The role of food during pregnancy, lactation and childhood illness at the Okhaldhunga Hospital, Nepal

Beliefs concerning food selection, distribution and consumption are found in all human societies. This study explores dietary proscriptions and prescriptions during pregnancy, lactation and common childhood diseases among the patients of the Okhaldhunga District Hospital: The hospital is located in a rural and remote area in the northeast part of Nepal. In the Okhaldhunga, the majority of the population is involved in subsistence agriculture, the health care services are not widely available and micronutrient malnutrition is prevalent especially among children and women in the reproductive age. Daily, the hospital staff experience that patients seek advice on what they should preferentially eat and avoid in the various cases of illnesses, during pregnancy and breastfeeding. Knowledge on local food practices and beliefs is important to enable hospital staff to facilitate practices that are beneficial to health and discourage harmful habits and unnecessary food restrictions, which may lead to nutritional deficiencies. This study is based on a qualitative research method, using a semi-structured interview guide. Twenty individual interviews and three focus groups were conducted in the spring of 2011. The sample consisted of parents of children admitted to the hospital and pregnant women staying in a waiting home before delivery. The findings reveal individual variations in the role of food. However, there are certain shared principles that serve to generate the various dietary beliefs and practices. Foods and fluids are prescribed as being strengthening or weakening to health in terms of its qualities such as pungency (hot and spicy), possessing strong tastes (bitter and sour), being wet or dry, easy to digest (light and soft) or difficult to digest (heavy), clean or unclean (basi) and hot and cold . The hot-cold classification refers to the ajurvedic tradition found among the Hindus in Nepal, assigning food, bodily states and diseases into the two abstract categories of hot and cold. Diarrhoea, fever, pregnancy and abortions are considered hot states. In these cases, hot food, such as potatoes, meat and oil, should be avoided and cold food, such as most fruits and vegetables, should preferentially be eaten. Respiratory diseases are on the other hand considered cold diseases, caused by environmental cold and cold food and fluids, and thus treated by hot food. If everything is eaten during illnesses, many people believe they will have chronic bad health or that the illness will be exaggerated. This might be one of the explanations why food restrictions appear to be a common practice in the Okhaldhunga area