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Newsletter #32 – Mothering the Mother: Making Confinement Work for Breastfeeding

By Nabila Hanim (BMSG Editorial Team Member)
Photos courtesy of Far’ain Jaafar

Far’ain Jaafar, a BMSG EXCO member and one of BMSG’s breastfeeding counsellors, recently gave birth to her second baby. During her pregnancy, Far’ain, who advocates for mothers prioritising self-care during postpartum, took great efforts to prepare for her second round of confinement. We speak to Far’ain and a few experts who have worked with new mothers to find out how modern mums who are living on their own can have a restful and invigorating postpartum recovery that is also conducive for breastfeeding.

For many of us, confinement may mean a lot of things. For some, it would mean endless days of no showering, a lot of pain and discomfort, and worrying over how to take care of a new baby.

For Far’ain Jaafar, however, confinement is a period for a mother to heal inside and out, while bonding with the baby in as many ways as possible. Having read about the many ways to practice confinement across cultures and believing that the postpartum period, or fourth trimester, is one that should be focused just as much on the new mother, Far’ain decided that she would like to give more thought to her confinement this time around.

After the birth of her first child, Far’ain was well taken care of by her in-laws. Knowing that she would be on her own with her husband and son this time around as they are now living on their own, Far’ain prepared herself and got her husband on board to ensure the postpartum period eased her transition into becoming a breastfeeding mother again.

Far’ain did a lot of reading and research prior to the birth of her baby. Reading up about postpartum, or also known as the Fourth Trimester, helped her better understand the needs of a new mother.

Mothering the Mother

Knowing that her Estimated Date of Delivery (EDD) was going to be during the holiday season where her family members were going to be on vacation, Far’ain ensured that her husband was equipped to provide for her well-being first, above everything else. “In general, I made sure that there (he was going to) be able to meet my needs so that I will be able to meet the needs of my baby, especially when it comes to breastfeeding.”

Johanna Wagner, doula and founder at Bumpwise, which provides antenatal classes, workshops and doula services for expecting mothers, believes that care and recuperation for the mother is just as important, if not more, during the postpartum period. “It’s such a crucial time for mum and baby, and we must focus on nourishment, healing, and bonding. Often, sadly, mums and everybody around them focus only on the baby, but we must make a point of also holding the mother who is going through a transformation physically as well as emotionally.”

Giving birth takes a toll on a new mother’s body; having spent nine months carrying baby and going through childbirth is enough to make a mother feel weakened. Yen Lim, owner at Madam Partum, a Traditional Chinese Medicine (TCM) company for pre- and post-natal care, says it is normal and expected for a new mother to feel this way. “The rigours of childbirth deplete the postpartum body of Qi (energy or life force) and blood. It is common for most mothers to experience a weakened body constitution after birth. Hence, the confinement period is a crucial moment where mothers are nursed back to their pre-pregnancy health and vitality through a proper confinement care and nourishment plan.”

Importance of Nourishment in Postpartum Care

Having understood this, Far’ain spent plenty of time during her pregnancy discussing with her husband how she will be cared for during confinement. “I knew that I needed to nourish myself with nutrient-dense food and eat in a timely manner so that I’ll be able to nourish my baby and meet her needs. Hunger, or even food not pleasing to me, will affect my emotional state during confinement,” said Far’ain.  This is a common occurrence with mothers going through postpartum, who go through drastic hormonal fluctuations as the body regulates itself to the pre-pregnancy state. “I ensured that my husband was equipped to prepare my confinement meals by discussing with him about the topic during my pregnancy and curating my confinement meals menu for him to refer to,” said Far’ain, who spent hours researching and reading up on confinement practices during her pregnancy.

“I made sure that there was someone who’ll be able to meet my needs so that I will be able to meet the needs of my baby, especially when it comes to breastfeeding.”

The Confinement Diet

While there was plenty of confinement catering options in the market, it was never an option for Far’ain. As she prefered to customise her diet to her needs, she felt that it was logistically easier for her husband to prepare confinement food that was also suitable for everyone in the family to consume. However, since she knew that a lot fell on her husband’s shoulders, she ensured that the recipes were easy to prepare. “Nothing complex or time-consuming. Anything that required long periods of time on the stove were prepared using the slow cooker,” she said.

Far’ain designed a diet plan and menu that was easy for her husband to refer to during her confinement. This was then printed and placed somewhere visible in their kitchen. *For explanations of some of the meals stated above, scroll to the end of this post.

Managing Expectations During the Postpartum Period

Far’ain admitted that confinement this time around was more challenging due to the presence of her older child who turns five this year. Feeling left out, as what is normal for children after receiving a new sibling, he threw a lot of tantrums and displayed attention-seeking behaviour when visitors fawned over the baby. This distressed her a little, but she knew that she needed the mental capacity to focus on breastfeeding and caring for her new baby. “I also kept in mind the rigour needed to meet the breastfeeding needs of a newborn. That greatly helped to strengthen my resolve,” added Far’ain.

As a second-time mother, Far’ain knew to expect and manage some breastfeeding challenges. She faced engorgement and also had to tackle her baby’s initial shallow latch. Managing her expectations actually made her feel more confident about her body and how to manoeuvre around the roadblocks along the way. “I religiously did my breast massages and kept a positive mindset to pull through the discomfort. I also made sure that I kept correcting my baby’s shallow latch in order to help her achieve a good latch. I varied my nursing positions in the day mainly to prevent any blocked or clogged ducts, and avoided underwired bras.” Far’ain found that going braless for many hours in the day also helped her to avoid any pressure on her already-tender breasts.

Prioritising Self-Care & Rest

Far’ain made sure to also allow time for her body to rest significantly during this period despite the demands of breastfeeding and caring for a baby and an older child. Doing what she called “breastsleeping”, Far’ain said: “Baby co-sleeps with me and I’ve mastered the art of nursing while side-lying. I’m still physically at rest while nursing!”

Whenever her husband was occupied with her first-born, Far’ain was open to having to carry her baby during meals as she knew he needed time to tend to their son. Sometimes, she was also alone at home with the baby when her husband brings him out to spend some time together. Maintaining a flexible and positive mindset helped her adapt to the little changes she had to make, as opposed to her first confinement period where her in-laws took care of everything.

Far’ain also coped with having to carry baby around by babywearing. “Babywearing helped me to meet the needs of my baby and took care of my sanity!” she laughed.

Having an older child and living on their own meant that at times, Far’ain still had to carry her baby during meal times when her husband was occupied with her first-born. Learning to manage expectations and developing a positive mindset was a good mental shift for her to cope with her expanding role as a mother of two, yet still being able to maintain her health and well-being.

As many proponents of postpartum would agree, focusing on self-healing is a crucial aspect of postpartum recovery. Far’ain, who followed the Malay cultural tradition of massage after confinement, went through daily postpartum massages for a few days in order to regain her physical strength and to pamper herself as many other mothers would. This did not stop her from continuing to breastfeed her baby.

“I scheduled my massages around the times that baby would feed. This meant that I would have to either feed her before or after the massage session, or on some days, express a little bit of breastmilk for others to feed her while I was in a massage session. My masseuse was also fine with me taking a little interval to feed my baby,” said Far’ain, who also added that mothers should be comfortable and open to discussing arrangements such as these with their masseuse and family members in order to give baby access to the breast as much as possible.

The postpartum period is focused on recovery, but it is also a period of adaptation and can be very overwhelming, what with the fluctuating hormones of a new mother. “Honestly, it was a really difficult and tiring time for me. But I knew that it’s not forever. So I ensured that I put in place whatever I could to make my recuperation smooth. The days get better as I regained my strength. There were bad days and there were good days. It’s all right to have bad days, cry, forgive, repair, reflect and learn to make it better.”

“I scheduled my massages around the times that baby would feed. This meant that I would have to either feed her before or after the massage session, or on some days, express a little bit of breastmilk for others to feed her while I was in a massage session. My masseuse was also fine with me taking a little interval to feed my baby.”

Recipe for Success

Far’ain also advises mums to breathe and adopt a positive mindset. Especially when it comes to breastfeeding, the people who make up the support system of the breastfeeding mother must be equip to help her achieve her goals, not prevent it.

Tips for Breastfeeding Success after Delivery:

  • Empower yourself, your spouse and your caregiver on how to get through the challenging early days of breastfeeding – read widely to gain knowledge or attend breastfeeding workshops
  • Know where to get breastfeeding support For example, BMSG has put in place multiple avenues for mothers to receive support. Also, request to see the lactation consultant before being discharged from the hospital, to ensure that your baby’s latch is corrected and checked for any possible issues in order to rectify them early. This is also a good time to ask any questions or concerns.
  • Assemble your support team! This is so essential during and after confinement. The people you place around you can make or break your breastfeeding efforts. Keep close the ones who will make breastfeeding easy and uncomplicated and who would help you to successfully breastfeed and learn to wear imaginary earplugs for those who would affect you negatively but whom you have to face daily/regularly during your confinement. Remember a “simple” remark such as “Are you sure you have enough milk?” can affect your greatly (thanks to fluctuating hormones and being new to breastfeeding)
  • Prioritise nutrient-dense diet – Remember to have your proteins, fats, carbohydrates, vitamins and minerals in your food. Drink water and consume lots of healing fluids in the form of soups/non-caffeinated teas/herbals. Confinement is not the time to be concern about weight loss. The goal is to regain health and vitality through nutrient dense food and being gentle to our body. Our bodies went through a life force of pregnancy and birth.

Words Can Make or Break

Echoing Far’ain’s view of how important it is to keep a strong support team near the breastfeeding mother, postpartum doula Fauziah Abas, who founded prenatal and postnatal care company Revivify, feels that it is important for family members or anyone who will be caring for the mum during the confinement period to be educated on how to treat her sensitively. “Family members need to be mindful about words that may have a negative impact on a new mother,” said Fauziah, who has been a birth and postpartum doula for several years now. Having spent a lot of time caring for new mums, she finds that well-meaning remarks can make or break a new mother, on top of the other physical and mental challenges that she may feel are insurmountable.

“The job of family members is to physically assist the mother and refrain from making hurtful comments especially when she faces breastfeeding challenges,” said Fauziah. “(Family members ought) to respect  the mother’s wishes to breastfeed as long as she intended to and not to impose their opinions about breastfeeding based on their own negative experiences,” she said. She also added that the immediate family can do more to control the number of visitors and help to give the mother as much space as she can to rest and breastfeed her baby.

Forty Days for Forty Years

Regardless of which cultural confinement practices you choose to follow or not, postpartum is a period for the mother to find herself and rejuvenate her body, mind and spirit to her old self. While it is particularly challenging in this period of time where the new mother may feel isolated and alone without her “village” of help and support, new families must be open to learning how to support a new mother and especially if she is new to breastfeeding. As many elders across cultures and ethnicities have widely advised, investing in these forty days (or more!) of confinement will bring meaningful returns for forty years to come.

[We have also previously written on Indian Confinement Practices. Click here to read.]

*** About the Confinement Recipes***

  • Most of the recipes Far’ain consumed were adapted from the book “The First Forty Days” by Heng Ou
  • Air Kunyit – Turmeric Water; helps with reproductive and womb health
  • Jamu Wanita – Women’s Jamu; traditional Indonesian herbal concoction meant for a woman’s overall well-being
  • Talbinah – A prophetic dietary tradition from the Arab culture; made from barley cooked with milk and sweetened with honey. It is believed that this dish soothes the heart and treats sadness.
  • Sourdough Waffles – Unlike the usual waffle made from plain flour, the sourdough waffle is made from the addition of a sourdough starter to the waffle mix. Sourdough is believed to have benefits for the human digestive system and is a good alternative to commercial bread or dough.

Nov 2018 Newsletter: Indian Confinement Practices

By Namrata Trivedi, BMSG EXCO Member

I can hear mum’s footsteps as she walks into the house while the maalishwali* is vigorously rubbing me down with a concoction of warm oils and herbs. My newborn is snoozing away in the cot nearby after being given a bath and massage, which he violently protests daily. I wonder why, though, because he seems peaceful now, all wrapped up and tightly bound like a cigar, as my husband calls it.

I can hear mum chatting with my helper, giving her instructions as she places my daily lunch tiffin on the table. The maalishwali asks me what’s on the menu today and whether my lunch will be dripping with ghee like yesterday’s meal. “Why of course!” mum exclaims as she walks into the room. She’s overheard our conversation and begins describing to her why it’s imperative that I eat ghee after giving birth. Their voices drown out as I begin piecing together in my mind every bit of advice on Indian confinement practices and diet I’ve overheard over the years from all the ladies in my family.

*Maalishwali – a female traditional Indian masseuse

The Crucial First 40 Days

For most Indians, the confinement period lasts for forty days after the day of delivery. This period provides the delicate newborn physical protection and allows the mother complete rest and recuperation, and also to establish breastfeeding. Tradition calls for the new mother to get daily massages and binding to help strengthen and heal her body, have hot showers or baths every day, cover her head with a scarf so that she doesn’t expose her ears and catch a cold, and have a diet rich in ingredients that promote lactation, digestion and resistance against infections.

A Nutritional Diet for Mums

Foods that promote lactation would include coconut, fenugreek seeds (methi), fennel seeds (saunf), dill seeds (sawa), cumin (jeera), carom (ajwain) and sesame seeds (til).

Green leafy vegetables such as spinach, fenugreek and mustard greens, and especially from the gourd family such as bottle gourd (lauki), apple gourd (tinda), and sponge gourd (tori) are traditionally believed to improve milk supply.

Carbohydrate sources such as oats, whole wheat and broken wheat (daliya), elephant yam (suran) and jaggery provide much needed energy.

Ginger, dry ginger powder (saunth), garlic, spring onions are encouraged because they promote circulation. However, the latter two should not be consumed with dairy products in the same meal. According to Ayurveda, milk generally does not tend to go with any food. It is best consumed on its own, and if mixed with garlic and onions, may tend to cause gas.

Many Indians, being vegetarian, rely on pulses and lentils as a source of protein and iron such as masoor and moong dal. Therefore, on my plate daily would be porridge (khichdi) made of moong dal and rice as opposed to just the latter on its own, which, according to the elders, would be gassy.

Nuts and dried fruits are a daily accompaniment to most main meals and snacks for the calories they provide. Ghee is encouraged in copious amounts because a mother is thought to have lost a lot of energy during childbirth and ghee helps one to regain strength, repair her pelvic muscles and promote bowel movement.

Turmeric is synonymous with Indian cuisine. Just as Salt Bae flamboyantly sprinkles salt over his meat like shimmering magic, imagine our Indian mothers doing the same with turmeric over our milk, stir fries and porridge after childbirth. This anti-inflammatory, antiseptic and antifungal agent is sure to be found in every Indian household.

Gondh (edible gum taken from the bark of Acacia trees) was another one of those magical ingredients that my grandmother extensively talked about and encouraged daily. It has been used for centuries in the Middle East, Africa and Ayurveda after childbirth as it helps with wound healing, digestion and bone health.

Foods Mums Should Avoid

Foods that should be avoided during the first forty days and gradually introduced back into the diet would include those that are believed to cause gas (even for the baby) and constipation, such as cauliflower, cabbage, okra, broccoli, onions, urad ( split black gram) and toor dal (pigeon peas), chickpeas (channa), kidney beans (rajma), black eyed peas (chawli), potatoes, foods fried with chickpea flour (besan), pickles, green peas and dry peas.

I think about the foods that were discouraged during confinement and came to the conclusion that all the knowledge from my western-educated degree (I happen to be a dietitian) had to take a back seat when debating with my mother about why I couldn’t have my favourite okra stew or chickpea curry just after childbirth. Surely the hundreds of years of experience and knowledge of our cultural practices passed down through generations of women should hold some weight? Plus, I was assured, again and again, that this is only for a short time!

I snap out of my thoughts as I am told that the massage is done. I grumble at the maalishwali as she wraps my belly so tight it feels as though she’s cut off my air supply. I waddle over the dining table to eat before the little one wakes up again. “Remember, what you eat for these 40 days will affect your next 40 years!” quips Mum as she walks out the door.

Confinement Diet Tips from the Author:

  • Start with eating easily digestible food and gradually go back to a regular diet towards the end of your confinement period.
  • Note that the above-mentioned foods and practices vary from family to family, and region to region. If a particular food doesn’t cause you any side effects such as bloating, constipation or gas, then go ahead and have it in moderation. These recommendations are general and each person should look at what suits their body type.
  • Eat local and seasonal produce.
  • Eat warm, freshly prepared foods and avoid cold leftovers (this makes sense as food poisoning is the last thing you want to get during this period).
  • Eat every few hours, rather than infrequent big meals that can cause discomfort.
  • As long as you are breastfeeding, you should aim to have more calories to produce more breastmilk for your baby. Do note that you should avoid filling up with empty calories. Rather, try and have nourishing foods packed with nutrients like green leafy vegetables, whole grains, fruits and nuts.