.::. How to do confinement? - Part 1 .::.

There are many pregnant friends around me and some have just given birth, some celebrating their full-month, while some are doing confinement. It's unbelievable that our birth rate is so low, because I seem to be surrounded by pregnant women or people who are trying to conceive. There's so much baby talk that I've been having all sorts of baby dreams. One of them involves a good friend having a water birth when the baby was 3 years old (yes, 3 YEARS old!) and breastfeeding him while the umbilical cord was still attached.  While I really love babies and children generally, some tug at my heart-strings more than others.

So among these baby talk and all sorts of pregnancy know-hows, I was helping to translate a confinement article/book written by a Taiwanese doctor and it's rumored to be what Hsiao S followed during her confinement according to some websites. I suppose you can search for the book to buy and read if you're really interested. But for those who can't read chinese, I'm sharing the translated version. Do read with a pinch of salt, although I personally think it makes a lot of sense - to the horror of one of my colleague. She practically shrieked with horror and asked me if there's still educated women in this era who believes in not bathing during confinement - I do!

Me, being the 'westernized' chinese, am still pretty much traditional in some ways..oh well. Moreover, these are part of traditional chinese medicine which has worked for many years, although not 'proven' like western medicine is. Not everything can be scientifically proven and that does not mean it's not true. Chinese medicine usually helps to cure the root of the problem and emphasize on the body's constitution, instead of curing the symptoms of problems like western medicine. People believe in what they would like to believe anyway.

So, what is confinement? Confinement is usually practiced for a period of a month, immediately after childbirth for asian woman, as they believe that the body is very weak and requires rest to recuperate. There are many different variations and beliefs, but most would agree to no direct wind and cooking with ginger/sesame oil for its warming properties and to get rid of wind in the body. Some beliefs include not drinking plain water (replacing it with red dates water/boiled rice wine) and not showering (but cleaning the body with a cloth and herbal water) - these are those which come under fire, especially under western doctors which we all consult these days.

P.S. I'm not pregnant nor will I be in the near future!

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Written by Taiwanese doctor, Dr. Zhuang Shuqin’s confinement theory for Chinese women and loosely translated:

Main points:

1. Do not drink water (substitute water with rice water instead of ordinary water) 

2. Do not consume salt (as little salt as possible) 

3. Use a waist cloth to bundle the waist

4. Have plenty of peaceful rest

This method has been tried and tested with positive results in many women – with improvement in health and weight. Taiwanese author Dr. Zhuang Shuqin, is a renowned expert in obstetrics and gynecology. She suggested that women have three opportunities in a lifetime to adjust their body, so as to restore youth, beauty and health, that is during the initial menses period, after reproduction and menopause. The most important opportunity is the post-reproduction stage. During this period, your body is like an open door and can expel all the excess water and toxins that was accumulated during pregnancy (this is the main reason for postpartum weight gain). Subsequently, the body could be properly nourished to improve health.

3 stages of confinement (坐月子三阶段：一排二调三补)

Confinement has 3 different stages: first, to expel toxins, second to adjust the body and third, to nourish the body.

The plan for the first month is to divide the month into individual weeks, and to eat different things based on your body needs.

Week 1

The main thing is to expel excess water and toxins as well as drink ‘sheng hua’ soup and eat stir-fried liver in sesame oil. Be careful not to drink water (otherwise you’ll be unable to expel access water). Only drink thirst quenching drinks like lychee ke drinks, hawthorn slices (san zha) drinks or boiled rice wine. Do not use water when cooking any food, replace water with rice wine instead. Do not use salt or soy sauce as it causes water retention and do not add vinegar as it softens your bones.

Week 2

It’s important to strengthen your bones and kidneys function and to restore the pelvis (gu pen). Eat stir-fried kidney everyday with gutta-percha (du zhong fen). This can help tailbone pain. If caesarean birth, continue drinking ‘shen hua’ soup. Similar to week 1 do not take salt, miso soup, kimchi and preserved food.

Week 3 – 4

All toxics and excess water should have been expelled, nourish your body with sesame chicken. Remember that your body can only absorb nutrients after expelling all toxins. Otherwise, toxins accumulated in your body would become excess fats. In the first 2 weeks, the body is weak and in Chinese medicine, it is believed that a weak body cannot be nourished. Nourishment would only increase the burden on the body.

All food should be cooked with a generous amount of rice wine, ginger, sesame oil, brown sugar (not herbal wine, cooking wine or yellow wine as it contains salt and has different purpose).

 During confinement, you should not be exposed to direct wind and should keep your feet warm and walk with thick-base shoes (no slippers, keep feet wrapped) or your heels would hurt in the future. Wash your face with boiled rice wine that is warm. Do not bathe; wipe your body with the warm rice wine that has been boiled before. Wrap your waist with a waist belt and it’s best to breast feed – it hastens recovery. Start exercise only after confinement. It’s easy to go back to pre-pregnancy weight after confinement. However, muscles would lose its tone and tummy will be loose during the first month. Be consistent with exercise after confinement. With a proper confinement, problems like water retention in the feet, swelling of joints would recover.

Although it may be difficult to go without salt for a month, a month’s of ‘suffering’ is easier than the effort taken to lose weight after birth.

Lifestyle during confinement period:

 1.       Have peaceful rest for the first 30-40 days.

The most important thing after giving birth is to rest. Everyone around including the husband, relatives and friends should work together and help to ensure that the mother has enough rest, do not let her leave the room and do not do anything. This is regardless of social status, number of births or miscarriage – the same care should be given. Natural delivery requires 30 days of rest while caesarian requires at least 40 days.

2.       Bed-rest for 2 weeks.

During the first 2 weeks the uterus (zi gong) is contracting rapidly. As the uterus has expanded to accommodate the fetus during pregnancy, it makes it very large and the birth leaves a void. As there is no pressure left to be exerted on the internal organs, they become loose and cause the internal organs to sag. Sitting and walking would cause the internal organs to sag permanently due to gravity which becomes the root cause of much woman sickness in the long-run. Thus, during the first 2 weeks after birth, the mother should lie down on the bed apart from toilet breaks and meal-times.  Bed-rest is recommended regardless of day or night.

3.       Wrapping a belt around the waist prevents the internal organs from sagging and helps the tummy to get back into shape.

It’s an important to make use of the confinement period to adjust your body shape and improve your body. Use this period to wrap your tummy to achieve the desired shape. It’s important to prevent the internal organs from sagging as it’s the root cause for many women sickness and pre-mature aging of the body, causing excess fats around the tummy and lower abdomen. For people who has sagging internal organs (perhaps due to previous birth), it’s important to take advantage of this period to improve. Wrapping the waist could help to contract the tummy and prevent the sagging of organs.

The belt used to wrap the tummy should be a long silk cloth, about 1.2m long and 15cm wide. Everyone should prepare 2 to be used interchangeably. As it’s easy to perspire during confinement due to the nourishing food, unleash the belt and wipe the sweat and add some (non-cooling) powder before tightening the belt again. The one-piece waist belts commonly available does not prevent the internal organs from sagging and may even exert pressure on the internal organs, causing bad blood circulation and internal organs to deform and breathing difficulties. It may also cause protruding of lower tummy.

Method to buddle the tummy:

1.     Measurement: Use a white breathable silk cloth 1.2m long and 15cm wide.

2.     Usage: up to the mother whether to wear underwear after bundling. Due to perspiration, prepare 2 pieces to be used interchangeably.

3.     Benefits: to prevent the sagging of internal organs and help the tummy to contract

4.     Time to start: from 2^nd day of birth for natural birth/miscarriage and from 6^th day after birth for cesarean (to wrap tummy only for first 5 days).

5.     To bundle daily: Loosen it before 3 meals and re-tie to tighten it before eating. Tighten it after bath. Leave it on for 24 hour during the first 2 weeks and tighten it whenever necessary. From 3^rd week onwards, only bundle it in the day.

6.     Cleaning: Wash with cold water and detergent, rinse with cold water and air dry before use. Do not use washer as it wrinkles easily.

7.     Method to tie the cloth:

(a)   Lie down and life up the knees with feet flat on the bed. Try to form a right angle between the abdomen and thighs, raise the hips and buttocks and place 2 pillows for support behind.

(b)   Place both hands on the lower abdomen, palms facing forward; massage by pushing your internal organs towards the heart, hold it there.

(c)    Split the tying into 2 stages – from pelvis to navel, wrap 12 rounds. For the first 7 rounds, overlap and fold once every 1.5 rounds (fold by inverting the front to back). For the next 5 rounds, move up by 2cm like a spiral every round. When reaching the belly button, use a safety pin to fix the position and fold in excess cloth.

(d)   It’s essential to wrap 12 rounds everytime. If bigger-sized, use a longer cloth.

(e)   If too slim and hip bones are jutting out, causing the cloth to be unable to tighten/fit around the tummy, use towels to fill the gaps.

4.       Do not wash the hair. Use proper methods to clean the scalp.

During pregnancy, there’s a great increase in pressure and burden on the uterus which will expand greatly. Thus, after birth, one should help the uterus to contract back to its original size as soon as possible. To restore the womb’s original functions, the most important step is to expel the ‘dirty’ blood in the womb completely. If the womb contracts quickly and expels all toxins, creating a vacuum, the secretion/production of hormones will be extra active and health would be better than before birth. The washing of hair would cause the scalp to be ‘cold’ and the ‘dirty’ blood in the womb would quickly harden, making it difficult to be expelled. Washing of hair is prohibited even if it’s quickly dried with hair dryer right after. The usage of hair dryer would cause headaches in future. Not expelling the ‘dirty blood’ in the womb completely would cause hormonal imbalance or less production of hormones, causing future problems. Thus, do not wash the hair for the first 30 days or risk future regret and problems.

Method to clean the scalp:

Warm medicinal alcohol and dip cotton wool into it. Separate hair and wipe scalp using left-right motions. Massage the back of the head slightly before using a comb to brush off the dirt. This will help you to feel lighter and could be done daily, before meals. Comb your hair with a soft-bristle comb as this will help the blood circulation and help you to stay alert.

5.       Do not bathe in the first 2 weeks, but wash using the right methods.

Use the correct methods to wipe the body for the first 2 weeks to prevent cold. Showering is permitted after 2 weeks, soaking in a bath is permitted after confinement.

Sponge bath method

Using boiled water and rice wine in the ratio of 1:1, and add 10cc of medicinal alcohol and 10g of salt. Mix it and use it to sponge yourself. Wet a towel and twist it dry, wipe the tummy and areas of perspiration in the morning, afternoon and night. If it’s winter, do it only once. After wiping, dust on powder that is not cooling. Change the cloth used to bundle tummy.

Cleaning the face and brushing teeth do not require salt nor medicinal alcohol but requires warm water to prevent headaches. Do not use cold water. For face, use suitable cleanser and skincare products as per normal.

For disinfection, use tea (separate the leaves) and add some salt and medicinal alcohol. Mix is and use it to clean the genitals and anus, This helps with contracting the area and close pores.

6.       Do not come into contact with direct wind, regardless hot or cold wind.

After birth, all pores in the body including the scalp is open. Any contact with wind would cause the pores to shrink. This will cause headaches, body and bone aches or flu.

7.       Stay in a comfortable environment that maintained between 25-28 degrees.

The mother requires a comfortable environment to rest and air-con may be required for an optimum temperature but strictly no direct wind is allowed. The mother needs to wear long-sleeved, long pants, gloves, socks and hat to block any wind from going into the body.

8.       Do not touch cold water.

Do not touch cold water to prevent body aches. Use warm water for washing, brushing and showering after 2 weeks.

9.       Do not carry your baby.

The most important thing during confinement is the peace of mind - to rest and stay calm, enjoy eating and sleeping. The body functions are quickly recovering, so do not carry heavy things, do not carry baby as this will cause the internal organs to sag. Also, the newborn does not have fully developed internal organs and spine and should not be carried often – should be left to sleep.

10.   Breast feed while lying on your side.

Even during breast-feeding, lie down on your side and let the baby suck horizontally. The mother could lie on her back and place pillows behind the back and behind the baby for support. Be careful of the baby’s nose and do not block it to avoid suffocation.

 11.   About breastfeeding

Every woman will secrete breast milk after birth. Breast milk is adequate initially but if the baby does not suck, no additional breast milk will be produced. Even if the baby finishes all the initial breast milk, the supply is continuous as this is the mother’s natural ability. Thus, not breast feeding is a very bad thing. If baby’s consumption is very little, the excess milk has to be expressed to stimulate the production of more milk.

If mother is unable to breast feed personally, she has to express the milk as the accumulation of the milk would cause hardening and infection. It’s best to breast feed in the first 6 months as this is the most natural form of parenting. This will also protect the mother and reduces future risk of breast cancer.

If milk is light colored or insufficient, eat pig trotters with peanuts. To stimulate milk production, practice the ‘press door bell’ on the nipples.

Press door-bell method to stimulate the nipples:

(a)  After birth, do the press door-bell to stimulate nipples every 4 hours till milk spurts out

(b)  Nipples can be stimulated in 3 ways – to let newborn babies suck it, using a breast pump, get the father to suck for better control of suction.

(c)  Do not exceed 15 minutes for each breast but do it continuously and consistently every 4 hours till there’s an endless supply of milk.

12.   Do not bathe for the baby.

Do not bend and bathe for the baby. Otherwise, it will cause body aches and backaches. Arrange for someone to bathe the baby or get the father to do it.

13.   Do not climb stairs and do not carry heavy things.

This will cause internal organs to sag and back aches, body aches

14.   Do not cry.

Women’s aging starts from the eyes, thus taking care of the eyes after birth is important.  As the Chinese saying goes “A drop of tear is as precious as 10kg of gold. “. Any bad news should not be made known to the mother. It’s the husband’s responsibility to protect his wife and let her rest peacefully during confinement.  Crying will cause the eyes to age quickly, and may cause pain the eyes and other eye diseases such as glaucoma or cataracts. The mother should stay happy and optimistic, smile often.

15.   Do not watch TV or read.

The mother should avoid watching TV or reading or limit it to 10-15 minutes and rest the eyes in between. It is best to listen to soothing music to rest the eyes and remain peaceful.

16.   Eyes massage.

For woman with tired eyes, soak a towel in hot water and place it on the eyes after meals and before sleep, together with massage.

Eyes massage method:

(a)   Close your eyes and use both middle fingers to push upwards from your nose bridge to middle of forehead.

(b)   Using the thumb, place it in the curve between eyes and eyebrow, exert pressure and knead but avoid the eyes.

(c)    Using middle fingers, apply downward pressure at the edge of the hair. Exert pressure with the thumb till gradually towards the end of the eye.