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Advice VERSUS Information & Support

Many times over the years have I had my knickers in a knot over advice versus information and support. It was the great late Pam Lacey, chair of the Association of Breastfeeding Mothers that first really opened my eyes to this concept - and it's one I really wish more breastfeeding supporters would recognise..

So if you're a breastfeeding counsellor, peer supporter or anyone who works with mothers as a lactation worker - please read on!

Advice definition:
"Advice is a form of relating personal opinions, belief systems, personal values and recommendations about certain situations relayed in some context to another person, group or party often offered as a guide to action and/or conduct. ".
"Recommendations concerning future action, typically given by someone regarded as knowledgeable or authoritative.
We see advice in many forms: "What I would do if I were you", "you need to", "you must", "you should", right through to a blunt "do X".

The role of a breastfeeding counsellor is not to convey personal opinion or beliefs or to tell mothers what they should do; it is to support the mother and help her explore her options, to help her unpick any confusion she has surrounding a problem and empower her to reach a resolution she is happy with (regardless of whether this sits with your individual beliefs - this isn't your journey).

Good reasons not to give advice:
  • To give advice assumes superiority, it presumes you know better than the person asking the question, it also makes you responsible for the outcome. If you give someone advice and they follow it - what if it doesn't work or worse still has a negative impact?
Here's an example of one I see regularly.
"My baby's poop is green, do I need to worry? What should I do?". 
Example of a typical "advice" giving reply: "This is caused by too much foremilk, you should start single side feeding - one breast per feed".
We know there are actually various reasons for green stools, one of which can be insufficient milk intake.  Limiting the baby to one breast could potentially create a more serious problem, particularly if the baby is very young.
And another 
"My baby is colicky and refluxy, won't settle, what should I do?"
Example of a typical "advice" giving reply: "You need to cut out all dairy ASAP".
We know there are actually numerous reasons for colic, one of which is dairy sensitivity - but what if that isn't the problem in this case and so doesn't improve or resolve things?  What if just being told to cut dairy without discussion, exploration or explanation sounds so drastic to the mum asking that she decides to formula feed instead, worried her milk is causing the problem?
  • It doesn't empower anyone.  Often mums have already had numerous people give advice - how do they pick who to listen to?  If a counsellor gives advice and then a paediatrician gives conflicting advice, who would you listen to as a vulnerable new mum?  How do they tell good advice from bad?
  • Giving advice can leave you open to mistakes.  A mum starts telling you about a situation, you think you have all the information, so you tell her she should do "X".  After hearing your suggestion the mum adds no she doesn't think that would work because of "Y" - a new bit of information the mum hadn't shared before.  Oh you say, then in that case I would do "Z".  The mums confidence is now faltering in you.....
  • Longer term advice doesn't help.  What does the mum do next time she has a problem?  She again needs to contact someone for advice!  If the mum had been encouraged to help resolve her own problems with information and support, this empowers her with skills to apply to future issues.
  • Advice involves making a "judgement" - offering a non judgemental ear can be very satisfying to the "talker", and help people to feel a weight has been lifted.  People can be reluctant to share what they feel the "listener" won't agree with if judgements are involved.
  • Sometimes what people state initially as the problem, actually may not be the real issue - if you give advice rather than encouraging them to unpick their thoughts, this may not come to light.
Alternatives to advice:

Active Listening:
Don't consider problem solving, but listen (really listen) to the big picture. Ask open and closed questions to get all the relevant information so the mum can unload everything in a safe space.

Always clarify clarify and clarify again - "so it sounds like you're saying X, is that right?", sometimes reflection can literally just be echoing back what the person said - when the mum hears it back or summarised, it gives her chance to add things or realise X point isn't as significant as Y and so on.  It can help clarify things for mum too!

Give information:
There is often more than one way of resolving a situation; discussing various options with a mum so she can select what she feels works best for her situation.  Examples include "some mums find X works for them, whilst others prefer " - recommending that a mum with four other children to take her baby to bed and baby moon for a few days may simply not be feasible (particularly if baby is a few weeks old and partner is back at work)

You can still give firm "facts" without giving advice - eg "we know that to maintain a supply if baby isn't at the breast, mums need to express 8-12 times per day".

Outlining WHY often empowers mum to begin to recognise poor advice eg "your breasts know how much milk to make based upon how frequently and how effectively they're drained - therefore if baby isn't feeding directly at the breast, we know mums need to express 8-12 times per day in order to mimic this and protect supply".

Support mum to think things through:
"So you feel X is the biggest issue, what would be the absolute ideal outcome for you?" or "If X was resolved, do you feel that would resolve everything?". "Do you feel X would be practical for you or is Z something you feel more comfortable with", "could X be impacting on Y do you think?"

Mums who receive advice, often leave an encounter feeling more confused than before they arrived - especially if they have previously received conflicting information.  Mums who have received information and support often feel "lighter", as though they have offloaded.  Listening can in itself make a person feel valued.

Believe it or not the most valuable tool you have as a breastfeeding supporter is not your mouth, but your ears.


  1. Thank you AA for this great post. I just started volunteering as a peer supporter and providing information and support rather than advice was one of the key areas of my training. This post sums it up really nicely and I will refer back to it many times before going to my breastfeeding support group.

  2. Was just thinking about this after an email from a mum thanking me for my visit and my great 'advice' - well, I know it was information and support...but she believes it was advice. Does it make a difference? Yes! She may not notice it on a concious level, but it is the difference between trusting mums to do what is right for them versus telling them what to do, and yes, the subtle differences in feeling at the end of the interaction. Perfect timing.

  3. Brilliant! This is an area I struggle with. An old friend called me recently for BFing help and before I answered the phone I took a deep breath and said "listen listen listen" to myself. I directed her to you.....sounded like a tongue tie (later confirmed by MW)But her original worry was that she was not making enough milk. I could easily have given advice and told her not to worry its prob cluster feeding! Hopefully the peer support training will help also! Thanks AA

  4. Sounds advice for allied health care professionals, too. As in IBCLC, my duty is to provide evidence-based infomratin and support, so **the mother** can make an informed decision about lactation issues affecting her health/her child's health. And all IBCLCs (dare I say it) should do that. Liz Brooks IBCLC

  5. @durhamdoula thats a really good point. I think most women who have spoken to a BFC or similar will have said that they recieved advice, they probably will percieve it as such even if the BFC actually supported them and guided them through making their own path forward by listening and giving factual information.
    Who does give 'advice' and who counsels? Advice is a very difficult term as we mostly just understand it as giving information, your GP gives healthy eating 'advice', the school road safety 'advice' and the government tons of advice. Its not part of a personal belief system in those cases but information giving in terms of the facts.
    I wonder if the term breastfeeding 'enabler' might actually cover what cpunsellors and other so somewhat better??

  6. I think the difference is though that those authorities ARE giving advice - they are telling you what to eat and how to cross the road. There isn't a "would crossing the road like this work for you, or do you feel y might work better". Ditto the eating - this is what you should eat is the message.

  7. Excellent work AA. I have posted a link on The Alpha Parent Facebook page and Twitter.

  8. Yes! Who can really feel empowered if they cannot find their own answers within? Giving advice adds to our sense of helplessness. This is the philosophy of LLL and that is why I love it.
    I wrote a piece about intuition and empowerment. But it's in French.

    In solidarity!

  9. Good article, just feel I have to make one comment onthe 'fact' that mums need to express 8-12 times a day to maintain supply if the bay is not feeding directly from the breast. I expressed for 16 weeks, 7 times a day which was more than enough to maintain my supply, I had a proper milk factory going. So, if I would give advice on this to another mum I would have to go against the facts?

  10. After reading the article, I would hope you wouldn't be giving advice at all? Your personal experience is anecdotal...

  11. Fabulous! I know a few professionals who could take a lesson from you on this one. The clients I works with know that if I have a personal opinion or am going to give personal advice I say so. Otherwise they get a handful of options and information that can be backed up. They also learn that there is a wide range of normal. For example - one mom may be able to only pump 5 times in 24 hours to provide enough milk for her twins (worked with her - she was amazing!) while if another mom of a singleton did that her supply would crash and burn in no time (had a mom who was given that anecdotal advice by a friend and her supply was irreparably damaged).

    Anecdotal experiences can be used as examples to give hope - I know a mom who brought an adopted 8 month old to breast - this story helps moms know that even if their baby is on a bottle for an extended time period, it can be done - but education and information give her options on how to make that happen. Education and information give mom a set of tools she can choose from to make the decision that is right for her - which may be busting her butt and bringing that baby back to breast...or not.

    I could go on - but I won't - LOVE your blog. LOVE your insights. Thank you!