3.3 Food & diet

The FGDs and KIIs produced a wealth of information on dietary preferences, restrictions, and taboos. So much so, that they were pulled out for separate analysis and discussion. Here we focus on references that occurred in the FGDs and KIIs, but note that the quantitative survey also contains a great deal of information on diet and food choice.

ASHAs and mothers are both avoiding some nutritious foods. Miscarriage is a common concern for consuming high acidic, sour foods during pregnancy.

In this table, typing “halwa” in in the “food reworked” column shows that this common sweet is recommended by multiple health influencers as a food to add postpartum. Foods easy to digest such as Halwa align with Ayurvedic recommendation to be concerned about digestion during pregnancy and postpartum.

Table 3.4: Searchable table of food-related practices

3.3.0.1 Traditional Ayurvedic Recommendation

Ayurvedic principles and practices provide unique recommendations for individual pregnant mothers to achieve a balanced state. In general, pregnant women are considered to be in a ‘hot’ state and should consume cold foods (bitter, sweet, astringent) and other easily digestible foods while avoiding heating foods (sour, pungent, salty) to balance their doshas. A wide range of ‘cooling,’ nutritious foods such as milk, apples, pulses, and pomegranates are added to the pregnancy diet by mothers and ASHAs. A wide range of ‘cooling,’ nutritious foods such as wood apple, papaya, and pickled foods are also frequently avoided during the postpartum period. Many of the avoided foods are sour, salty and oily, which risk creating imbalance due to their heating properties and compromise digestion, according to Ayurvedic principles.

3.3.0.2 Recommended added foods

For the participants in the FGDs and KIIs, cow milk was the most commonly named food item to add to the perinatal diet. Milk was often reported to add along with ghee and reasons included to ease labor during delivery, to help the body produce breast milk after birth, as well as statements about milk being nutritious or healthy.

The most commonly stated reasons across all of the participants for adding food to the diet are to promote health, strength, ease of labor, or aiding the production of blood. There were some less-frequently mentioned foods such as kichadi, where the mother should add it to her diet after the first delivery so she will have a baby of each sex in the future. Furthermore, certain foods such as betel were recommended frequently by Dais, mothers, and MILs to promote the “child’s lips becoming red.” Concerns with the child’s appearance, specifically fairness of skin and lips, was a common theme in these data.

Highly sweet foods like pudding, Horlicks (a malted drink powder), and biscuits, were frequently suggested dietary additions for delivery or postpartum. Reasons for potential benefits included easing labor, improving digestion and alleviating stomach problems, and giving strength or warmth to the mother’s body. These recommendations align with the Ayurvedic recommendation to consume sweets during pregnancy to aid digestion.

3.3.0.3 Recommended foods to avoid

The most commonly named food to avoid was the wood apple, a popular acidic fruit native to India, followed by several other sour fruits: papaya and pineapple. Pickled foods and those that are salty, sour, or spicy are also frequently avoided. The wood apple is known to have benefits that align with Ayurveda, but reasons to avoid consuming it were primarily to avoid pus in the ear or some other form of ear infection in the newborn. This concern was widespread across multiple health influencers. The majority of participants associated papaya with miscarriage, which is consistent with Ayurvedic principles; papaya is considered a ‘hot’ food. Likewise, sour and raw fruit such as pineapple was also almost always associated with miscarriage.

Overall, the most frequently stated reason to avoid certain foods during pregnancy were due to concerns with miscarriage and infection. Concerns regarding beauty were also reported in which mothers should avoid dark-colored foods such as black carrots and blackberries. Buffalo milk was mentioned to avoid because it could potentially make the child less intelligent.

Concerns with health, beauty, and cognitive development were concerns relevant enough for participants to recommend avoiding certain foods to avoid risking their chances with the newborn.