Bulletin of High Institute of Public Health  
                                                                           Vol. 37 No. 3 [2007] 
                                                                            
                                                                           Dietary Practices among Postpartum Women 
                                                                           Amany Ahmed Gamal El-Dean Mahmoud*, Nada Ahmed Ismail**, Maha Mohammed El-
                                                                           Habashy*         
                                                                           ABSTRACT: In order to assess the dietary knowledge and practices among postpartum women we 
                                                                           studied 420 recently delivered (within 2 months) women and reported to the specified centers for 
                                                                           vaccination  of  their  newborns  were  interviewed.  An  exploratory  descriptive  research  design  was 
                                                                           adopted. The study was conducted at seven Maternal-child health centers in Alexandria, EGYPT. An 
                                                                           interview  schedule  was  designed  and  utilized  to  collect  the  necessary  data.  It  included  socio-
                                                                           demographic characteristics, women's reproductive history, women's dietary practices, and women's 
                                                                           knowledge about postnatal nutrition. Results yielded   that the total nutrition knowledge scores of the 
                                                                           subjects was poor. Where only 6.0% had good score. As regards the practice; most of the studied 
                                                                           women (90.2%) had added fenugreek and of them 79.2% had added moghat to their postnatal diet. 
                                                                           While around half of they had omitted water intake. It can be concluded that there is poor level of 
                                                                           knowledge regarding during postpartum period about well balanced diet.  
                                                                            
                                                                           INTRODUCTION                                                                                                                                                                                                                                                      
                                                                               Maternal  mortality  and  morbidity  levels                                                                                                                                                                                                                  contributing  factor.  Ninety-nine  percent  of 
                                                                           are  key  indicators  of  the  public  health                                                                                                                                                                                                                    maternal  deaths  occur  in  developing 
                                                                                                                                                                                                                                                                                   (1)                                                                                                                                                                                                                                                             ,  (2)
                                                                           situation  in  a  country  (WHO)  2000.   The                                                                                                                                                                                                                    countries, most of them preventable                                                                                                                                                                                   .  To 
                                                                           Safe  Motherhood  Initiative  (SMI)  was                                                                                                                                                                                                                         reduce maternal mortality, more investment 
                                                                           launched  15  years  ago  with  the  aim  of                                                                                                                                                                                                                     in health systems is needed to improve the 
                                                                           reducing high maternal mortality, particularly                                                                                                                                                                                                                   quality  and  coverage  of  delivery  services 
                                                                           in  poor  countries,  where  maternal  health                                                                                                                                                                                                                    and to provide prenatal and postnatal care 
                                                                           care was identified as a priority. Despite this                                                                                                                                                                                                                  for the poor.(1-3)  
                                                                           initiative,  maternal  mortality  remains  very                                                                                                                                                                                                                      In                                both                                 developed  and  developing 
                                                                           high  in  low-income  countries,  and  lack  of                                                                                                                                                                                                                  countries, women and their newborn health 
                                                                           access to maternal care facilities is a further                                                                                                                                                                                                                  during                                          postpartum  period  have  been 
                                                                           **Obstetric and Gynecologic Nursing, Faculty of Nursing, University of Sana'a, Yemen 
                                                                           *Obstetric and Gynecologic Nursing, Faculty of Nursing, University of Alexandria 
                                                                                                                                                                                                                                                                                                                                   
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                   neglected when compared with the attention                       of a woman. The paramount importance of 
                   that     is    given     during      pregnancy  and              nutrition  of  a  woman  during  pastpatum  is 
                   childbirth. Such an eclipse ignores the fact                     widely      recognized         and      has     received 
                   that the majority   of maternal deaths and                       increasing attention in recent years. In many 
                   disabilities  occur  during  the  postpartum                     Third  World  countries  including  Egypt, 
                   period  and  that  early  neonatal  mortality                    malnutrition  is  endemic,  fertility  rates  are 
                   remains high. Poor quality care reduces the                      high,  and  women  enter  the  reproductive 
                   opportunities  for  health  promotion,  early                    stage  at  an  early  age  and  subsequently 
                   detection  and  adequate  management  of                         attain high parity and most of the time food 
                   problem and disease Therefore, quality post                      based  on  cultural  beliefs  and  practices  in 
                   partum care is a long term investment in the                     which  food  is  one  of  the  most  universal 
                   future      health      of     women  and  their                 symbols of culture, holding one of the key 
                                (3)                                                                                     (5 -7)
                   newborn. .                                                       point in postpartum period.                                                                    
                         Postpartum period is a time of profound                          Food  habits  and  practices  vary  among 
                   transition  making  great  demands  on  the                      people and are influenced by culture norms. 
                   woman’s resilience  and  capacity  to  adapt.                    Whether their foods supplies are limited or 
                   So  postpartum  care        includes      the                    abundant, women tend to develop trends in 
                   prevention, early detection and treatment of                     eating  that  are  derived  from  their  socio-
                   complications and diseases. Also, provision                      cultural  background.  These  will  in  turn 
                   of    advice  and  services    regarding    influence                              their       postpartum           eating 
                   breastfeeding,  birth  spacing,  immunization,                   practices.(8-10) 
                                                      (4)
                   and  maternal  nutrition. .      A  good                               Postpartum woman may have little or no 
                   postpartum  care  in  addition  to  a  well                      nutritional knowledge. Nutritional counseling 
                   balanced diet is very important for the health                   is   often  unavailable  or  ignored  during 
                                                                                  
               Mahmoud et al.,                                                                                                         713 
               postpartum  period.  Nurses  working  in         postpartum.  Such  information  will  help  in 
               maternal and child settings have a vital role    providing  more  specifically  tailored  nursing 
               in   providing   nutritional  education    to    interventions   to   women  during  their 
               postpartum  women;  they  are  in  a  favored    postpartum period. This may lead to a more 
               position  to  promote  better  nutrition  and    healthy     nutritional   practices    during 
               improvement of the health need of women.         postpartum period and positively reflects on 
               So  they  should  seek  every  opportunity  to   both women and newborns well-being 
               help postpartum women select foods within        MATERIAL AND METHODS 
               their personal preferences that will promote     Material 
               their  own  well-being      and    successful         Design:    The  exploratory  descriptive 
               lactation. It is important that nurses be able   design was adopted 
               to  identify  women  who  are  at  risk  for          Settings: 
               nutritional  deficiencies  and  make  sound           This  study  was  conducted  at  seven 
               dietary recommendations. The main role of        Maternal-Child  health  Centers  (MCH)  in 
               the nurse in the nutritional education during    Alexandria.  They  were  randomly  selected, 
               postpartum  period  is  nutritional  counseling  one from each of the following health Zones 
               which should follow certain sequential steps     in Alexandria Governorate.  
               that  include  assessment  of  nutritional       -   El-Mandrarah    health  Center  from  El 
               needs,  planning,  teaching,  and  evaluation.       Montazh Zone.                      
               (11, 12)                                         -   El-Gomrk MCH from El-Gomrk Zone. 
                     Because of dangerous consequences of       -   .Moharm Bek MCH from Middle Zone.                             
               malnutrition in postpartum, the researchers      -   Smoha MCH from East Zone.. 
               felt the need to assess mother’s knowledge       -   El-Ameria MCH from El-Ameria Zone.                                
               and  beliefs  about  dietary  practices  during  -   Karmooz MCH from West Zone.. 
                                                               
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                     -    Borg El-Arab MCH from Borg El-Arab                               postpartum  period;  the  sources  and  the 
                     Zone.                                                                 importance  of  each  food  group  during 
                     Subjects:                                                             postpartum period.  
                          A convenient sample of 420 postpartum                                  A     scoring         system         for      women's 
                     women  attending  the  study  settings  for                           knowledge regarding nutrition was adopted. 
                     immunization of their newborns constituted                            The  correct  answers  were  predetermined 
                     the  study  sample.    Sixty  women  were                             according to the literature and the questions 
                     chosen  from  each  of  the  above  seven                             were coded accordingly. A score of one was 
                     settings.                                                             given to each correct and complete answer, 
                      Tool of data collection:                                             a score two was given to each correct but 
                           An  interview  schedule  was  designed                          incomplete answer, and a score of tree was 
                     and utilized to collect the necessary data; it                        given  to  incorrect  or  doesn't  know.  The 
                     included four parts:Part one: includes socio-                         possible range of total scores was zero to 
                     demographic  characteristics  of  the  study                          39  which  as  classified  as  follows:  good 
                     sample  such  as:  age;  level  of  education;                        knowledge (75% or more correct answers); 
                     occupation. Part two: contains questions to                           fair  knowledge      (50%  to  less  than  75% 
                     identify  woman’s  reproductive  history  such                        correct  answers);  and  Poor  knowledge   
                     as     Gravidity        and  Parity,           number  of             (less than 50% correct answers). 
                     abortions.  Part  three:  comprises  women's                          Methods 
                     dietary practices during postpartum such as:                               An official permission was obtained from 
                     foods  she  omitted,  adds,  and  why.  Part                          the  executive  directors  of  Health  Affairs 
                     four:  includes Women's knowledge about                               Department  in  Alexandria  and  health 
                     postpartum            nutrition       such        as:       the       centers    mentioned   before  to conduct the 
                     importance  of  a  well  balanced  diet  during                       study and collect the necessary data.