Suvarnaprashana (सुवर्णप्राशनम्)

Suvarnaprashana is one of the exclusive preventive healthcare therapies advised specifically for children in Ayurveda. 'Suvarna' means 'gold' and 'prashana' refers to feeding, tasting or licking. Thus literally, Suvarnaprashana indicates feeding gold to the children. However, it should not be taken in literal terms. Ayurveda has a very well developed art and science of preparing medicinal formulations from not just herbs but also minerals and metals. These elemental substances like gold are not used in the form as they are found in the nature but, are systematically processed with specific herbs with the help of fire in furnaces and then only the transformed substances are used in medicinal formulations. The medicines prepared in this classical way are time tested, safe, effective and easy to use. The branch of Ayurveda dealing with all these types of processes is known as Rasashastra which is also popularly known as Alchemy in Ayurveda. Specifically 'gold' and no other metal is selected for suvarnaprashana because of its gunas and karmas as per Ayurveda. Suvarnaprashana is a comprehensive Rasayana Chikitsa, administered for strengthening the the physical, mental and intellectual faculties of the children.

Introduction

Acharya Kashyapa, in Kashyapa Samhita first coined the term 'Suvarnaprashana' and provided the unique formula for it thousands of years back. Other Ayurveda scholars like Acharya Sushruta and Vagbhata have also advised use of gold in an infant or neonate especially under Jatakarma Samskara (जातकर्म संस्कारः). Suvarnaprashana advised by these acharyas was of quite a primitive form. Over the years of practice and development of Rasashastra branch of Ayurveda, now-a-days, the practice and method of Suvarnaprashana is slightly modified. Suvarnaprashana described in Kashyapa Samhita is intended to boost memory, intelligence, agni (here, growth & metabolism) and immunity in infants. It is considered as one of the oldest applications of gold nano medicine. Although originally Ayurveda acharyas had advised this therapy either on the day of birth or over a period of 6 months to 1 year of age, today it is given to all children upto 12 years of age. It is specifically given on the Pushya nakshatra (constellation) of every month in Ayurveda clinics across India. Clinical and pharmacological studies show immunomodulatory, nootropic as well as therapeutic effects of Suvarnaprashana therapy. Thus it can be administered in all children as it acts at the level of nutrition, metabolism, growth and development, physical strength, and immunity.

Suvarnaprashana as a part of Childhood Samskara

Samskaras in Sanatana dharma are known as the rites of passage performed for purification of a human being or to generate or to infuse particular qualities in a person to prepare him for the new stages of life. Among 16 samskaras described in Grhyasutras Jatakarma (ceremony at birth) and Chudakarma (tonsure ceremony) are the 2 childhood samskaras which are performed to get rid of the impurities, which may be present in the Bija (sperm and ovum) and also due to the stay inside the womb as Garbha (fetus). Here, Jatakarma Samskara (newborn care) is told as a purification procedure, in which soon after cutting the umbilical cord the baby is made to lick the mixture of gold, honey, and ghee by chanting Mantra (spiritual hymns). Therefore Suvarnaprashana has been the integral part of jatakarma samskara since long time in Bharata. A newly born baby has a very weak and immature immune system. Owing to this, utmost care must be taken to protect the baby and implement measures that would boost the baby's immunity till the baby develops it by self. For this, now-a-days we give various different vaccines to the child to provide immunity against multiple diseases. In ancient India, the same purpose was served with the use of Suvarnaprashana. Thus Suvarnaprashana is also popularly known as the Ayurvedic vaccination method. However, the scope of Suvarnaprashana is far beyond that.

Suvarnaprashana in Jatakarma Samskara

Immediately after delivery of a baby, for first 4 days, there is mostly no adequate secretion of the breast milk. Thus newborn baby might not get sufficient breastmilk for growth and nourishment. Along with this there could arise some situations were the mother of the baby is not available to breast feed the baby due to any possible cause. In such crucial scenarios, there is a necessity to search for certain feeds which can provide nourishment as well as essential nutrients to support baby's growth and development. Ayurveda acharyas have recommended 'lehana' in such instances. Lehana indicates certain supplementary feeds in linctus (semisolid/fluid) form that facilitate nourishment, growth, protection and development of the baby with or without breastmilk. Acharya Sushruta and Vagbhata have suggested use of gold in such lehanas. Under Jatakarma samskara, Acharya Sushruta suggests, administration of Suvarna (gold) along with honey and ghee as a single dose at birth in the procedure of new born care. Acharya Vagbhata also provides formula that includes suvarna (gold) along with the combination of other herbs under Jatakarma samskara.

Why Gold?

Suvarna (Gold) is one of the most precious metals known to the man since long time. It has been used in ornaments, currency etc widely in India. At the same time gold has secured place as a therapeutically effective medicinal substance in Ayurveda medicine since thousands of years. In various Ayurveda texts, the types of gold to be used, mode of administration of different forms, theirs benefits and therapeutic indications are clearly explained. According to Ayurveda literature, gold is one of the 7 dhatus (metals) and also one of the pure metals used in medicines. It is known to show Rasayana (rejuvenation, immunomodulator, adaptogenic) and Vajikarana (aphrodisiac, invigorating, vitalizing) activity when consumed orally in different formulations.

Various modern research studies have validated the role of Gold in maintenance of health and wellbeing.

• The action of gold in the immune system is supported by an experimental study conducted using suvarna bhasma (calcinated ash) on mice. This pharmacological Study showed specific and nonspecific immune responses, which were modified in a positive manner in Swarna Bhasma‑treated mice. It also had a stimulatory effect on peritoneal macrophages, which may be helpful to fight against infections.
• One experimental study of suvarna bhasma conducted on immature rats showed that there is a significant stimulatory effect of gold chloride on female reproductive activity. The traces of gold have been found in endometrium and decidua of uterus in females and highest percentage of gold has been found in the semen fluid of males.
• One more study reports state that, colloidal gold colloidal is found to improve cognitive functioning, which was measured in that study by IQ scores.

Forms of Suvarna used in Ayurveda medicine

Classics of Ayurveda mention specific forms of Swarna for internal administration such as Patala/Mandala (leaf/foil), Churna (powder), Bhasma (ash).

Present day Suvarnaprashana

(ref: Patil, Vaidya Vasant & Samant, Chetali & Baragi, Umapati. (2014). SUVARNAPRASHANA THERAPY IN CHILDREN; CONCEPTS, PRACTICE AND PROSPECTS. Journal of Ayurveda and holistic medicine. II. 1-3. )

Practice of Suvarna Prashana

The classical descriptions of Suvarna Prashana therapy uses metallic gold- rubbed on a clean rubbing stone with water, till fine gold particles are released. The rubbed gold or gold powder mixed with fine powder of Medhya, Rasayana herbs, ghee and honey is given to the newborn[4] . Rubbed gold in metallic form carries the risk of toxicity. Hence, a safer option of Suvarna bhasma is being used for the Suvarnaprashana now a day. The ancient alchemists in India discovered the process of bhasmikarana (calcination) which involves controlled incineration of metals, non-metals, minerals and certain organic ingredients, to make them safer and biocompatible. Ancient texts like the Charaka Samhita also describe process of dipping red hot metals in herb decoctions to obtain fine powders/ dust of metals[5] . Methodical guidelines on the preparation of non-toxic bhasma or nano particles of Gold available in the Rasashastra texts dating back almost up to 4th century AD, is a testimony to the exhaustive research , efforts and dedication of ancient Ayurveda scholars and alchemists. Their methods have successfully passed the litmus test of time and modern science alike

Preparation of Suvarna bindu (Gold drops): Traditionally Shuddha Suvarna has been advised to be rubbed on a rubbing stone with water and then emulsified with madhu and ghrita to achieve a fine colloidal suspension. We now use Suvarna bhasma along with equal proportion of ghrita and madhu. Madhu and Ghrita in equal proportions have been considered as a Viruddha Samyoga (unwholesome combination) [6]. However, it is a popular belief that giving a low dose of this otherwise toxic combination is believed to trigger immune responses which helps to strengthen a child’s immunity for toxins and allergens. Ghrita fortified with Medhya and Rasayana herbs like Brahmi (Bacopa monnieri), Mandookaparni (Centella asiatica), Yashtimadhu (Glycerrhiza glabra) Shankhpushpi (Convolvulus pluricaulis), Vacha (Acorus calamus) and Guduchi (Tinospora cordifolia) are commonly used in Suvarnabindu preparation by clinicians expecting enhanced immunomodulatory and nootropic effects of Suvarnaprashana in children. Following are some of the widely used ratios for preparation of Suvarnabindu - Large Batch: 2.4 gm. of Suvarna Bhasma is added to 250 ml of honey and 250 ml processed ghee. Individual Doses: 100mg Suvarna bhasmais added to 6 ml of processed ghee and 6ml of honey is kept separately. Honey is mixed with ghee just before the administration. Although large batches are convenient for commercial use, Suvarna bhasma may settle down in ghee after some time, thus reducing the concentration of Suvarna bhasma per dose. Hence, preparing suvarnabindu in smaller batches is desirable. Suvarna Vacha Suvarna Vacha or Suvarna Vacha which is purified gold wire inserted into processed underground stem (dry or fresh) of Vacha (Acorus calomus) is yet another unique formulation which is popularly used for giving Suvarnaprashana. Suvarna vacha is rubbed on a clean rubbing stone (5-6 rotations) with milk or water, so as to get fine gold particles along with a paste of vacha. This is then mixed with equal amounts of Ghee and honey and used for Suvarnaprashana. Many practitioners use this as an alternative method for Suvarnaprashana. Suvarnavacha uses metallic gold as opposed to calcinated gold which is used in Suvarnabindu. The benefits of suvarnavacha are claimed to be same as that of Suvarnaprashana. The one special benefit of suvarnavacha is improvement of speech. Practitioners advise administration of suvarnavacha in infants after 3 months of age till 5-6 years or 12 years. Although there is one clinical study which reports immunomodulatory effects of suvarna vacha in neonates without any toxicity; further research on standardization of the technique, therapy, along with toxicity studies on appropriate animal models is required to establish the safety as well as efficacy of this therapy[7]

Duration of Suvarna Prashana therapy: Suvarnaprashana can be given from birth to sixteen years, keeping in mind the rapid growth and development during this phase of life. Some practitioners advise it only up to 12 or 14 years. Clinically, a minimum therapy of 6 months, 1 year to two years is recommended in order to get considerable results.

Why on Pushya Nakshatra

Pushya constellation is said to facilitate Pushti (Strengthening) or Poshana (Nourishing) i.e. strength in the universe. Hence this constellation is chosen to administer this Suvarna Prashana (Bhinde, Sagar & murthy, A & Dave, Hasmukh & Kiradi, Pallavi. (2013). A SURVEY STUDY ON ‘SUVARNA PRASHANA’- AN AYURVEDIC IMMUNIZATION. Journal of Vishwa Ayurveda Parisad. 10. 3-8. )

In the context of Rasayana and Pumsavana Karma, Acharya Susrutha and Charaka, respectively mention the usage of Swarna on Pushya Nakshatra (a star in Hindu calendar). The current popular practice of Swarnaprashana only on the day of Pushya Nakshatra may be due to the belief that it is an auspicious star to administer any medication due to its nourishing effect.

Benefits of Suvarnaprashana

As per classics or literature

The specific benefits ascribed to Swarnaprashana are as follows:

• Medha Agni Bala Vardhanam (improvement of intellect, digestion, metabolism, immunity, and physical strength) • Ayushyam (promoting lifespan) • Mangalam (auspicious) • Punyam (righteous) • Vrushyam (aphrodisiac) • Varnyam (enhancement of color and complexion) • Grahapaham (protection from evil spirits and microorganisms).

The specific benefits of Swarnaprashana according to the duration of administration have been mentioned such as: • If administered for 1 month, the baby will become Parama Medhavi (highly intelligent) and Vyadhibhir Na Cha Drusyate (will not be affected by any disease) • If administered for 6 months, the baby will become Srutadhara (will be able to remember the things, which are just heard).

All the above said benefits are indicating the enhancement of all favorable factors required for proper growth and development of a child, which is considered to be rapid during Shaishavavastha (infancy).

Results of the studies, evidence based

(Ref: Bhinde, Sagar & murthy, A & Dave, Hasmukh & Kiradi, Pallavi. (2013). A SURVEY STUDY ON ‘SUVARNA PRASHANA’- AN AYURVEDIC IMMUNIZATION. Journal of Vishwa Ayurveda Parisad. 10. 3-8. )

A survey study of Suvarna Prashana in healthy children has been conducted under the department of Kaumarbhritya, G J Patel Institute of Ayurvedic Studies and Research & S G Patel Ayurveda Hospital and Maternity Home, New V. V. Nagar, Anand. In this survey study, age specific dose has been given on every Pushya constellation for 12 months, to assess the effectiveness of the same. After providing the written proforma to the parents, we got the feedback and we made the analysis of the same to found that Suvarna Prashana is beneficial to maintain and even improve the weight, concentration, appetite, activity (Chapalata), mental stability, immunity, and memory power. No significant side effects were observed

Weight: 114 (87%) parents were satisfied with weight gain of their child,

Concentration: 112 (87%) parents were satisfied with improved concentration of their child

Appetite: 108 (82.44%) children noticed improvement in appetite during research time period

Alertness: 117 (89.31%) parents are satisfied with improved alertness of their child

Memory: 127 (96.95%) parents were satisfied with improvement in memory power of their child

Mental Stability: 119 (90.84%) parents were satisfied with mental stability of their child

Body Strength & Immunity: 121 (92.37%) parents were satisfied with improvement in body strength of their child

SP showed maximum improvement (>75%) in this study. Overall effect of SP on above mentioned parameters shows that, 116.13 (88.65%) parents found overall improvement in all parameters, 9.37 (7.16%) parents could not judge any change and only 5.5 (4.19%) parents found their children deteriorateChanges in Antropometry, IQ, milestones, health status, illnesses in children, and various lab tests like IgG, IgM etc.

Effect of Suvarnaprashana seen in clinical research studies

Multiple studies have been conducted on Suvarnaprashana done using suvarna bhasma. Most of the studies have assessed the effects of Suvarnaprashana on growth, development, disease characteristics, intelligence quotient, quality of life, hematological, biochemical or immunological parameters in children upto 12 years of age. Newborns including preterm infants have also been included in some studies.

1. A comparative pharmaco-clinical study on Suvarnaprashana medicine and just ghee-honey combination in full term newborns showed that, Weight, MUAC, head circumference had significant increase in SP group than control group. Episodes of recurrent Upper respiratory tract infections, diarrhoeal episodes were absent or infrequent in SP group than control group. Significan tincrease in WBC and lymphocyte count, IgG levels also showed significant rise. [Gaikwad AS et al. 2011] Once daily 4 weeks
2. A randomised controlled clinical trial on Suvarna prashana to assess its immunomodulatory activity in neonates showed that, significant increase in weight of the children treated with SP is observed as compared to control group. Moreover infrequent or absence of other illnesses during follow up episodes was also observed in SP treated group [Singh P et al 2016] Once daily 6 weeks
3. A comparative pilot study conducted to assess efficacy of Suvarnaprashana in Preterm born infants upto 3 years age, suggested that, SP leads to healthy weight gain in children significantly moreover these children are less likely to fall sick due to frequent illnesses during the course. [Rathi R et al 2017] Once every Pushya constellation for 6 months
4. One comparative clinical study was conducted to assess role of suvarnaprashana on recurrent illness in children from 3 to 10 years age showed that SP treatment lead to significant improvement in appetite in children. Moreover these children did not show recurrent cold, cough, loose stools, vomitting etc as compared to the children in the other group. Significan timprovement in Total WBC count and Hb % was observed in children treated with SP compared to the other group. [Joshi K et 2019] Once daily for 30 days
5. One study was conducted to evaluate role of Suvarnaprashana on growth and development in Indian toddlers. The reports showed that, along with the positive improvement in physical parameters like height, weight etc, the developmental quotient for mental age of SP treated group was highly significant than the non-treated group. [Kannan S et al 2018] Once every pushya nakshatra for 9 months
6. The effect of Suvarnaprashana on physical growth parameters like weight and height in children upto 12 years age was evaluated in one study. It showed that the effect on weight is significant but not statistically significant effect on height in SP treated group is observed. [Ramteke RD et al 2014] Every Pushya nakshatra for 1 year
7. Effects of Suvarnaprashana on multiple parameters in children were assessed in one more study. [Patil A et al 2017] SP was orally administered for 6 months once every pushya or 27th day. The study reports showed that not just the height and weight but also improvement in IQ scores of SP treated group is significant. Moreover, increase in mean levels of immunoglobins like IgG, IgM, IgA were observed among SP treated children group after 6 months of SP.
8. Effect of Suvarnprashana on physical growth as well as its immunomodulatory activity was assessed in children upto 14 years age in a study. The reports showed that SP therapy significantly improves weight, height and head circumference of children. [Khawale D et al 2017] Once every 27th day for 1 year
9. Other few studies evaluated the effects of Suvarnaprashana as a preventive healthcare measure in children upto 8 years age and its clinical effects. Highly significant decrease in occurance of illnesses like cough, dyspnoes, sleep problems and pharyngitis is observed in SP treated group highlighting its preventive role. Improvement in weight and height was seen in these studies as well. [Rao NP et al 2012] once daily for 30 days [Somaji LD et al 2014] once every pushya nakshatra for 12 months

Almost all the studies have reported significant improvement in weight of the child and decrease in illnesses after administering SP even at a monthly single dose. This reiterates the pharmacological action of gold and ghee as anabolic and immunoprotective.