Health

Some baby care books are giving advice that goes against safe infant care guidelines

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Written by: Amy Brown, Professor of Child Public Health, Swansea University

Parenting and baby care books may be unintentionally putting babies in danger. Cookie Studio/Shutterstock

Becoming a new parent can be one of the most stressful things you ever do. It’s normal to feel blindsided between what you thought it would be like, and the reality. But it can lead to all sorts of emotions from panic and anxiety, through to grief for your former existence, and even (often hidden) regret at what you’ve got yourself into.

This isn’t helped by how isolated many new parents now are. Just a few decades ago, family, friendships and networks were far more localised, but now, many new mothers have babies many miles away from family, and may not know a single person close by who is going through the same thing. These connections are important socially, but also in terms of learning from others and sharing information.

Without the advice of family and friends to hand, many new parents turn to baby books for advice. Parenting guides that suggest certain styles of caring have been around for many years. But recently there has been an explosion of these books, fuelled by the willing and waiting market of confused and isolated new parents. Although a whole range of parenting books are available, books that promote getting babies into parent-led sleep and feeding routines, along with the idea of them being settled and more “independent” in between, have become particularly popular.

We have previously shown that the more of this type of book that new mothers read, the higher their symptoms of depression and parenting stress, and lower their confidence in their own parenting abilities. Although it could be that mothers who are feeling stressed and depressed choose to try and follow the advice in these books, for this study we also asked mothers directly how the books made them feel. A minority (15–20%) did like them and felt more confident, but far more said that they felt more stressed because they didn’t work for them. Some mothers reported that they were even left feeling “like a failure”.

More recently, we have been exploring how these books are actually used and the impact they have on baby care. Speaking to 354 mothers with a baby aged 0–12 months old, we found that several pieces of advice in these books are associated with a number of behaviours that go against the UK government’s recommendations for safe infant care, and research findings too.

For example, when mothers read these books, we found that 39% of babies were placed in their own room to sleep, going against guidance that the safest place is to share a room with their mother. Although thankfully rare, babies who sleep in a different room are at a higher risk of Sudden Infant Death Syndrome (SIDS). This is possibly because parents are unaware of the temperature in that room, or that the baby has become unwell. While sleeping close to their baby can help parents regulate the child’s breathing, temperature and heart rate.

We also found that just 28% of mothers responded immediately if their baby cried at night, with 25.5% leaving a baby to cry themselves to sleep in the evening. Although occasionally leaving a baby to cry briefly is not going to cause harm, consistently leaving a baby to cry can increase the level of stress hormones circulating in a baby’s body, which could potentially programme their system to be overstimulated.

Breastfeeding rates were also lower, both in terms of starting and continuing breastfeeding. Breastfeeding protects maternal and infant health and stopping breastfeeding before mothers are ready is associated with an increased risk of depression. The guidance in these books sets women up to not be able to breastfeed.

Breastfeeding works best when babies are kept close and fed responsively whenever they want to. However, we found that mothers following the book guidance were more likely to try to feed to a mother-led routine, and as noted their babies were sleeping separately at night.

Of course, all this this might just be correlation – mothers who want to parent in this way may be more drawn to the books in the first place, rather than the books affecting their decisions. But we also asked mothers whether the books directly affected their behaviour in any way. Our findings showed that reading the books persuaded mothers to use a sleep and feeding routine (45%), sleep separately to their baby (23%), delay how quickly they responded to their baby’s cry (24%) and cuddle their baby less (15%).

Some advice books can promise a utopia to new parents desperate for a solution to a baby with frequent needs but such strict routines and separation behaviour often do not work and can place babies at increased risk of SIDS. We also know the importance of loving, responsive parenting interactions in the early years for longer term social, emotional and health outcomes – which some books appear to promote the antithesis of.

Although some parents may make an informed decision to follow such advice, for many this guidance doesn’t work, leaving mothers feeling even more stressed. Rather than selling new parents a promise that they can “control” their baby, we need to focus on helping fewer new families feel under such stress and anxiety in the first place.

The Conversation

Amy Brown has previously received funding from the ESRC, NIHR and Public Health Wales. She is author of three books published by Pinter and Martin Ltd – 'Breastfeeding Uncovered: who really decides how we feed our babies', 'Why starting solids matters' and the 'The Positive Breastfeeding Book'.

Victoria Harries does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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