Chinese zuoyuezi Rituals: Traditional Versus Modern Mothercare

  • February 19, 2009
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Zuoyuezi is the Traditional Chinese Medicine (TCM) term for the month a mother spends at home after giving birth during which she eats nourishing food, rests and recovers her strength. Weight gain and lethargy are among the consequences of failing to spend a good zuoyuezi, according to TCM.

It also advises that during the zuoyuezi period a new mother should stay indoors and avoid bathing, washing the hair or brushing the teeth. She should also wear a hat or scarf at all times, keep windows closed, and stay in bed for as long as possible.

Contemporary postnatal care considers certain TCM axioms as reasonable and scientific, others not so much wrong as obsolete. 

The TCM rule of staying indoors is to avoid exposure to communicable diseases, and keeping the head covered wards off chills. Modern mothercare, however, encourages mothers to get out into the fresh air, even in deep winter.  It also recommends high protein foods such as beef, mutton, fish and shrimp to produce ample breast milk, which conflicts with the TCM view that mainly advocates "tonic" soup and eggs immediately after giving birth.

Although eggs are indeed a good form of nourishment for new mothers, eating too many causes a dietary imbalance and weakens the digestion. Generally speaking, two-to-three eggs a day during zuoyuezi is sufficient.
TCM advises foregoing salt for the first few days after giving birth, to avoid edema, or dropsy. But food containing salt is actually beneficial  as well as tasty, because it helps regain energy lost through overactive sweat and mammary glands.

Tradition also discourages eating raw or cold foods, such as fruit and vegetables, during zuoyuezi. This is disputed by the fact that after going through labor women need to stay in bed to rest their abdominal muscles, and are consequently likely to suffer from constipation or hemorrhoids. The vitamins, mineral elements and dietary fiber in fruit and vegetables absorb sugar and protein, stimulate gastrointestinal peristalsis, thus fending off constipation as well as curbing the appetite. One piece of fruit and 50g vegetables gradually increasing to two pieces of fruit and 200g of vegetables are the recommended daily quantities. 

Chinese mothers of antiquity believed that drinking "tonic" soup would help them to produce ample breast milk after giving birth; also that they should wait until 24 hours post partum before nursing their babies. But sustained secretion and production of mother's milk is actually a reflex stimulated by a newborn infant's sucking at the nipple. Breast feeding is symbiotic in that it promotes uterine contraction and ensures the newborn receives nourishment rich in anti-bodies that allay future risks of obesity, diabetes, coronary heart disease, eczema and asthma. It is consequently advisable to breastfeed the newborn thirty minutes, rather than 24 hours, after giving birth. And as it takes at least one week to regain intestinal and stomach functions after going through labor, new mothers are advised to eat greasy "tonic" soup made from chicken or fish one week, rather than immediately, after childbearing.

When analyzing the principles of  zuoyuezi in the historical medical context, many of its practices make sense. Avoiding bathing and brushing the teeth was to prevent water-borne diseases. Prolonged bed-rest was to promote recovery of the strength needed to care for an infant while fulfilling all other household duties.

It is clear today that low living standards and poor sanitation were at the root of zuoyuezi principles, whose purpose was to prevent postpartum complications. Today it is not only safe but advisable to take a bath two-to-three days after delivery and wash the hair seven-to-10 days later. Bathing reduces risks of folliculitis, endometritis and mastitis but the bathroom should be warm and no longer than 10 minutes should be spent in the bath. As postnatal women often have a good appetite, they should pay attention to oral health and brush their teeth, as normal, twice a day or even after every meal.  

The TCM principle of staying in bed, even when eating and drinking, and taking no exercise is inadvisable. Although new mothers need abundant and rich nutrition they should avoid putting on weight. Adequate rest promotes strength and muscle repair but exercise helps regain the figure as well as promote contraction of the uterine and perineum muscles. Post partum women should get out of bed to urinate six hours after childbirth, sit up in bed 24 hours after delivery and do postpartum muscle training 10 days later. 
Tradition also expects mothers to abstain from sex until 100 days after delivery. Today it is generally agreed that sex six-to-eight weeks after childbirth is quite safe, although women who have given birth by cesarean section should wait three months. Another TCM misconception is that it is only during zuoyuezi that mothers can be cured of ills resulting from previous postpartum complications. They should actually seek necessary treatment within the first postpartum month.

Recommended zuoyuezi Food

Thick Soups
Nutritious and easily absorbed, thick soups made from chicken, pork rib, beef, pig's trotters and soybean increase the appetite and promote milk secretion.

Eggs are rich in protein, amino acids and minerals, and are conducive to digestion and absorption.

Millet Congee
This is a porridge rich in vitamin B, dietary fiber and iron.

Red Foods
Red food includes brown sugar, red jujube, and red beans. Abundant in iron and calcium, they help replenish the blood and prevent asthenic cold.  

Fish contains many nutrients and helps milk production. Crucian carp is the prime choice.

Sesame Seeds
The high protein, iron, calcium and phosphor content of sesames seeds make them another recommended source of nourishment for postnatal women.

Fruits and Vegetables
Rich in vitamin C and minerals, fruits and vegetables help digestion and ward off constipation. As postnatal women's intestines and stomach need time to recover, however, they should eat fewer fruits and vegetables than normal.

(Source: / Translated by

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