As any new mom can attest, people love to give advice about baby care. But a new study in the journal Pediatrics finds that many new moms aren’t getting the advice they need from the people most qualified to give it: doctors and nurses.

What's more, when doctors and nurses do weigh in, their advice sometimes conflicts with the recommendations of the American Academy of Pediatrics (AAP).

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Researchers surveyed more than 1,000 mothers of infants ages 2 to 6 months about advice they'd received (if any) from doctors, hospital nurses, family members and the media regarding five important infant care issues:

  • Breastfeeding
  • Vaccines
  • Sleep position (face up, facedown, on the side)
  • Sleep location (what room and what bed)
  • Pacifier use

They then looked at whether the advice given was consistent with AAP recommendations.

The new moms got most of their advice on baby care from doctors, but more than 50 percent said their doctors failed to advise them on pacifier use and where their baby should sleep. About one in five said their doctor didn’t talk with them about breastfeeding or sleep position. (Sleep position is particularly important because babies who are put to bed on their bellies or on their sides have a higher risk of sudden infant death syndrome, or SIDS, according to the AAP).

Vaccinations were the one topic at which doctors excelled: 86 percent echoed AAP-recommended advice.

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Wrongheaded advice

In a significant number of cases, the advice new moms said they got from caregivers conflicted with AAP recommendations.

For example, more than 25 percent of the mothers in the study reported receiving advice about sleep position and sleep location from their doctors that did not match the AAP’s. Doctors’ advice about breastfeeding and pacifier use conflicted with that of the AAP 10 and 15 percent of the time, respectively.

Interestingly, hospital nurses gave more and better advice about breastfeeding, but tended to give less (and sometimes conflicting) advice about the other topics.

Why the discrepancy between caregivers' advice and AAP guidelines?

The study authors suggest that some doctors and nurses either aren't aware of current guidelines or may disagree with them. They also may be pressed for time and not want to get into a lengthy discussion about a potentially controversial issue. The researchers also say that since their data was based on what the mothers said, it's possible the advice they remembered getting wasn't exactly the advice they were given. 

More outreach from the AAP may be one solution to the discrepancy between caregivers' advice about baby care and the group's recommendations. “In the case of health care providers in particular,” says Staci Eisenberg, MD, a pediatrician at Boston Medical Center and a co-author of the study, “it may be that the recommendations need to be communicated more clearly and explicitly.”

Kathleen Berchelmann, MD, a pediatrician at St. Louis Children’s Hospital and author of the blog ChildrensMD says, “Almost every pediatrician is up-to-date with the literature and modern guidelines.” But, she adds, “Pediatricians increasingly are being managed by large organizations that use patient satisfaction surveys to evaluate their work and determine their pay.” Not only are doctors under pressure to make patients happy, new moms don’t always want to hear advice that conflicts with their parenting ideas, she adds.

Take the issue of sleep location. “A lot of moms don’t want to hear that babies should sleep alone in a crib on their backs,” says Berchelmann. “Rather than take time to explain why, a doctor might give them a handout [about sleep safety] to avoid a low patient satisfaction score.”

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Family-advice fails

The information new moms get from other sources often misses the mark, too, the study found. More than a quarter of the mothers reported family members gave them advice on where and how babies should sleep that was inconsistent with AAP guidelines. Most mothers said they didn’t get advice on these topics from the media either, but when they did, 10 to 20 percent of the time it too was different from AAP recommendations.

So where should a new mother turn for baby care advice she can trust? Eisenberg encourages parents to be proactive and write down questions before doctor visits so they're as prepared as possible. “Ask questions if a health care provider gives information that's unclear or hard to understand,” she adds. Finally, double check any advice you receive from anyone at the AAP website

Mary Purcell is a freelance writer and health researcher in Piedmont, Calif., with expertise in policy analysis. She has a master's degree in Latin American studies from Georgetown University.