Dear Editor,
In the article titled “Cultural Practices and Beliefs Followed for Newborn Care in Santhal Pargana: A Cross-Sectional Study,” published in August 2024, the researchers explored various traditional practices in India and briefly discussed potential preventive measures. I would like to offer my suggestions on how to effectively address and mitigate these traditional practices.
India has made significant progress in maternal and newborn health, with 88.6% of births occurring in hospitals between 2019 and 2021 (NFHS-5). However, a critical challenge persists: the prevalence of traditional newborn care practices that often conflict with modern medical advice. These practices, deeply rooted in cultural beliefs, significantly impact infant health, especially during the crucial first 28 days when over half of infant deaths occur.
Prelacteal feeding involves giving newborns substances like honey or sugar water before initiating breastfeeding.[1] This custom, more common among lower socioeconomic classes and in joint families, can lead to infections and interfere with establishing breastfeeding. Other widespread practices include avoiding colostrum, considered impure despite its vital antibodies, and applying substances like turmeric or cow dung to the umbilical cord, increasing infection risks.[2] In tribal areas, unique customs, such as giving cord stumps to infertile women, exist.[3] When newborns fall ill, families often turn to traditional remedies like turmeric paste or herbal syrups instead of seeking medical help.
These practices continue due to various factors, including intergenerational influence in joint families, limited education of the caregiver and poor healthcare access, insufficient counseling from healthcare providers, deeply ingrained cultural beliefs, economic constraints, geographical barriers, and the influence of traditional healers. The interplay of these factors creates a complex challenge in improving neonatal health outcomes across India.[3]
Addressing this issue requires a multifaceted approach combining education, cultural sensitivity, and improved healthcare access. Continuous, culturally appropriate counseling for new parents is crucial, emphasizing safe practices and the risks of traditional methods. This should be reinforced through regular home visits by healthcare providers, including Accredited Social Health Activist (ASHAs), Auxiliary Nurse Midwife (ANMs), and medical officers, in the early postnatal period. Effective communication using local languages for educational materials and incorporating health messages into folklore can help resonate with cultural beliefs while promoting safer practices.[4]
Engaging influential community members, particularly elder women, in health initiatives can shift community norms toward evidence-based care. Improving healthcare infrastructure in remote areas, complemented by community health insurance schemes, can ensure better access to skilled care and alleviate cost concerns. Training healthcare workers to communicate effectively across cultural divides is essential.
Responsible use of technology, such as mobile health apps and social media, can spread awareness about safe practices, but efforts must be made to combat misinformation. Strengthening regulatory frameworks for traditional healers and midwives can help reduce harmful practices. Addressing environmental and socioeconomic factors, including access to clean water and sanitation, is important. Gender-sensitive approaches are necessary, ensuring equal care for all newborns. Collaborating with non -governmental organisations (NGOs) and integrating mental health support for new mothers can create a more comprehensive support system. By combining these strategies, it is possible to promote safer newborn care practices while respecting cultural traditions and beliefs. This balanced approach, recognizing the deep-rooted nature of these traditions while promoting evidence-based practices, offers the best path forward for significantly improving newborn health outcomes across India.
Conflicts of interest
There are no conflicts of interest.
Funding Statement
Nil.
References
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