A study on traditional food practices and taboo during pregnancy and lactation in tribal population of Eastern Gujarat

ABSTRACT

Background:

Taboo in a social or religious setting means a custom prohibiting or restricting certain practices. Many foods related myths are common in society which leads to poor pregnancy outcome. It is important to make the community aware about it and educate them regarding this. Being a tribal community, taboos are more prevalent and this was the main aim to do the study regarding food taboos.

Study:

The type of the study is Qualitative research method; The study was done in a tribal community in the eastern part of Gujarat. The subjects were taken on the basis of convenience sampling. Focus group discussion (FGD) was done and data was generated. The data was recorded in notes and audio recordings, which were further analyzed.

Results:

The study was conducted in a tribal area with 80 participants. Out of which 37 were pregnant mothers and 43 were mothers with babies aged 0 to 6 months. The most common foods avoided were Papaya, pineapple, chicken, eggs, onion, garlic, eggplant, Jaggery, Guwar, urad daal, and various other food items.

Discussion:

This study shows that many foods are considered hot and cold and they are restricted during pregnancy and postpartum. There is a strong notion in the community that consumption of certain foods is associated with poor outcomes of pregnancy and the health of the baby.

Conclusion:

The food taboo followed in these communities can lead to potential nutritional deficiencies which in turn can lead to adverse effects in the child and the mother. A need for education regarding proper nutritional practice is necessary at this level.

Introduction

“Taboo” is a Polynesian word, which means ‘sacred’ or ‘forbidden’; Taboo has somewhat magical or religious meaning. It means “unwritten social rules that manage human behavior.[1] It also means a social or religious custom prohibiting or restricting a particular practice or forbidding association with a particular person, place, or thing.[2] These vary from traditions or customs in a way that custom is a frequent repetition of the same behavior; habitual practice; or method of doing, which may not be inhibitory.[3] Certain foods aren’t allowed during certain religious periods (e.g., Lent), in some phases of life (e.g., pregnancy), or for specific classes of people (e.g., priests, sadhus,), even though the food is otherwise permitted.[4] The food taboo means certain foods and food materials are prohibited from consumption. They are also integrated with particular circumstances like pregnancy, lactation, childbirth, and menstruation, while in certain traditional societies – preparation for the hunt, battle, wedding, funeral, etc.[5] There is a strong impact of religion on the food habits of the people following it.[6] Taboos are often associated with the culture, traditional in nature, and are carried out as convention or as per the advice of the aged or ancestors.[7] Studying various food taboos may help in understanding the food practices, which will help in understanding the nutritional needs, and the various nutritional deficiency of the tribal community. In tribal communities, most of the participants belong to the lower socioeconomic status with lower nutrition consumption. Food taboos lead to more nutrition deprivation during the crucial phase of life which is pregnancy and lactation. In this study, the dietary diversity during pregnancy and lactation is explored. The study highlights the crucial need for having a culturally acceptable preventive measure for the tribal community.

Methodology

Study design

The type of the study is Qualitative research method, The study was done in a tribal community in the eastern part of Gujarat, using a mixing method of qualitative and quantitative research. Focus group discussion (FGD) was done to conducted and data was generated. The data was recorded in notes and audio recordings. The data was transcribed in English and analysed keeping the principal domains. The expecting and lactating mothers were included in the study and consent was taken from each participant. Those who did not want to be a part of the study were excluded and those with any underlying medical condition were excluded from the study. The data was collected by visiting Anganwadis of the area. There were 10 Anganwadis chosen as per convenience. The FGDs were done with the help of Anganwadi workers, each FGD was done for a group of 8 women. Total 10 FGDs conducted. The pregnant mothers who were in 7-month age of gestation or above were selected and lactating mothers of the immediate post-partum period. A total of 80 participants were there in the study as per convenience. Prior permission from the institutional ethical committee was taken. The study was done from April 2022 to July 2023. All the FGDs were conducted in the local language, each FGD lasted for around 30 minutes. Detailed notes were taken during it and later transcribed into English. Socio-demographic data, data about several children, and other quantitative data were collected using a preformed semi-structured questionnaire, which was later entered in a Microsoft Excel sheet and data was analyzed using open EPI 3.01 software.

Objective

• To explore the cultural beliefs and practices associated with food taboos among pregnancy and lactation among tribal women

• To investigate the underlying reasons and perceptions of tribal women regarding the restriction of certain foods during pregnancy and lactation.

Results

The study was conducted in a tribal area with 80 participants. Out of which 37 were pregnant mothers and 43 were mothers with babies aged 0 to 6 months. The participants were chosen as per convenience basis.

A total of 35% of participants had primary education and 32.5% had secondary education. 66. 3% were housewives. 70% of the participants belonged to the BPL class, and 96.3% followed the Hindu religion [Table 1].

Table 1.

Sociodemographic profile of the participants (n=80)

Parameters	Frequency	Percent
Literacy
Graduate And above	6	7.5
High School	12	15
Illiterate	8	10
Primary	28	35
Secondary	26	32.5
Occupation
Farming	9	11.3
House Wife	53	66.3
Labourer	4	5
Office Job	2	2.5
Working From Home	12	15
BPL/APL
BPL	56	70
APL	24	30
Religion
Christian	2	2.5
Hindu	77	96.3
Muslim	1	1.3

Food restrictions during the immediate post-partum and lactation period

Food restrictions were more during the post-partum period as compared with that during pregnancy. In our study, all the women were restricted from eating certain foods during pregnancy and lactation and all of the women were given special foods during pregnancy and post-partum period. For the first 3 days post-partum, no one else was allowed to touch the baby except the mother. The post-partum food restrictions, and postpartum isolation (Sutak) were done for almost 1.5 to 3 months and mothers were not allowed to touch the kitchen or food and were not allowed to do any household work too during this period. The newborns were offered Goat milk or Cow’s milk for the first 3 to 5 days post-delivery, as it is believed that mothers can’t produce enough milk during the initial days of pregnancy and the baby will be hungry. In this study, we found out that Colostrum was not offered as it is considered spoiled milk, and was believed to lead to ill health in the baby.

“Mothers can’t produce enough milk to fill the infant’s stomach, so we need to give animal milk, so the baby will not go hungry and the baby will sleep for a longer period.”: Said a 26-year-old mother with 1-month-old infant.

“No, we cannot touch anything after delivery and we are not allowed to go anywhere even in the house. We can only touch the baby and do baby related chores “: Said a 20-year-old mother with 15 days old baby.

The mean age of the participants was 27.5 + 4.7 years, and the mean number of children was 1.8 ± 1.1. The mean years of marriage are 5 years, the mean height of the women is 156 ± 6.5 cm and the mean weight is 52 kg ± 12.9 [Table 2].

Table 2.

Descriptive statistics of various parameters assessed in the study

	n	Minimum	Maximum	Mean	Std. deviation
Age in years	80	18	36	27.05	4.709
Total number of children	80	0	7	1.84	1.152
Years of marriage	80	1	15	5.009	3.2046
Height (in cm)	80	140	167	156.36	6.855
Weight (in kg)	80	41	154	52.07	12.841

Food avoided during pregnancy

In our study, we found out that certain foods were specifically avoided throughout the pregnancy. These foods were Papaya, pineapple, chicken, eggs, onion, garlic, eggplant, Jaggery, Guwar, urad daal, Chana daal, Bajra, Mango, beet, Black pepper, peanuts, cashew, almonds, Curd, Buttermilk, lemon, and Coconut water.

Reasons for food avoidance during pregnancy

In this study, we found out that Papaya, pineapple, chicken, eggs, onion, garlic, eggplant, Black pepper, Jaggery, Guwar, Bajra, and Mango were considered hot, and were believed to cause early labor, preterm birth, and abortion.

“Certain foods like mango, papaya, and nonvegetarian diets are hot and not allowed during pregnancy as it may cause early labor pains”: Said a 22-year-old, 6-month pregnant woman.

We also found out that Vegetables with seed pod and beans, Urad daal, and Chana daal were considered heavy. It was believed to be difficult to digest and cause stomach aches in the baby, so lactating mothers were prohibited from eating them.

“I can’t eat Beans and daal. Beans will cause stomach ache to my baby”: Said a 22-year-old 2-month pregnant mother.

Cashews, Almonds, and Peanuts are white, and it was believed that it will lead to a stickier White layer in the growing baby, which will be difficult to remove (vernix caseosa).

Both pregnant and lactating mothers were prohibited from eating Rice, Curd, buttermilk, lemon, and coconut water were considered cold and were believed to cause cold in the baby. Any Fused fruit or vegetables were avoided, as it may lead to Twin pregnancy.

“Lemon and curds are cold, it will lead to cough and cold in my baby, so I don’t eat it”.: Said a 24-year-old mother with a 2.5-month-old baby.

Dark foods like tea and coffee were prohibited from consumption as it was believed to give a dark complexion to the baby.

“I have stopped consuming tea since I got pregnant as I want a Fair complexion baby”: Said a 26-year-old 4-month pregnant mother [Table 3].

Table 3.

Food taboos in pregnancy and their possible reasons for avoidance

Food item restricted	Reason for restriction
Papaya, Pineapple, Chicken, Eggs, Onion, Garlic, Eggplant, Black Pepper, Jaggery, Guwar, Bajra, Mango, fenugreek seeds	Hot food may lead to abortion or premature labor
Any fused fruit or vegetable	Twin pregnancy
Cashews, Almonds, and Peanuts	Baby born with a White layer on the skin, which will be difficult to remove. (Vernix caseosa)
Urad daal, Chana daal, Toor daal	Heavy to digest and gas production
Rice, Buttermilk, lemon, and Coconut water	Cold food, leads to respiratory infections in babies.
Hot tea and any hot beverage	Burn lips of baby and baby lips will turn black
Black coloured foods	The color of the baby will be dark.

Foods encouraged to have during pregnancy

In our study, we found out that Fruits and green leafy vegetables specifically Spinach and bottle guard were encouraged to consume more during pregnancy. Specifically, pink or red color foods were encouraged to eat, as it was believed that it would give pink cheeks and pink lips to the growing baby.

“I eat more pomegranates, so my baby will have pink cheeks”: Said a 20-year-old 4 months pregnant mother.

Specifically, black tea without milk or sweeteners was given to most of the participants around 8 months of completion of pregnancy as it is believed to help with labor and delivery as they were considered hot. In the last part of the pregnancy, women were also encouraged to eat hot tea with Jaggery as it is believed to be hot and can help induce labor pains. Few women were given dried dates during the last part of the pregnancy as dates are also considered hot and can help in the induction of labor.

Food avoided during post-partum period

In the immediate postpartum period, many food products were avoided, 95% of women were given only bland Raab, which is a liquid soup-like consistency food product (made of Corn flour/wheat flour/fox tail millet, water, milk and salt only) during the initial part of the postpartum phase.

“I am given liquid consistency foods only because they are light for digestion otherwise my baby will get a stomach ache.” said a 28-year-old mother with a 1-month-old baby.

Sometimes Spinach is without any spices and Moongdaal, as it is believed to be easy for digestion and will not cause gas or colic in the baby, which is given for at least 3 months postpartum period. All other foods were forbidden as it was believed to be heavy for digestion for babies, and it would lead to Colic, gas, abdominal pain, and crying in babies. Immediate post-partum mothers were given the water of Dill (Suva nu pain), as it is believed to help in the digestion of food. The mothers were allowed to have only Cold tea, as it was believed that Hot tea would burn the lips of the babies, and it will lead to darkening of the lips. Though Roti made out of local Maize/wheat is a staple food for the given population, it is considered to be heavy and hard enough that it will not get digested and will lead to excessive crying in the babies. Rice, Buttermilk, lemon, and Coconut water were avoided as they cause cold in babies, and they were believed to be causing respiratory tract illness and are also believed to be hampering milk secretion.

Discussion

There are Beliefs regarding food to be consumed during pregnancy and foods to be avoided during pregnancy, as many foods are considered hot and others cold.[8,9,10] In this study Papaya, pineapple, chicken, chicken eggs, onion, garlic, eggplant, black pepper, jaggery, guwar, bajra, and mango were considered hot, and are believed to cause early labor, preterm birth, and abortion, a study done by Shwetha et al.[11] showed that protein-rich foods like eggs, meat, and pea, were some of the most common foods avoided considering that they induce abortion.

Food avoided during the postpartum period

This study shows that many foods are considered hot and cold and they are restricted during pregnancy and postpartum. A study by Parmar et al.[12] showed that the Concept of “hot” and “cold” food seems to be Old and is well-known to the other societies of India.[12] A study by Tugume P. et al.[13] showed that 27%% believed in restricting “hot” food during pregnancy. One study from Calicut showed that certain hot foods were avoided in pregnancy because they are believed to cause abortion and cold foods are advised in the nursing period to have a goodquality breast milk.[14]

A study done by Chakrabarti S. et al. also showed hot foods including papaya, banana, coconut, pineapple, red chilies, jackfruit, meat, and egg, are avoided during pregnancy and during nursing, cold foods are avoided as they can cause diarrhea, common cold of the baby, and decrease the milk secretion of the mother. Mothers were also forbidden to eat very hot and spicy food in this study,[12] this study showed that women avoided any fused vegetables or fruits, similar kind of results were found in a study done by Patil et al.[14] and other studies, which showed that fused double banana was prohibited from consumption (as a cause of twin pregnancy).[12,13,15,16,17] Many studies showed certain hot foods as common reasons for avoiding it as they are believed to cause preterm birth and abortion.[14,18,19] A study done by Parmar et al. also showed certain Foods that were considered hot were: Papaya, sesame, brinjal, jaggery, and mango. The study was done by Parmar et al.[12] also showed that it is believed that certain foods generate “gas/air” in the stomach and are difficult to digest so these foods were avoided from consumption, mainly pulses, which are rich sources of proteins. Some Foods avoided during lactation in the postpartum period were considered cold foods as they can lead to respiratory infections, alter the quality of milk.

A study by Ahuja et al.[20] showed a very restricted diet immediately following the delivery of their child to dry out the uterus and aid in the production of milk. A study done by Surekha R. showed Special foods were consumed during the postpartum period[21]

A study done by Chakrabarti et al.[15] showed that Cashews, almonds, and Peanuts were prohibited during pregnancy as it is believed that they are white and cause more white layers on the skin of the baby (vernix caseosa), and also certain which have a sticky appearance (such as tender jackfruit, banana stem) were not consumed during pregnancy as they are believed to be causing more greasy material (vernix) over the new born’s body.

Conclusion

There are lots of food-related and other taboos practiced in this community. This leads to lower nutritional status in the women, which results in the low health status of the upcoming newborn. There should be a culturally acceptable educational program to make them aware of their nutritional needs, which can help in improving their nutritional status during pregnancy and lactation.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.