The Practice of Prelacteal Feeding to Newborns Among Hindu and Muslim Families

Kathleen M. McKenna, MPH, SNM; Rani T. Shankar, CNM, MS, MPH


J Midwifery Womens Health. 2009;54(1):78-81. 

In This Article

Abstract and Introduction


A 21-year-old gravida 2, para 1001 female at 39 weeks and 4/7 days gestation was admitted to the labor and birth unit in active labor. She moved to the United States from Pakistan during the last 2 months of her pregnancy. She is a practicing Muslim. Her sister-in-law accompanied her. She had an uncomplicated antenatal course, except for iron deficiency anemia (at admission, her hemoglobin was 9.40 g/dl and hematocrit was 29.1%). She had an epidural anesthetic for pain relief. Her first stage of labor was 9 hours, her second stage was 5 minutes, and her third stage was 15 minutes. The baby was born over an intact perineum with Apgar scores of 9 and 9, respectively, and weighed 3,095 g. The baby was placed on the mother's abdomen, and once cleaned and wrapped in a blanket on the infant warmer, the baby was held by the mother. When asked her infant feeding preferences, the mother expressed eagerness to breastfeed. However, before initiation of breastfeeding, the sister-in-law asked the midwife permission to feed the baby a sweet (a drop of brown sugar). The sister-in-law explained that it was customary in Muslim families that "the first thing to touch the baby's mouth should be something sweet." After the midwife agreed, the sister-in-law said a prayer. As requested by the mother, the baby was fed the drop of sweet. Breastfeeding was initiated within an hour postpartum. She reported exclusively breastfeeding from her birth until her 6-week postpartum visit.


The women who midwives serve are often from varying cultural backgrounds. Awareness of and respect for diverse cultural practices is an inherent part of being a culturally competent midwife. Balancing our ability to provide optimal health care while respecting and incorporating a woman's beliefs and customs is just one aspect of the art of midwifery. There are instances, however, when these are in opposition. This case offers an opportunity to explore the Hindu and Muslim traditions of feeding sweets to newborns. A midwife may embrace and respect a Hindu or Muslim woman's religious practice of feeding sweets to the newborn while also being cognizant of practices that may be harmful to the newborn or mother's health.

Islam and Hinduism are the second and third largest religions in the world, respectively.[1] Women from Hindu and Muslim communities, many of whom seek the care of midwives, are a growing population in the United States. They may include recent, more established immigrant communities or first- and second-generation American citizens. Hindu and Muslim families may originate from the South Asian subcontinent, Southeast Asia, the Caribbean, South America, or Africa. Estimates from 2001 suggest that there are more than 1 million Muslims and nearly 800,000 Hindus in the United States.[2] In New York City, Asians, of which many are Hindu and Muslim, comprised 12% of the population in 2006.[3] In that same year, it was estimated that up to 10% of the births in New York City were to Hindu or Muslim women with ancestry from Guyana, Trinidad, India, Bangladesh, and Pakistan.[3] According to the US Census in 2000, there were approximately 2.3 million Asians of Indian, Bangladeshi, Indonesian, Malaysian, Maldivian, Nepalese, Pakistani, Sri Lankan, or Singaporean descent in the United States.[4]

Given these diverse roots, it is recognized that Hindu and Muslim families' beliefs and practices vary from country to country, and family to family.[1,5] Therefore, it is important to ask a pregnant woman about her infant feeding preferences. This would include discussing the practice of feeding sweets or other prelacteal feeds and any other customs or practices believed to assist the newborn transition. Prelacteals, including definitions, practices, and beliefs, are explored in this article.


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