Our thanks to Mary Nolan for writing for us on the subject of parenting advice, confusion and consistency. Mary is one of our main session speakers at the Growing Families: Facts, Fiction and Other Stuff event in Manchester this October, and will be delivering the section on Understanding Baby, in conjunction with Helen Ball of the Durham University Parent-Infant Sleep Lab.
Mary trained as a nurse in the 1970s and then as a childbirth educator with the NCT. She has worked with parents across the UK and has trained educators in Australia, New Zealand, Ireland, Belgium and Germany. She has published several books including, ‘Antenatal Education: A Dynamic Approach’, ‘Home Birth: The Politics of Difficult Choices’, and chapters in ‘Essential Midwifery Practice: Intrapartum Care’ edited by Denis Walsh and Soo Downe. Her PhD examined the impact of antenatal education on women’s choices around pain management in labour and her research into women’s and men’s experience of early labour, what women want from antenatal classes, and health visitors’ engagement with new fathers has been published in peer-reviewed academic and professional journals.
My father is 88 years old – a truly splendid octogenarian who maintains a keen interest in a world which he sometimes finds confusing. He is not slow to remind us – with a twinkle in his eye – that advice is like fashion; it comes and goes and if you hang onto what you wore/were told in the 50s/80s/00s, you’ll eventually find yourself ‘on trend’ and doing ‘the right thing’ again after being out of fashion and doing ‘the wrong thing’ for a couple of decades!
He’s particularly keen to point out that the parenting my mother considered appropriate – three meals a day (sitting at the family table) and only water and fruit in between, and bed-time before 8pm are now being advocated again. (Along with real butter which my Dad loves!)
It’s hard today being a mother or a father or a kinship carer or anyone who has charge of children and wants to do the best they can to ensure they are physically, emotionally, socially and spiritually healthy. And people like myself, who are in the business of parent education and research, don’t always make life easier – although we are totally committed to finding the very best evidence to give to parents and co-parents.
Helping out at a playgroup the other day, I was startled to hear two young mothers (mid to late twenties) talking about what kind of milk to give their babies. The babies in question were adorable little girls of around 4-6 months of age. The babies were sitting in their pushchairs smiling amiably at each other and occasionally demanding some attention from their moms which was very willingly given. I presumed that the mothers were discussing breast milk v formula, or different kinds of formula. Not so. The mothers were discussing when to give cow’s milk and whether it should be full fat or semi-skimmed. The conclusion they came to was that it was all right to change from formula (which both babies were receiving) to full fat cow’s milk at 6 months of age. The World Health Organisation and the Department of Health recommendation is not to give cow’s milk before a year at the earliest. It’s one of the few recommendations that has been consistent over quite a long period of time.
These were clearly devoted and conscientious mothers with healthy and happy babies. So how could they have got hold of such wrong information?
It’s not just mothers, of course, who are victims of the confusion that inevitably arises when health information changes from one week to the next, or is transmitted in a confused way or is different according to which health professional you speak to. Health professionals are confused as well. While leading a seminar recently for a bright and dedicated group of student midwives, I found myself in a debate with one young and ardent student about whether caesarean section was as ‘good’ as vaginal birth. I mounted the usual (and, to my mind, correct) argument that caesarean can be a life-saving operation for some mothers and babies and that we are fortunate to have easy access to it, but that vaginal birth has many advantages that may affect the new baby for the whole of their life. I therefore suggested that it is the midwife’s role to support women and their birth companions physically and emotionally to have a straightforward vaginal birth whenever possible. The student quite definitely did not agree with me and felt that vaginal and surgical birth should be presented as equal options.
You might be thinking now that I have made these two stories up for the sake of this Blog – but, actually, I haven’t. Both are true and both incidents occurred in the last month.
Research into health promotion is very clear that conflicting and inconsistent advice leads (who would have guessed?) to conflicted and inconsistent parenting. And that inconsistent parenting doesn’t help young children to feel secure and ‘get a grip’ on the world. The baby and toddler are busy developing a template for life. Their fast-growing brains are trying to sort out which behaviours lead to which responses. As humans, we all need to feel pretty certain that our actions will have predictable outcomes if we are to function effectively on a day-to-day basis and avoid becoming anxious and indecisive. As a very young child, I need to know, for example, that food arrives at certain times and that eating it makes me feel content; that smiling at dad and reaching out to him elicits a warm playful response, and that pulling grandma’s hair hard makes her sad. I need my mom and dad, or whoever is looking after me, to do things in ways that I come to recognise as ‘how things are done in our family’. If mom and dad are continually changing the way in which they look after me because the advice they are receiving is always changing, that’s not particularly good for me as the little person on the receiving end of that inconsistent parenting.
For me as a birth and parent educator, and an academic who’s interested in how to transmit accurate health and child care messages, the age of social media is challenging. Twitter and Facebook can function rather like a game of Chinese whispers with a message starting out as one thing and becoming something very different by the time it reaches the hundredth or the thousandth or the ten-thousandth recipient. For parents and co-parents, trying as hard as they can to be not just ‘good-enough’ parents, but excellent parents, ever changing advice is a nightmare.
It’s a conundrum. So what advice would I give about advice???!! I think exactly the same as I would have given when I first started practising as a parent educator about 30 years ago. Choose one person who you have reason to believe knows what s/he’s talking about and understands the way in which you want to parent, or one website that has been recommended to you by a health professional, or one book that is authoritative (the reliable ones generally have reference lists so you can check the research on which they’re based) and stick with that person or information source. As a very wise friend once said to me (rather shockingly, I thought at the time), ‘Even better than loving your children is being consistent’.