Positive Parenting

Post-Natal Diet: The Malaysian Experience
Getting back on your feet
Back to work
Feeling down?

Post-Natal Diet: The Malaysian Experience

Do traditional Malaysian confinement diets practised by moms locally really help?

By Dr Tan Ay Eeng, Consultant Obstetrician and Gynaecologist, and Associate Professor Dr Poh Bee Koon, Nutritionist

After giving birth to her baby, a great amount of energy and reserve has been drained from the mother’s body. Therefore, a mother’s post-natal diet is crucial to help her heal and recover from the exertion of labour, as well as for the production of breast milk.

Most Malaysian mothers adhere to traditional confinement rules that have been passed down for generations. Different cultures have their own recommended confinement food choices. Read on to find out what experts have to say about some of these diets.

Jamu (medicinal herbs, roots and spices)

Traditional view: Jamu helps to keep the mother’s body warm, increase her energy levels, eliminate excess fats and toxins from the body, and shrink the uterus.
Doctor’s say: Currently, there are no detailed studies or evidence to prove the benefits of consuming Jamu post-natally, but experts do agree that the aroma of Jamu is certainly soothing and comforting when applied over the body. When it comes to oral consumption, do take heed of the quality and cleanliness of Jamu to avoid undesirable side effects.

Ginger

Traditional view: Ginger is considered a “hot” or “warming” food; it helps to promote blood circulation, prevent or relieve flatulence or wind, and strengthen the joints.
Doctor’s say: While studies show that ginger may help reduce nausea and vomiting during pregnancy, no studies has thus far supported it as a “warming” food. It is perfectly alright to use ginger as a spice in confinement foods, but consuming this tuber in large amounts may cause mothers to pass out “wind”. Rest assured that this wind is not from the joint or head, and has nothing to do with future backache or joint pain.

Ikan Haruan (snakehead fish)

Traditional view: Fish soups prepared from fresh ikan haruan has nourishing and healing properties that promote internal wound healing, especially for women who underwent Caesarean section.
Doctor’s say: Studies show that ikan haruan contains certain amino acids and fatty acids that are essential for wound healing. In general, foods high in protein (eg poultry, lean meat, fish, and dairy products) are all beneficial to speed up healing of cuts and wounds. New moms should include a variety of protein food sources to help her recover faster.

Chinese Herbs

Traditional view: Herbal soups prepared using specific traditional Chinese herbs, such as red dates, kei zhi (wolfberry) and dong guai (angelica), are said to help nourish blood, treat afterbirth symptoms such as prolonged discharge, and improve energy level.
Doctor’s say: There is no concrete evidence to show that Chinese herbs would benefit moms post-natally, but studies do show that these herbs exhibit antioxidant properties. Such effect may be helpful in promoting tissue healing and strengthening the immune system. Don’t overdose on herbs though, as antioxidants like vitamins C and E can be obtained naturally from fruits and vegetables.

Gourd Vegetables (eg bottle gourd and zucchini)

Traditional view: Helps to increase production of breastmilk.
Doctor’s say: There are no specific foods to increase the production of breast milk. However, keep the milk flowing, drink sufficient fluids to replenish lost fluids from your body. You also need to eat and rest well, so that you have the energy necessary for optimal milk production. Most importantly, keep on breastfeeding.

New Moms, Listen Up!

No matter which confinement dietary rules you are following during your confinement, it’s vital to eat a nourishing and wellbalanced diet to ensure optimum nutritional intake.

• Emphasise on good quality protein diet from fish, poultry, red meat, as well as legumes.
• Ensure your calcium intake from milk and milk products is adequate, especially if you’re breastfeeding.
• Include more fibre into your diet by consuming more fresh fruits and vegetables to prevent constipation.
• If your intake of quality food is limited, consider including vitamin and mineral supplements or nutritional beverages into your diet.
• Avoid caffeine, alcohol and nicotine if you’re breastfeeding.

Getting Back onYour Feet

Learn how to take good care of yourself for a
speedier recovery after delivery

By Assoc Prof Dr Tan Ay Eeng, Consultant Obstetrician & Gynaecologist

Congratulations! After nine long months, your little bundle of joy is finally in your arms. While you make sure that your little one gets a good start in life, you also need to take especially good care of yourself after having gone through tremendous changes to your body during pregnancy, labour and birth. Believe it or not, even after childbirth, your body still needs to go through changes as it recovers and prepares you for the challenges of caring for your new baby.

During the first few weeks after childbirth, you will most probably have some discomfort and even pain as your body struggles to transform back to its prepregnancy condition. Listen to your body for any of these symptoms and take the necessary action. In the meantime, eat healthily and stay physically active.

Try not to leave all responsibilities to your midwife or a member of your family if you can. If you want to catch up on all the things that you have missed while you were pregnant soon, learn to take certain matters into your own hands and you will be out and about in no time. Rest assured that your road to recovery is not all work and no play. You can still enjoy your new baby. Besides, the sheer joy of having your new baby will most likely compensate for the struggles you may have to face along the way. You will find your efforts worthwhile as good recover and restoration after childbirth will help you achieve long-term physical and emotional health.

Changes to your body

You will experience many changes to your body after you have given birth. There is no reason to panic as these changes are normal. Here are some changes that you can expect:

Your womb will gradually shrink back to the normal size. Because of this, you may feel cramping pains in your lower abdomen for several days. Do not be alarmed as this is a good sign that your body is returning to normal.
You will have a bright red, bloody discharge (also called lochia) from your vagina during the first 3-4 days after delivery. It will gradually change to pale brown and then, yellow over the next 10-14 days. It may be followed by one of your normal periods.
Hormonal changes will occur, preparing your breasts for breastfeeding. More blood is circulated through the breast tissue causing your breasts to swell, harden and become warm.

Caring for yourself after birth

You will most probably feel sore and experience bleeding after birth. Here’s what you can do to take care of yourself during this time:

Take warm, shallow baths to relieve soreness and hasten healing. If you have stitches, dry the areas thoroughly afterwards.
Lie down as much as possible to take pressure off the stitches.
Wear sanitary pads to catch the flow of your discharge. Avoid using tampons as they can cause infection.
Change your sanitary pads often so that you can observe the colour of the discharge. Tell your doctor if you notice anything out of the ordinary.
Do not strain yourself, especially while recovering from a Caesarean delivery. Get your family and friends to help around the house during the first few days after going home.
Drink plenty of water and eat high-fibre foods (eg. fruits and vegetables) to stimulate your bowels. When you need to open your bowels, do so at once. Do not strain or push.
Avoid driving until after 6-8 weeks.

Practise pelvic floor exercises to speed up healing and get back into shape. Build up your exercise regime slowly and gradually. Stop immediately if you feel pain or are tired. You can begin these exercises from the first day after birth. However, if you have had a Caesarean, you will not be ready to begin exercising until much later after birth. Check with your doctor first before exercising. You should also avoid abdominal exercises until your doctor says it is safe to do them.
Remember to go to your doctor for a check-up about six weeks after the birth.

Confined?

During the first few weeks after birth or better known as the confinement period, you are bound to be caught in the web of ‘advice’ from your grandmother, mother, mother-in-law, aunts and even relatives and friends, especially if you have just given birth to your first baby. Advice such as “Do not eat ‘cooling’ foods such as jackfruit and melon”, “Do not watch TV or read” and “Do not drink water for the first 20 days, drink only rice wine (without alcohol)” may sound familiar to you. You may also be expected to follow certain confinement practices such as drinking herbal soups and tonics, going for a traditional massage using a heated stone or wrapping yourself tightly in a herbal wrap while standing over a fire.

Since you have been brought up in an Asian society which is anchored by traditions and customs, you may feel the need to follow these confinement practices. Although there is no scientific basis to these beliefs, it is all right to follow them provided they do not cause damage to your health and body. As such, make sure that you do not omit certain foods from your diet which could cause you to miss out on important nutrients. Since some traditional methods could even be hazardous if not done properly, please use your common sense and practise caution and moderation at all times. Most importantly, continue to adopt good lifestyle habits and eat a balanced and varied diet.

Back to Work

Prepare yourself and baby for the change in
routine when you get back to work

By Assoc Prof Dr Tan Ay Eeng, Consultant Obstetrician & Gynaecologist

During your maternity leave, you devote every second of the day to caring for baby. So when the time comes for you to return to work, your heart may begin to feel heavy. You know you will miss baby a lot and you certainly dread the possibility of having to go through all the work stress again.

Nevertheless, with the way life goes for most people these days, you will most probably have no choice but to hop back into the rat race again. Be prepared to change your current daily routine and leave baby in the care of someone else for about 8 hours a day. You may wince at this thought but remember, there is always a first time to everything. You will soon learn to achieve a balance and get used to being a working mum.

Although you may feel as if you are walking on a tightrope, try to keep your chin up and assure yourself that you are doing the best you can. Nobody ever said that being a working mum is a piece of cake. You are likely to experience some hiccups along the way. However, with good preparation, you and baby will get comfortable with this new way of life in no time. If possible, let the man of the house help in any way he can as well. He certainly has a share in the baby too! Remember, no matter what changes you may have to make to your life as a working mum, your baby’s love for you will never change (and your love for him too!).

Your baby is naturally close to you.

He may cling on you when you try to put him down, or cry inconsolably if he is put with someone else. However, even a clingy baby will eventually become independent. Whether you leave baby with a babysitter, your parents, your inlaws or in a day-care centre, here’s what you can do to make babysitting easier for everyone, including baby:

Get to know each other.
Try to get baby acquainted with the caregiver about two weeks before you send him over. This way, baby will not get overly upset during the first few days when you leave him at the caregiver’s.
Never too young.
Always tell baby when you have to go out, even if he is too young to understand. Do not just sneak out to avoid a scene.
Do not rush.
Once you have left baby with a caregiver, do not rush to leave even if you are in a hurry. Spend some time cuddling him and reassure him that you will be coming back.
Have fun time.
Show the caregiver which are baby’s favourite toys. Also, teach the caregiver how to play the games baby likes to play.
Bring comfort toy.
Most babies are attached to a favourite soft toy, blanket, pillow or any other objects. He may want to carry it around wherever he goes because it gives him comfort. So let baby bring it with him to the caregiver’s.
Know baby’s habits.
Make sure the caregiver knows every detail of baby’s special habits.
Keep an eye.
During the first few weeks when you are back at work, keep a careful eye on baby. If he seems generally unhappy, you may need to reconsider your childcare plans.

Breastfeeding for the Working Mum

Breast milk is best for baby. But if you are going to spend about 8 hours a day working in the office, how are you going to continue breastfeeding and keep your milk supply up and going? Here are some tips on how you can ensure that baby continues to enjoy the benefits of breast milk while you are at work:

Before returning to work

Seek advice.
Talk to your paediatrician, dietitian or nutritionist on how you can combine breastfeeding with work. Take the opportunity to discuss any concerns or problems you may have.
Learn to express.
Spend time to learn how to express milk efficiently by hand or using a pump. If you are still not sure, ask your lactation consultant to teach you.
Start practising.
You should start practising at least two weeks before going back to work. Soon, you will be more confident and become quicker.
Prepare baby.
Spend time ‘training’ baby to help him get used to expressed milk. Try getting your husband or close relative to start giving him expressed milk once a day and increase the frequency gradually for about two weeks before going back to work.
Prepare caregiver.
If possible, get your caregiver to practise feeding baby expressed milk with a bottle, a small spoon or a small cup.

When back at work

Let others know.
It is advisable to let your relevant superiors and colleagues know that you will have to express breast milk while at work. Let them know which room you will be using. The privacy will help.
Express regularly.
Express milk as regularly as you can, or at least every 3 to 4 hours, to maintain your milk supply. Try to let these times concide with your lunch or tea breaks.
Store milk.
You can store your milk in bottles and keep them in the office refrigerator. Remember to label them with time and date. Alternatively, you can keep your bottles on your desk for up to 8 hours without worrying that they will spoil. Just remember to bring the bottles home with you. Make sure you go home straight after work and put the milk in the fridge right away. Milk stored in the fridge should be used within 48 hours of storage.
Dress right.
It is best to wear two-piece outfits with lightweight, front-buttoned tops. To avoid embarrassing stains, line your brassiere with breast pads.
Take every opportunity to breastfeed.
Try to make breastfeeding a routine before work, after work and before bedtime each day. This can help strengthen the bond between you and baby, while helping you maintain a good and steady milk supply.

Feeling Down?

Many new mothers experience mood swings.
Find out what’s serious and what’s not.

By Assoc Prof Dr Tan Ay Eeng, Consultant
Obstetrician & Gynaecologist and Dr Teoh Hsien-Jin,
Consultant Clinical Psychologist

Being a new mother, it is perfectly natural for you to feel bogged down with the stress and strains caused by the bodily changes after birth and the added responsibility of caring for baby. With baby demanding full attention from you all the time coupled with exhaustion, everything just seems to go out of hand. You may feel as if your previously organised and controllable world has just turned upside down. Suddenly, it is as if the carefree and serene family life you envisioned has vanished before your eyes. As such, it is not surprising that your emotions have gone haywire.

Red-eyed and drained of energy, you may ask yourself again and again: What did I do wrong? Resist the urge to bang your head against the wall (unless it brings a certain amount of comfort and does not cause a head injury!). This chaos at home is not your fault; neither is it baby’s fault. You certainly have not ‘lost your mind’ or ‘gone crazy’. Believe it or not, 80 percent of new mothers experience emotional upsets after childbirth too.

These emotional changes most probably occur as you are grappling to adjust to this new chapter in your life. Although it is normal to feel a little emotional from time to time, you need to keep track of your feelings and prevent your emotions from turning into something more serious which could cause harm to yourself and baby.

Coping with the blues

Ever heard of the ‘baby blues’? They are not a type of music and in this case, not the name of a comic strip either. They are actually a mild form of depression, which usually go away within two weeks and require no formal or medical treatment.

Symptoms

Disappointment that the birth was not as expected
Urge to cry for no reason
Irritability and impatience
Anxiety and restlessness
Loss of appetite

Even though it is normal to feel the blues from time to time, it does not mean that you should just allow yourself to ‘suffer’. Here’s what you can do to help chase the blues away:

Find a nonjudgemental person you can talk to. Open up your feelings to him/her.
Be honest with yourself. You are not expected to do everything on your own. So if you need help, just ask.
Get someone to help you around the house.
Make time each day to do something you enjoy as baby sleeps, even if it’s just for 15 minutes.
Keep a diary. Write down all your emotions and feelings every day.
Try not to get angry at yourself when you can only seem to get one thing done or none at all in any given day. Take one step at a time.
Discuss whatever concerns you may have with your doctor.
Tell your spouse and close relatives how you feel and get them to help cheer you up by showing you the positive side of life.

Managing post-partum depression

Post-partum depression (PPD) is a more serious and long-lasting form of depression compared with the ‘baby blues’. It is actually a mental illness caused by hormonal changes which affect the way your body functions. Thus, it requires medical treatment to relieve its symptoms. So please consult your doctor for further information about PPD. Also, always remember that there is nothing to be ashamed of, and you are not alone.

It is important to recognise PPD as early as possible. The sooner you recognise you have PPD, the better your chances of treating it. Here are some of its symptoms:

Feelings of guilt that do not go away
A sense of hopelessness and sadness
Sudden urges to hurt yourself or baby

Drastic mood swings, feeling very happy at one moment, and suddenly very depressed at the next
Either over-attentiveness or lack of concern for baby
Feeling that life is not worth living
Changes in sleep patterns and appetite
Fear of being alone

If you suspect that you have PPD, you should:

Seek medical help as soon as possible and follow your doctor’s advice faithfully.
Talk to close family and friends about how you feel.
Learn more about PPD from your doctor and other medical books.