Cultural considerations in postnatal dietary and infant feeding practices among Chinese mothers in London
Zuo yuezi (ZYZ) is the traditional Chinese practice of confinement for 1 month after childbirth. During this time, there are customs that Chinese mothers may choose to follow, which affect their dietary choices and how they feed their infants.
This study aimed to explore Chinese women's cultural considerations around their diet and infant feeding practices.
Ten self-identified Chinese mothers who live in London were interviewed in a qualitative study during June–September 2015.
All participants were aware of ZYZ and a majority practised it to varying extents, depending on practicality and availability of specific ingredients. Most of the practice was through dietary approaches, to regulate the intakes of different foods and drinks for recovery and breast milk production, to foster the balance of yin and yang based on principles of traditional Chinese medicine. The participants' partners and own mothers were important influences in shaping their diets, which suggests ZYZ as a period to help foster family bonds. All women breastfed their babies either exclusively or with supplementation of infant formula. For those who had introduced solids, the women cooked a Chinese dish called ‘congee’ (rice porridge) for their babies. There was consensus on the limited awareness of ZYZ and cultural sensitivity by midwives and health visitors in providing postpartum dietary advice, which can be contrary to their cultural beliefs.
Training and the creation of a trusted online resource available in English may help promote understanding of traditional health beliefs among health professionals, and support them to build rapport with Chinese mothers in the UK.
Zuo yuezi (ZYZ)—which, by direct translation, means ‘sitting the month’ or sometimes ‘doing the month’—is a traditional Chinese practice of confinement and convalescence for women for a full month after giving birth. During ZYZ, the new mother is expected to follow a collective set of ‘restrictive prescriptions and proscriptions’ (Pillsbury, 1978: 11). The origins of ZYZ date back millennia and the practice broadly follows the logic of classical Chinese medicine and folk traditions, to restore the body's ‘imbalance’ during pregnancy and childbirth through the diet and daily hygiene practices, as well as a preventive measure against future ailments (Pillsbury, 1978). Fok (1996) explained that perceptions of health among Chinese people are based on the ‘yin and yang’ health theory, informed by the Taoist concept of balance.
When a woman gives birth, her body is believed to be depleted of the ‘hot’ element through blood loss and inner energy (‘chi’), placing her in a ‘cold’ state for around 40 days while her womb heals. This is generally regarded as the first and second stages of the postpartum period (Romano et al, 2010). As a result, the new mother is advised to observe certain restrictions to her diet and movements, to keep her body warm and rest as much as possible. The consumption of confinement foods of the ‘yang’ properties is seen as particularly important to restore the woman's lost energies through birth and balance, alongside restricted consumption of ‘yin’ foods, based on five categories (Fok, 1996):
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