Every science in the modern era is following a philosophy of reductionism as part of its instinctive development processes. This reductionist approach in science helps to condense its complicity, simplifies the process of conceptualization and enhances comprehension. This approach also pervades medical science and complements its development in the field of diagnosis, management and prevention of diseases. However, nowadays the concept of reductionism is misinterpreted and implemented improperly in modern science which has led to several negative impacts.
This reductionist nature in due time also impacted the development of Ayurveda, evident in the form of Ashtangas as well as surgical school of thought and medical school of thought. Such constructive influence was persistent till the period of 10th decade however later on gave way to a phase of visible developmental stagnation apart from, few regional advances in some specific areas of Ayurveda like progression in Kaumarabritya and Agadatantra in Kerala. Koumarabritya is one of the primary division of Ayurveda emerged as part of the reductionist approach and this branch aimed at the procreation and growth of a good progeny. From its establishment as an independent branch, Kaumarabritya focuses on the comprehensive health aspects of a child, which encompasses the preconception stage of an individual including age of marriage, procreation, sex measures for good progeny, an ideal manual for gestational care, uncomplicated birth of a baby and postnatal care extending from 45 days to 6 months and complete growth aspects of a child from birth to 16 years. Later, with the advancement of practices this reductionist impression has paved the way for further categorization of the same to Prasoothi tantra and Streeroga as well as kaumarabritya encompassing all the above mentioned domains. Hence in the present stage, Kaumarabritya is merely confined to the health management of a child from birth to 16 years of age.
According to Indian philosophy, the ultimate aim of human life is considered as the achievement of Dharma, Artha, Kama, and Moksha. Health is said to be an inevitable component to achieve that. So the ultimate aim of Ayurveda is to achieve or maintain good health so that human beings can achieve moksha. We should keep these points in mind before understanding the concepts of kaumarabritya in ancient days.
In those days, the average life span of human being was considered to be a maximum of 120 years. While considering that, kaumara kala can be taken as till the age of 30.
There are 3 phases of structural status in the human body. The first phase is structure development or generation of body, the second phase is stagnancy of structure and the final one is a de- generative phase. So generally, the developmen- tal phase of structure in the human body is dealt with kaumarabhritya. Hence, kaumarabritya comes under the age up to 16 years
Kaumarabritya not only dealing with children who have already born, but its area starts from when to conceive to get a healthy child, care for pregnant woman, care for child in the womb, care for mother during delivery, care for child immediately after delivery and few days later, and care of child according to his age.
Susruta has considered the optimal age of male procreation is 20 and that of female is 16, even though reproductive age of female can be attained at the age of 12. That shows Ayurveda has not supported the concept that procreation should happen if a girl attains reproductive maturity, rather it gives im- portance to the improvement of gamete quality in producing a healthy child. So, the kaumarabri- tya starts from the age of parents before procreation. Ayurveda has explained its sexual codes and conducts to get a good progeny known as maidhunacharya beginning from the mental dis- position of partners, things to do for the achievement of good mental health, explanation about the place where the sexual act should conduct for a healthy progeny and then the act of procreative sex, procedures to be followed immediately after procreative sex, procedures to be done expecting the pregnancy and procedures after conceiving the child. And garbhiniparicharya also has explained according to her daily living activities, environment, thought process and food. Prasavaparicharya according to the knowledge in those days were an act of parturition, management of labor, neonatal management, how a parturient woman and her health is related to the child, samskaras to be conducted till 45 days after delivery. The samskaras to be conducted later, diseases and its preventive methodologies and curative aspects according to child age, and the procedures for child till he attains reproductive maturity were also dealt by Ayurveda.
There are 16 samskaras explained for a healthy living of a child. They are 1) Garbhadana (Sacrament of Impregnation or Conception) 2) Pumsavana (Engendering a male issue) 3) Simantonnayana (Hair-parting) 4) Jatakarma (Birth rituals) 5) Namakarana (Naming ceremony) 6) Nishkrama (First outing or outing ceremony) 7) Annaprashana (feeding ceremony) 8) Chudakarma or Mundan (Shaving of head) 9) Karnavedhana (Piercing the earlobes) 10) Upanayana (Sacred thread initiation) 11) Vedarambha (Be- ginning of Vedic study) 12) Samavartana (End of studentship) 13) Vivaha (Marriage Ceremony) 14) Vanaprasta (Renouncing the householder’s life) 15) Sanyyasa(Leading the life of a monk) 16) Anteyeshti (Death cremation).
Later, this branch has started developing since 20th century. It is divided into Prasutitantra, Streeroga and Kaumarabritya. Prasutitantra deals from pre-conception care to delivery care whereas gynecological health and disease management fell under streeroga and child care dealt under Kaumarabritya.
In the current scenario, the Kaumarabhrithya (Ayurveda paediatrics) has developed a lot of specialist practitioners, PhD programs, Postgraduate diploma, certificate courses, different academic institutions etc. Nowadays many types of research and practices are in progress with the pediatric diseases in which Ayurveda has got an upper hand is a remarkable phenomenon to be considered. By understanding the scope of Ayurveda in the neurological conditions of children especially in chronic static encephalopathy, the institutions including AIIMS Delhi have undertaken Ayurveda researches by collaboration with the faculties from esteemed Ayurveda institutes. In the 21st century, the developed countries are facing many health challenges from the diseases like autism. As a result of which many Ayurveda research projects are going on in this subject with a lot of International and central government funding is another peculiarity of Kaumarabhrithya.
Different universities and research centers in different countries are conducting studies on child health and disease management of children has started searching for a remedy in alternate systems of medicines such as Ayurveda. For example, the first medical university in Moscow is making collaborations with Kerala Ayurveda Studies and Research Society, Kottakkal (KASRS) in relation to their research in Cerebral palsy. The results of such researches are getting International acceptance and as per the bench to benchmark principles, the common public of the total global population is getting the benefits out of it. The most classical example of that is the AGASTYA protocol (Ayurveda drugs, Gut therapy, Ayurveda Standards of living, Training of parents and Yogic Assistance) for the management of children with autism spectrum disorders developed by the department of Kaumarabhritya, Vaidyaratnam P.S.Varier Ayurveda college kottakkal.
Many types of research at the minute level are going on with the reductionist approach on ‘how Ayurveda medicines are working in pediatric diseases’. AYUSH-Extra Mural Research project is an example of that. The department of Kaumarabritya, Vaidy- aratnam P S Varier Ayurveda College, Kottak- kal is funded by AYUSH for a project entitled “A randomized controlled trial to assess the effect of a gut therapy protocol [koshtachikitsa] for man- aging dysbiosis in children with autism” under Extramural project. The objective of the study is to analyze the effect of 30 days Ayurveda gut therapy protocol in reducing gastrointestinal dysfunctions in autistic children. It also analyzes the quality and quantity of microbial gut flora before and after Ayurveda gut therapy protocol in reducing the symptoms of dysbiosis in autistic children by sequencing the 16 rRNA technique. By keeping all these in mind, the stakeholders are using this knowledge among the public and as a result of which the Pediatric specialized Ayurveda hospitals are emerging in Kerala. The ATIDHI Group-(Ayurveda and Therapeutic In- tegration for Developmental Habilitative Inter- vention) and The CNS Ayurveda Chikitsalaya, Pattambi are few examples of that.
Ethno practices in the traditional background got developed with the modern technologies and are getting popularized in the field of Kau- marabhritya as a result of which the mother and childcare centers in Ayurveda were started. Es- pecially in the state of Kerala, a 2months package called ‘Prsavapariraksha’ (Post Delivery manage- ment) is being widely accepted as a custom for the health of mother and child in the postpar- tum period. A medicine called Suvarnnaprasa has been developed for the preventive healthcare aspects of children has become a massive trend in the state of Karnataka which already exists in Kerala as part of its tradition.
By considering this public interest, the Government of India has started funding many public utility projects in Kaumarabhritya. Eg. The AYUSH Public Health Initiative project. “A community outreach programme of Ayurveda for an immunity en- hancement in children suffering from recurrent upper respiratory tract infection from select- ed Gramapanchayaths of Malappuram district” is a project funded by AYUSH under its public health initiatives. The primary objective of the project is the complete cure of RURTI by achiev- ing adequate immunity with respect to their clinical parameters among the selected school children from the selected Grama Panchayaths of Malappuram district. The secondary objective is to assess the improvement in awareness created on Ayurveda guidelines about immunity management among children, parents, teachers and Anganwadi workers of the selected gramapanchayaths under the Vengara block of Malappuram district, Kerala.
Ayurveda is gaining momentum among the global population with its edges of non-harming nature and its nearness to natural harmony. The World Health Organization is now stepping forward to integrate as well as preserve the values of different traditional medical systems for the benefit of humanity. Children are highly vulnerable in the society and are cornerstones of the future of the nation. Keeping the values of every traditional medical system the ideal mankind is striving to manage the health and diseases of every individual. Kaumarabhritya is one such step of Ayurveda for the benefit of health and disease of children globally from a traditional epistemology of the Indian health care system.