthcare practices. This study could inform appropriate stakeholders, healthcare staff, researchers, and policymakers.
Supplementary Information
Acknowledgements
The authors would like to thank Zahide DARWISH, Busra TEKGUL, Erbil TURAN, Zumrut OZGUN for their contribution during data collection. The authors would also like to thank parents for their participation in this study.
Clinical trial number
Not applicable.
Authors’ contributions
V.B.D.: Conceptualization, Resources, Data curation, Software, Visualization, Methodology, Project administration, Formal analysis, Writing – original draft, Writing – review & editing. A.B.: Conceptualization, Resources, Data curation, Software, Visualization, Methodology, Project administration, Formal analysis, Writing – original draft, Writing – review & editing.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Data availability
The datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request.
Declarations
Ethics approval and consent to participate
Ethical approval was obtained from the Mardin Artuklu University Non-Interventional Research Ethics Committee (Date: 05.12.2023, REF: 2023/12–35). Informed consent forms were obtained from all participants. The legal guardian or an appropriate representative of participants, who cannot provide consent, provided informed consent on their behalf. The research was carried out in accordance with the principles of the Declaration of Helsinki.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Data Availability Statement
The datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request.