Misconceptions about Fruits Consumption among Nursing Mothers

Abstract: Poor nutritional practices especially in pregnancy and early childhood can result in dire consequences in the growth and development of a child. The nutritional status of nursing children can be determined by maternal knowledge, attitudes, and perceptions towards certain foods.Objective:This study was conducted to find out the existing beliefs and practices about food misconceptions among nursing mothers at the Sir Ganga Ram Hospital, Lahore. Methods:Data size was 100 nursing mothers and they were selected through non probability convenient sampling technique. SPSS version 21.0 was used to analyze data. Results:Findings showed that majority of mothers were practiced false dietary habits for the sake of good health of their children. Total 83 nursing mothers were practiced these misconceptions because their family elders told them. It was considered that banana increase mucus production(89), oranges increase soreness of throat(76), mango increase the chance of allergy in children, dates are hot(70) and papaya can cause miscarriage(58). Conclusions:Current Study concluded that existence of food myths and taboos was very common among nursing mothers and they also practiced it. Fruits such as papaya, mango and saffron were practiced as hot and also considered as anti-pregnancy fruits.

Poor nutritional practices especially in pregnancy and early childhood can result in dire consequences in the growth and development of a child. The nutritional status of nursing children can be determined by maternal knowledge, attitudes, and perceptions towards certain foods. Objective: This study was conducted to find out the existing beliefs and practices about food misconceptions among nursing mothers at the Sir Ganga Ram Hospital, Lahore. Methods: Data size was 100 nursing mothers and they were selected through non probability convenient sampling technique. SPSS version 21.0 was used to analyze data. Results: Findings showed that majority of mothers were practiced false dietary habits for the sake of good health of their children. Total 83 nursing mothers were practiced these misconceptions because their family elders told them. It was considered that banana increase mucus production (89), oranges increase soreness of throat (76), mango increase the chance of allergy in children, dates are hot (70) and papaya can cause miscarriage (58). Conclusions: Current Study concluded that existence of food myths and taboos was very common among nursing mothers and they also practiced it. Fruits such as papaya, mango and saffron were practiced as hot and also considered as anti-pregnancy fruits.

I N T R O D U C T I O N
There are many factors that have great influence on children health. Maternal child feeding practices directly correlates with child health and food intake. Other factors that have great impact on children health are parent's life style, maternal health and maternal knowledge [1]. During early life there is a strong relation between parents and children because at that time parents act as caregiver, role models and providers [2]. Children's eating habits and food preferences are also influenced by cultural [3], socio-economical and physical environment [4]. Food taboos, beliefs and practices play crucial role in the development of child feeding practices among nursing mothers, in this way these taboos are transmitted from generation to generation [5]. Parental food choices, food awareness and knowledge act as the base of children food habits and health [6]. Parents with high knowledge of nutrition have healthy children on the other hand parents with low education have unhealthy or sick children [7]. Higher level nutrition education directly associated with fruit, vegetables and healthy consumption. They avoid fad diets and unhealthy food products [8]. Restrictive parenting practices are useful to maintain small consumption of beverages and artificial products [9]. Malnutrition is a leading cause of death and disease among children. Almost 6.9 million children below 5 years were died in 2011 and 33% of these were occurred due to malnutrition [10]. Different parental perceptions and attitudes or misconceptions are the major reasons of poor child growth. These misconceptions and beliefs must be denied for the promotion of child and nation health [11]. In South Asia Pakistan has highest infant and child mortality rate. Stunting and wasting among children has been increased from last few years. This shows that malnutrition is a major problem in Pakistan. Malnutrition acts as a major constraint in the development of Pakistan [12]. Major food perception/taboos show unwritten social and family rules. These perceptions or temperaments are based on some cultural and religious norms which effect the food consumption of a community [13]. On the other hand some foods are considered harmful for a specific group of people [14]. Food taboos can be said as complex attitudes and behavior which are difficult to explain. Food taboos show both negative and positive impacts [15]. These are positive when there is a strong relationship between food and health issues [16].
Current study was designed to determine the dietary misconceptions of nursing mothers about fruits. So that after highlighting the misconceptions, false food practices resulting in malnutrition among children could be reduced, through extensive health education and burden of malnutrition in the society could be reduced.

M E T H O D S
A cross sectional study was conducted at Pediatric and Gynecological department of Sir Ganga Ram hospital, Lahore. Study duration was 4 months and sample size was 100 nursing mothers. Data were collected after the ethical approval from The University of Lahore by using the nonprobability sampling technique. Prior written informed consent was taken from the mothers. Mothers having children above the age of 2 years and non-cooperative mothers were excluded. Data collection was carried out by using pre-tested questionnaire/Performa. Data were analyzed with the help of SPSS version 21.0. Frequencies were calculated to determine the exiting beliefs and practices among nursing mothers.

R E S U L T S
Results showed that none of the nursing mother was below 20 years of age, 51 were between 25 to 30 years of age. 75 mothers were having normal nutritional status, 16 were underweight whereas only 9 were overweight. Whereas 68 children were malnourished and 32 were normal. Majority of the participants were from urban areas having their own house with lower to middle socioeconomic status, Table 1.
Findings showed that 32 mothers believed that saffron consumption is responsible for fairer skin complexion of new born and 6 mothers also practiced it and 82 participants believed that mango and papaya causes miscarriage while 58 mothers also practiced it, Table 2.
As far as mother's conceptions during lactation were concerned, 14 were believing and 47 were practicing as well that oranges consumption by mother can cause diarrhea in feeding child. 20 were believing and 41 were practicing as well that mangoes consumption by mother trigger skin allergy in the nursing baby. Whereas 16 were believing and 42 were practicing that nuts are hot for both baby and mother's health, Table 3.
In this study 35 mothers were believing and practicing that mango causes allergy in children, 70 were practicing and believing that dates are hot for girls. 46 were practicing and believing that oranges and mangoes can cause diarrhea in children, 89 were practicing that banana stimulates mucous production and 76 were believing that oranges cause sore throat, Table 4.
Analysis of current study also exposed some perceptions related to food intake during fever. 76 were believing and practicing that during fever oranges increases throat soreness, while 10 were only believing. 35 were practicing that mango increases allergies during fever and 58 were practicing that banana consumption during fever cause breathing difficulties, Figure 1. Age distribution of children    Oranges consumption by children cause soreness of throat 10 76 14 Table 4: Misconceptions during normal conditions about child nutrition Findings showed that 32 mothers believed that saffron consumption is responsible for fairer skin complexion of new born and 6 mothers also practiced it and 82 participants believed that mango and papaya causes miscarriage while 58 mothers also practiced it. A study performed by Patil et al., in 2010 reported similar findings, that 62.8% individuals were having believe that saffron consumption by pregnant women causes a fairer skin child birth and 86 participants believed that most fruits and vegetables trigger abortion such as papaya and green leafy vegetables [17]. In recent study 24 mothers believed that milk products can increase the production of mucous in fetus. A similar study conducted by Zerfu et al., (2016) in rural Arsi to find out maternal preferences and food taboos. They described that the most common taboos were related to the consumption of green leafy vegetables, yogurt, cheese, sugar cane, and green pepper. These food taboos were based on some social and cultural norms [18]. In current study banana and orange were classified as cold by 33 and 75 mothers while 29 and 69 mothers respectively also practiced it. Current results also informed that nursing mothers restrict some types of foods such as rice, condiments, oranges and hot-cold food to prevent some adverse reactions such as gestational issues, cold and cough. In 2017 Sethi BA et al., conducted a similar kind of research to find out different food restrictions and preferences among breastfeeding mothers. They exposed that common dietary restrictions were yoghurts, potatoes, Banana, carbonated drinks and spices among breast feeding mothers [19]. Current study also exposed some perceptions related to food intake during fever. Forty-nine (49) mothers believed that during fever or illness food needs are reduced while 43 mothers also practiced it. Similarly, 76 and 87 mothers also believed that oranges and yogurt increase the soreness of throat. A crosssectional study in 2012 performed by Benakappa and Shivamurthy, to evaluate mothers dietary practices, culture and religion perceptions to feed an ill child, revealed some similar results. Analysis exposed that most of the caregivers assumed that child must be fed less during disease or illness. In some cases doctors also were responsible for unnecessary dietary restrictions. Mostly caregivers preferred to reduce breast feeding and food intake because they believed that during illness child's energy requirements are reduced. Strong belief about hot and cold food caused restriction of many healthy and nutritious foods among nursing mothers [20].
C O N C L U S I O N S Current Study concluded that existence of food myths and taboos was very common among nursing mothers and they also practiced it. Fruits such as papaya, mango and saffron were practiced as hot and also considered as anti-pregnancy fruits. During lactation mothers followed some false dietary practices that lead towards many nutritional deficiencies among mothers and children.