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Food habits during pregnancy and lactation in Iraq
Olfat A. Darwish and Ezzat
High Institute of Public Health, Alexandria University, Alexandria, Egypt
Sabiha M. Abdalla
University of Basrah, Basrah, Iraq
This is a report on a study of food habits related to pregnancy and lactation in different areas of Iraq. The general plan of the study was to interview housewives and mothers about their food habits during pregnancy and lactation. A stratified, random sample of 1,020 housewives was chosen from three areas in Iraq: north (Mosul and Kirkok), middle (Khademeya, Adameya, Najaf, and Kalis), and south (Basrah and Amara). An interview questionnaire was used to collect data related to dietary habits during pregnancy, puerperium, and lactation. The validity of the questionnaire was tested in a pilot study carried out on 221 housewives from the middle and southern areas. The questionnaire was redesigned on the basis of the results of the pilot study.
Table 1 presents the pattern of maternal diet during pregnancy and lactation in the three different study areas. The proportion of women who usually consumed special foods-mostly meat, chicken, eggs, and milk-was 14.5 per cent in the south, 26.8 per cent in the middle region, and 35.6 per cent in the north. Extra foods, such as fruits and milk, were included in the diets of 22.5 per cent of mothers in the south, 21.4 per cent of those in the middle area, and 33.2 per cent of those in the north. Those who did not usually change their meal patterns constituted higher proportions in the southern and middle area-63.0 and 51.8 per cent, respectively. Fruits, milk, and eggs were special foods consumed by 27.8 per cent, and the majority of these were in the north. Mothers who were accustomed to consuming milk, meat, chicken, and fish during lactation were mostly in the middle sector, while the rest did not eat any special diet during this period.
Table 2 indicates foods avoided during pregnancy and the reasons why by area of residence. There was no one particular food avoided during pregnancy. Only 14.4 per cent avoided spices; melons, onions, leeks and radishes were avoided by 31.0 per cent. The majority of mothers did not give any particular reason for their avoidance of these food items. Over 25 per cent believed that these foods might produce harmful effects on the foetus, while 19.2 per cent avoided these foods because of abdominal distension and discomfort.
TABLE 1. Mothers Consuming Special Foods during Pregnancy and Lactation, by Area of Residence
|Meat, chicken, milk, eggs||29||(14.5)||153||(26.8)||89||(35.6)||271||(26.6)|
|Fruits and milk||45||(22.5)||122||(21.4)||83||(33.2)||250||(24.5)|
|No special diet||126||(63.0)||295||(51.8)||78||(31.2)||499||(48.9)|
|Fruits, milk, eggs||57||(28.5)||123||(21.6)||104||(41.6)||284||(27.8)|
|Fish, meat, dates, sweets||60||(30.0)||157||(27.5)||38||(15.2)||255||(25.0)|
|Milk, meat, chicken, fish||16||(8.0)||139||(24.4)||55||122.0)||210||(20.6)|
|No special diet||67||(33.5)||151||(26.5)||53||(21.2)||271||(26.6)|
a X24 = 53.23 (P<0.05)
b X24 = 64.76 (P<0.05)
TABLE 2. Mothers Avoiding Particular Foods during Pregnancy and the Reasons Given for Avoidance, by Area of Residence
|Melons, onions, leeks, radishes||19||(8.5)||222||(38.9)||75||(30.0)||316||(31.0)|
|No particular food avoided||161||(80.5)||256||(44.9)||140||(56.0)||557||(54.6)|
|Undesirable effect on foetus||15||(7.5)||179||(31.4)||67||(26.8)||261||(25.6)|
|Vomiting, abdominal distension||24||(12.0)||125||(21.9)||47||(18.8)||196||(19.2)|
|No definite reason||161||(80.5)||266||(46.7)||136||(64.4)||563||(55.2)|
a. X24 = 77.2 (P<0.05)
b. X24 = 72.9 (P<0.05)
TABLE 3. Mothers Consuming Special Food during First Post-partum Day, by Area of Residence
|Protein rich foods||101||(50.5)||386||(67.7)||172||(68.8)||659||(64.9)|
|No special diet||43||(21.5)||95||(16.7)||54||(21.6)||192||(18.8)|
X24 =30.51 (P<0.5)
Table 3 presents special foods served at the first few meals after delivery. Meals composed of protein-rich foods, namely chicken and meat, were usually given to 68.8 per cent of postpartum women in the north, to 67.7 per cent in the middle, and to 50.5 per cent in the south. A carbohydrate-rich food composed of dates, wheat flour, and fat (hisswo) is usually given to women post-partum. This habit was practiced by 28.0 per cent of mothers in the south, 15.6 per cent in the middle, and 9.6 per cent in the north.
Table 4 shows the special foods avoided during lactation and the reasons why in relation to area of residence. Onions, leeks, radishes, melons, and fish were avoided by 12.0 per cent of mothers in the south, 51.8 per cent in the middle area, and 52.8 per cent in the north. The majority of mothers who avoided these foods did not know the reason for doing so, and some of them stated that they had been told that these foods might harm the infant.
The diet consumed during pregnancy deserves special consideration to make sure that it will not be a limiting factor to the good health of both mother and foetus. An adequate diet during pregnancy results in fewer complications of pregnancy and a less difficult labour. The lifetime dietary habits of the mother and her nutritional status before the onset of pregnancy may be more influential than the diet followed during it. The women who had either good or poor dietary habits in the past were likely to continue the same pattern during pregnancy (1, 2). This was confirmed by the results obtained in this study, where 48.9 per cent of the women sampled did not change their food habits during gestation.
TABLE 4. Mothers Avoiding Particular Foods during Lactation and the Reasons Given for Avoidance, by Areas of Residence
|Onions, leeks, radishes, melons, fish||24||(12.0)||295||(51.0)||132||(52.8)||451||(44.2)|
|No particular foods avoided||176||(88.0)||275||(48.2)||118||(47.2)||569||(55.8)|
|Undesirable effect on infant||14||(7.0)||222||(38.9)||95||(38.0)||331||(32.5)|
|No definite reason||176||(88.0)||268||(47.0)||115||(46.0)||559||(54.8)|
a. X24 = 103.4 (P<0.05)
b. X24 =114.7 (P<0.05)
It was evident that geographical location was a decisive factor in establishing food habits: Most of the differences observed were due to the types of food available in different sectors. Geographical location may affect food habits through customs and beliefs of the people in a given area. Studies in some African countries reported by deGarine (3) show that the pregnant woman is considered to have two persons to nourish. She is encouraged to consume curdled milk, palm oil, meat, and butter with the staple food.
The additional demands of lactation depend to a great extent on the amount of milk produced and the length of time lactation is continued. The fat reserves deposited during pregnancy supply approximately one-third of the calories needed for a three-month period. The continuing high requirements for calcium and phosphorus, and the increased needs for vitamin A, ascorbic acid, and some of the B vitamins reflect the high content of these nutrients in breast-milk. Good food habits during lactation imply consumption of protein-rich foods, even more often than during pregnancy. in this study, milk, eggs, meat, and chicken were consumed by mothers in the northern sector more often than in the other two areas, while fish was more commonly eaten in the southern sector because of the availability of these protein-rich foods in the respective areas. Dates and sweets are believed to promote milk secretion and are often recommended for lactation. In the Sudan, lactating mothers are given milk, butter, fat, dates, wheat flour, and meat to increase milk secretion, while some villagers prefer to give the mother only pap (wheat flour with sesame) (4). Food habits, including food preferences and avoidances, during pregnancy and lactation varied with customs and beliefs in the three areas of Iraq included in this study.
1. C.H. Robinson, Normal and Therapeutic Nutrition, 13th ed. (Culab Perimlani IBH. Publishing Co., 1967), chap. 13.
2. M. Arlin, The Science of Nutrition, 2nd ed. (Macmillan, New York, 1977).
3. I. deGarine, ''The Sociocultural Aspects of Nutrition." J. Ecol. Food Nutr., 1:143 (1972).
4. G.M. Gulwick, "Diet in the Gezia Irrigated Area in Sudan, Sudan Department FEB, No. 304 (1951), p. 110.
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