Dealing with conflicting advice

Why does everyone say something different?

Mothers who breastfeed often find that they receive conflicting advice. Sometimes it’s understandable: For example, there may be more than one way to fix a problem. Other times it is because there is not enough known about breastfeeding problems, or because hospitals don’t have appropriate policies. Some people give advice based on their cultural norms or their own experiences. Try to ensure that any advice you take is effective, safe, and research-based and discard the rest.

A) Acceptable reasons for differences of opinion

Families are often frustrated and confused by the range of advice they receive (McInnes 2008). Indeed, this is the most common complaint we hear from our patients in our clinic about their previous care.

There are many reasons for this. Some are acceptable:

  • Babies change as they grow, and advice on how to breastfeed has to change as well.
  • Different approaches work for different families.
  • There may be more than one effective way to fix a problem.
  • Two people giving the same advice can sound different.

B) Less acceptable reasons for differences of opinion

1) No captain of the ship

One study (Garner 2016) found that most health-care providers relied on other health-care providers to provide breastfeeding care. This study is titled in part: "There's No Captain of the Ship" and this nicely describes the problem with multiple health-care providers.

It can be helpful to choose one knowledgeable health-care provider instead of several and to ensure that any advice you take is effective, safe, and research-based.

2) Using opinions and experiences instead of research

Instead of using research-based evidence, people may give advice based on their cultural norms or their own experiences (Wright 2018).

This can cause problems, because they may give information that:

  • Is no longer up-to-date because they had their own babies a long time ago.
  • Is incorrect because their own breastfeeding challenges were not properly addressed.
  • Is practiced in their culture but not evidence-based. 
  • Is based on infant-formula feeding as they did not breastfeed.

Indeed, daughters of mothers who did not breastfeed, are less likely to breastfeed (Wagner 2019).

3) Other reasons for differences of opinion

Other reasons for differences of opinion include:

  • There is not enough research on the best way to fix breastfeeding problems.
  • Some hospitals do not have appropriate breastfeeding policies for providers to refer to.
  • Some health-care providers do not support breastfeeding.

References

Garner CD, Ratcliff SL, Thornburg LL, et al. Discontinuity of Breastfeeding Care: "There's No Captain of the Ship". Breastfeed Med. 2016 Jan-Feb;11(1):32-9
 
McInnes RJ, Chambers JA. Supporting breastfeeding mothers: qualitative synthesis. J Adv Nurs. 2008 May;62(4):407-27
 
Wagner S, Kersuzan C, Gojard S et al. Breastfeeding initiation and duration in France: The importance of intergenerational and previous maternal breastfeeding experiences – results from the nationwide ELFE study. Midwifery. 2019 Feb;69:67-75
 
Wright AI, Hurst NM. Personal Infant Feeding Experiences of Postpartum Nurses Affect How They Provide Breastfeeding Support. J Obstet Gynecol Neonatal Nurs. 2018 May;47(3):342-351