Pregnancy malnutrition

(Source: https://threader.app/thread/1460844066187399179)

A thread on mortality in colonial Burma.

In agrarian economies, births & deaths must equalize in the long-run. Late marriage, periods of voluntary abstinence, labor migration, & longer breastfeeding are possibilities for affecting the fertility side of the equation. Infanticide, which may be subjectively classified as either fertility restraint or mortality is another method. Conscious infanticide was common in Europe, East & South Asia and the Middle East (IDK about SS Africa or indigenous pre or post-1500 Latin America, happy to learn). In Europe the church would not tolerate open infanticide. East Asian states expressed disapproval as well, but tacitly tolerated it to some extent. European infanticide could take the form of abandonment in the woods (e.g. Hansel & Gretel), abandoning a child to a foundling home with an 80% chance of death before reaching adulthood, exposure, or unequal allocation of nutrition among children. But there is no evidence of infanticide in colonial or pre-colonial Burma. So what fertility or mortality factors drove the Malthusian equilibrium?

SE Asian demographic history sources are sparse & hard to use: (exception: The Philippines) so creativity is needed. Judith Richell’s book (below) applies a critical eye to the scattered quantitative evidence & more abundant qualitative evidence. Sadly Richell passed away before the monograph, based on her doctoral research, was finished. Thankfully her husband was able to edit her drafts. The book argues that population (not counting Indian immigrants) was stable from 1783-1826, then shifted to 1% growth from 1826-1941. She calls 1% “slow” growth (though by previous standards, fast) and searches for reasons.

She cannot estimate TFRs, but estimates crude birth rates of 4.5-4.8, which she believes would put TFR < India’s but still high & with no ↑ under colonialism. So the “slow” 1% annual ↑ must be explained on the mortality side. She puts CDR at ~33 before 1910 & ~38 from 1910-41. What mortality factors => “only” 1% pop growth in the face of high fertility, especially considering the successful smallpox vaccination efforts (major ↓ in recorded deaths by smallpox between 1906-32), and the decline of cholera from 1880-1930?

  • Richell notes that one key reason is beri-beri due to the ↑ in mechanical rice milling which ↓ thiamine by 60% as well as ↓ protein & other crucial nutrients.
  • Another factor was British changes to the agro-ecological environment that ↑ malaria significantly.
  • Cholera was rampant in the 19th cent but declined steadily after 1880 from 9% to 0.7% of all deaths, possibly responsible for the pop growth rate increase to 1.25% by the end of her period of study. She rules out tuberculosis, while citing tetanus, measles, respiratory diseases, dysentery and stillbirths from pre-natal syphilis as endemic and demographically significant.
  • Malnutrition from poverty is a background factor behind some of this of course, but Richell IDs another source of malnutrition: pregnancy food taboos.

Mothers in colonial Burma, by intention, gave birth to underweight babies w/ small heads. Richell suggested circular causation: small women => preference for small infants => malnourishment => small women.14/ Contemporary observers (1920s-30s) noted that Burmese mothers, even middle class ones with sufficient food budgets, believed they should suppress calories and avoid most foods. They would starve themselves, eating only rice, salt, dried fish & a few other dried products. Green vegetables were thought to be bad for the fetus.+++(5)+++ Fresh fish, meat or eggs, and any calorie-rich foods were to be avoided. Ditto for spicy foods like chilis or sweets like honey, and pulses & beans. Research in the 1950s and again in the 1970s replicated the findings.

The link between this kind of diet-induced low birth weight and neonatal tetanus is particularly strong. Richell speculates on some limited quantitative evidence that Burma suffered an unusually high number of infant deaths in the first week of life.

The maternal diet taboos extended through the lactation period of 2-3 years. Thin fish or mutton bone soup with garlic or pepper or the rice & salt minimalist diet thought to be optimal for nursing. Consequently, Burmese mother’s milk had less nutrients than could have been. As common elsewhere, the rich immunity-boosting colostrum was discarded and infants were given water & honey “until the milk comes”, often the first 3 days of life. Again this pattern detected in the colonial period was found anew in the 1970s.

The elimination diets also reduced milk quantity, with 40% of women producing insufficient milk in 1955-57 surveys; 54% for poorer women. Richell notes some unhelpful endogeneity here: ↓ birth weight of the baby => body making less milk.

One could imagine that the death rates of children were interpreted through the Buddhist idea of karma, or fate. Richell repeatedly reminds that Burmese women believed they were helping their children and themselves.

So did this unintentional nutritional self-sabotage evolve because it gave groups competitive advantages? Or was it random chance + lock-in through self-reinforcement? She cites the work of Robert Whyte (1974) who said that maintaining a Malthusian equilibrium by reduced nutrition => ↑ mortality was common in Asia. There pregnancy & nursing food taboos in Thailand (cite: ethnography by Christine Mougne, “Changing Patterns of Fertility in a Northern Thai Village”, in a 1978 edited volume), but less restrictive than Burma & was fading away at the time of the fieldwork (late 1960s). In 1950, even before Thailand’s growth explosion got going, Burma’s child mortality was already much higher. The food taboos would have to cause cognitive deficits. Evidently these practices faded in the 1980s-90s. Could ↑ avg cognitive ability from improved infant & child nutrition 20-40 years ago be the reason why Myanmar seems poised for rapid ec growth?