Friday, August 24, 2012

Interpreting Traditional Pregnancy Confinement in 2012




The Chinese refer to the postpartum period following a baby’s birth as 坐月 “Zuo Yue Zi”.  It was believed that, after childbirth, the mother’s body is weak and requires special protection and nourishment.  During this time, new mothers traditionally remained in the family home, resting and eating foods prepared by family members from special recipes.  This practice, which in the West is referred to as “confinement”, was first recorded in the Qing dynasty, although most of the recipes predate that period.  While modern medicine and lifestyle changes have had an impact on this ancient tradition, it is still widely practiced, both in Asia and in the West.

“Zuo Yue Zi” was generally practiced for approximately 40 days commencing immediately after the birth, but in modern times many new mothers have shortened the confinement period to 30 days.  The primary purpose of confinement is to ensure that mother and baby get plenty of rest. Mum and baby are not to leave the house, and are both considered susceptible to illness and pollution.

It is believed that, after birth, the mother loses bodily energies commonly translated from the Chinese as “heat”.  This loss of “heat” is believed to be caused by the strenuous activity of giving birth, and new mums are encouraged to stay in warm rooms bundled up from head to toe during confinement.  It is believed that the absence of “heat” can allow cold air (commonly translated as “wind”) to enter the body, resulting in susceptibility to joint ailments later in life. 

While most mothers who practice confinement will adhere to the main practices described above, there are some traditions that are more challenging.  For instance, some believe that all windows in the house should remain closed during confinement to prevent “wind” from entering the home. (Keep in mind that when many of these practices originated, plumbing/electricity was non-existent, which meant no hot showers, hair dryers, or heated rooms.)

The mother is not allowed to wash her hair, walk around the house, read books or watch television.  Bathing is discouraged, though it is permitted to soak the feet and hands in dried ginger skin with hot water, as this is believed to promote “heat”.  Consumption of cold water is not allowed, as it is believed to remove “heat” and promote water retention.  It is imperative that mothers remain hydrated, including by drinking teas and other warming drinks.

The new baby’s grandmother generally performed the cooking, cleaning and other household duties needed to support a traditional confinement. However, as times have changed and many Chinese have become more prosperous and less likely to live with family members, there has been a shift in some circles to hire a “confinement lady” who prepares the traditional recipes and attends to the needs of mother and baby.  However, it can be assumed that in the modern economy, the majority of mothers practicing confinement will be doing so without the help of either a grandmother or confinement lady.
Confinement Cuisine
Confinement cuisine basically consists of “heating” ingredients, for example old (dried) ginger, sesame oil, rice wine, and black vinegar, which are believed to introduce “heat” into the body.  Chinese herbs such as ginseng and dong qui are also considered to be vital tonics that help the body heal.
Must-have confinement recipes include ginger and black vinegar pig trotters, sesame oil chicken, pork liver and kidneys cooked with ginger and sesame oil, and DOM chicken soup.  Hot drinks such as ginger & date tea and longan & date tea were also consumed. A sample of some traditional confinement recipes are listed at the end of this article.  
Alcohol such as DOM and rice wine was consumed to keep the body warm, replenish lost nutrients and give the mother more strength and energy.  However, modern medicine clearly discourages any alcohol consumption by new mothers, especially those who intend to breastfeed.  If you intend to use any confinement recipes that include alcohol as an ingredient you should consult with your doctor beforehand, particularly if you intend to breastfeed.
After Confinement
After completion of confinement, there is a full month of celebration. This is an opportunity for the new parents to celebrate their baby's first month of life with relatives and friends. Traditionally, the baby's name was announced as part of this celebration. To mark the occasion, eggs colored with red dye, known as "Red Eggs" are given to the guests.

My takeaway

Regardless of your view of the traditions of confinement, spending a month at home after giving birth gives mum a great time to rest, recuperate and bond with her new baby. There are also potential benefits for baby, who will be a month older, stronger and better prepared for the attentions of his or her hordes of adoring fans.

Nutrition and the Recipes for Confinement

In addition to the main ingredients used during confinement, new mothers need to ensure they maintain a balanced, nutritious diet, with emphasis on an adequate intake of calcium (for breastfeeding), fiber, protein, vegetables, fruit and sufficient calories in addition to any supplements recommended by your doctor.  It is believed that some vegetables and fruits are more warming than others.  For example, snow peas, papaya, apples, pears are believed to be warming, whereas bitter gourd, cabbage, some mushrooms, lettuce, cucumber, bananas, fig, kiwi, watermelon, and grapefruit are believed to be cooling.

My Plan

My own personal game plan is to observe confinement for 30 days at home with my baby.

I have prepared one recipe so far: the ginger and black vinegar pig trotter (currently stored in the freezer.) Honestly, this was a particular tricky recipe to make, not least because pig trotters are hard to come by in Dublin!  I had to call several butchers, and once I found one that could oblige my odd request, I discovered that getting it chopped was particularly troublesome, as the trotters have to be frozen before chopping or they get caught in the meat grinder. I hope I made enough to last for the month because I don’t foresee me making this one again, especially the process of boiling stinky chunks of meat before actually preparing the recipe.  Ladies, be warned, this stinks up the house for a few hours. But the result is yummy (well, the boiled eggs are anyway.)

The rest of the soups, teas, and foods will be made with the help of my dear husband.

I don’t intend to abstain from showering and washing my hair, but for ladies who plan to observe this, dry shampoo and baby wipes will be a godsend.

Below are the recipes I have hand picked as the top essentials. All these recipes are courtesy of www.chinesesouplady.com or http://chineseconfinementfood.blogspot.ie. I have modified the ginger and black vinegar recipe to make it tastier as well as the sweet potatoes and ginger soup.

Notes on the Recipes:
Ginger packs a lot of heat and spice, so if you find it’s too spicy, modify it to your taste. Each person is different. 
Ensure that all meat, eggs and other raw ingredients are fully cooked prior to consumption.


RECIPES:

Ginger and black vinegar pig trotters

Ingredients:
1 whole pig’s feet, halved and cut into edible sections(2 kgs)
10 large pieces of old fresh ginger (roughly 5000 grams)

2 large bottles of sweet vinegar (1000 mL)

1 large bottle of black rice vinegar (500 mL)
1 cup of black beans
3 tablespoons of rock sugar
12 eggs(you can put as many or as few as you like, I love the pickled eggs so I put in 12)

Method:

  1. Rinse the pig’s trotter in hot water. Then cover in water to boil for 30 minutes to deep clean the meat.
  2. Drain and rinse pig trotter. Dry the piece and then stir-fry in a preheated wok until sides have been browned slightly. Add rock sugar to it and continue to stir until sugar is fully dissolved and aromatic.
  3. Peel the skin, and cut the old ginger into pieces, flatten lightly and set aside.
  4. Boil one dozen eggs for 5-8 minutes, peel and set aside.
  5. Heat the sesame oil in a pre-heated wok(medium heat) and sautee the old ginger pieces and black beans till fragrant(they will start cracking). Remove and transfer into a large claypot. (I used a ceramic pot because a claypot was not available)
  6. Pour in the vinegar and water, cover and bring to a boil. Reduce to low heat and cook for about 20 minutes. Set aside.
  7. Lastly, bring the soup back to a boil. Add the pre-fried pig's trotter pieces into the claypot along with one dozen eggs, cover and simmer over low-medium heat for 2-3 hours.
  8. Let it soak until the all the pig's trotter pieces are tender and the flavor has been absorbed and aromatic. 
  9. Let cool. Portions can be stored in double-bagged freezer bags for a later use of up to 6 months. Should be eaten hot.


Chicken Essence Soup aka DOM Soup
Ingredients:

500g chicken
1 cup/250ml Benedictine D.O.M. or Brandy

Method:

  1. Wash chicken thoroughly.
  2. Scald chicken in hot water and remove the skin. Rinse, pat dry and set aside.
  3. Place chicken and cognac into a double boiler. Cover with lid and double boil for 2 1/2 to 3 hours.
  4. Remove chicken and pour the Chicken Essence into a cup or bowl. It's best served warm.



Winter Chicken Soup
Traditional Chinese Name: 清雞湯 (qīng jī tāng)

This soup contains some vegetables and fresh Chinese radish and is meant to be warming in the cold winter months.  It is excellent for nourishing the lungs and adding moisture to the body when it is particularly dry.  An excellent source of carbohydrates, you can add more vegetables as you see fit (mainly carrots, tomatoes, celery, or neutral vegetables) to turn this into a hearty chicken broth. This soup increases blood circulation and blood flow.


Ingredients
1 fresh whole chicken
1 foot of fresh chinese yam
2 fresh corn on the cob (get frozen if fresh is not available)
10 dried longans
5-6 dried scallops
1 handful of wolfberries
1.5 litres of water





Method:

  1. Prepare chicken (in quarters) by rinsing and blanching in a pot of hot water
  2. Boil your soup water
  3. Wash and soak for 10 minutes all the dried herbs
  4. Wash & peel fresh Chinese Yam (be sure to wear gloves) and cube as large as necessary
  5. Wash and chop corn
  6. When your soup water is boiling, add all the ingredients together
  7. Boil on high heat for 30 minutes and reduce to low boil for another 2 hours.
  8. Serve and enjoy!



Chinese Sweet Potato & Ginger Soup Dessert

This sweet dessert is traditional to Hong Kong and the Chinese.  It is a warm and heaty dessert (especially if you use more ginger) and said to be extremely nourishing and helps removes toxins


Ingredients
2-3 medium sized sweet potatoes (can use any variety of sweet potatoes)

3-4 thin slices of ginger
Chinese brown sugar (in bar shaped)

2 Litres of water


Method:

  1. Boil water
  2. Peel the sweet potatoes and cut into edible cubes
  3. Wash and slice ginger thinly (with or without skin)
  4. Add all ingredients to boiling water
  5. Boil until sweet potatoes are soft

Variation: I added tapioca with the cold water. Instead of 2 liters of water, I added one, and used a can of coconut milk.



Chinese Fried Rice with Egg & Ginger

Ingredients:

200g cooked rice
80g old shredded ginger
2 eggs beaten lightly
2 tbsp sesame oil

A pinch of salt and some soy sauce will make the dish more delicious

Method:
  1. Heat up sesame oil and fry the shredded ginger over a low fire until fragrant. You can tell when it turns a light golden color.
  2. Add in the beaten egg slowly and stir-fry till cooked.
  3. Add the bowl of rice and a little salt to the ginger and egg. Stir-fry over high heat till fragrant. Just before serving, add the soy sauce in and stir till all ingredients are well combined.
  4. Serve immediately


Sesame Oil Chicken Recipe

Ingredients:

3 chicken drumsticks (chop into 3-4 pieces each, bone-in)

2-3 inches knob of ginger (peeled and cut into thin strips)

1 1/2 tablespoon soy sauce

1/2 tablespoon oyster sauce

1 tablespoon Shaoxing wine or Chinese rice wine

2 tablespoons sesame oil

1/2 cup water

3 dashes white pepper powder

Method:
  1. Heat up a wok over high heat and add the sesame oil.
  2. When a swirl of smoke appears from the wok and the oil is fully heated, add the ginger strips and stir-fry until light brown or aromatic.
  3. Add chicken to the wok and stir fry for about 10-15 seconds before adding the soy sauce, oyster sauce, wine, and white pepper powder.
  4.  Continue to stir-fry until the chicken is 70% cooked.
  5. Add water and do a few quick stirs.
  6. Cover the wok with the lid and turn the heat to medium to low heat and let the chicken cook for a few minutes or until the sauce thickens and the meat becomes tender.
  7. Dish out and serve immediately
  8. If the sauce dries up, add more water and cook until the chicken reach your desired doneness.


Daily Nourishing Teas:
Benefits of the Teas:
Effective drink in removing “wind” from the body
Helps warm the body
Assists in helping those in confinement get lots of fluid into the body
Helps improve water levels in the body

Black Beans & Nan Dates Tea


Ingredients:

200g nan dates

50g dried longan
10 sliced fresh ginger

100g black beans

2000ml water



Method:
  1. Cut the dates into half.
  2. Soak black beans in water for about an hour until slightly soft. Drain and set aside.
  3. Cook all the ingredients together in a pot with the water till boiling.
  4. Reduce to low heat and simmer for at least 3 hours.

  5. Remove from heat. Strain well and serve.

Fried Ginger Rice Tea


Ingredients:
300g white grain rice

150g fresh ginger (shredded finely)


Method:
  1. Stir-fry the rice and shredded ginger in a pre-heated dry wok until dry and golden brown.
  2. Remove and keep in a bottle
  3. Soak 1tbsp of ingredients in a cup of boiling water.
  4. Cover for 30 minutes.
  5. Serve hot.
  6. Can be taken everyday.

Dates tea


Ingredients:

50g black dates
50g nan dates/ nan zhao
150g red dates

50g dried longan

1500ml water



Method:
  1. Rinse dates and flatten. Remove the core.

  2. Cook dates with water until boiling. Simmer over low heat for approximately 2 hours.

  3. Remove from heat, strain well and serve hot.
  4. Place the remainder into a thermos flask and drink throughout the day

Dang Shen Tea

Ingredients:

150g dang shen

100g red dates

50g dried longan

2000ml water





Method:
  1. Cut the dang shen into slices or sectionals.
  2. Flatten the red dates and core them. Set aside.
  3. Bring water to a boil.
  4.  Add in dang shen, red dates and dried longan.
  5. Cover and boil for approximately 3 hours over low heat.

  6. Remove from heat.
  7. Strain well and serve hot.

Black Bean, Rice and Ginger Water
Ingredients:

1 teaspoon of oil
2 tablespoons of ginger juice pulp optional
1 cup of black beans
1 cup of pre-rinsed white rice
Drink/Tea:
1 cup of boiling hot water

Method:

  1. In a frying pan, heat up oil on medium heat.
  2. When oil is hot, add black beans, white rice and ginger juice and cook for 2 minutes, constantly stirring
  3. Add 1/2 cup of water and continue to stir and mixture until all the water evaporates.  Be sure to adjust the heat accordingly to prevent burning.
  4. Once mixture is dry and golden brown (see picture below) and cooked, set aside and cool.
  5. In a cup, scoop 1 tablespoon of mixture and add hot water to it.  Steep for 10 minutes and drink hot.
Dear readers:

I will be taking the month of September off to observe my confinement. But I will be back in October with my observations and experience of those 30 days, as well as new and exciting articles on health and fitness!

Pictures of ingredients for reference:

Old ginger: Skin is typically thicker. But if not available, use regular ginger


 Black Beans

 Wolf berries aka goji berries

 Dried longan

 Rock sugar
 Red dates
 Brown sugar

Dried scallops

Black vinegar

Sweet vinegar





Resources:

http://sgmummy.com/chinese-postpartum/

http://www.usatoday.com/yourlife/parenting-family/2010-09-20-china-confinement_N.htm

http://www.nytimes.com/2011/06/05/nyregion/bringing-an-asian-tradition-for-new-mothers-to-new-york.html?pagewanted=all

http://www.healthxchange.com.sg/healthyliving/womenhealth/Pages/Myths-about-Confinement.aspx

http://www.echinacities.com/expat-corner/zuo-yue-zi-and-chinas-traditional-childbirth culture.html

http://www.4panda.com/chinatips/culture/baby.htm

http://rasamalaysia.com/recipe-sesame-oil-chicken/2/

http://chineseconfinementfood.blogspot.ie

http://www.thechinesesouplady.com

http://www.shlcares.com/gallery/albums/userpics/10001/foodexplore.pdf


Tuesday, August 7, 2012

Pelvic Floor Exercises and Perineal Massage






In the interest of efficiency, I have put pelvic floor exercises together along with perineal massage. Pelvic floor exercises can be performs everyday while perineal massage should be done after week 34 of your pregnancy.

Most people don’t think about pelvic floor muscles as a form of calorie burning exercise they need to do so they just don’t do it. As a trainer, when I tell someone to engage their pelvic floor muscle and lower abdominals, they typically look at me like I have two heads.

Doing pelvic floor exercises can improve your sex life and help with incontinence. Incontinence is the inability to control your bladder. When I was working at Sports Club LA, I would have to ask every single new client if they suffered from it. It was quite an personal question but there are easy exercise solutions that can help with this problem. One of the most discreet way is by doing pelvic floor exercises which has an bonus benefit of helping engage your lower abdominals more effectively, which means seeing results quicker, with less reps.

The pelvic floor muscles are often described as a trampoline like structure that works to support the bladder, vagina, womb, and rectum, holding them in the correct place. During pregnancy, these muscles become stretched from week 12 and get weaker as your baby grows.

Doing pelvic floor exercises will help you support your baby as your bump grows and shorten the second stage of labor, as well as speed up your recovery after the baby is born.

The stop test is an effective way to help you check the strength of your muscles. When passing urine, try to stop mid stream. This is NOT the exercise and should not be performed more than once a week. 


To locate the muscles, sit relaxed on an upright chair, knees apart, pelvis in neutral, keep your buttocks relaxed.
  1. Inhale, and tighten up the muscles around the vagina and then relax them. Try not to tighten the muscles of your buttocks. You will know if you are, because you will notice that your body lifts up a little.
  2. Exhale and relax.
  3. Repeat, and tighten the muscles around your vagina and try to imagine giving your baby an internal hug.
  4. Exhale and relax. Try not to hold your breath, or let your shoulders tighten up while you do it
  5. Repeat the tightening 8 more time, then relax. Repeat for 3 sets
  6. Once you have perfected this technique, you can try to exhale as you tighten, and inhale when you relax.

Another technique used in Pregnancy Health Yoga with Tara Lee is the elevator technique.

  1. Knee onto all fours with elbows below shoulders
  2. Inhale and draw your pelvic floor muscles upward in 3 stages, lift, lift , lift. Picture yourself going up on an elevator 1, 2, 3.
  3. Exhale, lower, lower, lower. Picture yourself going down on the elevator in 3 stages. 
  4. Do this for 10 reps, 3 sets. 


Perineal Massage

Research has shown that if this massage is done correctly, it can help prevent tearing, and the dreaded episiotomy.  


  1. Wash your hands.
  2. Then find a private place and sit or lean back in a comfortable position.
  3. Bend your legs, and open them out to the side.
  4. Use a lubricant such as KY jelly, or  olive oil, vitamin E oil or pure vegetable oil on your index fingers and around the perineum.
  5. Place your fingers about 1 to 1 1/2 inches (three to four centimeters) inside your vagina. Press downward and to the sides at the same time.
  6. Gently and firmly keep stretching until you feel a slight burning, tingling or stinging sensation.
  7. With your fingers, hold the pressure steady for about two minutes or until the area becomes a little numb and you don't feel the tingling as much.
  8. As you keep pressing with your thumbs, slowly and gently massage back and forth over the lower half of your vagina, working the lubricant into the tissues. Keep this up for three to four minutes.
  9. As you massage, pull gently outward (and forward) on the lower part of the vagina with your thumbs hooked inside. This helps stretch the skin much in the same way that the baby's head will stretch it during birth.
  10. Do this massage once or twice per day, starting around the 34th week of pregnancy.
  11. After about a week, you should notice an increase in flexibility and stretchiness.

Below is a video that shows you the how to if you find the instructions confusing. But unlike what she says, most ladies will not be able to use their thumbs for the massage as their bump is too big and can’t reach.

Video: Perineal Massage




Resources:



http://www.ivillage.com/perineal-massage-your-how-guide/6-n-145602

http://www.mayoclinic.com/health/kegel-exercises/WO00119
http://www.babycentre.co.uk/pregnancy/fitness/pelvicfloor/