New moms get conflicting advice on infant care, survey finds
Soon after new mom Sarah Cavanagh delivered her baby, she was told by nurses to keep trying to breastfeed, despite her concern that she was not producing milk. It wasn't until a few days after she was discharged from the hospital that a home nurse noticed the child was beginning to develop jaundice because she had not eaten.
"She told us to immediately start formula. She also told us not to tell anyone about her advice as she feared getting reprimanded or losing her job," Cavanagh said. In Montreal, where she lives, breastfeeding recommendations are similar to the U.S. and public health campaigns strongly promote the benefits of breastfeeding. But Cavanagh said that formula was the best and only option for her daughter.
Rachel Francis Feller, a mother of four in Plantation, Florida, struggled to get her children to sleep. She was told by family members to lay the children down on their sides, despite doctors' recommendations to place babies on their backs to sleep -- a practice that has been proven to reduce the risk of sudden infant death syndrome (SIDS).
Feller's and Cavanagh's experiences are hardly unique. A new study shows many new mothers receive inadequate or conflicting advice when facing questions about how to care for their babies.
The study, published Monday in the journal Pediatrics, surveyed mothers of infants between two and six months old and found they commonly received infant care advice from doctors, nurses or family members that is inconsistent with existing recommendations. Some said they received no advice at all from medical professionals on the recommended practices for breastfeeding, sleep and other issues. Advice mothers heard from the media was also sometimes out of step with medical recommendations.
The study focused on infant care recommendations on breastfeeding, sleep position, sleep location, pacifier use and immunization.
Researchers surveyed more than 1,000 new mothers who had delivered babies at one of 32 participating hospitals around the country. Nearly 20 percent of mothers said that they did not receive advice from their doctors about current recommendations for placing their babies on their backs to sleep or for breastfeeding. The American Academy of Pediatrics recommends babies breastfeed exclusively for the first six months and continue nursing as other foods are introduced in their first year.
More than 50 percent of mothers reported that they received no advice about sleep location. Practitioner groups recommend that babies sleep in the same room as parents, but not in the same bed, as that can also increase the risk of SIDS or accidental injuries. More than half also said they received no advice about pacifier use.
When a doctor's advice strayed from current medical recommendations, the researchers found it was usually because mothers were told both the recommended practice and at least one other option that was not consistent with recommendations.
The survey found that doctors were reported as the most prevalent source of advice to mothers, followed by nurses, whose recommendations were similar to those of doctors, although nurses did not provide mothers with as much advice about immunization.
Dr. Tanya Altmann, a pediatrician in Southern California, said conveying this guidance to new parents is an important part of a pediatrician's job. "As a physician, we cannot assume our patients know what to do," she told CBS News. "I hope this study is a wake-up call pediatricians to slow down and make sure they effectively communicate information to new families."
She acknowledged that this doesn't always happen the way it should. "Sometimes in today's healthcare system, a lot of physicians may find they don't have as much time as they want, and that they are often rushing between patients," Altmann said.
New mothers also reported family members provided advice on infant care. However, more than 20 percent of the advice they gave about breastfeeding and nearly two-thirds of their advice on sleep position, sleep location, and pacifier use was inconsistent with medical recommendations.
Fewer than half of new moms in the study reported getting infant care advice from the media, with the exception of about 70 percent of mothers who said they got media advice about breastfeeding. Almost 20 percent of that advice was not consistent with recommendations, the survey found.
Roughly 25 percent of mothers who said they got media advice about vaccination reported advice that differed from official recommendations.
"The American Academy of Pediatrics is in a position to give the best advice," Dr. Tonse Raju, chief of the Pregnancy and Perinatology Branch at the Nation Institutes of Health (NIH), which funded the study, told CBS News in an email. "They're the practitioners who see new infants every day. Their expert committees review the studies that NIH has funded, and sort through the evidence to come up with the most fact-based recommendations possible."
An interesting finding of the study was that black and Hispanic mothers were more likely than white mothers to receive advice that was consistent with recommendations for all infant care practices except sleep position. The report stated: "It may be that certain mothers are perceived by potential advisers as needing less advice, though there is no evidence that some mothers need less advice than others."
Authors of the study note that there may be a variety of reasons for this lack of consistency with infant care recommendations.
"Reasons may include a lack of knowledge of the recommendations, a perception of controversy surrounding the recommendations, or actual disagreement with the recommendations" Dr. Staci Eisenberg, pediatrician at Boston Medical Center and one of the authors of the study, told CBS News in an email. "I would add that, in the case of health care providers in particular, it may be that the recommendations need to be communicated more clearly and explicitly."
Recommendations are generally updated when there has been sufficient new evidence to warrant a change. For example in 2011, the American Academy of Pediatrics (AAP) expanded its 2005 recommendations on SIDS from placing infants for sleep on their backs to also focusing on a safe sleep environment, such as avoiding soft bedding and bed-sharing, which had been shown to reduce the risk of all sleep-related infant deaths.
Despite these findings, Eisenberg says new moms should not be discouraged or confused. Her best piece of advice: ask questions.
"Our study highlights the need for parents to be proactive participants in their child's health care. At a minimum, this means making sure to ask questions if a health care provider gives information that is at all unclear or not easy to understand," she said. "Going to reliable sources online, such as the American Academy of Pediatrics, the American Academy of Family Physicians, or the CDC, can also be a good way to prepare for a visit ahead of time or to double check information."