New mothers face conflicting breastfeeding advice leading to distress and feeding struggles

Maddy Barrett wanted more than anything to feel "empowered" enough to make informed decisions after becoming a first-time mother.

But after receiving inconsistent advice from multiple practitioners while struggling to breastfeed her newborn daughter, she was left feeling "frightened that I was doing something wrong".

In the first 24 hours after giving birth, Ms Barrett said nurses, lactation consultants, and midwives gave her conflicting advice on how to get her daughter to latch.

Despite the volume of advice, in the end she left the hospital with no feeding plan or ongoing support with breastfeeding.

"What I found incredibly confusing was the huge variation in advice and approaches from different healthcare professionals," Ms Barrett said.

In the weeks that followed, her daughter began to lose weight because she was not receiving enough milk from breastfeeding alone.

Emotionally exhausted and sleep-deprived, Ms Barrett said she was then put on a "triple feeding" plan by nurses, which involved breastfeeding, pumping milk and formula feeding her daughter.

"I was up around the clock, trying to pump every three hours to establish and protect my supply.

"My daughter was often unsettled and unhappy throughout the process, and I felt like our entire lives revolved around feeding."

Ms Barrett's postpartum experience was similar to several other women the ABC spoke to, who reported inconsistent advice from care providers after they'd delivered their babies.

According to a 2024 review of antenatal care guidelines used in Australia, several commonly used guidelines for parents were found to be inconsistent in their recommendations for childbirth and early parenting.

The independent review, published in the Journal of Midwifery, evaluated five guidelines for antenatal care across six domains: scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability, and editorial independence,

All five guidelines scored low in each section.

Mental health, social media and 'overwhelm of information'

Getting conflicting advice could increase a new parent's level of distress and worsen their mental health, according to the executive director of the Centre of Perinatal Excellence (COPE), Nicole Highet.

"It undermines their confidence because they have got no reference point as a new parent. They don't know what to expect. Then they're constantly getting conflicting advice, which increases their stress and their levels of anxiety," Dr Highet said.

People might delay getting help early because they fear being "judged" for not being a successful parent, Dr Highet said.

"The overwhelm of information, all of these things together make it an extremely stressful and vulnerable time for parents when it comes to mental health."

Information may not be uniform across all health practitioners for multiple reasons, including practitioners giving personal or anecdotal advice, she said.

Guidelines are reviewed every five years, which could make some information outdated, she added.

The national guidelines only recommend screening for postnatal depression before and after birth, but that is not enough according to Dr Highet.

"We know that for most people who develop postnatal depression, that will occur after six weeks. It might occur between six to eight months, yet no one is screening after that," she said.

"This is an example of where we have guidelines, but we don't have policy that aligns with the guidelines … and guidelines are not being reflected in practice," she said.

Erin Seeto, director of clinical services at the Gidget Foundation, said postnatal depression and anxiety could occur in one in five women and one in 10 men.

"Depending on whether you're a woman or a man, you might seek help differently," Dr Seeto said.

"We know that men tend to delay help-seeking until things are more acute, whereas women tend to have multiple touch points with health practitioners, but maybe not then be directed to the help that works for them within the time frame that they need."

A lack of continuity in care for a parent could lead to missed diagnoses, prompting large-scale calls for more consistency among practitioners, she said.

She said social media can contribute to mental health stigma postpartum, making some women hesitant to seek help.

A recent example is a woman on trial for killing her three children, which has sparked comments on social media about postnatal psychosis, a rare mental illness linked to the stress, sleep deprivation and hormonal changes that follow childbirth, she said.

"In some ways there are benefits to it. In other ways, it can be very detrimental to vulnerable women and families that are going through the perinatal period right now."

'Feeling as though I was failing my baby'

Looking back at the beginning of her postpartum journey with her now 11-month-old daughter, Ms Barrett said the way advice was delivered without consistency had a "profound" impact on her.

Eventually, it was identified that her daughter had a severe tongue-tie that was affecting her ability to latch effectively.

The mixed advice continued up until her daughter began starting solids, at about six months.

"The hardest part was constantly feeling as though I was failing my baby," she said.

"As a first-time mum, hearing variations of 'your baby isn't getting enough' every few days was incredibly distressing.

She stressed that it was important that new mothers received support that was consistent, evidence-based and compassionate.

"But they also need to feel heard," she said.

"When you're exhausted, vulnerable and responsible for a tiny human, conflicting advice can make an already overwhelming experience feel impossible."