Why am I getting Conflicting Advice?

And what should I do with different bits of information?

Something you commonly run across in feeding advice, but often in other baby-related issues as well, is conflicting advice from providers. We know that can be incredibly frustrating for you all, and thought we’d address it a bit here today.

Guidelines Get Updated

• There’s no simple solution to this situation, but I can offer some thoughts on how it occurs, which may provide helpful context. One simple explanation is that guidelines change, and providers aren’t always up to date on the latest information. For example, the Academy of Breastfeeding Medicine released updated guidelines on treating plugged ducts and mastitis in the fall of 2023 which turned upside down some of the advice we’d been giving for a long time - we should no longer be recommending the use of heat, the ‘dangle method’ for drawing out plugs, etc. If somehow a provider missed that update (for example, if they aren’t an IBCLC and breastfeeding is not their primary area of work, and they haven’t read the current literature), an L&D nurse might still tell you to use a heating pad when you know from taking our class that you should not - and of course, you would be frustrated at that conflicting advice! But that is how it could have happened. Needless to say, the internet gets into this same tangle - some sites will have up-to-date information, and some will not.

Differing Perspective and Priorities

• The other reason you might get conflicting information is your providers have different priorities. When you’re talking to an IBCLC (lactation consultant), their main job is to help you breastfeed. Your pediatrician is primarily concerned with the baby being healthy - maintaining a good weight, not getting dehydrated, etc. The L&D nurses at the hospital might mainly want to keep the baby quiet and soothed and let you get sleep. There are all kinds of perspectives people might be bringing with them as they help you. As an example, when you speak with me for virtual infant feeding counseling, I’m listening to you as not only a lactation counselor, but also a postpartum doula, who is fully aware of all the challenges that you are experiencing in your body, the wide range of emotions, the staggering logistics of it all, not to mention the sleep deprivation. I want to help you with all your feeding questions, but in the context of not making it harder than it needs to be for you with everything else that is going on. I’m also a mom of three kids, ages 9, 11 and 13, and those newborn days aren’t so far in the rearview mirror that I don’t remember how hard it can be! So when we talk about triple feeding, I usually suggest only double feeding at night, because I believe the baby has plenty of practice breastfeeding during the day, and I think your sleep takes priority for a couple sessions at night. But an IBCLC might feel it’s more important to be quite strict about the triple feeding around the clock. So there you would have a conflict in the advice - neither is wrong, it’s just different perspectives, coming from different priorities. 

"BRAIN" Decision Making Framework

• How do you sort through all this and decide what to do? We actually address this decision making process in our postpartum prep class. We propose using the following framework, and we call it your SOSES:  I think it’s a balance of following your gut, and doing what feels right in your spirit and body for you and your baby, and using the skills we all now have to use anyway in determining what is a trustworthy resource.

Know Your Source

Who is the source, what is their motivation, what is their background, what other kinds of advice/writing/research are they putting out there? Granted, you have limited time to do all that sifting and work. So if you find one or two sources that you really like and trust, you can keep coming back to them repeatedly to save yourself some time and effort. One source I find helpful is Emily Oster, an economist, who puts out a newsletter and now has a website with a searchable database of all kinds of pregnancy and early childhood related information. She’s a bit more down on breastfeeding than I would prefer, but in general, she lets the data speak for itself and takes a very ‘the sky is not falling’ approach. I find her paid subscription to be worth it, and you might as well.

~ Naomi, Infant Feeding Expert*

*If you need help to schedule your bundled Infant Feeding session with Naomi…email Elizabeth Parish.