EBB 402 – Cultural Aspects of Lactation and Infant Feeding in India with Yogyata Wadhwa, IBCLC and Young Child Feeding Specialist

Dr. Rebecca Dekker – 00:00:00:
Hi, everyone. On today’s podcast we’re going to talk with Yogyata Wadhwa about cultural aspects of lactation from the early days of breastfeeding all the way to starting solid foods Welcome to the Evidence Based Birth® Podcast. My name is Rebecca Decker, and I’m a nurse with my PhD and the founder of Evidence Based Birth®. Join me each week as we work together to get evidence-based information into the hands of families and professionals around the world. As a reminder, this information is not medical advice. medical advice. See ebbirth.com/disclaimer for more details.

Hi, everyone, and welcome to today’s episode of the Evidence Based Birth® Podcast. Today, Yogyata Wadhwa, an international board-certified lactation consultant from India, is going to join us to share her insights on how families can incorporate evidence-based practices while honoring their cultural traditions from the very early days of breastfeeding through the introduction of first solid foods. For those of you listening who are birth professionals, Yogyata provides a lot of insight both into the practical work of supporting families, as well as some of the particular cultural and traditional practices of families from India. So if you have clients from India or whose parents are, you can’t miss this episode. If you’re a new or expecting parent, there’s a lot of info from Yogyata that can be valuable for you as well. The role our families play in childbearing and child raising, our need for support in pregnancy and postpartum, the journey from breastfeeding or bottle feeding to solids. These are common experiences worldwide and things we all navigate in the first year of parenting, no matter what you or your family’s country of origin may be. So if you are interested in learning about breastfeeding and baby led weaning in a different culture, or if you are just curious about how some of the people in the world’s largest country approach breastfeeding and infant feeding, I am so excited for you to listen to what Yogyata has to say.

For those of you who don’t know, India is the world’s most populous country with more than 1.42 billion people, making up one-sixth of the world’s population, and 25 million babies are born in India each year. And in North America, there are 7 million people of Indian descent in the United States and Canada combined. In this podcast episode, Yogyata references a few topics and terms that may be new to you. So before we begin our interview with her, I wanted to briefly go over those terms so that you can recognize them throughout our discussion with Yogyata. So some of the terms that Yogyata references include Annaprasan, the Jappa period, curd, creche, and rai pillows. Annaprasan is a celebratory Hindu ceremony where a child is offered their first non-milk food, which is usually a sweet rice pudding called kheer, spelled K-H-E-E-R. The Jappa period has to do with a period of postpartum rest. So many cultures practice a period of postpartum rest when new parents do not leave the home. They take a break from their usual chores or household obligations and they eat nourishing foods. In some parts of India, this is called the Jappa period. It lasts roughly 40 days, though in some communities, this period is called by a different name or lasts a different length of time. Curd is another word for yogurt. In India, fresh, plain, often homemade yogurt is an important part of daily meals. This is not like yogurt with fruit in the bottom. Think of it more like plain Greek yogurt.

A creche is a daycare. Some companies have their own creche for their employees, while other creches are standalone operations. And finally, we have an interesting conversation in this podcast about rai pillows, spelled R-A-I. A rai pillow is a small pillow filled with mustard seeds and sometimes other fragrant herbs that is used traditionally in India to help promote a good head shape for the infant. As you’re listening, I also want to remind you that you can use the closed captions feature on the YouTube version of this podcast if you’d like that for accessibility purposes. There’s also a human verified transcript of this podcast available if you visit our website link, ebbirth.com/402. The automated transcripts that go along with podcast players are not always accurate. So if you want the human verified version, I encourage you to go to our website.

And now I’d like to introduce our honored guest. Yogyata Wadhwa is a physical therapist, a Lamaze childbirth educator, an international board certified lactation consultant, or IBCLC, a birth doula, sleep consultant, and young child feeding specialist with more than 10 years experience. Yogyata is based out of Delhi, India. She has supported more than 10,000 families through pregnancy, birth, breastfeeding, sleep, and starting solids with evidence-based practical guidance. Through her work, she also bridges medical science with compassionate, culturally relevant care for modern parents. Yogyata is also the founder of @thebirth.life, a global education platform that is empowering new mothers with reliable, positive postpartum support. Yogyata’s mission is to help families feel confident, informed, and deeply supported in the early years of parenting. Yogyata, welcome to the Evidence Based Birth® podcast.

Yogyata Wadhwa – 00:05:34:
Thank you so much, Rebecca. Thank you so much for having me here on Evidence Based Birth®. I have hugely been a fan of this platform. And to be honest, when I was learning, you know, giving my exam around Lamaze and prepping up the classes for my clients and parents who were expecting. So most of the evidence I used to find from your YouTube videos around, you know, the natural methods of inductions and all of that. So I’ve created all of my notes from there. So it’s really, really a pleasure being on this platform, sharing the screen with you. Thank you so much.

Dr. Rebecca Dekker – 00:06:18:
You’re welcome. I love to hear when people use it as like their study guide and like, you know, I’m going to study these articles so I can pass my exam. That’s so cool. So could you tell us, I know you’ve been doing this work for more than 10 years, but what first drew you to supporting families through pregnancy all the way through to infant feeding?

Yogyata Wadhwa – 00:06:40:
Basically It was out of… Lack of work, to be honest. When I almost around 13, 14 years back, I shifted cities. And when I shifted cities, I didn’t have much work around as a physical therapist. So slowly, slowly, I just, you know, approached OBGYNs in the city I moved to. And I asked them to take some antenatal prep sessions for their clients who were coming, who were pregnant at that point of time. And when I started taking some exercise antenatal sessions for them, I realized that… Mothers lacked so much of awareness and education around birth choices. How active, how important it is to be active and exercise in pregnancy and labor. And they were almost not aware of that, you know, how to cope in labor and so many things around it. So there was such a void in that scenario that quickly struck my mind that this is where, you know, I can start working in and help the mothers in postpartum as well. And slowly, slowly when I ventured. I started taking up certifications so that I can provide evidence-based information to them. And then this is how when I ran into it, one thing led to the other and then it led to the other. And it was kind of, even I didn’t know how it ventured and navigated through that. I came to becoming an IVCLC and also a sleep consultant because the mothers needed that kind of support and information.

Dr. Rebecca Dekker – 00:08:31:
And what are some of the common challenges you see where you live in India with breastfeeding in particular?

Yogyata Wadhwa – 00:08:38:
When it comes to common challenges, the first common challenge that we hear is mostly not enough milk supply. You know, that’s the biggest challenge that most of the mothers will come to me, that I don’t think my milk is enough for my child. That’s one of the biggest challenge. And the second is making them understand around that what are the right signs of not having enough milk supply because of the cultural myths and ideas around it that what makes your supply enough. Another challenge is around when children, when babies, they have compromised sucking skills. So when children have compromised sucking skills or tounges, you know, like tongue ties or lip ties, then making the parents understand that what needs to be, you know, counseling them around that is the biggest challenge because they are not ready to accept many a time that the, that. Challenges in breastfeeding journey are not coming because of the mother, rather because some skills in the infant are compromised. It is very difficult. It is very overwhelming also for them to take that information.

Dr. Rebecca Dekker – 00:09:59:
Okay, so difficulties with milk supply first, and then the second most common challenge you see is with the latch and the ability to suck while they’re feeding. Yeah. Do you see any… Birth traditions that are happening that you think are interfering or maybe helping impact the first one with the low milk supply?

Yogyata Wadhwa – 00:10:24:
Actually, there are many traditions, cultural traditions in India around breastfeeding. Although there are a lot of support systems as well, but there are certain cultural traditions like they have a higher tendency of introducing pre-lactial feeds to the infant. They believe in giving honey or there is a concoction called gooty to babies as the first feed. In many parts of the country, they also believe that the initial milk, that is the colostrum, should be discarded. So various cultural communities have different kinds of myths. Some cultural communities, they believe that milk takes time to come in at least three days. So there are some times when breastfeeding is initiated after 24 hours or even three days. And this totally, totally, we all know, interferes with the, you know, breastfeeding, both qualitatively, quantitatively, early skin-to-skin is impacted and frequent nursing after birth is impacted, for sure. And when we talk about India or any other Asian culture, even studies, there are review articles that tell us that because in India, we mostly have the influence in the household is usually by the grandmother of the infant. So if the grandmother is very breastfeeding pro, we see good, good breastfeeding journeys. But if the grandmother is not breastfeeding pro, then we actually see 70 percent of those face challenges when the mothers or mother-in-laws are not breastfeeding pro in case of a family system.

Dr. Rebecca Dekker – 00:12:30:
So do you feel like, you know, what percentage of grandmothers are supportive of breastfeeding? Was there. Movement when a lot of the current grandmothers were were giving birth, were they encouraged to use formula like what what is it about that this current generation of grandmothers

Yogyata Wadhwa – 00:12:50:
So they have their own transgenerational myth. Transgenerational myths like that initially you have to first clean the breast and then bring the baby you know you’re the first milks are sometimes should be discarded and impure and they they they are carrying it throughout It’s not that they were given formula. India is a primarily breastfeeding nation. But the rate is declining because of these myths wherein they tell the new mother that you should be, you should be leaky. You know, you should be full of, your breasts should be tight enough or full enough, then only you have milk. And they compare it with other, their breastfeeding journey sometimes. And they are like, oh, we had so much milk that our clothes used to get wet. You know, I don’t think you have enough milk, your child is crying. So that kind of puts so much pressure on the new mother who doesn’t have an idea that what do you mean by enough milk. We are rather relying on these transgenerational myth, mythical information rather than the correct measures of urine counts and weight counts and other things.

Dr. Rebecca Dekker – 00:14:08:
So there’s probably a combination of truly not enough milk because you said they’re not, they’re often not breastfeeding for the first two or three days. So the supply is impacted, but then also there’s this perceived low supply because the mother-in-law is saying you don’t have enough milk because you should be leaking all the time. Your breast should be so full. Yeah. Okay. Any other cultural traditions or anything else surrounding breastfeeding that our listeners might want to learn about?

Yogyata Wadhwa – 00:14:44:
So otherwise, once the mother starts breastfeeding, then over a period of time, there are not much cultural beliefs that hamper it. But once the mother starts reaching around one year of age, then again, some cultural practices are around that you should be weaning off the baby around one year of age. Or there are some even mythological texts which say that, you know, when you get pregnant, you should be stopping breastfeeding for the baby and things like those. So there are certain cultural practices that can hamper, you know, extended breastfeeding or breastfeeding for longer durations. Until we see even in well, affluential and educational families, these kind of myths are there that you should not be feeding the baby much longer. You know, if you feed the baby, they will not be eating solids nicely or things like those. Or they are waking up frequently in the night because you’re still choosing to breastfeed and things like those.

Dr. Rebecca Dekker – 00:15:55:
So trying to shorten the breastfeeding sessions and say, you know, your baby’s not sleeping through the night because you’re still breastfeeding. Those sorts of things. Okay. And what about, you mentioned, you know, weaning. What about starting infant foods? Like what is cultural infant feeding in India and what does that mean to you?

Yogyata Wadhwa – 00:16:18:
Cultural feeding, solid introduction of solid practices are somehow aligned with evidence. To be honest. When we talk about the cultural practices, the Indian texts and mythological books also, religious texts also, they talk about that the Annaprasan ceremony. The Annaprasan ceremony means introducing solids for the first time. It is believed to be done around six months, but not later than an year. And they believe that once the baby starts, you feel the parents are confident that the baby is able to digest foods, then we should be introducing the solids. So those guidelines are in alignment, those cultural practices are in alignment with the guidelines usually. The books and texts and practices also talk about introducing rice or curd as the fast foods which are also good gut friendly foods you know carbs and yogurts are good probiotics so that is also aligned with the practices however there are some practices wherein they aim at starting honey for the baby which is again not not advised before one year of age but honey is considered very pure in Indian scenarios and therefore they are very much aligned around introducing honey And sometimes some cultural practices, we see that they are also aligned on introducing water before six months when there are, you know, summer. Because we are a very tropical country. So they believe, okay, the baby will get dehydrated. Let’s give him some water, which is not aligned. But usually most of the practices are aligned just that. The grandparents still, even now, they are not aligned with the practice of not giving salt and sugar to the child before one year of age. They are like the sweet, sweet things should be given to children. They are considered auspicious. Whenever there’s a festival coming in, they will be like, okay, some sugar doesn’t do any bad to the baby or doesn’t worsen anything for the baby. So out of their love, I would say there’s unintentional not following the guidelines is happening.

Dr. Rebecca Dekker – 00:18:59:
Okay. You mentioned honey was also supposed to be the first food for some newborns. Okay. Yes. And where does that come from, that practice? Do you know the history of it?

Yogyata Wadhwa – 00:19:12:
It’s been in ages. And also there are some certain Vedas, we call it as texts. In Hindu mythology, especially Hinduism is the biggest religion in India. It’s also the third largest religion in whole of the world. In Hindu Vedas texts, in those books, it is mentioned that honey is very, is like nectar for the babies and things like those. So it is mentioned in those religious texts and hence it is deeply, those religious beliefs are deeply embedded into the cultural practices and have been followed since long and been. Nowadays we do see that urban population does not follow these kind of pre-lactyl feeds like honey. Rural population, most of them are still following.

Dr. Rebecca Dekker – 00:20:08:
And for our listeners who are maybe new to parenting, can you explain why babies are not supposed to have honey. And I know in Western cultures, we talk about it a lot, how you’re not supposed to give it to them before one year of age. Could you explain why?

Yogyata Wadhwa – 00:20:27:
Honey causes infant mortalism in children. So it should not be allowed before one year of age. It has a bacteria which can actually cause muscular paralysis in children. And there have been incidences reported. You know, it will not be allowed before one year of age, but it is very difficult for these. You know, they will be like, we’ll just you’ll just dab a finger and, you know, just put it on the tongue of the baby. And that’s it. It’s just a ritual. So they they just, you know, don’t understand the importance of what how how scary it can be if the baby catches that kind of bacteria.

Dr. Rebecca Dekker – 00:21:10:
Yeah, because their immune systems are not ready to fight off the botulism. What is some of the advice you give to parents when they’re starting their infants on solid foods? You mentioned rice is a good starting food. What are some of the other foods that you like to suggest?

Yogyata Wadhwa – 00:21:32:
When we talk about the… Usually, when we are starting solids for the babies, the important thing is that we are loading their digestive systems, their gut systems to digest something which they never have had. So introducing gut-friendly foods initially and starting with, you know, maybe exploration of foods initially in a baby-led way. With maybe one meal a day to begin with and understanding, okay, how it is, is it impacting their digestion? Is my baby, you know, in discomfort or is my baby not able to, you know, waking, sleep through the night or waking up frequently and tossing and turning in the bed? So this can be, or feeding frequently at night just because they need vibration or energy around digesting those solids. So I usually first focus on gut-friendly foods, which can be, you know, a rice porridge or a rice cereal. Worldwide, it is usually one of the, you know, first foods that are started. Other things that we usually focus on are fruits like banana, like apples and also curd. These are first few foods that we look into. But apart from that, if carrots, cooked carrots and pumpkins, they are also a very good idea to begin foods with. And then slowly, slowly we shift to other vegetables and fruits as we go up further in the journey.

Dr. Rebecca Dekker – 00:23:16:
So starting with soft vegetables and fruits, and when you said apple, I assume you mean like cooked apple or applesauce?

Yogyata Wadhwa – 00:23:24:
We usually recommend, we don’t recommend sauces. We usually recommend that you steam an apple and mash it nicely. Okay? So it’s lumpy to begin with.

Dr. Rebecca Dekker – 00:23:34:
You mentioned the phrase baby lead. Could you talk about what that means? Because I’m familiar with it, but I’m sure many of our listeners are not.

Yogyata Wadhwa – 00:23:45:
So baby lead is a way to introduce solids wherein the baby is the decision maker. The baby leads the way. And in that scenario, we start making the baby a part of our eating times when the parents are sitting for a meal, they also make the baby a part of the eating time and maybe hand over a few foods which can act as food teeters, like a mango pit or a corn cob without the corns or something which is very hard, which they cannot bite it, bite it. And they start exploring those foods and they start understanding when they watch parents doing it. So they start understanding what to do with the food and they explore it first as an activity, which develops a lot of gross motor, fine motor coordination in them. And then once we see that they are showing interest in foods, they are sitting nicely, safely at the table, then we slowly, slowly start offering real foods to them so that it is safe for them. And it is also that they develop a positive experience with the food. They explore various textures. They explore various skills around them. And then this brings them to be not picky eaters in the future.

Dr. Rebecca Dekker – 00:25:22:
Because they’re eating what the family is eating and they’re part of the meal.

Yogyata Wadhwa – 00:25:29:
Yeah. And our main aim is to bring them to the family part by one year of age.

Dr. Rebecca Dekker – 00:25:33:
Okay. So that by one year they can be eating the family food. Just like everybody else.

Yogyata Wadhwa – 00:25:41:
And it’s very sustainable for the mother also. The cooking part, you know?

Dr. Rebecca Dekker – 00:25:46:
Exactly. One of the things that I have a question about is the commercial baby food, is that popular where you live or not? You know, with the cans, with where you start babies with like almost like pureed or sauces. And parents think that they have to, you know, buy these different jars of food to feed their baby.

Yogyata Wadhwa – 00:26:08:
In my geographical location or in Indian context, if we talk about. I’ve also, for the infant feeding or baby feeding practices, I’ve even gone to some government or public health areas wherein there were rural areas and we talked to the mothers, so they are giving the home food mostly, but they are sometimes overwhelmed by the marketing of these cereals that this has so much of nutrition, this has this and this will make the baby grow larger in height. Or they catch on their inferiority complexes and all of that. And so the mother believes that and sometimes even when they are economically not that strong, still they are striving to give those powders to the children because they are made to believe that they are healthier. So breaking that myth is happening, but still there is some kind of that belief. Although babies are mostly on the home food, but they still come into those marketing gimmicks. In the urban population, we see that again, in India, we have in the urban population, we see that their economic status is better. So they can hire lots of house elves. And they come at a very economical cost in India as compared to the United States or western part of the world. So they are also more aligned towards home cooked food. But when it comes to traveling or something or when they, you know, then they do resort to these packaged cereals and packaged foods, all of that. But it’s still not as prevalent as in the West.

Dr. Rebecca Dekker – 00:28:04:
I also have a question about, you know, you mentioned six months is kind of the evidence-based guidelines to start offering foods. But how do you know when your baby is ready to start solids? Because I’ve had some friends, their babies like are not interested at six months or they they spit out the foods or they can’t seem to be able to swallow the foods. Could you talk a little bit about signs that your baby is ready?

Yogyata Wadhwa – 00:28:34:
So we usually talk about that. The signs that the baby tells you that they are ready is one that when you’re making them sit either in your lap or in a high chair or something like that, then they should be able to hold their head upright. You know, they should be sitting upright. They should not be hunching over like chin going into the chest or something like that. There should be at least two to three fingers gap. So that we know that their food pipes or airways are open and they will not choke while they are eating. Number two, they should, you don’t have that form of grasp and able to hold on to things. Another scenario is when you’re making them part of the family eating routine. They should start when they’re seeing you, they should start showing that interest in food. And also, when we talk about reflexes, then babies which still have the tongue thrust reflex, we should wait for the tongue thrust reflexes to go away. Because if we are giving them food, then their tongue would just be pushing it out and although the parents are thinking that they are refusing food, they are not refusing. Actually, their body is still getting ready to feel safe around eating solids.

Dr. Rebecca Dekker – 00:29:58:
So it’s a reflex to keep them from choking because they’re not ready for solids. Okay, that makes sense. And I have so many fond memories of my second child is when I learned about baby led weaning. And, you know, he would sit at the table and you knew he was ready because he was trying to steal my food, you know, and you couldn’t keep it away from him. He was like so ready to eat. Whereas my first child, you know, I had no, I had never learned of this baby led weaning. So I was trying to just feed the spoonfuls of, you know, pureed carrot or applesauce. And she hated it. She was always spitting it out. And I thought I was, you know, what’s going wrong? And I realized now it’s just because she wanted to eat regular food, not the, not the sauces. So it was interesting kind of seeing the contrast. Definitely with my second, the mealtimes were much more happy and fun because it was like you said, use the word exploration. And that’s what it felt like. Yeah.

Yogyata Wadhwa – 00:31:03:
Also in India, there is a not so accepted, although culturally baby led was the norm. But somehow when we talk about nowadays cultural practices, they are also around giving, you know, rice water or lentil water to the baby because they believe that, you know, there is some quantity of food that should be going into the baby’s mouth. So there are still some strata of people who are yet, yet to understand the baby led method. And they are like, what all will the baby eat? You know, they will keep throwing the food. They will keep wasting the food. So it is again, difficult to make them understand that that is the beginning of studying to explore food is the beginning to, to start solids and to start eating independently by themselves.

Dr. Rebecca Dekker – 00:31:58:
If your baby is not ready at six months, if they have the tongue thrust reflex or they’re just throwing their food and they won’t put it in their mouths and eat it. Is it normal for it to take longer sometimes for a baby to be ready, like maybe seven, eight, nine months?

Yogyata Wadhwa – 00:32:16:
See, it can be normal, especially we see that in cases wherein the baby was a preeminent baby, so they may take more time. There are babies who have tongue ties and sometimes it also impacts the mature following. So some babies with tongue ties may pocket their foods and take more time to understand how to take it in, take it in. So it may take more time for them. However, we see that many, many reflexes and teething is happening around eight, nine months. So if the baby is not eating at six months completion or something like that, we can wait, you know, three, four weeks. But ideally, we should not be delaying it beyond nine months of age or 8.5, 9 months of age because then we miss that critical window of all those chewing reflexes coming up.

Dr. Rebecca Dekker – 00:33:17:
Okay. So if your baby’s not eating solids by eight or nine months, maybe seek help just to make sure there’s no tongue tie or something else. I was also curious, as someone practicing in India, you know, what are some differences in maternity leave or postpartum support compared to Western models of care?

Yogyata Wadhwa – 00:33:41:
When we talk about maternity leaves, in most of the Indian practices, the government gives, you know, paid leave for six months, 26 weeks in first and second babies. In the third child, they offer around 12 weeks. It is largely followed in most of the formal sectors, but not so much followed in the informal sector. But we still have, from that perspective, as compared to the Western scenario, wherein there is no mater leave or something like that, you know, we still have support around that. Also, the Indian Maternity Act guidelines, the guidelines say that work scenario allows work from home for the mother, so she can opt for work from home. But if her work process does not allow that, or she is in such kind of a profession that she has to visit the office, then the company or the officers should offer a crutch facility. If the company has more than 50 employees, they should offer a crutch facility to their mother so that they can in between go and feed the baby. Although these are not followed diligently by many, many officers, but larger organizations do follow them. And hence, as compared to the West, on paper, we have much higher guidelines. They are being followed, but not very diligently. That’s why we say that that’s why breastfeeding at one year of age, we see only 43 percent of the mothers are doing that. Considering all of these guidelines, sorry, at six months, 43 percent are exclusively breastfeeding. Considering all these guidelines when government is giving so much of maternity benefits, we should see a higher number. Right.

Indian mothers in India versus Indian mothers in the West. You know, there are starking differences in the way they are breastfeeding their children. So there is a cultural impact. You know, when it comes, when we see mothers over here, they get support from the family. So if the grandparents, if they are not living together, they sometimes come there for the first time. Mom and grandparents take their turn the maternal grandparents will take you know for six weeks either they will call the mother to their place or come over for six weeks and then the paternal grandparents will come for some durations and they will try to help the mother with the baby also Just like you have postpartum doulas, we have Jappas helpers over here who come over here, help the mother with all the baby feeding and nighttime practices. And they are a support system to the mothers. There is also cultural practice of a period of confinement, which we call it as the Jappa period, in which the mother is confined to a warm, cozy room, not much visitors coming in, you know, rooming in, rooming in with the baby so that, you know, the baby is less overstimulated, has lesser crying spells or poor licks and the mother is more regulated towards the baby and they are finding that co-regulation together. So that kind of a cultural practices help the mother and the baby to not thrive together much better. When we see Indian mothers in the UK or the US, and they do not have that kind of a support system over there or that kind of cultural practice over there.

Dr. Rebecca Dekker – 00:37:48:
Or their parents, the grandparents are not available because they don’t live there. Yeah.

Yogyata Wadhwa – 00:37:53:
They don’t live there. They are not available. And also, the practices around making the baby sleep in a crib and say, and the guidelines over there are, we are primarily a bed-sharing co-sleeping nation, you know. Before, the word co-sleeping was, it was a new word for us because co-sleeping meant sleeping for us. You know, it was like that. So, they find those practices hard to achieve. And also, the postpartum doulas are kind of…they are expensive over there as compared to, I’m not saying they’re expensive in what they do, definitely they deserve that kind of, because the living standards are also very high over there, but as compared to what we have in India, it is much more affordable to have house health support and paid health here in India. So postpartum, I feel when I talk to mothers in the West, Indian mothers in the West versus Indian mothers in India, we still have much better support. In India as compared to the West.

Dr. Rebecca Dekker – 00:39:09:
Yeah, it sounds like it. You have live-in support and it’s easier to hire help as well. And it sounds like you have several months of family living with you, helping while you’re recovering and breastfeeding and taking care of baby. Yeah. For families who might feel torn between kind of the typical evidence-based advice around lactation, infant feeding, and then their family expectations, maybe from their mother-in-law or their own mother, what advice do you like to give parents to help them make decisions and feel confident about it?

Yogyata Wadhwa – 00:39:46:
We usually advise them to, most importantly, to listen to their instinct. That’s, that’s primary. Mother has her own parental gut instincts around what are her parenting choices. Apart from that, whatever cultural guidelines do not align with evidence-based guidelines, then we look into, “Okay, what cultural practices are there which are not aligned but also not harmful for the baby?” So maybe just for the sake of following or pleasing the grandparents or the family or following the cultural practices, you can let that happen. But there will be some practices which are red flags and not okay to be followed. In that scenario, the parents are assertive and put their foot down around, yes, okay, we are so they take a step in following some of the practices that are okay no benefits no harm okay benefits yes definitely allowed no benefits no harm okay do follow to please the grandparents and the cultural society but those which are like giving honey like you know these things so these they are a big no and now parents are taking taking those conversations with the grandparents although, you know, this does not come easy to many parents because the cultural practices are deeply rooted in the systems. But otherwise, yes, that’s what we usually tell them. For example, there’s a very wide practice of using a special pillow for the baby for head shaping. Hmm. Which is usually not evidence-based at all. We see that no pillows are allowed for babies, but they have those specials feeding yourself, head shaping pillows and all of that. And there are some pillows which are, you know, they are called as rai pillows in India. Rai pillows means like they are pillows made of edible mustard seeds, small mustard seeds. So those pillows are like when the baby puts the head on it. So they are like, you know, they just compress as per the baby’s head shape. So we tell the parents, okay, no pillows till one and a half to two years of age. And they’re like, no, grandparents are like, you should use these rai pillows. They will shape the head of the baby. Other head shaping pillows, like those round pillows, we say no, a big no, but okay, right pillow, if you want to use them, no benefits, no harm, use it for the sake of the grandparent. That kind of an example, it’s just a basic example that I can give.

Dr. Rebecca Dekker – 00:42:54:
It’s called a rai pillow. R Y E

Yogyata Wadhwa – 00:42:58:
R-A-I.

Dr. Rebecca Dekker – 00:43:00:
R-A-I. Okay. Interesting. I had never heard of that. I learned something new every other minute talking with you. I have one more question, Yogyata. You mentioned some of the differences for Indian parents in India and Indian parents in the Western countries. For those who are listening who may, you know, be living in the West and from Indian culture and maybe feel like they don’t have the support that they would have in India. What advice do you have for them to make postpartum easier, to make parenting and breastfeeding easier? Do you have any advice for those who are far away from family?

Yogyata Wadhwa – 00:43:43:
So, I usually see them quitting exclusive breastfeeding or breastfeeding earlier. They find pumping very hard. You know? Because they are not used to that kind of a practice. And over a period of time, they are in a guilt of not being able to pump, pump, and also not being able to exclusively breastfeed because of, you know, no help around. And they’re managing the whole house by themselves.

Dr. Rebecca Dekker – 00:44:18:
Or they have to go back to work early.

Yogyata Wadhwa – 00:44:21:
Going back to work early. Yeah. And so many things. So in that scenario, we talk about sustainable feeding and parenting choice. Okay. Because maintaining the sanity of the mother is very, very important over here. You know, you don’t have help and you also don’t have emotional help also around. If you are, you know, emotionally overwhelmed, you have, you know, some people to support you. Therein, when you are an immigrant, very few people can understand your cultural practices at that point of time. So we usually, with those parents, we talk about sustainable feeding and parenting choices and how can they, whatever their goals are, if they are choosing to exclusively breastfeed, how can that be achieved? And if they are choosing to combination feed, then they should be off the guilt of combination feeding or formula feeding. And that’s what usually the advice is, that how can we make it more sustainable for them?

Dr. Rebecca Dekker – 00:45:33:
And how would you define sustainable, you know, parenting choices? Like what’s a good, you know, way to summarize that?

Yogyata Wadhwa – 00:45:44:
So sustainable parenting choices would mean that without having, you know, anxiety or pressures around following certain practices. Some practices which you and your partner or whatever system you’re in, you know, whatever help you have or whatever help you don’t have in that scenario. And most of the fathers are also contributing now. So in that scenario, what is easily practiced? What is the easy practice for you so that every day you don’t have to wake up being stressed around, oh my god, I have to do this, I have to do that, I have to do that. And in your brain, you’re sorted, okay, this, this, this, this, I have to do this. With the support right now available, I will be able to do that without getting too much overwork or too much stressed around it.

Dr. Rebecca Dekker – 00:46:45:
Trying to avoid overwhelm and making choices you can live with every day. Exactly. Well, thank you, Yogiata, so much for all of the wisdom you’ve shared with us today. Do you have any final words of advice for our listeners today?

Yogyata Wadhwa – 00:47:04:
So, my final advice, especially to the first-time parents, is that parenting is the toughest job in the world. It is very, very hard. And we want babies to raise in an environment which is responsive parenting and happy parenting. So choose those methods, those practices, keeping evidence in mind. Use those practices which are sustainable, easily adaptable and followable in whatever situation you are. And keep following Evidence Based Birth® for such podcasts.

Dr. Rebecca Dekker – 00:47:45:
Great advice. Thank you so much, Yogyata.

Yogyata Wadhwa – 00:47:48:
Pleasure, Rebecca.

Dr. Rebecca Dekker – 00:47:49:
Pleasure. This podcast episode was brought to you by the book Babies Are Not Pizzas: They’re Born Not Delivered. Babies Are Not Pizzas is a memoir that tells the story of how I navigated a broken healthcare system and uncovered how I could still receive evidence-based care. In this book, you’ll learn about the history of childbirth and midwifery, the evidence on a variety of birth topics, and how we can prevent preventable trauma in childbirth. Babies Are Not Pizzas is available on Amazon as a Kindle, paperback, hardcover, and Audible book. Get your copy today and make sure to email me after you read it to let me know your thoughts.