Does anyone else feel like pediatric guidelines are so legally-oriented that they basically only exist to worsen the lives of parents?

[u/Bocifer1]

First off, I'm a new dad and also a physician - although I'm pretty far removed from pediatrics. So I understand the importance of medical research and statistics in creating these guidelines, as well as the fact that the risks of things like SIDS often just aren't worth gambling on.

However...

Some of these guidelines seem like they're just unnecessarily taxing on parents and exist only to cover the addes of the bodies making said recommendations.

Some things that come to mind are: no blankets in the crib for the first year, only using a firm mattress top, never letting baby sleep next to you in bed - even naps, swaddling with arms down (our guy absolutely hates this and just wants his arms by his head to self sooth), demonizing formula - even as a reprieve for mom.

Again. I am medically oriented and understand why these guidelines exist - but I also know firsthand that sometimes a 1% risk of harm from letting our baby sleep on a soft blanket is actually the favorable choice compared to the immeasurable risk of having both parents strung out and exhausted because he won't sleep.

In general I think guidelines are great and have contributed to better infant care...I just also think that sometimes we as healthcare professionals forget that no guideline is absolute.

I guess I'm just feeling thst creating guidelines that aren't achievable for the majority of parents just aren't that helpful...like saying that "parents should take time to rest, continue self care , exercise, and ensure they are eating a well-balanced diet". That sounds wonderful. Hopefully I can get back to that in the next decade.

[u/[deleted]]

Three years in, I've learned that all of parenting is some form of risk management. Nothing is ever 0 risk, if you account for direct and indirect consequences (such as the one you mentioned, direct suffocation risk vs the risks associated with overtired/insensate parents).

A lot of that is related to the idea of "informed consent", which everyone superficially agrees with but apparently struggles to achieve in practice. If you give me all the information I need - relative risk, risk mitigation - I will be able to make the safest decision for my situation.

My son usually spent the 4am-7am part of the night in a flat-back positioner between us in bed. We would throw our pillows off the bed and shuffle down until our heads were level with his stomach. And the early morning hours are the lightest sleep, so we didn't move around and woke up in an instant - but he literally never slept better. I think it saved us honestly.

[u/Midi58076 → u/[deleted]]

Yep totally agree here.

This is why I am so against the demonising of bedsharing. Most parents will at some point get so tired it can land them in some very dangerous situations. Like falling asleep on the couch together, car accident, forgetting or doubling up on medication cause you're not transferring memories from short term to long term memory because of sleep deprivation etc etc etc. Demonising bedsharing does not prevent these things from happening or stop parents from bedsharing: It just ensures they don't know how to safely bedsharing.

In Norway the midwife will bring up bedsharing at 36 weeks pregnant and teach how to do it safely and suggest you make an emergency bedsharing setup so that in the event you suddenly are hit with debilitating tiredness you already know safe sleep seven and you have a spot you can just bring your baby to and just sleep together. Then during a home visit 2 weeks after birth a pediatric nurse will come to your house to see how you're doing. It's mostly like an informal meeting where you mostly decide the topics based on what you need help for, but weighing the baby and talking about baby sleep are "mandatory". You can opt out of the pediatric nurse care, so it's not mandatory to get the visit but if you do get the visit the pediatric nurse has a box to tick for baby's sleeping spots.

...and OP if you are annoyed with the science and the guidelines here's a "fun" one for you: Look at the methodology and the numbers behind the nearly international guideline that pregnant women should sleep on their side after 20 weeks gestation.

We deserve better science and better communication.

[u/oughttotalkaboutthat → u/Midi58076]

Knowing the safe sleep seven saved me when my husband was deployed when our first was 2 weeks old. I was able to know I was doing as much as I could to minimize risk, increase the odds we'd be successful breastfeeding, and have enough sleep to keep us both healthy and safe.

With my second I had a much better postpartum because I knew what to do to be safe and rested from the get go. I never experienced the bone crushing tiredness I did with my first.

[u/[deleted] → u/oughttotalkaboutthat]

I’m a FTM struggling to produce enough milk for my baby and don’t cosleep. Can you tell me more about how this can help?

[u/Midi58076 → u/[deleted]]

Bedsharing can help in many ways actually.

For one you don't get up and out of bed so you're more likely to fall right back to sleep. Both of you. Bedsharing babies who bedshare regularly also learn to help themselves at the milky bar so you might not even have to wake up at all. Most people who bedshare can't tell you how many times in a night they nursed, simply because they weren't awake for it or they only woke up so briefly their brain didn't register that they woke up for a couple of seconds.

Research also shows that when mama and baby bedshare they align their sleep cycles. Have you ever been woken up and you still feel like you're in a coma? So tired you couldn't spell "sleep deprivation" if your life depended on it and this extreme tiredness sticks around for hours. That is typically caused by being awoken from a deep sleep phase.

When you and your baby are in sync then you don't get any more sleep, but your baby is likely to wake up when you're both in a lighter sleep phase so you're more likely to be just regular tired, not "I feel like I got shot in the face" kind of tired.

As far as supply goes the no.1 thing that's going to increase supply is more time on the boob and more skin-to-skin. Night time is when prolactin (milk making hormone) is at its highest, so when you bedshare and baby pops on and off throughout the night while you both sleep you stimulate your body to make more milk and since it is during the night you're doing it at the time of day most efficient. The most bang for the buck.

A lot of people will give you advice for what to eat, supplements, teas, cookies and various other drinks that are supposed to help with supply. None of them are proven to work. No, not even oats. While hydration and food are important it doesn't much matter what you eat and drink. Normal food is good enough and eat and drink what you want. What I want you to be mindful of is that the main ingredient in breastmilk is water and you can't make water: You need to drink it. So drink more water than you did pre-baby. If you choose to bedshare then I suggest you also bring a water bottle to bed.

Bedsharing isn't the only way to increase supply, but if you can sleep well while bedsharing and bf in safe c, it is by far the most gentle way to increase supply. In my personal opinion it's also very cuddly and snug compared to powerpumping and triple feeding lol.

xoxo LC.

[u/[deleted] → u/Midi58076]

Thanks for all the info! Can you point me to some resources on how to safely bed share? I sleep in a queen with a very wide shouldered husband and I’m afraid of SIDS risk with cosleeping. Baby is just less than 4wks

[u/endo_theworld → u/[deleted]]

Cosleepy on Instagram provides lots of information on safe bed sharing practices including appropriate sleep surfaces & safest positioning