The Health and Wellness Benefits of Traditional Postnatal Practice (TPC) on Postnatal Mothers: A Systematic Review

@#Introduction: Postnatal is a transition process for the mother back to her non-pregnancy state and involves the changes in hormones level. During the postnatal period, many health issues need to be addressed for both mother and newborn. One of the upsetting health issues for the mother due to the increasing trend is postnatal depression and if it is not identified and treated early, it may cause further complicated problems not only to the mother but also to the baby, family, and local community. With this issue, the Ministry of Health Malaysia has taken a few initiatives to encourage the postnatal mother to also practice the non-medical approaches or traditional postnatal care (TPC) as a self-care for the prevention of postnatal depression. Aim: To systematically identify and review studies examining the influence of TPC on postnatal mothers. Design & Data Sources: A systematic search strategy on the research trend for the period between the years 2013 to 2020 through the Scopus database, Science Direct, and PubMed database. Methods: This review has identified 7 journal articles based on the preferred reporting items for the systematic reviews (PRISMA) framework. Results: There are many methods of TPC, such as traditional postnatal body massage, herbal consumption, herbal bath, body steaming, and body wrapping based on own culture and beliefs. Besides the TPC preparation and techniques, some studies also describe the effects of TPC on a mother’s health and wellness. Conclusion: TPC shows encouraging health trends, and it helps to enhance the well-being and good health of postpartum mothers.

Postpartum depression and associated risk factors: a descriptive study in tertiary care teaching hospital

Background: Postpartum depression is a mood disorder that can affect women after childbirth which may cause feeling of extreme sadness, anxiety, and exhaustion that may lead to hamper of daily care activities for themselves and others. Aim: To determine presence of depression and associated risk factors among postnatal mothers. Methods and material: Fifty postnatal mothers, aged between 18-44 years were selected from the Department of Obstetrics and Gynaecology, Gauhati Medical College Hospital (GMCH), Guwahati, Assam, India. The presence of postpartum depression and maternal bonding with baby were assessed by using the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Bonding Instrument. Results: The prevalence of postpartum depression among mothers was 26%. Prevalence was found higher among the Muslim postnatal mothers. ‘Confidence and anxiety’ and ‘aggression to baby’ were found more significant which adversely affected bonding with their babies. Conclusions: Postpartum depression was found in a high number of mothers and it adversely affected bonding to their babies.

Prevalence and determinants of postnatal depression in a tertiary care teaching institute in Kerala, India

Background: Pregnancy and childbirth produce a variety of physiological, psychological and social consequences. Attitudes toward pregnancy and childbirth vary from culture to culture. Prevalence estimates range from 13 to 19% in resource-rich settings and 11 to 42% in resource- limited settings PND has a significant impact on the mother, the family, her partner and mother-infant interaction. This research aims to aid the early diagnosis of postnatal depression and the socio-demographic, obstetric, family dynamics, neonatal characteristics and psychiatric determinants of depression using EPDS among postnatal women in a tertiary hospital in Kerala state, India.Methods: 119 women between 2 to 6 weeks of postpartum period were subjected to a pre-tested pre-structured standard questionnaire. Diagnosis of depression was made using the Edinburgh postnatal depression scale. Possible depression is values >13 or more are invariably associated with depression.Results: Young age at marriage (p-value 0.022), love marriage (p-value 0.040) and low social support inadequate relationship with the in-laws was significantly associated with PND (p-0.003). Low birth weight was a significant determinant of PND (p-value-0.018). Gender of the new-born, fear and preference towards any particular gender and order of female child in multiparous woman had no association in determining postnatal depression. Childcare stress (p-value-0.011), psychiatry history in family and personal history of depression and mothers with low self-esteem (p-value-0.001) had odds of developing postnatal depression in the study.Conclusions: Early screening of the women and counselling of women and their family will reduce the maternal morbidity and adverse child outcomes.

Factors affecting breastfeeding techniques among postnatal mothers: an experience in a tertiary care centre

Background: Large number of factors related to mother and neonates can affects breastfeeding technique. Therefore, the main objective of this study was to know the association of maternal and neonatal characteristics that can affect correct breastfeeding techniques after intervention among post natal mothers admitted in a tertiary care centre.Methods: An institutional-based pre and post interventional study design was used. 414 lactating mothers were contacted during study period.Results: It was found that parity, time of delivery, mode of delivery, birth weight were statistically significantly associated with correct breast feeding technique.Conclusions:This study highlights that correct breastfeeding technique depends on various factors related to mother and neonate.

Breast feeding knowledge, attitude and perspective in immediate postnatal mothers

Background: The aim of the study is to understand the knowledge, attitude and practice of breastfeeding among postnatal mothers and optimize the breast feeding practices and overcome various factors that hinder and influence the full realization of benefits of breast feeding.Methods: The study was conducted in the postnatal ward of Rajarajeswari medical college and hospital, Bangalore. 500 postnatal mothers were included. A structured interview schedule was prepared to collect sociodemographic data, perceptions, knowledge, attitude and practices of mothers regarding breastfeeding. Data was collected by interviewing mothers (in their own language) using proforma.Results: About 100% of mothers and newborn infant have skin to skin contact within one hour of an uncomplicated vaginal delivery. Majority of the mothers knew about the importance of breast feeding for babies and herself. Only 17% of the mothers were working in our study and majority of them had resigned from their work as there was no option of maternity leave and baby friendly work environment at their working places. 69% intended to breastfeed up to 6 months. 23% mothers discarded colostrum and 11% gave prelacteal feeds to their babies.Conclusions: The mothers should be encouraged and reinforced about the benefits of breastfeeding for both baby and herself. The workplace condition has to be improved and make it more breast feeding friendly. The study also will assist the health care providers and community workers to understand the attitude and practice in the area and help them to prioritize and focus on these aspects and decrease the incidence of suboptimal feeding practices.

Do the pregnant mothers utilize supplementary nutrition along with other antenatal services? A cross sectional study from Mangaluru, Karnataka state, India

Background: Antenatal care services including supplementary nutrition services are the essential services for reducing maternal mortality. As per National Family Health Survey (NFHS) 4 data, 62% pregnant mothers received supplementary nutrition in Karnataka state and only 49.4% received health and nutrition education. Study was conducted to assess utilization of antenatal services with special reference to supplementary nutrition and advice on nutrition.Methods: A cross sectional study was conducted among the mothers admitted in obstetrics and gynecology department of Yenepoya Medical College Hospital. All the 140 mothers admitted during August and September 2017 for safe confinement of pregnancy were enrolled in this study and data was collected using semi-structured questionnaire. SPSS software version 22 was used for data analysis. Descriptive statistics was expressed in terms of frequencies and percentages. Chi square test was used to study the factors association with utilization of antenatal services.Results: Of the 140 participants, most of them i.e. 38.6% were in 25-30 years age group. The mean age was 46 years. Only 86 mothers (61.42%) received supplementary nutrition of whom only 53 (37.85%) had consumed it. Utilization of antenatal services was 100% with respect to minimum antenatal visits, routine laboratory investigations and TT immunization. Awareness about Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) was very poor (5%). Educational status of mother was found to be associated with utilization of supplementary nutrition (p=0.026).Conclusions: Utilization of routine antenatal services was reported to be very good. Efforts should be made to improve utilization about supplementary nutrition and awareness about nutrition education.

Suburban Breastfed Infants In Klang Valley Are At Higher Risk Of Dioxins Toxicity

Dioxins are a most toxic compound ever studied by human until today. Their significant health effects involved all ranges of age, including infants due to exposure to contaminated breast milk. The objective of the study was to appraise the status of dioxin contamination in breast milk among postnatal mothers live in urban and suburban areas in Klang Valley. It was conducted as a cross sectional study involving 101 postnatal mothers who came for their infant second hepatitis B vaccination. The samples were analysed using High Resolution Gas Chromatography (HRGC) following the USEPA Method 8290. About 70.3% of the samples were found detected with dioxin congeners. More suburban mothers have positive breast milk dioxins compared to urban mothers, 100.0% and 67.0% respectively. Significant associated factors include high fat daily intake (p=0.013), high milk daily intake (p= 0.044), high meat daily intake (p=0.001), body mass index more than 30 kg/m2 (p=0.005), and body fat % of more than 26% (p=0.046). In conclusion, amount daily intake of fat diet, meat, milk, body mass index and body fat are significant associated factors for the present of dioxins in breast milk among postnatal mothers in Klang Valley. More suburban mothers contain dioxins in their breast milk, which poses higher risk of health problems among their infants. A comprehensive study need to be conducted and regular followup need to be established in monitoring the future severity of maternal breast milk contamination to ensure the health of the next generations.

The knowledge, attitude & behaviour on neonatal jaundice of postnatal mothers in Provincial General Hospital, Badulla.

Objectives: To determine the knowledge, attitude & behaviour on neonatal jaundice of postnatal mothers in Provincial General Hospital (PGH), Badulla. Method: In this observational cross-sectional study, 396 mothers, who delivered at PGH Badulla from 1st May 2010 to 15th June 2010, were interviewed using a structured questionnaire. The questionnaire was used to assess the participant’s knowledge, attitude and behaviour on neonatal jaundice. Results: The mean knowledge score was 31±14, the mean attitude score 65.7±20.6 and the mean behaviour score 66.1±18.8. Ethnicity, level of education and previous experience with neonatal jaundice showed a significant association with the knowledge score. Conclusions: The knowledge of neonatal jaundice among postnatal mothers was low. There was significant correlation between mothers’ attitude and behaviour scores with the knowledge scores.