Postnatal Care: Learning the Stages of Confinement for New Moms

This article discusses the facts and myths as well as the four stages of nourishment of confinement, a form of traditional postnatal care.

A partial view of a new mother in a hospital bed looking sideways at her baby

The term “confinement” concerning postnatal care might sound unfamiliar for new mothers used to Western medicine. Some might find it strange or even unsafe. Read along as we discuss the myths about this traditional postnatal care practice and the four stages of confinement nourishment.

What is Confinement?

In its simplest form, confinement refers to a period (usually a month) for new mothers to recuperate from childbirth. In Mandarin, it is called zuo yue zi or “sitting the month” because it lasts four to six weeks. During this time, postpartum moms would be “confined” to her room and observe traditional postnatal care methods that ensure proper recovery of her body.

Benefits of Confinement in Postnatal Care

A partial view of a sleeping baby with her hand slightly touching the mother’s fingers
Confinement can potentially strengthen mother-baby bonding.

There are many advantages when it comes to confinement. These include:  

  • Helping mothers heal from their postnatal syndromes like hair loss, swollen breasts, body aches, hot flashes, and haemorrhoids to abdominal cramps, blood loss and vaginal bleeding. From a Traditional Chinese Medicine (TCM) point of view, a woman loses a large amount of blood and qi (vital life energy) during the childbirth process. This condition causes her body to enter a “cold and weak” phase, lowering her immune system, and causing her vulnerable to pains and illnesses. 
  • Allowing a woman’s maternal body functions and reproductive organs to repair and return to their prenatal state. For instance, ensuring the uterus contracts back to its normal size, vagina wounds are healed, and stretched loose skin, joints, and ligaments resume to their normal states. 
  • Encouraging smooth lactation and avoiding issues such as engorgement and mastitis. 
  • Calming the new mother’s mind and spirit and preventing postnatal depression. Confinement also allows the mother’s body to recover naturally from physical and psychological fatigue due to childbearing. 
  • Promoting mother-baby bonding.

What Do Mothers Do During Confinement?

A woman holding a bowl of soup
Confinement requires new mothers to rest and consume nourishing meals.

So, what does confinement entail? In general, new mothers need to rest and consume a nutritious diet following TCM practices.

Fact-checking Confinement

As the custom has been going on for so long, the line between what’s right and wrong has blurred. Let’s find out whether the myths about confinement have any truth in them:

1. No water: False

New mothers experience changes in their hormones, which cause them to sweat more than usual. Hence, they should drink more water at this time. TCM believes that the new mother’s body is in a “cold” state, so it helps to drink boiled and warm water. It is also beneficial for moms to consume brewed herbal soup or tea.

2. Drink alcohol: False

TCM uses alcohol to eliminate coldness in the body and strengthen blood circulation. This can be done through cooking methods such as stir-frying dishes or brewing soups with confinement or ginger wines, rather than direct consumption, especially for new mothers who breastfeed their babies. For mummies who prefer to drink the herbal alcohol directly, it is advisable to do so after breastfeeding and have an interval of 2-3 hours before the next feed.

3. No showering: False

Showering and washing hair during confinement is allowed, but it’s better to use warm water and bathing herbs that help to expel “wind” from the body. It’s best to shower during the day and immediately dry hair and body thoroughly after washing up.

4. No reading and crying, no cell phone and air conditioner: False

Instead of completely forbidding air conditioners or fans, TCM advises moderation. A new mothers’ body is already in a “cold and weak” state, so it’s better to not expose themselves to the “wind and cold” that comes from the direct blowing of air conditioners and fans. However, it doesn’t mean they should avoid air conditioners or fans altogether, especially if they experience hot flashes. Set the air conditioners to moderate temperatures such as 25°C or 26°C to avoid catching the “cold and wind”. 

Likewise, it’s okay to read, cry or use a cell phone occasionally. Find a well-lit environment and avoid prolonged duration of doing so. TCM notes that blood loss during childbirth weakens the liver. Since the liver is related to the eyes, it is important to rest the eyes more to prevent negatively affecting the visual system. Reading, crying, or using the cell phone strains the eye muscles and should be done in moderation. TCM also suggests eating herbs like Goji berries that protect the liver and keep the eyes healthy.

The Stages of Postnatal Care Nourishment

In TCM, there are 4 stages of confinement nourishments that are specially designed to nourish different parts of the woman’s body. Each of these stages assists in her recovery by taking care of various organs. Eu Yan Sang TCM physician Jolene Chong elaborates on the four respective stages and their importance in new mothers’ recovery, along with an introduction of healthy dishes:

First Stage: Promote blood and qi circulation and improve appetite and absorption

Going into labour costs a woman a lot of blood and qi (vital life energy). This condition weakens the body leading to deficient veins, low immunity, and reduced energy. That’s why the first stage focuses on smoothening the flows of blood and qi.

According to physician Chong, it is essential to ensure the smooth expulsion of vaginal bleeding (lochia) after delivery to regulate the uterus contraction and ensure the recovery of the uterus and overall body function at this stage. This is done by promoting blood circulation to remove blood clots in the uterus which may cause pain too. 

New mothers can take shenghua soup for this. It is also necessary to expel wind and the removal of the body’s excess water by having good qi flow. A light diet could help to improve appetite and the digestive function to aid recovery and to achieve good qi flow. Mummies can try Chinese light and clear tonics such as si shen soup (appetizing support nourishing soup) and shang deng dun tang (revitalising soup) to strengthen the gastrointestinal system, increase breastmilk quality, reduce water retention, and promote digestion and nutrient absorption.

Second Stage: Milk secretion and blood and qi replenishment

After a week, the focus moves on to the mother’s milk secretion to ensure that she can breastfeed the baby well. Physician Chong recommends increasing Chinese medicinal herbs intake during this stage for a smooth lactation process and avoiding breastfeeding issues such as engorgement and mastitis.  

To produce sufficient and good quality breast milk, it is also essential to replenish blood and qi as TCM believes these are the essence of breast milk. It is advisable to consume foods like blood nourishing soup, ba zhen soup (longevity tonic soup) and papaya fish soup.

The replenishment of blood and qi would calm and nourish the new mother’s mind and spirit, preventing postpartum depression and improving her sleep quality.

Third Stage: Physique strengthening (muscles, bones, tendons, ligaments)

The following week focuses on strengthening the mother’s physique, including her muscles, bones, tendons, and ligaments in the joints, allowing her to regain pre-pregnancy vitality, and to better prepare for future pregnancies. 

Physician Chong suggests consuming du zhong soup (kidney tonic soup containing eucommia bark, du zhong) to relieve lower back pain or muscle strain around the lumbar area. As these soups contain calcium, they can promote the recovery of the bones and tendons.

Fourth Stage: Boosting overall body performance

The last stage focuses on the mom’s overall physical capacity, including brain function, memory, and skin and hair health. New mothers can consume dishes containing black vinegar pork knuckles rich in collagen to nourish these organs and body parts or take shi quan bu tang (energising tonic soup) and black bean soup with he shou wu. These soups help keep the body warm and boost the body’s overall performance. 

While this traditional postnatal care practice is beneficial, some new mothers might find confinement overwhelming. But there are many ways to make this time a more comfortable one. For instance, packages containing confinement nourishments for one month are available in the market. These packages help new mothers easily prepare a nourishing confinement diet so that they can fully focus on their recovery.

This is an adaptation of the articles, “Beware These 6 Confinement Myths” and “Confinement Nourishment in 3 Stages“, which first appeared on Eu Yan Sang website. 

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