DIET PROTOCOL DURING PREGNANCY

( GARBHINI PARICHARYA)

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More emphasis is given on the consumption of ghee, milk & meat by all acharyas.

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“ KSHEERAM-------PUSHTI ,DHRUDATVAM, LABHATECHA,? GARBHO”----------(KA. SAM)

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PROTOCOL FOR THE FIRST TRIMESTER:

“? KSHEERAMANUPASKRUTAM, MATRAVAT, SEETAM, KALE, KALE,----------PIBETH”|???? (CHARAKA)

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“MADHURA, SEETA, DRAVA, PRAYAMAHARA, MUPASEVET|?? (SUS)

“DVITEEYE,? MASE, KSHEERAMEVACHA, MADHURAOUSHADHASIDDHAM” (CHARAKA)

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The above statements are indicating the importance of milk. Some of the authors also mentioned the use of honey and butter.? During the second month it is advised by charaka and vaghbhata to consume medicated milk with madhura drugs. (i.e.carbohydrate rich substances)

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During third month it is advised to consume milk with? honey and ghee. susruta advices the intake of specially cooked rice cereal with milk.

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SCIENTIFIC OUT LOOK:??

?The? advice to use milk constantly 9 months? and particularly first 3 months indicates the emphasis laid on supplementing the essential? nutrients. Milk is considered as the? best jeevaneeya dravya as per Ayurveda, i.e. which is essential for life.

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Milk is having the property of antacid and mild laxative to combat the common ailments during first trimester like constipation and heart burn. During the first trimester of pregnancy the foetus is in a formative stage.? During this stage the embryo is nourished by a process called upasnehan (percolation). Therefore more liquid diet as per susrutha is adviced.? The milk medicated by drugs such as satavari (asparagus) ,and vidari (pureria tuberosa) acts as sustainers of pregnancy (prajasthapana).

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The use of butter and ghee is also justifiable as fats are essential for the absorption of vitamins A,D,E etc.? recent studies ?proved? the consumption of pure ghee can check? various diseases. (new Indian?? express? 13 July 2004). Use of cold and liquid diet along with milk prevent dehydration during the first trimester as most of the woman expirience nausea and vomitings hampering the intake. Madhura indicates the substances rich in glucose content which help to reduce vomitings. Susrutha even says that milk has got the property of preventing abortions.

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PROTOCOL OF DIFFERENT ACHARYA’S

FIRST TRIMESTER

?SUSRUTHA	?Ksheera with madhura, Seetha, Drava Ahara & Sali Odana (Milk along with, cool, liquid diet rich in carbohydrates, rice cereal.)
CHARAKA	Ksheera with Madhura Oushadha yukta (mderate cool milk frequently, followed by milk with drugs rich in carbohydrates eg. Vidari).
OTERS	Amalaki,? Madhu, Navaneeta, Ghrutha (Emblica officinalis Honey, Butter and Ghee)

FOURTH MONTH :??

Charaka advices milk with butter and susrutha advises cooked rice with curd and rice with butter and meat.

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“GHRUTAM-------SMRUTHIMATI------MEDHA------KANTI-------BALA KARAMAYUSHYAM-----MEDHYAM---VISHAHARAM------(SUS)

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Ghee? increases the intellectual capacity of the child and also with its vishara (anti toxin) property helps in eliminating any form of toxins produced in the body. It even helps in controlling convulsions (moorcha)? and prevents unconsciousness (apasmara).

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The advice of meat from? fourth month onwards stress the importance of development? of dhatus (tissues) particularly muscular tissue? which require more protein which is supplied by meat. Meat is also one of the best source of folic acid, iron, iodine and essential aminoacids.

FIFTH MONTH :

?Along with butter, rice gruel and sweet rice enriched with ghee is advised.

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SIXTH MONTH:???

“SHASHTE, SWADAMSHTRA, SIDDASYA, SARPISHO, MATRAM, PAYAYED, YAVAGUVA, “? (SUS)

Susrutha specially advised the intake of ghruta or rice gruel medicated with gokshuru. (tribulus terrestris)

The advice of gokshuru with ghee during sixth month is a unique protocol which can? help in preventing PIH? and? related conditions like pre- eclamptic toxaemia and? their complications.?? This drug is a diuretic and considered? as the best choice in the disorders of urogenital system.? Recent studies proved this drug has got Nephorprotective???

Activity ( tried in albino rats).

Some of the cases with? past History of PIH & PET responded well with this protocol with uneventful antenatal & post natal periods.

Probably this protocol helps in reducing the angiotensin sensitivity in susceptible subjects and produce vasodilator effect by helping in the elimination of elevated concentration of extra cellular sodium. It needs a more scientific evaluation through sufficient clinical research.

DIET PROTOCOL FOR SECOND TRIMESTER

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Seventh Month :

“ SAPTAME, SARPHI, PRITIHAK PARNYADI, SIDDHAM |
EVAMAPYAYATE, GARBHAHA || (SUS)

?Susrutha advises medicated Ghee with prithakparnyadi drugs (uraria picta etc) These group of drugs are said to have the property of Foetal Nourishment. During eight & ninth Months most of the Acharya’s advice in addition to the above diet protocal, administration of cleansing and Anabolic enema’s with medicated drugs to promote a safe and easy labour by making the birth canal more flexible and brining foetus into right position, achieved by regulating apanavata, which is the controlling factor for expulsion of foetus.

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During the last trimester plenty of intake of different varieties of cereals is advised.
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DIET PROTOCOL FOR THIRD TRIMESTER?

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Some of the important medicines used during antenatal period contain the fruits like Pomegranate (Dadima), embilica officnalis (Amalaki), Grapes (Draksha) etc., as main ingredients. These will help in preventing abortions and premature labour. Conditions like threatened abortion, Habitual abortions, can be effectively handled with these preparations. Pomegranate is a uterine relaxant. amalaki has got anti emetic, anti diabetic property and growth promoting activity with plenty of vit ‘C’. It helps in the good absorption of Iron and if administered from the early ante natal period can prevent the Gestational diabetes. The Juice of amalaki and Honey improves haemoglobin levels.

IMPORTANT PHARMACOLOGICAL PREPARATIONS WITH GHEE AND FRUITS ?

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BENEFITS OF MONTHLY DIET PROTOCOL

"EVAMAPYAYATE, GARBHA, …………………. ANULOMEHI, VAYAU, SUKHAM, PRASOOYATE, NIRUPADRAVACHA,?????

?BHAVATI ……………………….EVAMUPAKARNTA, SNIGDHA BALAVATI, SUKHAMANUPADRAVA, PRASOOYATE | " (Su.sam)

?The diet protocol helps in normal development of foetus with good nourishment, by preparing the birth canal helps for easy and uneventful labour and also helps in the expulsion of placenta.

?BENEFITS OF DIET PROTOCOL?

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"SOOTAYASVAPI, TATRA, SYADAPARA, CHENVA, NIRGATA |
?? PRASOOTAPI, NASOOTA, STREE, BHAVATYEVAM, GATESAT ||"??
(ka. Sam)

After the delivary of the child till the placenta is not expelled, the woman can not be called sutika. Sutika term can be used only after expulsion of placenta.

DURATION OF PUERPERIUM (AVADHI)

??????????? According to susrutha it is 1 ? month. Some authors opine that it is till the appearance of next menstruation. Kasyapa mentioned it as six months

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Dietetics of Puerperal Lady:

Lot of emphasis is given on the mode of diet that has to be given for a puerperal lady. Kasyapa particularly mentioned the protocol according to the living area i.e. basing on the climatic and geographical considerations. Ayurveda stress on normalcy of Tridosha’s for health. During the labour the dosha vata gets excited and if not pacified properly, causes nearly 74 diseases. Even the modern science agrees that the nervous system is in hypersensitive state during the puerperal period. Improper management of puerpera results in causing number of gynaecological and medical disabilities.

The aim of dietetic protocol followed strictly for 7 days after the delivary is to restore the normal health of puerpera.

If the dosha’s are aggravated in the puerpera even the child on lactation gets effected with the vitiated milk.

GENERAL CARE THROUGH DIETETIC PROTOCOL

All the authors of classics have advised 7 days protocol with slight difference of opinion.

“SOOTIKA TU,? KHALU BHUBHIKSHITAM, VIDITWA, SNEHAM………………..Ch. Sa

“SOOTIKA, BALATAILA BHYAKTAM, VATAHAROUSHADHA, NISHKWATENOPACHERET, |….Su,? Sa

“UPAKRAMAMTU SOOTANAM, SAVISESHAMATAHA…………………

DESHAVIDESHA, KULASATMYATA, ……………………….

CHARMAVANADHHA, MASANDEEM, BALATAILOSHNA POORITAM,…Ka, Sam

Though with minor differences all the authors advisedto give initially oil massage to puerpera which helps in controlling the excited nervous system (vata samaka) It also helps to ensure the toning of abdominal, pelvic & Back muscles thus helping in preventing the laxity. It prevents the back ache. Oil slitz bath helps in regaining the pelvic floor strength.

Administration of medicated ghee & oil according to the? tolerance and capacity of the puerpera after feeling hungry helps in clearing the prescence of blood clots and bits of after births which produce after pains due to ishaemic and spasmodic contractions (? the drugs include pippali, pippalimoola, chavya etc.) (Makkalla Soola).

?After the digestion of this medicated ghruta, rice gruel medicated with the above drugs and ghee should be given. This should be given for seven nights, followed by slow administration of protein substances (mamsarasas). Kasyapa advices to give the vegetables? like pumpkin, radish, cucumber etc. fried in ghee.?

PROTOCOL OF PUERPERA AND ITS BENEFITS

According to kasyapa, puerpera residing in marshy land should consume scum of boiled rice medicated with appetizing and strength producing substance without fat (ghee or oil)

Puerpera residing in dry land area should be treated with initial administration of fat substances, followed by the use of cereals mixed with ghee.

??????????? He even advised the management for foreigners.?

"VAIDESAYASWA PAAYACHHANTI? VIVIDHA? MLECHAJATAYAHA? |? RAKTAM MAMSASYA NIRUHYAM KANDAMOOLA? PHALANICHA. | " (KA. SAM)

The above reference states that the foreign ladys after labour should consume meat soups, blood (probably iron rich food), tuberous? roots and different fruits.

DESANUSARA SOOTIKA PARICHARYA
(DIET PROTOCOL OF PUERPERA ACCORDING TO THE LIVING AREA)

This differentiation probably might be given due to the biological differentiation of the people in different places.? Often we see some of the diseases are common in some places and in some traits.

Since all the body tissues become affected during pregnancy resulting in the loss of strength and hyperexcitation of nervous system. It is very much essential to regain the pre pregnant state of the body. According to ayurvedic science if the advised ditetic protocol is not followed, the doshas get vitiated resulting in nearly 74 diseases both gynaecological and medical which will be very difficult to cure or incurable. Plenty of water, cereals, meat, milk, & ghee are also advised to consume.?

"MITHYACHARAT SOOTIKAYA,YO,? VYADHIRUPAJAYATE|
???? SA, KRUCHRASADHYOASADHYOVA---------" (SU.SAM)

A pharmocological? preparation named “ SOUBHAGYA SUNTHI” which contains dry ginger (sunthi),? ksheera (milk),? ghruta (ghee)? and sarkara (sugar), is a very unique preparation which helps in treating a many puerperal diseases, particularly anaemia, menorrhagia and polyuria.

Most of the conditions that trouble the woman during pregnancy & puerperal period can be effectively tackled through a protocol combined diet with drugs, which will be easily acceptable by woman who are sensitive? to take Medicines.? As it is combined with diet, additional attention need not be given for medicine intake.

All the drugs (herbs) that are included in the protocol are safe and effective.? There is no need of any additional supplements if this protocol is followed.? The drug like Tribulus terrestris (Gokshura) effect in preventing toxemia’s of pregnancy need to be evaluated as it can be? a break through in the management of PIH& PET.
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Effective involution in the post natal period can be achieved.

Finally this protocol keeps the mother and the child healthy which is ultimate aim of any science.