Traditional prenatal and postpartum food restrictions among women in northern Lao PDR

Abstract

Culturally determined food restrictions are common among pregnant and postpartum women in Asia. This study aimed to describe perinatal dietary restrictions, factors associated with food avoidances and attainment of minimum dietary diversity (MDD-W) among women in Lao PDR. Mother-child (aged 21 days to <18 months) dyads (n = 682) were enrolled into a cohort study in northern Lao PDR and interviewed at one time point postpartum. During pregnancy and postpartum, 1.6% and 97% of women reported following dietary restrictions, respectively. Cluster analysis identified four distinct postpartum dietary patterns: most restrictive (throughout first 2 months postpartum); least restrictive; 2 weeks highly restrictive and 1 month highly restrictive, followed by 19%, 15%, 5% and 62% of women, respectively. Greater maternal age, gravidity and higher household socioeconomic status were associated with allowing more diverse foods, while women from food insecure households followed more restrictive diets for longer. Women belonging to the Hmong ethnic group followed a highly restrictive diet of white rice and chicken for the first month postpartum. MDD-W was achieved by 10% of women restricting their diet at the time of the interview compared with 17% of women who were consuming their normal diet (p = 0.04). Postpartum dietary restrictions are widespread among women in northern Lao PDR. These highly restrictive diets, low dietary diversity and food insecurity likely contribute to micronutrient deficiencies in women that may have important consequences for their breastfed infants through reduced breastmilk micronutrient content, which requires further exploration. Culturally appropriate strategies to increase micronutrient intakes among women should be considered.

Nutrition and health-seeking practices during pregnancy and lactation and potential strategies to increase micronutrient intakes among women in northern Lao PDR

“…ANC and supplementation utilisation may be low due to physical, geographical and financial factors but may also be influenced by cultural factors and traditional ideas and beliefs surrounding pregnancy and childbirth (41,59) . In Lao PDR, dietary restrictions and food avoidances are commonplace during the perinatal period, especially postpartum (31,32) , and it remains relatively unexplored if supplements are culturally acceptable during this restrictive period. A high proportion of women (86⋅3 %) in the present study reported that they would be willing to take supplements during the period of postpartum dietary restrictions if provided to them by health facilities, indicating that these may be culturally acceptable.…”

“…As culturally determined restrictive postpartum diets are common in the study population, a comprehensive questionnaire was developed to interview women about their diets during pregnancy and postpartum, as previously described in detail (32) . This included the determination of what foods and condiments (salt, fish sauce and soy sauce) were consumed or restricted in weekly (for the first 4 weeks) and monthly intervals postpartum.…”

“…In addition to supplementation, micronutrient fortification of centrally processed food vehicles provides an opportunity for a large-scale, population-wide preventive intervention (30) . Given the high prevalence of postpartum food avoidances among Laotian women (31,32) , it is important to understand traditionally consumed and restricted foods and/or condiments when considering vehicles for food fortification.…”

The Use of Prebiotics from Pregnancy and Its Complications: Health for Mother and Offspring—A Narrative Review

“…In this sense, vitamins are commonly recommended by physicians, but other bioactive compounds are overlooked. Moreover, nutritional programs that include a nutritionist do not normally accompany pregnancies; however, some women often resort to strict diets in the postpartum stage [ 3 , 4 ].…”

Changes in household food security, access to health services and income in northern Lao PDR during the COVID-19 pandemic: a cross-sectional survey

“…Heavy reliance on rice with limited animal protein contributes to nutritional deficiencies 27. In northern Lao PDR, newborns are commonly fed masticated sticky rice after birth, and 97% of women report following culturally determined restricted diets for one or more months postpartum, reducing consumption of all food groups, except rice 28…”