Childhood practices
The way a child is reared is influenced by the culture, religious
beliefs and societal norms of the particular community into which the
child is born. Parents and families tend to follow what they have
observed being practiced for generations, and don’t often stop to
question the logic behind these practices. It can be reassuring to go
along with what you see others doing, rather than going the extra step
to do something different and risk being criticised for it. Most Nepali
families have several dos and don’ts when it comes to handling a
newborn, and these have become common irrespective of the religion and
ethnicity of such families, owing to the fact that various communities
have long co-existed in harmony in our country, and have naturally come
to share certain cultural beliefs over time.
It is, for example, a good practice to keep a newborn warm and wrapped up, to simulate the environment within the mother’s womb. But people tend to overdo this. Clothing the baby heavily in many layers and confining the child to a heated room can cause dehydration through sweating. Post-delivery, the mother and baby are usually kept in very warm rooms without proper ventilation because it is believed they will get sick from the cold air outside. And when visitors come into these poorly-ventilated premises, it is even more risky, particularly if they are carrying air-borne infections like a cough or a cold—the baby could easily get infected. And using coal heaters to warm the room could also lead to carbon monoxide poisoning if the rooms are not allowed enough access to fresh air.
Making sure that the baby is getting enough fluid is important, something that is attested to by culture as well. This does not mean that the newborn babies need extra liquids apart from breast milk. Even during the hot days of the summer, a breast-fed baby will not require supplemental water as breast milk contains enough water to compensate for this. There is also a common misconception that if the breast-feeding mother drinks too much water, it will cause her milk to thin and make the baby vulnerable to colds. Similarly, it is also said that if the mother consumes fruits and vegetables, the newborn will have diarrhea. These beliefs have no scientific basis; the mother should be encouraged to maintain a balanced diet with fruits, vegetables and adequate water.
Gentle massaging can help babies grow better and faster, and Nepalis are great believers in massaging newborns. We generally see babies being oiled with mustard oil and left out in the sun for hours. Exposing a child to the scorching day-time heat in this way, especially in summer, could be dangerous; the baby could get sunburnt or severely dehydrated. And vigorous massaging could lead to skin breaks, or if the oil isn’t clean, to skin infections as well. Many families have the custom of wrapping the baby tightly around the abdomen with a cloth (patuka), thought to prevent air from entering the stomach through the naval. This is a misconception as the naval opening seals itself soon after birth and there is no possibility of air entering the stomach in this way. Besides, the patuka, when wrapped too-tightly, can cause the baby a great deal of discomfort. A similar custom exists of applying homemade gaajal or kohl to the baby’s eyes, believed to result in improved vision. Since the preparation and application techniques are often not sterile, it could very easily lead to eye infections. And the tiny particles of the gaajal can also find their way into the tear duct opening, blocking these and causing further problems like watery eyes and repeated eye infections.
It is a good practice to avoid bathing the newborn within the first 24 hours, as this could wash off the vernix (white material) on the baby’s skin that has anti-infective proteins, protecting the baby from infections and it also helping to maintain body temperature. Culturally it is prescribed that babies not be washed or bathed for fear of catching cold and becoming sick. But not bathing or cleansing entirely could lead to various infection-related illnesses.
Ultimately, there are certainly many good concepts that are borne of tradition which truly do benefit the newborn, and we do need to encourage people to follow these, but with some minor adjustments to ensure that our practices are baby-friendly.
Dr Shrestha is the Chair of the Department of Paediatrics at Patan Hospital and Professor of Paediatrics at the Patan Academy of Health Sciences
It is, for example, a good practice to keep a newborn warm and wrapped up, to simulate the environment within the mother’s womb. But people tend to overdo this. Clothing the baby heavily in many layers and confining the child to a heated room can cause dehydration through sweating. Post-delivery, the mother and baby are usually kept in very warm rooms without proper ventilation because it is believed they will get sick from the cold air outside. And when visitors come into these poorly-ventilated premises, it is even more risky, particularly if they are carrying air-borne infections like a cough or a cold—the baby could easily get infected. And using coal heaters to warm the room could also lead to carbon monoxide poisoning if the rooms are not allowed enough access to fresh air.
Making sure that the baby is getting enough fluid is important, something that is attested to by culture as well. This does not mean that the newborn babies need extra liquids apart from breast milk. Even during the hot days of the summer, a breast-fed baby will not require supplemental water as breast milk contains enough water to compensate for this. There is also a common misconception that if the breast-feeding mother drinks too much water, it will cause her milk to thin and make the baby vulnerable to colds. Similarly, it is also said that if the mother consumes fruits and vegetables, the newborn will have diarrhea. These beliefs have no scientific basis; the mother should be encouraged to maintain a balanced diet with fruits, vegetables and adequate water.
Gentle massaging can help babies grow better and faster, and Nepalis are great believers in massaging newborns. We generally see babies being oiled with mustard oil and left out in the sun for hours. Exposing a child to the scorching day-time heat in this way, especially in summer, could be dangerous; the baby could get sunburnt or severely dehydrated. And vigorous massaging could lead to skin breaks, or if the oil isn’t clean, to skin infections as well. Many families have the custom of wrapping the baby tightly around the abdomen with a cloth (patuka), thought to prevent air from entering the stomach through the naval. This is a misconception as the naval opening seals itself soon after birth and there is no possibility of air entering the stomach in this way. Besides, the patuka, when wrapped too-tightly, can cause the baby a great deal of discomfort. A similar custom exists of applying homemade gaajal or kohl to the baby’s eyes, believed to result in improved vision. Since the preparation and application techniques are often not sterile, it could very easily lead to eye infections. And the tiny particles of the gaajal can also find their way into the tear duct opening, blocking these and causing further problems like watery eyes and repeated eye infections.
It is a good practice to avoid bathing the newborn within the first 24 hours, as this could wash off the vernix (white material) on the baby’s skin that has anti-infective proteins, protecting the baby from infections and it also helping to maintain body temperature. Culturally it is prescribed that babies not be washed or bathed for fear of catching cold and becoming sick. But not bathing or cleansing entirely could lead to various infection-related illnesses.
Ultimately, there are certainly many good concepts that are borne of tradition which truly do benefit the newborn, and we do need to encourage people to follow these, but with some minor adjustments to ensure that our practices are baby-friendly.
Dr Shrestha is the Chair of the Department of Paediatrics at Patan Hospital and Professor of Paediatrics at the Patan Academy of Health Sciences
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