Advice mothers receive is often inadequate in quality and quantity

October 1, 2015

Article

A nationally representative survey of more than 1000 mothers of infants aged 2 to 6 months showed that mothers report receiving little or inappropriate advice-even from physicians-about 5 key infant care practices: immunization, breastfeeding, sleep position, sleep location, and pacifier use.

A written survey, which mothers generally completed when their infants were between 60 and 180 days old, assessed how much advice participants received about the 5 targeted infant care practices and whether that advice was consistent with recommendations of the American Academy of Pediatrics (AAP). In addition, the survey addressed variations in the quality and quantity of advice mothers received from 4 sources: doctors, nurses at the hospital at which the infant was born, family, and the media.

Doctors were the most common source of advice though roughly 20% of mothers reported receiving no advice from doctors about breastfeeding and sleep position, and more than 50% said they got no advice from their doctors about sleep location or pacifier use. Also, mothers reported that as much as 10% to 15% of physician-provided advice was not consistent with AAP recommendations for breastfeeding and pacifier use, and more than 25% was inconsistent with recommendations for sleep position or location. Doctors were most likely (89%) to offer guidance about vaccinations and that advice almost always was accurate. Participants reported that advice from nurses was generally similar to that from doctors.

The prevalence at which advice was received from family or the media was 20% to 56% for most care practices and was often inconsistent with recommendations (Eisenberg SR, et al. Pediatrics. 2015; 136[2]:e315-e322).

Commentary: So, this could mean that we aren’t giving advice or, as the authors mention, “perceived receipt of advice is not the same as actual advice given.” Since new mothers deal with so much activity, visitors, pain, and emotion in the postpartum period of their hospitalization, it is a wonder that many even remember the doctor, much less his or her advice. That’s why this advice needs to be promulgated by more than just primary care providers at the time of birth. Parents and their families need to know what is recommended before the baby arrives. This requires an alliance of physicians, nurses, public health officials, and media fanning out to change community beliefs on issues of infant care. For more on this multimodal approach, see the accompanying editorial by Drs. Krugman and Cumpsty-Fowler (Pediatrics. 2015;136[2]:e490-e491).

Ms Freedman is a freelance medical editor and writer in New Jersey. Dr Burke, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland. The editors have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.