Case Study 5

The following case study illustrates a parent’s religious and cultural perceptions about food and the value of having “pale skin” and how the GP responded to the parent’s views. The case study provides questions for viewers to consider and reflect. 

Case Study 5: Religious beliefs (Hindu)

Mrs Shukla presents with her 2 ½ year old son Rajiv, who has a persistent cough and recurrent chest infections. This is her third visit for a chest infection this winter.

Rajiv looks pale and sickly. The GP tests him for anaemia and Vitamin D. He asks about his diet. Rajiv is cared for by his grandparents as his parents work long hours in their business.

Rajiv is fed on whole milk (blue top milk) 3 times a day as he will not eat any solids.

His blood tests show him to be anaemic and to have severe Vitamin D deficiency. The GP recommends that Rajiv is introduced to solids including red meat to increase his iron levels.

The GP prescribes Vitamin D for Rajiv and for Mrs Shukla.

Mrs Shukla says that they are vegetarian and would not feed their child meat. The GP suggests that Mrs Shukla introduces eggs. Mrs Shukla says that it is against her religion (Hindu) to eat eggs and that her parents in law would object strongly.

The GP consults with a colleague who practices the Hindu faith, who suggests that the family introduce rajma (a curry made with beans or lentils). Foods such as kidney beans, dahls and lentils are rich in protein, folate and iron and will replenish Rajiv’s iron stores.

Mrs Shukla says that her 6 year old Sanjay was also pale as a toddler but “came right” when he was older. In consultation with a colleague, you find out that having children with pale skin is highly valued in Indian culture, which may have provided a disincentive for the family to consider that their child was unwell and lacking in essential micronutrients.