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Confinement practices in the Chinese, Malay and Indian communities are examined in detail to determine how effective they are and whether there is a scientific basis to them.
Confinement is a period for your body to recuperate and recover from childbirth. The idea of confinement is familiar to Asians but foreign to Westerners. In the past when infant and maternal mortality rates were high, it was a practice to keep both baby and mother indoors during the period of confinement. This was meant to protect them from ill health.
By now, you may have been exposed to some of the practices or ideas from your parents. You may or may not agree with them but many of these have originated from our Asian culture and hence, possess no scientific basis at all. They range from the prohibition of certain daily tasks to the restriction of certain foods — with the strong belief that these practices can provide the mother adequate rest and replenishment during this period.
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Chinese practices |
Malay practices |
Indian practices |
| Confinement period |
30 days |
44 days |
40 days |
| Dietary requirements |
• To purge out the “wind” in the body after delivery, promote “blood
circulation”, strengthen the joints and promote milk supply
• To avoid “cooling” foods |
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Traditionally, they use
a lot of ginger, wines
and sesame oils in
their diet. Common
dishes include pigs'
trotters cooked with
ginger and vinegar,
fish soup, chicken
cooked in sesame oil
and a traditional tonic
brewed from 10 herbs.
Fish soup boiled with
papaya is believed to
be beneficial for milk
production.
It is also recommended
that plain water
consumption be
avoided during this
period to reduce the
risk of water retention.
Instead, specially
prepared drinks from
a mixture of herbs and
preserved dates are
recommended. |
During confinement
a woman follows a
special diet in which
heating foods are
encouraged and
cooling foods avoided
to restore the balance
upset by the birth of the baby.
Some Malay mothers
who have just
delivered often take
a special drink called
“jamu”. It is believed
that the pores on
the body are opened
during labour and
“jamu” has properties
that can keep the
body warm. |
Indians take
garlic milk to prevent
“wind”. Like the
Chinese and Malays,
“cooling” foods are
avoided, especially
tomatoes, cucumbers,
coconut milk and
mutton.
Only chicken and
shark fish cooked with
herbs are allowed
while other seafood is
not allowed.
Chilli is not allowed.
Plenty of garlic
cooked without oil is
encouraged. Cooking is done with gingly oil.
Oral intake of herbs is encouraged to keep the body warm.
There is a restriction on
the intake of fluids/fruits/vegetables
as well as cold
drinks. |
| Other practices |
The basis for such practices is to protect the new mother from future ill health, restore her strength and protect the family from ritual pollution. |
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The Chinese believe
in staying indoors
throughout the
confinement period
to avoid outdoor
pollution. Strenuous
physical activities are
discouraged to prevent
further “muscle
weakening”.
Some hire a
confinement nanny
to help with the
housework and caring
for the baby.
Other practices may
include:
• Not washing the
body or hair
during the month;
especially avoiding
contact with cold
water.
• Not going outside
for the entire month
(or at least avoid
wind).
• Not eating raw or
“cooling” foods or
foods cooked the
previous day.
• Eat chicken,
especially chicken
cooked in sesame
oil; pork liver and
kidney are also
good; eat five or
six meals daily and
rinse the rice bowl
with scalding water.
• Avoid all wind,
fans and air-
conditioning.
• Avoid walking or
moving about; the
ideal is to lie on the
back in bed.
• Do not go into
another person’s
home.
• Do not get sick.
• Do not read or cry.
• Do not have sex.
• Do not eat with
family members.
• Do not burn
incense or visit a
temple or altar. |
Traditionally, childbirth
is in the mother’s
home attended by a
bidan (Malay midwife)
and the umbilical
stump dusted with
a mixture of spices.
Fortunately, this has
been replaced by
hospital births that
reduce complications
and infection rates.
Both mother and child
should be bathed
immediately in heated
water filled with herbs
after birth.
The mother will
“keep warm” through
various traditional
methods. These may
include sitting near
to or lying above
a heat source or
warming the abdomen
by applying a heated
stone over it.
During this
confinement period,
a female masseuse is
engaged to help the
mother regain her
figure or at least to
keep her extended
tummy trim. The
practice of tightly
binding the tummy
is called berbengkong,
and is believed to help
in maintaining the
body shape.
Sex is also strictly
prohibited during the
confinement period. |
Indian mothers are also discouraged from leaving their homes during their
confinement period.
Bathing is discouraged
and if done, it should be performed with special herbal preparations and
turmeric powder.
Bathing is only allowed between 11 am and 2 pm when the temperature is at its highest. Daily body massages with oil are also encouraged.
• Not allowed to enter the prayer altar room.
• Warm water is splashed on abdomen during bathing to expel clots from uterus.
• Washing of hair is
done on odd days
i.e. day 3,5,7… during the first two weeks. Dry hair after washing with
incense smoke.
• Place incense smoke in between legs to dry
episiotomy wound.
• Binding of tummy with six feet cloth.
• Sex is strictly prohibited.
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Let us now examine some of these myths in detail:
| Myths |
Medical perspective |
“Now that my baby is
born, I will lapse into
depression.” |
It is true that most women experience a sad/depressed mood,
beginning some days after the birth of the baby and continuing
for varying lengths of time. These symptoms are termed the
"baby or postnatal blues" and are believed to be associated with
hormonal changes following the birth of a baby. Fortunately, this mood is of a relatively short-term duration (about two weeks) and most women recover from it.
Depression is diagnosed only when these symptoms persist in a
small proportion of women. It may be accompanied by suicidal
or infanticide intent. Prompt psychiatric attention is imperative in
such instances. |
“I am not allowed to bathe or touch water for fear of
'wind' entering the body.”
“I can only wash my hair
with water in which ginger
has been boiled.” |
There is no basis to this at all. In fact, bathing regularly ensures
good personal hygiene and comfort. It reduces the incidence
of skin and wound infections. On a personal note, it certainly
ensures that people around you find you more bearable. |
“I must consume plenty
of wines, sesame oils and
traditional herbs to drive
out the ‘wind’. ” |
Again, there is no medical reasoning behind this recommendation.
In moderation, there is no harm in consuming these substances.
However, when taken in excessive amounts, they may affect you and your baby adversely. Furthermore, there are various substances present in the herbs that we are not fully aware of.
Alcohol and other organic substances might go into your breast
milk, and when breastfeeding, these might be transferred to your
baby. These substances may affect the liver and worsen jaundice
of the newborn if it is already present. |
“I cannot drink plain
water at all during
confinement.” |
Adequate fluid consumption is advised especially if the mother is
breastfeeding. The kidneys will produce more urine in the next
few weeks after the baby is born to remove the excess fluid that
has accumulated during the course of the pregnancy. |
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“I must not expose myself
and my baby to any wind drafts or air-conditioning.”
“I must not leave my
house for one month.” |
For personal comfort, there is definitely no harm in switching on
the air-conditioner or fan, as long as it makes you and your baby
comfortable. It may even help prevent heat rash from developing
in our hot and humid climate. |
“I must eat liver and
meats only.” |
The confinement period is a time when physical changes that
occurred in the last nine months will revert to the original state. It is also a period when nutritional demands on you are high, owing to the recent blood loss from the delivery and the demands of
breastfeeding.
The belief here is that the mother has been “cooled” by the
delivery, and there is a need to eat “heating” foods such as meat.
Many “confinement foods” have been devised to ensure that these
nutritional demands and beliefs are met.
Whatever your beliefs are, it is important to have a well balanced
diet rather than specific food types to replenish the body’s stores. This is especially so during breastfeeding. If necessary, as in the case of vegetarians or vegans, iron or vitamin supplements may be taken to satisfy these nutritional demands. |
“I have been told not to
read or cry.” |
The traditional belief is that this causes eye problems later in life
which has no scientific basis. |
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“I cannot pray before an
altar or enter a place of
worship.”
“I cannot mingle with the
rest of my family members
or enter the kitchen.” |
Many believe that the post partum discharge (lochia) is unclean
and therefore, this practice prevents any spiritual contamination.
Again, there is no scientific basis to it. |
“I heard that the Malay
traditional practices are
effective for regaining
health.” |
There are six components to the traditional practices of postnatal
care. These are:
1. Tuku — daily massage over the abdomen with a ball-like metal
object
2. Mengurut badan — massaging by an experienced masseuse
3. Barut — tight wrap around the woman’s waist
4. Salai — lying on a warmed wooden apparatus
5. Air akar kayu — tonic drinks made from medicinal plants
6. Pantang makan dan minum — to prohibit oneself from eating
or drinking certain food items
The main idea of the above is that specific massaging/heat/
selective dieting helps promote blood circulation and recovery;
while the Barut helps regain the woman’s figure. Dieting to the
Malays, like what the Chinese believe, ensures the avoidance of
“cooling foods” and the intake of “heating foods”.
Although these practices have never been proven scientifically, it is
possible that certain benefits can be derived from them. However,
all these should be done in moderation to prevent burns and
injuries during these massages and therapies.
After a Caesarean section, these practices have to be delayed for a month to prevent the disruption of a healing wound.
As mentioned previously, it is still essential to have a well-balanced diet to ensure adequate nutrition during this recovery period. |
| “Bathing should not be an issue.” |
This is prevalent in the Malay culture and is contrary to the
Chinese practice. The water is warmed and herbs are added for a “heating effect”. As mentioned before, this is good for personal
hygiene and is encouraged. |
| “I cannot have sex for 40 days.” |
This is against the religious teachings of certain cultures, e.g. the
Malays.
From a medical perspective, it allows for the lochia to be over
and the episiotomy wound to be completely healed and this may
reduce the incidence of infections. |
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