To think a lot of parenting guidance is flawed?

[Cellocecilia]

I am a scientist by ‘trade’ and since having my first daughter at the end of last year I can’t get over how flawed much of the official advice/guidance and even medical instructions are around new babies. Honestly as an analytical thinker having DD has been a bit maddening in terms of analysing all the information coming my way.

For example, I had a c-section and was told I couldn’t lift anything heavier than my baby, she was born 6lbs. People have babies twice that size. So that’s flawed advice. There objectively must be a maximum weight people post op should lift. I however suspect that might be less than some babies weigh and therefore the NHS don’t want to be telling new mothers not to lift their own babies, or it’s more than an average baby but they don’t trust the masses to correctly assess the weight of objects they wish to move.

Secondly the ‘don’t roll a baby onto their front to sleep, but once they can roll themselves onto their front you don’t need to roll them back’ physiologically there is no difference in position or sleep safety if a baby is rolled onto their front or they roll themselves onto their front, if they can roll from front to back.

The guidance seems to be based on it not being practical to expect or tell parents to sit up all night rolling their babies back over, not because it’s safe for babies to sleep face down if they roll themselves there. There is also some argument that by the time most babies can roll from back to front they’ve got past the most dangerous months for SIDS and their breathing is more mature.

Same applies to the safe sleep guidelines, it doesn’t help that all the ‘recent’ guidance was published at the same time so no one really knows what factor contributed the most to the reduction in SIDS. For example the theory on why it’s better for a baby to sleep in it’s parents room until 6 months is based on the fact that noise from parents will prevent baby from falling into too deep a sleep, this would be achieved by just having white noise, soft music playing or a fan on.

I put in a FOI request to the lullaby trust to get access to the data sources for their safe sleep guidelines and it’s a very interesting read to say the least.

So AIBU to be so frustrated by the lack of scientific basis for most of the guidance we are given as new parents?

The second part of your comment is exactly why the guidance is flawed tbh. There is no physical difference in a baby being put on their front (if they can roll back) and those that roll themselves onto their fronts in terms of aspirating milk, being able to breathe properly etc.

If a baby rolls themselves onto their front their windpipe is just as much in front as a baby who is put on their front.

But if they are a roller they can roll back. If they are a tiny non roller, they just choke!

I thought it was the parents exhaled carbon dioxide nearby that would encourage/help baby take appropriate breaths rather than due to noise.

Yes I would like for those giving out medical advice to give factual information. Or at least make it available for those that want it.

It’s not easy to find most of this information, that’s the issue. I had to submit a FOI request and wait weeks to get most of the data.

It also leads to people taking risks they maybe shouldn’t. It’s very difficult to only lift stuff the same weight as your baby for 6 weeks after having a section, it would actually be helpful to know an actual maximum so people didn’t put themselves at risk, every c section parent I know lifted things heavier than their child, as they had to, but some lifted items that were pretty damn heavy so might have done with being told to definitely not lift more than 10kg for example.

No it's so a baby regulates their breathing to their parents it's nothing to do with noises .

You are ignoring the fact that babies are individual.

So some babies who can roll, stop rolling in their sleep when refining another motor skill.

So the simplest public health message to give is put your baby to sleep on their back (and if they roll over themselves leave them alone).

You do know there's no known cause for SIDS? It's all down to correlation and there's no scientific basis behind any of it? Also every mother and child and family is different so the advice is for an entire population regardless of your mobility, financial situation or family circumstance. It's a best fit scenario. As pp already said often the guidelines takes into account what people are most likely to respond to instead of scientific excellence? It's why policy makers are not just scientists or statisticians or analysts but a combination of many different streams. It's no good having incredible guidelines that the lay person can't understand or apply to their own situation.

How would you know something is 10kg? Would you measure it before you lift it? Or would you need to weigh everything before your section? The reality is a lot of people won't know what 10kg feels like.

It’s definitely not, the studies the lullaby trust cite using on their safe sleep guidelines are pretty clear with their conclusions, many split out white noise and fans and saw the same beneficial reduction in SIDS occurrences

I think you need to let it go OP otherwise you will drive yourself mad. I agree with the points you have made, but public health info is different from what you do as a scientist.

Most items are quite easy to either judge the weight or have it listed

again, after most other surgeries patients are given clear weight limits in terms of what to carry. Why are new parents different?

Because new parents have a baby to look after. They can't relax and recuperate.

Yes I would like for those giving out medical advice to give factual information. Or at least make it available for those that want it.

Good luck with that.

Some maternity healthcare professionals can't give out correct vitamin advice, and the information isn't hard to find.

You are ignoring that you (and the people you know) may actually have more knowledge than some of the maternity professionals treating you.

Love the idea, that “definitely do not lift anything heavier than 10 kg” will work better, than nothing heavier than your baby, whilst acknowledging that parents push boundaries.

I’m not sure too many parents would be confident in estimating which objects weigh 10kg, yet I am sure they would be able to roughly assess if something weighed more or less than a baby they hold regularly.

Also you're being massively presumptuous that most people would be able to identify the weight of their kids, school bags, tables, dining chairs, books, kettles, roast in a roasting tin, toy boxes etc. whether it's 5kg or 7 or 2.

100% this.

It’s hard enough getting some parents to understand the most basic of information.

I work in health visiting. The majority of advice appears to err on the side of caution (when compared with the evidence) on the basis that most people won’t do everything ‘perfectly’.

every c section parent I know lifted things heavier than their child, as they had to, but some lifted items that were pretty damn heavy so might have done with being told to definitely not lift more than 10kg for example.

If they lifted something heavier than their baby "because they had to", why wouldn't they lift something heavier than a given weight "because they had to".

Also it's hard to judge whether a shopping bag etc is heavier than a certain weight. I can't judge if something is more than 3kg for example. I can tell you if it's heavier than one or both of my children though. And would find that even easier if they were a newborn who I carried all the time.

Charities aren’t subject to the Freedom of Information Act so it’s odd that you were given the data at all.

Just to take one of your examples, who told you that you can’t pick up anything heavier than your baby and what guidelines did they get it from? The medical belief is that there is no safe lifting limit but it is widely acknowledged that the overwhelming majority of women will pick up their own baby whether they are recommended to do so or not.

The weight thing is, as you say, probably because you shouldn’t lift anything more than 2kg. But your baby weighs more than that and you have to lift them, so it’s sensible to make that the limit. Not ideal but the most practicable and safe advice.

I have no idea what 2kg (or 5kg or 10kg) feels like, but I do know roughly what my dog feels like in terms of weight and can judge if things may be heavier than her.

I don’t get why you think the right answer is to give the general population advice suited for trained scientists. The aim should be to communicate the basic message as effectively as possible in a way that can be understood by those of below average intelligence and those who are sleep deprived.

You’ve not been able to suggest any better messaging (yes more accurate, but not meeting the aims above) so I think the general advice nails it based on what we know at the moment.

The issue is them issuing the guidance as a package leads people to making silly decisions as they have no idea which factors are most important.

An example, a mum friend locally, her baby is huge and outgrew their next to me crib by 3 months. They couldn’t fit a cot into their room, she was about to start co-sleeping until her midwife told her the risk of suffocation is higher when co-sleeping than the risk of SIDS if baby moves into their own room before 6 months.

Babies being in their own sleep space, free from suffocation hazards seems to be the most important factor, but when it’s presented alongside other guidance people don’t always understand there is a difference in terms of how important or impactful each piece of guidance is. So as long as baby is in their own space it doesn’t really matter as much the rest of it

I imagine they are happy to give out their references and just eye-rolled at the mention of FOI.

I don’t know… I‘ve never read any of the books, done any of the sleeping / eating stuff. Just went purely on instinct. Asked my friends with kids if I wasn’t sure. Asked my mother. There’s so much information out there now…
Agree, that how much of it is right? My view is that everyone is doing it differently. As long as you love your child & it feels like you are doing the right thing for them. Then that can’t be wrong, can it?

"Don't lift anything heavier than your baby" is just a catch-all that's easy to repeat and remember as a way of reminding post-op patients not to overdo it. They know most women are going to lift other things because that's just life and the maximum load is probably far greater than you'd expect. As an example, say the maximum load is 25kg and they say "don't lift anything heavier than 25kg" you'd have patients going over it and hurting themselves but vastly understating the load as "don't lift anything heavier than your baby", a weight somewhere between 2kg and 5.5kg, accepts that there will be patients who lift more than that but who are still unlikely to breach the maximum load.

It's a bit like how the dosages on OTC medicines are usually understated as they're based on age and average size/weight for that age plus a bit of understatement to account for any errors in dosing. According to the side of a bottle of Calpol my DC can have 10ml whereas when they were last poorly, the GP weighed them and said they could actually have 20ml.

I think that often there's a balance between giving the scientifically-proven advice and rules of thumb that people will actually follow.

When mine was little, the official advice was "don't wean before six months", but what the health visitors kept saying was "the current guidance is that you should not wean before six months, but whatever you do, don't wean before four months". They knew lots of people would not heed the six months advice, so they wanted to be sure that the four months message did get across. (I wasn't impressed that they weren't able to tell me whether for a prem baby we should be working with actual or corrected age.)

A friend who is a biologist really struggled with formula milk instructions - they emphasised the importance of using sterilised spoon/bottle/etc, but the instructions for doing this did not meet her standards for "sterilised", so she wasn't sure what was required!