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Newborn care in India: Why we need to bridge cultural beliefs with science
Summary
In a country where cultural rituals related to newborn care are plentiful, what's needed is evidence-based practice that blends science with tradition to ensure the well-being of newborns
Newborn care in India is deeply influenced by a blend of cultural beliefs, traditions, and modern medical science. Although all these customs have been handed down the line of generations and have significant cultural meaning, evidence-based medicine asks for certain practices to be reviewed. As a pediatrician, I appreciate tradition in patient care, yet feel a responsibility to provide evidence-based practice that protects the safety and well-being of newborns.
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Traditional beliefs and their origins
The cultural landscape of India is so vast that customs related to newborn care are also innumerable. Application of kajal to a newborn's eyes or forehead is one such common practice. This is believed to ward off evil spirits to keep harm away from the baby. Similarly, massaging newborns with oil, followed by a bath, is considered essential to strengthen the baby's muscles and bones.
Many families also follow japa or confinement of the mother and baby for the first 40 days post-birth, wherein the care for the baby falls to elders in the family. It gives time for the mother to rest, and it is believed to protect the baby from acquiring infections. While these customs have their historical background, especially when healthcare access was poor, modern science shows a different light on these.
Scientific explanation and current practice
Regarding the use of kajal, there is no scientific basis to support its health advantages. On the contrary, kajal may contain lead or some other toxic ingredient when prepared as homemade soot or from some commercial product, thus causing infection or developmental disorders.
There is the oil massage, which, although good for bonding and circulation, might irritate the tender skin of the newborn if certain oils are used. Parents should consult pediatricians to know what kind of oil to use and that the massage is done in a gentle manner so as not to injure the baby.
Though confinement practices have been there, ostensibly to protect newborns from infections, they cannot replace modern hygiene standards. On the contrary, scientific evidence has identified frequent handwashing, breastfeeding, and clean surroundings as appropriate methods of keeping newborn babies healthy.
Bridging the gap between culture and science
Improvement in the care of newborns in India, I believe, is better brought about through a synthesis between continuity of cultural traditions and scientific recommendations. For instance, instead of an outright rejection, medical personnel can provide safer options for customs. For instance, instead of the application of kajal on the eyes, a black dot on the baby's clothes does the same cultural purpose without the risks entailed in the former.
With pediatric-approved oils, massage can be continued; however, confinement may be helpful in mother-baby bonding. The importance of vaccinations and regular pediatric checkups during this period is to be educated to the families.
Raising a child in India goes deep into the roots of family and social structures. For safe newborn care in consideration of cultural beliefs, the practices are best taught to the parents for the all-rounded advantage of the newborn. But as modernization sweeps through and changes the face of India, there needs to be a dialogue between tradition and science so that newborn care remains sensitive to culture and yet medically sound. We need to come together to create a new standard of care that will serve as a bridge from the past to the future.
Dr. Imran Patel, MBBS, MD (Paediatrics), is director of Asian Children Hospital, Ahmedabad.
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