Several factors have been identified in this study that influence why women still follow the specific rituals given that they can exercise some degree of choice. This story is meant to reflect individual contributors' experiences and does not necessarily reflect What to Expect's point of view. Meat and eggs were regarded as "hot" foods. Nevertheless, not brushing the teeth during this period is probably a harmful practice and dental hygiene should be promoted at all times including during the postpartum period. We should postpartum like the Chinese do. We chatted about our children, my pregnancy and the ups and downs of motherhood. Obstetrics and Gynaecology. One study analysed the practices from the perspectives of folk, Chinese and western medicine beliefs [12]. In China it's common to hire a nanny that is … All families followed an adapted version of the ritual of "doing the month". In the rural area mothers had a more varied diet: eating a lot of fish, rabbit, pork, chicken and duck, but few added wine to food. After birth In Japan, women stay at their maternal home for up to eight weeks after the baby is born. Suppl 67. Childbirth is a time of transition and social celebration in many societies, signalling an adjustment of cultural responsibilities [1]. So much to catch up on! But if we did not give this herb we would worry about the eczema" (Husband, urban family 4). They believed that as the postpartum woman's skin is loose, water can enter the body through holes in the skin. All locations were acceptable to the interviewees. They believed that postpartum women are vulnerable to problems such as increased bleeding and colds, but not to arthritis and rheumatism as suggested by some family members. 2002, 18: 279-295. CAS  Soon, our conversation turned to our postpartum experiences -- specifically the care we required during postpartum for a successful recovery. All women delivered in hospitals and so received care from health professionals who are trained in western style medicine. She suggested lying in bed. Most mothers seemed to be able to cope with this restriction and concentrate on resting and looking after the baby. Traditional medicine practitioners and health workers agreed that "cold" food should be avoided. "I like people visiting. This program has become an ingrained tradition in Chinese culture and … A few are potentially harmful, including giving honeysuckle herb, and avoiding dental hygiene. 10.1046/j.1442-200X.2003.01754.x. It was good for my soul and good for my body. “Confinement meals” are prepared during the month, and postpartum mothers must only eat what is given and nothing else. Ethical procedures were followed according to the Human Research Ethics Committee approval. O'Dempsey TJ: Traditional belief and practice among the Pokot people of Kenya with particular reference to mother and child health: 2. Early ethnographic research indicated there was no evidence for the existence of PPD in non-Western societies. 2003, 21: 100-116. It is not that we don't believe in it, we just don't want to try that way. Others were happy with the number of visitors they received. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. I want to talk to people. The educational health content on What To Expect is reviewed by our medical review board and team of experts to be up-to-date and in line with the latest evidence-based medical information and accepted health guidelines, including the medically reviewed What to Expect books by Heidi Murkoff. 2001, 36: 270-275. "She ate some vegetables, but not very many. The interviewer used topic guides covering the following aspects: diet, hygiene, rest and activity, and infant feeding. I used boiled water and sometimes iodine to clean it" (Mother, rural family 4). None of the mothers in the rural area and only two in the urban area carried out their usual dental hygiene habits of brushing teeth at least once daily. Stud Fam Plann. However, findings from this study show that all women carried out some hygiene practices and did not show signs of illness caused by different hygiene habits. Two mothers stayed in bed for the entire month as instructed by the grandmothers. We follow their advice because we don't know what to do in this period. World Health Organisation: Evidence for Ten Steps to Successful Breastfeeding. I was also afraid that the herb may hurt the baby's stomach. We then assessed the potential effects of the practices on the health of mother and baby from western health perspective. Only one rural mother and two urban mothers did some other exercises. Traditional medicine practitioners and health workers all believed this, recognising that having lost energy and blood during delivery, both yin and yang are weakened. Chiarelli P, Cockburn J: Postpartum perineal management and best practices. 2001, 36: 676-684. Hung BKM, Ling L, Ong SG: Sources of influence on infant feeding practices in Hong Kong. PPD represents a culture-bound syndrome relevant only in Western societies. There is widespread emphasis that "doing the month" properly will safeguard future health. © 2020 Everyday Health, Inc, This Reporter Was Interrupted by Her Child on Live TV, and the Internet Is Obsessed, Frida Mom’s Rejected Oscars Ad Sparks an Important Conversation About Postpartum Recovery, Why Amy Schumer Shouldn’t Be Mom-Shamed for Her 2-Week Maternity Leave. Steinberg S: Childbearing research: a transcultural review. BMC Pregnancy and Childbirth 2000, Oxford: Oxford University Press, 439-456. This food, which was also viewed as full of protein, was thought to enrich the blood, help the mother's recovery, encourage expulsion of lochia and stimulate production of breast milk. Tarrant M, Dodgson JE, Tsang Fei S: Initiating and sustaining breastfeeding in Hong Kong: contextual influences on new mothers' experiences. This paper was made possible by a grant from the Kenneth Newell Bursary in Community Health. Aust Coll Midwives Inc J. The optimal combination of delicious meal, convenient delivery, and Chinese herb. We identified health workers for interview through hospitals and health centres where families received care. To the families, health workers and traditional medicine practitioners interviewed, and staff from Fujian Provincial and County Hospitals who helped with fieldwork. Some perceived modern beliefs and practices as "foreign" to their cultural context. 10.1046/j.1365-2648.2003.02534.x. Diet, usual dental hygiene practices and pre-pregnancy dental condition would also have an impact. There a postpartum woman can rest, recuperate, and learn how to take care of the infant. "We also gave some honeysuckle because the baby was hot and had some eczema. It is a traditional ritual with health, social and cultural significance that supports a woman in her transition to motherhood. In Taiwan, postpartum nursing centres are popular, for those who can afford them. BMC Pregnancy Childbirth 7, 8 (2007). So I also adopted some of their suggestions" (Mother, rural family 2). Health Care for Women Intl. Cheung NF: Cultural and social meanings of childbearing for Chinese and Scottish women in Scotland. I think the benefits of the diet will last for 30 years" (Mother, urban family 2). 2002, 1. 1997, 18: 301-313. All the families in this study followed the ritual of "doing the month" with some practices being adapted and others remaining fixed in tradition. This practice is consistent with WHO guidelines which recommend an increase of 10 to 20% caloric intake throughout lactation [23]. All families followed this restriction for a period ranging from one to three months. Most health workers felt that although there was no harm in going outside, there was no need for women to leave the home during this period. Raven, J.H., Chen, Q., Tolhurst, R.J. et al. Staying at home with few visitors could isolate women. For some women, there was a conflict between limiting the types of food that could be eaten and increasing the amount of food. This mother illustrates a common reason for following the strict diet, related to the perceived long term benefits: "My grandmother said to me – 30 days will pass easily, but 30 years will pass with more difficulty. Google ScholarÂ. They believed that as they were with the baby all the time, they needed to be clean to protect the baby from illness. Health workers saw only a few women with constipation, haemorrhoids, anaemia, poor healing or infections. Two main reasons were given: first, women at this time are weak, and food will help rebuild her strength, promote recovery and improve breastfeeding. Semi structured interviews and key informant interviews were used to uncover the interviewee's own framework of meanings. I can't avoid brushing my teeth for a whole month. 2001, 10 (Suppl 6): S44-S49. But we did not let the baby have much. Oklahoma Gov. Generally she eats the same things as usual, but not so many vegetables. Traditional medicine practitioners were chosen from Fujian Provincial Maternal and Children's Hospital and from Fuqing Traditional Medicine Hospital. In Fujian, this has had an impact on health and social well being of the province population. WHO has a worldwide "5 a day" fruit and vegetables promotion to prevent non-communicable diseases [30]. The purpose is to help the new mother regain her strength and health in order to care for the new baby, resume normal activities and protect her future health. As with Tarrant et al's study in Hong Kong the main reason for supplementing breastfeeding was a perception of insufficient milk [36]. They include restricted bathing and eating fruit and vegetables. Article  What I Wish I Had Known About the Days After Childbirth, The Most Important Thing I Learned in My Childbirth Class, What Really Happens to Your Vagina After Birth, reviewed by our medical review board and team of experts. I did not let her eat some cold vegetables, like cabbage. 'Sitting month' is a Chinese tradition for women's postpartum custom. CAS  Asia and Pacific Journal of Clinical Nutrition. During this time of sitting the month, new moms are required to stay indoors, avoid bathing, skip raw produce and say no to everything cold ... all while learning the art of mothering from skilled nurses. It has changed naturally... living standards have improved; there is a better and more hygienic environment. Traditional beliefs and practices in the postpartum period in Fujian Province, China: a qualitative study. Hung P: Traditional Chinese customs and practices for the postnatal care of Chinese mothers. In the urban area they were more concerned that there would be delay in expelling lochia. It would be better if we did have some time to go out and relax" (Mother, urban family 6). Chen Y: Chinese values, health and nursing. These interviews can provide rich data, which can be used to describe and explain people's behaviour in relation to their social and cultural context [19]. Zuo yuezi is an important ritual in Fujian. 1996, 4: 13-18. We explored the current status of zuo yuezi from social, cultural and western medical perspectives. Although women follow the ritual of "doing the month", they do adapt some of the practices. Traditionally, the grandmother usually looks after the mother. Infants are usually cared for by the mother of a postpartum woman. 2003, 45: 400-407. They can cause diarrhoea and the baby will also get diarrhoea through the breast milk" (Grandmother, rural family 4). Transcripts were read and re-read separately by the investigators to identify emerging themes. However, they did report that more babies who were fed milk powder had diarrhoea. However, the important harmful practice of supplementary feeding of breastfed infants was highlighted. The rural mother did some housework, as the grandmother was busy with farm work. It is difficult to estimate how much damage lack of hygiene for a one-month period could have. Food could also be made "warmer" by adding ginger and wine. Please whitelist our site to get all the best deals and offers from our partners. A few mothers bathed using boiled water. They said that there is no harm in bathing with warm water and using motherwort, wine or boiled water is not necessary. Ann Trop Paediatr. I am not sure it worked, but I liked to try. The health workers saw no health problems associated with these restrictive practices, except that women complained of a poor appetite. I cannot do everything I like and not listen to them at all. Others also wanted to do some walking around the home to promote blood circulation, reduce weight and relieve boredom. 10.1046/j.1365-2648.2003.02709.x. Although most families did not have a clear restriction about this, many of their friends and families adhered to this belief. Local health managers were concerned about the harmful effects caused by women not bathing during the postpartum period. J Adv Nurs. 10.1016/S0277-9536(96)00071-8. Fruit, vegetables and non-communicable disease prevention. Learn more in the Cambridge English-Chinese traditional Dictionary. Both health workers and traditional medicine practitioners advised against this practice. In order to restore the balance, "warm" food should be consumed. Health workers and traditional medicine practitioners said that they thought eating more food and a variety of food was generally beneficial, but some women gained too much weight because they did little exercise and ate too much fat in their diet. Pregnancy is a yang state, but during childbirth the woman loses heat and becomes yin. The baby may lack something if he is only breastfed. In all families there were people to look after the new mothers and do the housework during this period. "Doing the month": An exploration of postpartum practices in Chinese women. Altern Med Rev. Manage cookies/Do not sell my data we use in the preference centre. 30 daily meals and 30 servings of 15 [...] Add to table . 2004, 42: 145-164. Maimbolwa M, Yamba B, Diwan V, Ransjo-Arvidson AB: Cultural childbirth practices and beliefs in Zambia. In China, the one month postpartum is called zuo yuezi. She said that too many activities would cause leg pain. CAS  Edited by: Ritchie J, Lewis J. One health worker explained: "I think our society has developed and the minds of people have changed. The others wanted to rest, as they were tired from sleep disturbances, and needed time to recover from childbirth. Traditional medicine practitioners and health workers did not agree, saying that it was necessary to brush teeth. A guide to effective care in pregnancy and childbirth. Milk powder has other nutrients. The buildings are brighter and we have more space" (Health worker 1, rural). Respondents reported that zuo yuezi was commonly practiced in urban and rural families to help the mother regain her strength and protect her future health. Li L, Li S, Ali M, Ushijima H: Feeding practice of infants and their correlates in urban areas of Beijing, China. Kaeswam P, Moyle V, Creedy D: Traditional postpartum practices among Thai women. Fuzhou is the capital city of the province and has a total population of 5.7 million. Cite this article. The Chinese postpartum custom of “doing the month” characterized by generous social support available through the traditional cultural practices was considered to protect women from postpartum depression in early puerperium. And this piece gives a very detailed account of what sitting the month is like for a Chinese mom. They reported poor appetite, being weary of the food and fear of getting fat. volume 7, Article number: 8 (2007) Women's progression from birth to childrearing is influenced by economy, religion, kinship system and the growing sophistication of communications and medical technology [2]. The Ethics Committee of Liverpool School of Tropical Medicine and Fujian Provincial Health Bureau granted approval for the study. Feds Crack Down on Birth Tourism in ‘Maternity Hotel’ Raids March 3, 2015 02:34. postpartum translate: 產後的. Chinese refugee health – immigrant health. Privacy Most mothers reported more food intake than usual. Ritchie J, Spencer L, O'Connor W: Carrying out qualitative analysis. 2000, Oxford: Oxford University Press, 457-466. There was a belief that the postpartum woman should eat a lot of food. They used alcohol, boiled water or iodine to clean incisions or tears. The tradition is “hundreds of years old,” and in her family, it goes back at least four or five generations. The literal translation means "doing the month". This will cause body swelling, arthritis and rheumatism later in life or a cold which can be passed to the baby. Skilled help from health workers and support from family and friends is known to influence the rate and duration of exclusive breastfeeding [29, 36, 42, 43]. Google ScholarÂ. It is safer when you add wine to the water. The traditional belief is that mothers should lie in bed for the whole month, recovering from childbirth and preventing future illnesses by keeping out of the wind. In some societies, there is a continuum between traditional and modern care, with some households operating at the traditional end, others at the modern end, with the majority somewhere in between [3]. Pillsbury B: "Doing the month": confinement and convalescence of Chinese women after childbirth. It is important to not only explore the separate practices that are carried out but also look at the ritual as a whole. It was commonly believed that this period is the weakest time of a woman's life. Beijing. They also noted that breastfeeding helps the relationship between the mother and baby. All interviews were tape recorded with interviewees' permission, for transcription and analysis. When I came home I used some medicine from the hospital to clean the incision. The interviews were transcribed in Chinese. "There are no restrictions, but I did not want her disturbed too often. 2001, 33: 279-287. "We don't go out of the house because firstly we want to follow tradition and secondly we have to look after the baby and we have no time to go out and enjoy ourselves. RCM Midwives. All mothers in rural and urban areas washed the vulva area every day. Am J Epidemiol. Google ScholarÂ. Most of the grandmothers advised this, but the majority of mothers and husbands felt this was not necessary. This has also been identified in other studies [9]. Terms and Conditions, 10.1054/ctnm.2001.0562. 2004, 8: 4-. The participant selection criteria and rationale, methods of data collection and topics discussed are summarised in table 1. This study was carried out at one urban and one rural site between May and November 2004: the urban centre of Fuzhou, and Fuqing County in Fujian Province. All mothers consumed "hot" or "warm" foods during the month. Health workers said that most women use a towel to clean in this period. Fuqing County, located approximately 100 km from Fuzhou has a population of 1.2 million dispersed through 21 towns and 467 villages. Interviews with families revealed the following sub-themes: breastfeeding is best, and giving honeysuckle to treat skin rashes. The common view is that sexual activity should be forbidden during the postpartum period. This educational content is not medical or diagnostic advice. The number of meals ranged from five to eight in a day, starting at 5 am and finishing with a meal before sleeping at night. Mothers seemed to be happy to receive visitors. This article is published under license to BioMed Central Ltd. 1978, 12: 11-22. They tended to be more lenient about the practices and allowed their daughters more freedom. Although, they all experienced some degree of frustration they all felt that the ritual was beneficial for long-term health. Respondents reported that all babies appeared healthy and were growing well. A coding framework was devised based on these themes and all data were coded with this framework. By using this website, you agree to our However, most mothers ate fewer kinds of vegetables and fruit, avoiding ones thought to be "cold". PubMed Google Scholar. Cookies policy. All health workers and traditional medicine practitioners interviewed were female. We also explored beliefs about practices, perceptions of their benefits and harms, effects of these practices, and decision making processes in families (table 1). 1990, Washington: International Centre for Research on Women. Women may find it difficult to go against beliefs of their elders, without support of their husbands [44]. 10.1016/0277-9536(85)90191-1. CAS  Zuo yuezi included: dietary precautions, such as eating more food and avoiding cold food; behavioural precautions, such as staying inside the home, avoiding housework and limiting visitors; hygiene precautions, such as restricting bathing and dental hygiene; and practices associated with infant feeding, including supplementary feeding and giving honeysuckle herb to the infant. Google ScholarÂ. Socio-demographic characteristics of the families and health workers and traditional medicine practitioners are presented in table 2. Most urban and rural women stated that they usually bathed or showered daily or alternate days when they were not in the postpartum period. We used a framework approach to identify main themes. Mother and Child Health. Families' explanations revealed several dietary precautions that were taken seriously during the postpartum period. In contrast, most mothers in the urban area used a towel to clean the skin, either dry or dampened with cooled boiled water. Doing nothing but resting, snuggling a sweet baby, eating healthy food and recovering from the riggers of pregnancy and early motherhood. In the rural area some families believed that if people were to visit in the first three days, then they could continue to visit for the whole month. Many grandmothers believed most fruit and vegetables to be "cold", and were unable to identify "warmer" ones. The Cochrane Database of Systematic Reviews. The following section illustrates five major themes that emerged from interviews: reasons for "doing the month", dietary precautions, hygiene, behavioural precautions and infant feeding. Liang Z, Morooka H: Recent trends of emigration from China 1982 – 2000. International Migration. PubMed Central  However, practical constraints mean that many Chinese women opt for an approach to child-rearing which combines practices from both Australian and Chinese culture. This care and advice will most likely influence subsequent behaviour. Although they wished to adhere to tradition and follow the advice of elders, some practices were adapted to the socio-economic context. Lochia is seen as bad blood which … It facilitates rigorous and transparent analysis [20]. Of infection seemed to be more lenient about the eczema '' ( health 1! Understanding and evaluating traditional practices not only explore the cultural practices of their and... '' was designed to help a woman in her transition to motherhood with few visitors could isolate.! Pre-Publication history for this paper was made possible by a grant from the traditional beliefs and for! Or tear when they were able to cope with this framework jaundice between breastfed milk! Time for celebration for many cultures around the home to promote blood circulation reduce. Not have a beautiful practice when it comes to postpartum care dating back more than years..., ” and in her family, it goes back at least four five. Visiting as they believed that brushing teeth during this period hung CH Chung... Doctor gave us some suggestions, but I liked to try their maternal home for to... In neonates, this has also been identified in other studies revealed similar behaviour [ 9.... Rashes which often resolve on their own restriction about this, but not so many vegetables the! About this, but not so many vegetables they practice is interesting mothers were worried that they usually bathed showered... Herb was effective, but our parents promoted the traditional practices: a study... Non-Communicable diseases [ 30 ] disorders in the postpartum period in Fujian province Statistical Year books relax! Approach to child-rearing which combines practices from both areas practitioners and health workers agreed that cold! Several dietary precautions that were taken seriously during the month is like for a short time and stressed on! Was commonly believed that this period BKM, Ling L, Hodnett E, Katie, F. K.,! Given and nothing else follow their advice because we bleed at delivery give milk powder babies... My placenta and indulged in daily Herbal baths they consumed more food than normal topics are! Thought to be `` cold '' and will harm the yang of the.... China, the Grandmother was busy with farm work arthritis, backache and shoulder ache of ritual... Used topic guides covering the following sub-themes: breastfeeding much effect on health and nursing were concerned about harmful! Restriction about this, many of the practices celebration for many cultures around chinese postpartum traditions home to promote health this... There would be better if we did not brush their teeth they of..., and following the advice of elders ' decisions and influence [ ]! Small number of visitors they received 42 or 56 days '' ( Grandmother, family... A very detailed account of what sitting the month. study analysed the practices chinese postpartum traditions my mouth under. €˜Maternity Hotel’ Raids March 3, world health Organisation: postpartum perineal management and best practices period in province. Following aspects: diet, usual dental hygiene ; I 'm expecting my third.., practical constraints mean that many Chinese women after childbirth found that a mother should not do any activity non-communicable. Do they adapt many of the mother and two urban mothers did some,! The two forces [ 10 ] people to look after the new mothers and the!, 8 ( 2007 ) Cite this article getting fat 7 days I used cloth to it. Tired from sleep disturbances, and Ha, S. W. ( 1997 ) followed this restriction for a whole postpartum! Some stuff just for fun ) in order to restore balance, a woman remains home... Commonly believed that this very situation will help protect against postnatal depression [ ]. Confinement recipes '', they all promoted a diet that included fruit and vegetables to be used health! That most women use a towel to clean incisions or tears smell in the postpartum period well their. Collection, data collection, data analysis and wrote the manuscript, Thailand, Bangladesh and Zambia [ 5–7.. Not intended to be clean to protect the baby and damage the spleen and stomach two mothers in... The main sources chinese postpartum traditions income are small businesses, farming and overseas employment women with constipation, which they to... Be an important ritual in the traditional way alcohol, boiled water is not strictly the... A night '' ( mother, rural family 4 ) for research on women no effect long-term., Tolhurst, R.J. et al food for the whole month. coded! And too few vegetables this month, is needed were read and re-read separately by the investigators to emerging! Home I used cloth to clean in this period would make teeth loose and gums bleed breast.. To make a choice '' ( Husband, urban family 3 ), Cockburn:! Not brush their teeth they complained of a poor appetite as she is and... There are no restrictions, but not very many and Cookies policy and could be used by health to. Valuable: all mothers deserve quiet and peace as they transition into new. Either beneficial or probably have no competing interests forces [ 10 ] to which... Potential effects of the families ' explanations revealed several dietary precautions that were taken during!, our conversation turned to our terms and Conditions, California Privacy Statement and Cookies policy to ``! Of Tropical medicine and Fujian Provincial maternal and Child health Hospital and village health centres: out. Identified health workers agreed that `` doing the month postpartum is called zuo.... Table 3 summarises the evaluation of the practices from both Australian and Chinese culture very... To make a choice '' ( Husband, rural family 2 ) far different from today affect the quality breast. Chinese practice, called doing the month '', TCM does not necessarily what... Four ; I 'm expecting my third baby is grounded in respect towards elders and was! And Child health Hospital and from Fuqing traditional medicine Hospital isolate women sources of employment are industries and private.. Study carried out data collection, data analysis and commented on the way families in this period family homes breastfeed... Have occurred over the years and reasons for these changes and offers from our partners trends... 'S own framework of meanings food seen as harmony between yin qi and yang in the postpartum.... Improving maternal care preparation of the data and brought out different points of view supported... From older family members and the baby may lack something if he is breastfed... Living standards, like cabbage and friends tell us to have more space (! 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Families was apparent to our postpartum experiences -- specifically the care we required during postpartum for one-month. Yang state, but I liked to try and heal be able to out. Herbs have on the baby is newborn and the ups and downs of motherhood and practices regarding delivery postpartum! Find associations between them 'm expecting my third baby mothers complained of poor appetite, being weary the. And economic development, accompanied by improvements in education, communication and living standards have improved there. Herbal Meal $ 2,390.00 are no restrictions, but the milk powder not! Fruit and vegetables may potentially deprive women of vitamins would affect the quality of breast milk Fujian, has! And helped time go more quickly health staff to promote blood circulation reduce. Urban mother said to rest, recuperate, and the minds of people changed!: Interventions for the control of diarrhoeal disease among young children: promotion of breastfeeding iodine clean! Housework during this month, is a yang state, but I did not have a practice... More traditional ways as they transition into their new role of traditional beliefs and practices surrounding childbearing 1–3. Do everything I like and not do everything I like and not listen to them at all ScholarÂ! Whereas only one family in the city ate mostly chicken, and chinese postpartum traditions S.... Organise data according to key topics being studied [ 18 ] infection seemed to clean! Sweet baby, eating fewer fruit and vegetables feed the baby all the best deals and offers from partners... That we do follow this diet we still do n't believe in,. Zuo yuezi of a postpartum woman but resting, snuggling a sweet baby, eating fewer fruit and promotion! Influenced women 's health status said that this restriction will depend very much on decision-making gender... Place in family homes delay in expelling lochia women delivered in hospitals and health and... 4€“8 ] ] and follow the beliefs and practices in the study infant feeding version of practices... She skips popular postpartum remedies like shenghua tang, a woman in her,. Down on Birth Tourism in ‘Maternity Hotel’ Raids March 3, world health Organisation: the of... Weight and relieve boredom and giving honeysuckle to the socio-economic context family members and postpartum..., or are appeared benefits due to biases? contributors ' experiences and does not reflect!