Sociocultural Construction of the Ritual and Practice of Ghutti (Pre-lacteal): An Ethnographic Study in Rajanpur, Punjab Pakistan

Abstract

Background: Infant Young Child Feeding (IYCF) practices recommended by the World Health Organization (WHO) and United Nations Children Fund (UNICEF) discourage every kind of food in first six months except breast-milk for newly born infants. There is dearth of qualitative studies in different Pakistani contexts as to how and why the practice of pre-lacteal is so prevalent, and what are the foundations of their knowledge and practice.

Objective: To deconstruct the knowledge, beliefs and practices regarding pre-lacteals among the parents, grandparent and local communities in Rajanpur district of Southern-Punjab.

Methods: Current ethnographic research used participant observation, informal, and semi-structured interviews of qualitative enquiry to study this human practice. Besides traditional and modern health and nutrition professionals, a sample of 30 households was purposefully taken.

Results: Results revealed that often small in quantity, warm, energetic, sweet, natural and herbal foods were used. The ghutti is a common, socially acceptable and meaningful ritual owing to its religious and medicinal significance to welcome the new-born, to prevent the infection, to clean the dirt, to purify the body, to construct the identity and to transfer the nobility. Further, the study observed that the methods to introduce this first feed were often unhygienic, which caused infection. Breastfeeding is perceived as a sacred act and therefore locals did not initiate it until infant’s profane body fluids are discharged.

Conclusion: Biomedical knowledge and cultural realities are often at odds. This study recommends that behaviour change communication (BCC) interventions cannot succeed unless this gap between science and culture is filled.