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Traditional Baby Care Practices of Mothers of Children Aged 6-12 Months in

The Provincial Centre of Trabzon, Turkey

Article  in  TAF preventive medicine bullletin · February 2011

DOI: 10.5455/pmb.20101223033611

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 TAF Preventive Medicine Bulletin, 2011: 10(1)

Araştırma/Research Articl e TAF Prev Med Bull 2011; 10(1) : 61-70

Traditional Baby Care Practices among Mothers with

Children Aged 6-12 Months in the Turkish Province of
Trabzon

[Trabzon İl Merkezinde 6-12 Aylik Çocuğu Olan Annelerin Bebek Bakımına

İlişkin Geleneksel Uygulamaları]
ABSTRACT İlknur Kahriman1
2
AIM: To evaluate traditional baby care practices employed by mothers in the Turkish province of Trabzon. Murat Topbaş
METHOD: This descriptive study was planned around babies born in the provincial center of Trabzon between 1 2
Gamze Çan
June and 31 December, 2005, and aged 6-12 months at the time of the research. Data were collected in July-
September 2006. In order to determine sampling size the prevalence of mothers using traditional practices was 1
Karadeniz Teknik
calculated at 50%, with a deviation of 0.05, giving a sample size of 384 mothers, the final number being put at
Üniversitesi Trabzon Sağlık
400. The study was performed at six clinics selected on the basis of settlement location and socioeconomic level
Yüksekokulu,
out of 11 health clinics in the city center of the province of Trabzon. Data in the study are presented as numbers, 2
Karadeniz Teknik
and percentage distributions as mean±standard deviation.
Üniversitesi Trabzon Tıp
RESULTS: It was determined that 69.8% of mothers breastfed their babies immediately and that 91.3% gave
Fakültesi Halk Sağlığı AD,
them colostrum. It was also determined that 3.7% of mothers resorted to various practices in order to ensure a
Trabzon.
male or female baby, 44.5% in order to facilitate labor, 25% in order to avoid puerperal fever, 63.5% in order
eliminate postnatal pain, 88% to prevent their babies smelling, 86.2% for the shedding of the umbilical cord,
Key Words:
54.2% to protect their babies against jaundice, 73.7% to protect their babies from the evil eye, 26.2% so their
Baby Care, Traditional
babies would be good-looking and 40.7% to safely complete the first 40 days after childbirth. The main practices
Practice, Child Health.
having a harmful effect on health in the study were swaddling, salting the baby, waiting for the call to prayer
before breastfeeding the baby after birth and not giving colostrum.
Anahtar Sözcükler:
CONCLUSIONS: Traditions were observed to have an impact and to be persisting in childcare in Trabzon. This
Bebek Bakımı, Geleneksel
suggests it will be useful for health personnel working in the field of infant care to evaluate the traditional
Uygulama, Çocuk Sağlığı.
characteristics in the locations where they work and to correct negative behaviors.
Sorumlu yazar/
ÖZET
Corresponding author:
AMAÇ: Bu çalışmada Trabzon‟daki annelerin bebek bakımlarında yaptıkları geleneksel uygulamaların
İlknur Kahriman Karadeniz
değerlendirilmesi amaçlanmıştır.
Teknik Üniversitesi Trabzon
YÖNTEM: Tanımlayıcı tipteki araştırmanın evreni Trabzon il merkezinde 1 Haziran – 31 Aralık 2005 tarihleri
Sağlık Yüksekokulu,
arasında doğan ve çalışmanın yapıldığı dönemde 6-12 ay arasında olan bebekler olarak planlanmıştır. Veriler
Trabzon, Turkey.
Temmuz–Eylül 2006 tarihlerinde toplanmıştır. Örnek sayısını belirlemek için geleneksel uygulama yapan anne
ilknurkahriman@mynet.com
sıklığı %50, sapma 0,05 olarak alındığında örnek büyüklüğü 384 anne olarak hesaplanmış, bu sayı 400 olarak
planlanmıştır. Çalışma, Trabzon İl Merkezinde bulunan 11 sağlık ocağı arasından yerleşim yeri ve
sosyoekonomik düzeyleri gözönünde bulundurularak seçilen 6 sağlık ocağında gerçekleştirilmiştir. Veriler, anket
formu kullanılarak toplanmıştır. Çalışmada veriler sayı, yüzde dağılımları, ortalama±standart sapma ile
sunulmuştur.
BULGULAR: Annelerin %69,8‟i bebeklerini hemen bebeklerini emzirdikleri, %91,3‟ünün bebeğine kolostrumu
verdiği saptanmıştır. Annelerin %3,7‟sinin bebeğin kız veya erkek olması, %44,5‟inin doğumun kolay olması,
%25‟inin al basmasından korunmak, %63,5‟inin doğum sonu ağrısını geçirmek, %88‟inin bebeklerin kokmaması,
%86,2‟sinin göbek düşmesi ve bakımı, %54,2‟sinin bebeğin sarılık olmaması, %73,7‟sinin nazardan koru mak,
%26,2‟sinin bebeklerinin güzel olması, %40,7‟sinin kırk basmasından korunmak için herhangi bir yöntem
uyguladıkları saptanmıştır. Çalışmada bebeklere uygulanan sağlığa zararlı uygulamaların başında; bebeği
kundaklamak, bebeği tuzlamak, doğduktan sonra emzirmek için ezan vakti beklemek, kolostrumu vermemek gibi
uygulamalar yer almaktadır.
SONUÇ: Bebek ve çocuk bakımında Trabzon‟da geleneklerin etki ve izlerinin sürdüğü görülmüştür. Bebek
sağlığı konusunda çalışan sağlık personelinin hizmet verdikleri yerlerdeki geleneksel özellikleri değerlendirmeleri
ve olumsuz davranışları düzeltmelerinin yerinde olacağını düşündürmektedir.

INTRODUCTION need to understand how the group receiving care

perceives sickness and health and how it reacts to
People‟s beliefs and practices concerning health them (1).
are part of the culture of the society in which they Society‟s cultural values, attitudes, beliefs and
live. To be able to provide a better health service we behavior affect people‟s life styles, and therefore also

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TAF Preventive Medicine Bulletin, 2011: 10(1)
health conditions, and society‟s cultural values are at
the same time clues that enable contemporary
medical practices to be implemented. Awareness of
these clues is the key to establishing communication
with individuals in the provision of health services to
society (2). Individuals‟ health-related beliefs, culture
and previous experience of sickness/health constitute
an integral whole and play a vital role in the
development of individual health (3).
It is of great importance in terms of health service
efficiency for doctors, midwives and nurses working
in health services to be aware of the cultural structure
and practices of the individuals, families or
community they serve in their catchment areas. It has
been reported that society‟s cultural features have a
significant impact on the health or sickness of
individuals, and of babies in particular (4).
One important issue affecting child health in
Turkey is the care given to children. Prenatal
maternal care, giving birth under hygienic conditions,
the reduction of behaviors having a negative effect on
health, and measures such as making surroundings
suitable and ensuring water is clean all have a
positive impact on child health. Proper care does not
just protect the child against disease and other ills, but
also enables it to grow and develop in psycho-social
and cognitive terms and makes possible the creation
of a healthy environment. Some births in Turkey are
still performed by local midwives, and this is
reflected in child health, particularly the care given to
sick children, and even when it comes to treatment,
traditional practices are sometimes tried first, with
doctors only being called in if these fail to achieve
results (5).
It has been emphasized that the improvement,
protection and maintenance of child health levels and
the health care to be provided in the treatment of
disease are also related to a community‟s structure
and culture; those involved in medical and social
sciences have recently drawn attention to traditional
practices having a positive or negative impact on
infant health (3).
For that reason, health care providers must bear in
mind the effect of culture on health, be aware of the
cultural features of the region in which care is
provided, be acquainted with traditional practices
affecting health, correct traditional practices that may
have a negative impact on health and further enhance
those having a positive impact (3).
This research was planned and conducted with the
aim of investigating traditional childcare methods
known to and applied by mothers with babies aged 6-
12 months in the provincial center of Trabzon.
62
METHOD
The study was a descriptive one, with data being
collected in July-September 2006.
The study was planned to be performed with
babies aged 6-12 months and born in the Trabzon
provincial city center between 1 June and 31
December, 2005. Study data were collected in July-
September 2006, following approval from the local
ethical committee No. 133 dated 01.06.2006.
According to data from the Trabzon Provincial
Health Directorate Statistical Office, the number of
children born at Trabzon Health Clinics between
01.06.2005 and 31.12.2005 was 1461.
No similar studies on the subject have been
conducted in the region. For that reason, since the
prevalence of families using such practices was
unknown, a prevalence of 50% was adopted to
determine the sampling size. With a traditional
practice prevalence of 50% and deviation of 0.05, a
sample size of 384 mothers was calculated. The final
number was planned as 400. The study was
performed at six clinics selected on the basis of
settlement location and socioeconomic level from 11
health clinics in the center of the province of
Trabzon. Mothers were determined in proportion to
the health clinics in the region, and health clinics on
the basis of their level of settlement representation.
A two-stage sampling method was employed,
with the health centers to be studied being selected
first. The mothers of 6-12-month-old babies and their
addresses were then located using Baby-Child
Monitoring Forms and Pregnancy Postnatal
Monitoring Forms in the relevant clinics.
A questionnaire was prepared, based on studies
and information in the literature, in order to evaluate
mothers‟ knowledge of baby care and also traditional
beliefs and practices on the subject. The form
consisted of a total of 111 questions. Data were
collected by a researcher at face-to-face meetings at
home with mothers who agreed to participate in the
study.
The first part of the questionnaire contained
questions about the sociodemographic characteristics
of mothers and fathers participating in the study.
These refer to mother‟s age and civil status, father‟s
age, the parents‟ educational level and professions,
age at marriage, social security, total monthly income
and the other people they lived with. Part 2 refers to
the baby‟s characteristics with questions about the
baby‟s age and gender. Part 3 contains questions
about the mother‟s fertility. These elicit information
about the mother‟s age at first pregnancy, total
number of pregnancies, number of live births, number
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 TAF Preventive Medicine Bulletin, 2011: 10(1)
of still births, number of miscarriages, number of
abortions, family planning techniques employed
before the last pregnancy, after birth and at the time
of the study, and about the most recent pregnancy and
birth. Part 4 refers to traditional baby care practices
applied by the mother. These include measures taken
by the mother to ensure a male or female child, for
ease of birth, for protection against puerperal fever
and for the relief of postnatal pain, the time of the
baby‟s first feeding, colostrum, what was given at
first feeding, and practices involving reciting the call
to prayer into the baby‟s ear, swaddling, umbilical
cord care, jaundice, the evil eye, the baby being good-
looking, completion of the first 40 days after
childbirth and a menstruating woman being permitted
to approach the baby, with mothers being asked open-
ended questions in order to establish their opinions.
Data are given as number or %.
RESULTS
Of the mothers enrolled in the study, 61% were in
the 24-34 age group; 44% of mothers were primary
school graduates, 44% middle school graduates and
28% high school graduates. Of the mothers‟ spouses,
47.5% were in the 31-40 age group, with 35.3% being
high school graduates and 22% university graduates.
Eighty percent of the mothers in the study were
housewives, 14.2% worked in clerical positions, 3.5%
worked in private businesses and 2.3% were manual
workers. Of the fathers, 44% worked in the private
sector, 30.8% were laborers, 24.7% occupied clerical
positions and 0.5% were unemployed. It was also
established that 54.3% of families had a low income
level while 21.0% were of an extended type. Average
age of mothers at first marriage was 21.5±3.3,
compared to 25.4±3.8 for fathers. Only 1.2% of
families had no social security provision.
Of the babies in the study, 174 (43.5%) were 12
months old, and 204 (51.0%) were male.
First pregnancy occurred at 22.6±3.6 years of age,
with 37.3% having undergone 1 pregnancy and
15.5% 4 or more. We determined that 4.5% had
experienced stillbirths, 13.3% had miscarried and
8.5% had had abortions. We also established that
81.3% of mothers had become pregnant intentionally,
99.5% had given birth in hospital, 54.5% had given
birth with the assistance of a doctor and 57.5% had
had normal births.
Additionally, 3.7% of mothers had used various
measures in order to ensure a male or female baby.
These techniques included “eating sweet food for a
boy, bitter food for a girl,” or “rising early in the
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morning, praying, and the father putting his hand on
the mother‟s stomach and praying for a child of the
desired sex.”
It was established that 55.5% of mothers
employed methods such as exercise, walking, sport
and swimming to facilitate childbirth.
Twenty-five percent of mothers practiced some
method to prevent puerperal fever. These included
praying, mother and baby remaining indoors for a
period of 40 days, matches, bread, the Qur‟an, beads
for warding off the evil eye, crochet hooks and water
being placed in the baby‟s swaddling clothes, and the
mother wearing red texts or ribbons.
It was determined that 36.5% of mothers
employed various techniques in order to obviate
postnatal pain. These included medical ones such as
taking pain-killers, as well as keeping the abdomen
warm and wrapping it up.
Of the mothers, 69.7% breastfed their babies
immediately, and 26.8% 1 hour or more after birth.
Three percent of mothers stated they breastfed their
babies after the call to prayer had been recited into
their ears, and 0.5% after waiting for the call to
prayer to be issued. When mothers who did not
breastfeed their babies immediately after birth were
asked why, 30.8% suggested this was because of
Caesarian sections, 21.6% because they had no milk,
20.0% because the call to prayer had not been read
into the baby‟s ear, and 4.5% because they were
waiting for 3 calls to prayer to be made. In addition,
97.7% of mothers said they had had the call to prayer
recited into their babies‟ ears at birth.
We determined that 91.3% of mothers put
colostrum into their babies‟ mouths, while 4.1% did
not.
In addition, 93.3% of mothers gave their babies
mother‟s milk at first feeding, 2.7% giving them
mush, 1.2% sugar water and 1.0% cow‟s milk (Table
2).
It was determined that 31.3% of mothers
swaddled their babies. In terms of preventing their
babies smelling, the most popular practice (32.5%)
was washing, followed by 31.5% putting “salt into
the water they used for washing.” For umbilical cord
maintenance, the most popular practice was
bandaging the cord, used by 71.2% of mothers, with
6% keeping it clean. A further 45.8% of mothers said
breastfeeding was needed in order to avoid infantile
jaundice and also recommended washing in water
into which gold or wormseed had been placed.
For protection against the evil eye, 73.8% of
mothers said they pinned beads, the Qur‟an, talismans
or prayers onto their babies and also prayed over
them.
63
TAF Preventive Medicine Bulletin, 2011: 10(1)

Table 1. Traditional methods employed by mothers to determine the baby’s sex, for ease of birth, to protect
against puerperal fever and to relieve postnatal pain.

Traditional practices No %*
For a male or female baby (n=15)
Eating sweet foods for a boy, bitter for a girl 6 40.0
Rising early in the morning, praying, the father placing his hand on the mother’s 5 33.3
stomach and praying for the desired gender
Post-menstrual washing for a girl, washing at time of menstruation for a boy 3 20.0
The woman experiencing sexual relief first for a girl, the man for a boy 1 6.7
For ease of birth (n=222)
Exercise, walking, sport, swimming 189 85.1
Frequent bathing 8 3.6
Sitting in the warm with the feet in warm water 6 2.7
Doing housework 6 2.7
Not putting on excessive weight 5 2.2
Swallowing dates or rice that has been blessed 3 1.3
Regular check-ups 2 0.9
Harmonious relations with spouse 1 0.5
Drinking mint tea every day 7-10 days before birth 1 0.5
Not lifting heavy weights 1 0.5
For protection against puerperal fever (n=100)
Praying 20 20.0
Not going out at night 16 16.0
Placing bread, water, matches, the Qur’an and beads to ward off the evil eye in the 15 15.0
baby’s swaddling clothes
Red scripts or ribbons being placed on the baby, wearing red clothes 13 13.0
Not leaving the mother and baby alone 11 11.0
Placing a Qur’an by the pillow 8 8.0
The husband’s jacket being alongside the mother and baby until the 40-day mark 5 5.0
has expired
Blessing by an imam, writing on red paper 4 4.0
Avoiding other women who have just given birth 2 2.0
Nothing hot being poured outside at night 2 2.0
Not lying on one’s back 1 1.0
Leaving the light on 1 1.0
Hanging a broom above the child’s head 1 1.0
Pinning a crotchet needle 1 1.0
To Obviate Postnatal Pain (n=254)
Taking pain-killers 195 76.8
Keeping the abdomen warm, wrapping it up 21 8.3
Rest 12 4.7
Walking, exercise 12 4.7
Drinking sherbets and warm liquids 5 1.9
Avoiding foods that cause stomach gas 3 1.2
Bathing 2 0.8
Frequent breastfeeding 2 0.8
Massaging the abdomen 2 0.8
Percentages obtained from “n” numbers

64 www.korhek.org
 TAF Preventive Medicine Bulletin, 2011: 10(1)

Table 2. Traditional practices employed by mothers Table 3. Traditional practices applied by mothers in
concerning baby feeding. daily care of their babies.

Traditional practices No. % Traditional practices No. %*

Feeding time Swaddling
Immediately after birth 279 69.7
Yes 125 31.3
1 hour or more after birth 107 26.8
No 275 68.7
After the call to prayer has been 12 3.0
recited into the baby’s ear To avoid the baby smelling
Waiting for 3 calls to prayer 2 0.5 Washing 130 32.5
Colostrum Washing with salt water 126 31.5
Given to the baby 365 91.3
Wiping 48 12.0
Don’t know 18 4.5
Rubbing with baby cologne, oil
Thrown away, not given, 17 4.2 4 1.0
or cream
expelled
Keeping clean, dressing in
1 0.3
clean clothing
Percentages obtained from the “n=400” number.
For care of the umbilical cord
In order for their babies to be attractive, 26.3% of
Bandaging 285 71.2
mothers ate quinces, strawberries, peaches, apples,
dates or pomegranates, and that when they felt strong Keeping it clean 24 6.0
caprices or when the baby first began to move they Using medicaments (rubs) 6 1.5
looked at pictures of someone they loved, at pretty
babies or in the mirror. Powdering 5 1.2
In order to ensure the safe completion of the first Plentiful feeding 5 1.2
40 days after birth, 40.7% of mothers did not leave
the home after the afternoon prayers until the 40 days Rubbing with cloth doused in
5 1.2
alcohol
were up, while some did not buy meat that had been
weighed until the expiry of the period. In addition, it Squeezing mother’s milk 4 1.0
was determined that 73.3% of mothers placed prayer It will fall off of its own accord 4 1.0
beads or gold in washing water, took their babies out
and about or had prayers read when the 40 days were Rubbing with oxygenated water 2 0.5
up. Frequent bathing 2 0.5
A total of 45.5% of mothers said they did not
allow menstruating women to approach their babies; Frequent rubbing with soapy
1 0.3
water
43.4% said this was customary, 36.3% that this would
cause itching in the baby, 6.6% said warts or heat Keeping it dry 1 0.3
rash would break out on the baby‟s face, 3.8% said No bathing until the cord drops
rufiya (miliaria in Turkish) would break out on the 1 0.3
off
baby‟s and 2.2% said the baby would develop sores.
Finally, 24.8% of mothers had prayers recited
*Percentages obtained according to the “n=400”
after the birth of their children, 14.5% had sacrificial number.
animals slaughtered, and 6.3% gave help to the poor.

The greatest limitation on the study is that it was

DISCUSSION
This study investigated traditional baby care
practices of mothers with babies aged 6-12 months in
the provincial center of Trabzon, and examined the
results and the relevant literature.
carried out in the city center of Trabzon and might
not reflect rural tendencies.Yet even if the great
majority of the local inhabitants of Trabzon live in
the city they still have close links to outlying villages.
For that reason, we can still say that the study does
reflect rural practices.

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TAF Preventive Medicine Bulletin, 2011: 10(1)
The first thing that comes to mind in the context of
family and community traditional baby care is those
measures intended to obtain the desired gender.
Katebi investigated traditional practices concerning
pregnancy, birth and the postnatal period among
married women aged 15 and over living in different
cultures and determined that 62% of mothers resorted
to such measures as changing a daughter‟s name,
lying on their right sides following relations, eating
sweet foods, making vows, reversing a daughter‟s
placenta, falling pregnant in fall or winter and
entering into relations on specific days in the
menstrual cycle in order to have male children (6).
Practices intended to produce a female baby include
making vows, praying, lying on the left after
relations, falling pregnant in spring or summer,
entering into relations on specific days of the
menstrual cycle and eating bitter and low-calorie
foods. In one study by Özden, 19% of mothers said
they ate bitter foods for a girl and sweet foods for a
boy, 4.8% said they had themselves blessed by a
religious figure, 52.4% gave a special name for the
purpose, and 23.8% lay on a specific side after
relations (2). Biltekin et al. investigated traditional
baby care practices among mothers in the Naldöken
Clinic Region and determined that 16% of mothers
with babies aged 0-11 months sat on two cushions
tied together, and believed that if these separated the
baby would be a boy, that eating fried pepper would
result in a boy, turning to the left after relations
would result in a boy and to the right in a girl, and
that the most frequent practice was that of eating
sweet/bitter foods. The practices intended to
determine the gender of the baby in this study were “a
woman eating sweet foods for a boy and bitter foods
for a girl” and “rising early in the morning, praying,
and the father putting his hand on the mother‟s
stomach and praying for the desired gender (7).”
In our study, mothers stated that they ate quinces,
strawberries, peaches, apples, dates or pomegranates
during pregnancy in order for their babies to be
attractive and looked at a picture of a loved one,
pretty babies or in the mirror when craving special
foods or when the baby first moved. Biltekin et al.
reported that blood from the umbilical cord was
smeared on the mother‟s cheek, that the baby was
squeezed to prevent its nose subsequently growing
large or wrapped in cloth in order to stop it
developing protruding ears (7).
One of the subjects of the greatest interest,
concern and fear to mothers is that of the facilitation
of childbirth.
66
Analysis of the practices used to facilitate
childbirth revealed that the most frequent (47.2%)
was “exercise, walking, sport and swimming.”
Katebi determined in one study that 39.3% of
mothers applied contemporary practices and 18%
traditional ones in order to have an easy childbirth.
Heading the list of the traditional practices was
reciting the “bismillah” prayer (in the name of Allah,
the Compassionate and Merciful), ritual ablution,
reciting the call to prayer, blessing and rubbing the
back, rubbing the back with vinegar, sitting in the
warm, rubbing the stomach and back, jumping from a
high place, drinking water from the husband‟s shirt,
rubbing olive oil on the womb, boiling and drinking
cumin water, drinking water from the hand of a
woman who had had an easy childbirth, unraveling
knots, eating dates, putting one‟s hair in one‟s mouth
and eating fat (6). In another study it was reported
that 37% of mothers employed such traditional
practices for an easy birth as giving birth in a sitting
position, drinking sugared water, drinking oil,
jumping out of water, putting it in cloth and shaking
it and having the Qur‟an or the call to prayer recited,
with 8% breathing easily, going to the doctor, and
40% doing nothing (2). Biltekin et al.‟s study, the
practices employed for easy birth included passing
olive oil between the legs and rubbing it on the vulva
(7). In a study by Şenol et al., 33% of respondents
said that among the measures in the region taken for
easy childbirth were unraveling the woman‟s bound-
up hair, knotted goods, the husband‟s shoe laces or
knots; 8.3% said that water should be drunk from the
hand or skirt of a woman who had undergone an easy
labor or that her blouse should be wetted and the
water drunk from it, and that no heavy work should
be performed during pregnancy. It was established
that 15.3% of mothers employed such methods (8).
In addition to the facilitation of labor, physicians,
nurses and midwives must also be aware of
traditional practices for relieving postnatal pain. In
the event that these methods are incorrect or
inappropriate, they may lead to puerperal sepsis and
have a negative impact on sex life and subsequent
pregnancies. For example, Polat reported that in order
to relieve pain, mothers drank honey water, boiled
and drink hot peppers and that equine scoria would be
placed in hot water and then squeezed out, and the
water drunk (9). Biltekin reported that it was believed
that it was necessary to fast one day for the first baby,
two for the second etc., and that no painkillers were
provided(7). Practices such as keeping the mother
warm, drinking aniseed, sage tea, linden tea, mint,
lemon or sweet marjoram and having the mother
blessed were also used to reduce postnatal pain (6). In
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 TAF Preventive Medicine Bulletin, 2011: 10(1)
Özden‟s study, 65.5% of mothers reported placing
hot salt or soil on the stomach, boiling oil and treacle
and drinking the liquid, eating carrots, eggs, dates or
dried mulberries, placing crushed groundnuts on the
abdomen, sweeping around the house or calling in a
religious figure to give a blessing in order to relieve
postnatal pain, while 12.5% said they went to the
doctor and 4.5% said they did nothing (2). Analysis
of the practices applied by mothers in this study to
relieve postnatal pain revealed a preference for
medical methods over traditional ones, with 48.7% of
mothers using pain-killing drugs and only 5.3%
keeping the abdomen warm by wrapping it up.
Puerperal infection is popularly known by various
other names in Turkey. The reason for puerperal
fever is poor care. Bearing in mind the impact of
puerperal fever on the mother‟s health, the fact that
none of the methods employed has any protective
qualities is significant in showing the risks that
mothers face (2). Practices aimed at protecting
against puerperal fever include placing a knife, a
needle or the Qur‟an under the pillow, placing the
Qur‟an, a broom, a needle, a knife, bread, scissors or
a comb over the head, tying a red cloth, keeping a
copy of the Qur‟an, a broom or a man‟s shirt in the
room, covering up with a red duvet or tying a red
ribbon, fixing a needle to the duvet or headscarf,
keeping to the room, wearing black beads, blessing
by a religious figure, not leaving the new mother
alone, not going out in the evening, wearing red
clothing, putting one‟s hair in one‟s mouth, not
annoying the new mother, putting fire in front of
anyone entering from the outside and not leaving
clothing outside in the evening (2,4,6,7,10). Despite
believing in puerperal fever, some mothers say that
nothing can be done to protect against it and that
“puerperal fever comes from Allah.” Among the
practices employed to protect against puerperal fever
in this study were reciting prayers, the new mother
and baby not going outside for 40 days, placing
matches, bread, the Qur‟an, beads for warding off the
evil eye, crochet hooks or water in the baby‟s
swaddling clothes, and pinning red writing or ribbons
on the new mother (2).
There is a practice in various parts of Turkey
concerning waiting for 1 or 2 (sometimes even 3 or 5)
calls to prayer before breastfeeding the baby after
birth (2,7,8,11-16). In addition, there are also
practices with a religious orientation, such as dust
from the Qur‟an being placed in the baby‟s mouth
before suckling so that it may subsequently learn it by
heart, suckling the child after reciting the call to
prayer in its ear and giving the baby water from the
well of Zemzem to drink. Eryılmaz reported that
www.korhek.org
43.4% of mothers cited maternal and baby health as a
reason for delaying the start of breastfeeding, with
16.8% saying they were influenced by older members
of the family and 12.1% saying that religious beliefs
played a role in this (17). A similar situation was
observed in this study, with 3% of mothers saying the
call to prayer was read into the baby‟s ear before
breastfeeding and 0.5% saying they waited for 3 calls
to prayer to be issued before breastfeeding. The fact
is, however, that delaying breastfeeding is a matter of
considerable importance as it may lead to various
unwelcome consequences, such as reducing milk
production and breastfeeding duration, delaying the
development of the mother-child bond in the early
period and failing to meet the baby‟s increasing
energy needs. The baby‟s blood sugar falls to the
lowest level in the first 2-4 hours postnatally. If the
baby is not breastfed within that time frame, and if
breastfeeding does not take place until 3 or 5 calls to
prayer have been issued after birth, the baby will
become hypoglycemic. In fact, it is incorrect to
ascribe any religious basis to this practice, since it is
something that has no place in Islam. For that reason,
it needs to be emphasized to parents-to-be, and even
in training provided for older people, that this
practice is incorrect in both health and religious
terms.
The importance and value, in terms of
immunological characteristics and neonate and baby
health, of foods containing colostrum is so great as to
be indisputable. Unfortunately, however, studies in
Turkey have determined that colostrum may be
thrown away rather than being given to the baby
(7,13,17-20). In this study, 91.3% of mothers gave
their babies colostrum, and only 4.2% not.
For the first 6 months, the baby should be fed on
mother‟s milk alone even if no water is provided
unless necessary, and breastfeeding should then be
maintained with the provision of appropriate and
sufficient supplementary foodstuffs (4). The giving of
mother‟s milk first of all is widespread in Turkey,
though mush, rice flour, sugared water and cow‟s
milk have also been reported (7,21-24). In addition,
traditional practices also include sugared water
blessed by a religious figure or bread soaked in tea
(4). We determined that mothers first fed their babies
with mother‟s milk (93.3%), but observed that mush,
sherbet/sugared water and cow‟s milk were also
given. Such measures are unacceptable, since they
delay the secretion of mother‟s milk and can even
have a negative impact on the chemical nature of
mother‟s milk, and represent a matter requiring
special attention.
67
TAF Preventive Medicine Bulletin, 2011: 10(1)
One of the significant features of baby care in
Turkish society is swaddling. Studies performed in
Turkey report prevalences ranging from 41% to 79%
(4,5,7,8,14,18,25-27). Although this study was
carried out in the Trabzon provincial city center, a
high rate of swaddling, 31.3%, was still determined.
This subject must also be concentrated on in check-
ups and monitoring both during pregnancy and
postnatally.
One interesting practice in Turkey is that of
rubbing the baby with salt or washing it with salty
water to prevent it smelling (5,7,14). Şenol et al.
reported that 44% of respondents salted their new
born babies to avoid diaper rash and prevent their
babies smelling unpleasantly when older, and also as
a requirement of the Sunna of the Prophet
Muhammed. We also determined that 31.5% of
mothers “put salt in the water they used to wash their
babies (8).”
Studies have reported that once the umbilical cord
is cut, mothers rub it with substances such as ash,
salt, oily dough, butter, hand cream, the ashes from
burnt cloth, coffee or talcum powder (4,6). No such
harmful substances were encountered in bandaging
the cord in this study.
Jaundice in the neonatal period is a condition
needing to be controlled both physiologically and
pathologically. Delay in the treatment of jaundice
may lead to kernicterus and even death. Jaundice is
equated with yellow in Turkish society, and attempts
are made to prevent or treat it sympathetically with
yellow objects, plants or substances. Among the
measures reported to be used by mothers in order to
prevent or treat jaundice are washing the baby with
gold water, pinning gold onto the infant, washing
with poppy juice, washing with egg yolk, not putting
yellow clothes on the baby or, in contrast, wrapping
up in yellow cloths or putting yellow coverings over
it, and even such traumatic measures as making a cut
between its eyebrows using a razor blade (4,
5,7,8,12,14,25-27). In this study, 54.2% of mothers
engaged in some practice aimed at avoiding jaundice,
the most important being breastfeeding the baby,
together with the baby being washed in water into
which gold or wormseed has been placed. However,
we also observed a preference for medical assistance
instead of traditional practices in the treatment of
jaundice.
Many diseases and symptoms today known to
modern medicine are regarded as “the evil eye,” and
maternal preferences for various solutions reflecting
traditional beliefs rather than taking children to a
health care institution may be regarded as a situation
that may have a negative impact on the infant‟s health
68
(4). Practices aimed at avoiding the evil eye are
widespread in Turkish society, and include attaching
the Qur‟an, talismans, metal plates, beads for warding
off the evil eye or blue beads to the baby, pouring
molten lead into a bowl, saying „Masha‟Allah,‟
pinning 41 black cumin seeds or gold to the infant,
smearing a black mark between its eyebrows or
covering it in red muslin (4, 6, 7, 14, 18, 25-27).
Mothers in this study pinned beads to ward off the
evil eye, the Qur‟an, talismans or prayers to their
babies and prayed in order to keep them from evil.
Babies reaching 40 days of age are described as
having “passed the 40 mark.” The idea is a baby
reaching the age of 40 days is now able to survive
and has become acquainted with the world. The
mother is also perceived as having her womanhood
restored. For that reason, passing the 40 mark is
important for both baby and mother, and cleaning in
that period takes place in a manner different to
normal cleaning. For example, 40 stones, barley,
worry beads, green leaves, a comb, wheat, soap and
flowers are placed in a bowl and the baby washed
before the mother. Alternatively, gold may be placed
in the washing water. Similarly, in this study,
practices such as placing worry beads or gold in
washing water when the baby passed the 40 mark
were encountered (4,6,8). One activity frequently
encountered among passing the 40 mark practices is
reciting the “mevlit,” a nativity poem, and this was
also observed in our study.
Keeping menstruating women away from the
baby to prevent itching or warts or rashes breaking
out on the face were also observed in this study.
Ninety-nine percent of mothers said they believed
the call to prayer should be recited into the ear of the
baby when it is born, and 97.7% stated that they had
the call recited.
In conclusion, the results from this study show the
influence and traces of traditions in Trabzon and how
these are reflected in practice, and that features of
social change in the modern sense are now making
headway.
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