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?

YABU.

You're only looking at the guidance from a singular perspective.

For example, being in the parents room isn't just about parents keeping baby's from sleeping too deeply. It's also about parents being able to wake up if baby is making concerning noises, like spluttering.

And most babies roll from back to front first, then front to back, don't they? So you shouldn't place your baby on their front as they may not be able to roll on their back. And if they can't roll at all yet, then their head support and strength may not be enough to mean they don't smother in the pillow.

Why are you so against safe sleeping advice?

Advice for the masses has to be delivered at a basic, broad reaching level. Assume the population has a reading age of about 10 and work from there. Keep it simple.

Then, those parents who want to do more research can. And they can make their own decisions for their own babies. After all, it's just guidance.

Also, and I mean this kindly, your baby is under a year old. Try not to overthink it all. Parenting guidance is just that - guidance. It's not law and it's pitched at a societal level rather than specifically to individual babies/children. Figure out what works/doesn't work for you and your child, what your deal breakers and red lines are, and do that.

You sound a bit nitpicky tbh, and in that vein... I'm surprised an FOI worked for the Lullaby Trust as they're not a public body and charities aren't subject to the FOIA.

@SchoolShenanigans
Most babies roll belly to back first, because this direction is gravity assisted. Back to belly is much harder, and occurs on average a month later. YMMV of course.

Yes this really annoyed me too OP.

The most annoying one is wind. I used to wake up my sleepy baby burping her after a feed because I accepted the advice that this is what I was meant to do to stop wind and that this was somehow important.

And then I looked into it and I couldn’t find anything anywhere which even proves that babies do have more “wind” after a feed and even if they do there’s no proof that burping them is in any way helpful. And yet there’s all this advice out there about it and even medicines being sold for it.

Also tummy time. The minimal benefits of this really don’t seem worth the stress that many new parents put themselves through by forcing their babies to endure tummy time!

You're coming at this as as scientist but its a problem of communication not science, eg how can we make this data as easy as possible to understand so the widest range of people actually read it and act on it rather than ignore it because its too complicated.

Whilst this sounds awful (sorry this happened to you), it is completely different to the situation the OP describes so I’m not sure your argument makes sense?

I dont think most people are that great at assessing risk or understanding population statistics to be honest.

I know i hated breastfeeding but did it because the advice at that time was it reduced the risk of hayfever which I have badly. Anyway when I moaned to my gp that my son got hayfever anyway, she said that because me and dh both had hayfever there was something like a 75% chance my son would get it and the breastfeeding reduced that risk to something like 73%. These arent the exact figures so dint quote me. I cant help feeling that wasnt a significant change and the breastfeeding pamphlet was a bit cheeky sticking it in the list of benefits.

Agreed OP, I read all sorts of stuff about how c-sections are terrible. When I went to look for the studies I found that they hadn’t separated out emergency c-sections from elective and therefore risks were considered higher for c-sections overall bs natural birth. I found a study AFTER I had DD that did separate out elective vs medically required and it found that elective c-sections were safer and associated with lower risks. Everyone I knew was convinced that C-sections were terrible things.

It would be nice if information is specific with research referenced accurately. I’m not a scientist but I am able to read. It was very frustrating trying to find information.

I don’t want to start a breast vs bottle debate here but so much of the “evidence” quoted about breastfeeding is like this. And often it’s not clear whether the benefits are down to correlation or causation. Or it doesn’t specify what is actually meant by breastfeeding e.g. it can include those who mix fed etc.

I share your frustration OP, but also understand why the information has to be tailored for mass consumption. I do wish there was a “click here for the real information” link on all the pages!!

OP, I absolutely get where you are coming from, but I'm afraid you're going to run into much much more of this over the next few years.

My recommendation to you is, follow guidance that works for you, and for guidance that you're not sure about, do as you have evidently done and look for the research to make your own decisions. "Back to sleep" is definitely important guidance, I recall being told about it when I was still a medical student in the 90s (in Australia, red nose day was SIDS fundraising). Despite that, when my refluxing firstborn came along 20 years ago, I propped her on her side until she could roll, and after that she was exclusively a front sleeper till at least the age 5. If I were to find myself involved in counselling a mother about sleep positions I would absolutely feel correct to encourage putting a baby down on their back, but would also listen to concerns and explore alternatives if there were reasons to do so for a particular baby. Oh and I had been initially rather concerned about the UK infant vaccination schedule at 2,3,4 months, having learned the 2,4,6 month Australian schedule (and also having a family history of odd reactions to various things). Pragmatism won, after a discussion with my GP (used to a fairly international population) - eldest was dosed at 2, 3.5 (due to travelling home to see grandparents) and about 5.5 months. The next baby followed the standard UK schedule.

It is often said that medicine is both an art and a science. A lot of decision making is pragmatic rather than 100% scientific. There is a balance to find between "how likely is this to be X" and "how serious is it if we don't treat X immediately". In young babies we have a very low threshold to do blood tests and start IV antibiotics, which can mostly be stopped after a couple of days if blood cultures don't grow anything. As they get older we will wait for more evidence of significant infection before starting antibiotics.

On the question of recovery from C-section, I'm pretty sure that advice after other comparable surgery will be to refrain from lifting; as others have said, allowing up to your baby's size is a pragmatic approach. (should our society look after new mothers better than it currently does?). As a poster above described though, in a higher risk situation she was advised much more minimal lifting.

Wish I could 'like' this. Spot on.

Even as a scientist the last thing I wanted to be doing with a new baby was reading detailed guidance. Rough guidelines were perfect for me - clearly I was going to lift the (very big) babies, but knowing not to lift more than that was helpful.

Back to sleep is crucial with little ones, clouding that message at all by adding asterisks about babies who can roll isn't going to be helpful at the population level.

The people who made the guidance know more about their areas of expertise than me, so I'm happy to follow them broadly. If they don't work for us, then I can do more reading to see if they work.

As others have said, we do this in lots of walks of life - I'm more than happy to just take two paracetamol rather than weigh myself and work out an exact dosage.

So much advice is based on trial and error tbh.

SIDS advice is always going to be emotive because the price is so high. But since certain things being changed have coincided with a reduction in SIDS rates these changes are given to parents as guidelines.

The reality is that there will still be babies who die from SIDS even if all the guidelines are followed, because the actual cause is still unknown, and it’s not about prevention, but reduction.

Things like allergies are guesswork and experimentation. It used to be that babies shouldn’t be given anything containing nuts for the first year I think it was. Now the science seems to be suggesting that doing this increases the possibility of allergies, and so it’s better to introduce small amounts from six months.

Similar weaning. The science actually still suggests that between 4-6 months is the best age to wean a baby. Some babies are absolutely ready to start on purées at four months, but because there are people who put rice in the bottles of their six week olds the advice was changed to six months in the knowledge that many of those people would wait for four months at least.

Most countries have reverted back to four months now because of the increase in intolerances.

Also, terms like “baby led weaning” and “food before one is just for fun” are just catchphrases and a load of bollocks.

Not just parenting advice. A whole lot of medicine in general, for example there is no good evidence on postoperative activity restrictions, whether you have had a c section, a hysterectomy or a hernia op. Lift nothing heavier than your baby is as made up as lift nothing heavier than 2/5/10kg.

Completely UR, OP.

Other PPs have mailed it; it's about simple clear messaging that all parents can follow, broadly. Individually, our own babies may differ.

Additionally, you are really misinformed eg regarding rolling. A baby can often roll one way first, but not the other. A baby might roll during the day - but sleep deeply & not do it at night. The 'Back to Sleep' message is clear & unequivocal, without asking parents to make a multi-faceted decision each time they put their baby down,