Things parents need (or don't need) to buy when they are expecting or have a baby. Dr Pamela Douglas May 2022

About the things everyone wants to sell you once you're expecting or have a baby

You can listen to the ABC Radio National podcast, on which this article is based, here.

Expecting and new parents are heavily targeted by people or ads wanting to sell them something. Our 21st century world is dominated by extremely powerful and often quite insidious or difficult-to-identify market forces. Marketing pressures on parents have seriously ramped up in my lifetime.

New parents are a lucrative market because parents are naturally and passionately committed to protecting their babies. We want the best possible developmental trajectories for our little one – cognitively, emotionally, physically, and sleep-related. We want to be the very best parents that we can be. We want to breastfeed. We want to help their baby sleep well and be as settled as possible. Unfortunately, you’ll receive enormous amounts of conflicting advice about how best to do these things.

Historically, there is a relative lack of research into what works for parents and babies when problems arise. Small and large businesses step into this gap and try to sell you products which promise to prevent problems, or to help with them. New parents are targeted by people marketing products which are things, stuff, and by people marketing products which are information packages and programs or services. The people and providers who promote products, whether stuff or programs and services, genuinely believe their own explanations about why you need these products, so it can be hard to figure out what’s going on.

It may surprise you just how much market forces shape not only the products and services parents buy, but the research that is performed, how researchers interpret their own data, and how easy it is to access that research. The phrase ‘evidence-based’ is now used as a marketing tool. But most providers are not trained to understand what it really means to have a research evidence-base supporting their work. When we look closely, many of the products being sold are not evidence-based, may even make life with baby harder rather than more enjoyable, and may impact negatively on developmental outcomes.

It helps to make decisions about what products you and your baby actually need by thinking about your baby’s ‘environment of evolutionary adaptedness’, that is, the things that your baby evolved to need over our long evolutionary history. You could say that the Possums programs are aiming to support you as you provide a wrap-around 'evolutionary care package', in a way that is easy and makes the days enjoyable. Any human baby's basic biological expectations are

• The mother’s breast and milk – unrestricted access, which makes life easier rather than harder (once underlying problems are sorted out). You can find out about frequent and flexible breastfeeds here, and frequent flexible bottle feeds, if your family uses the bottle, here.

• A warm and loving adult’s body – frequent or constant contact, which also provides irregular postural stimulation against gravity during the day. You can find out why baby carrying makes life easier, not harder, here.

• Responsive care from a loving adult when the baby communicates that things aren’t quite right. You can find out about the importance of responsive care here and here.

• Rich sensory motor experiences for large parts of the day, that is, lots of input across the senses from both the physical or natural environment and from the social environment. We might call this environmental enrichment; I have called it sensory nourishment for short. You can find out about this here.

The latest research clearly shows that these four factors not only improve developmental outcomes, but make the days with a baby more enjoyable, rather than more burdensome. This is because if our baby’s ancient evolutionary needs are met (and any underlying clinical problems properly addressed), babies tend to be dialled down and easier to care for.

I’ll share with you some ideas about how these evolutionary needs might help you decide what products are worthwhile investing in. Actually, it seems to me that you’ll experiment. You might buy a range of things, some of which turn out to be helpful and some less so. But experimenting is a normal part of the journey!

Products which you and your baby are likely to actually need

Items that support basic hygiene and baby’s temperature regulation

• Nappies, ideally 85% biodegradable disposable nappies if you can possibly afford it, or cloth nappies.

• Soft (non-prickly) loose-fitting garments

  • T-shirt until the umbilical cord separates

  • Bodysuits: snap-crotch, onesies

  • Socks or booties, depending on the climate

• Soft (non-prickly) blankets

• Non-alcohol wipes or very soft soap for nappy area (for use when necessary only)

• Barrier cream such sudocrem for the nappy area at night, a light balm for during day

• A bowl of some sort for bathing (which doesn’t have to be every day) prior to baby being ready to use the family’s bath tub or shower

Transport needs

• Car capsule fitted to comply with your country’s regulations, to bring baby home or drive around safely

• Baby carrier (since the body of a loving adult is the baby’s primary home)

  • A soft cloth carrier which holds baby vertically close against you in the first weeks

  • Semi-structured or buckled carriers once you and the baby are ready. You can find out about using carriers safely here.

  • For most of us, baby carrying devices include a pram or stroller. For some families, the carrier is all they need, at least early on

Sleeping arrangements that minimise risk of Sudden Unexpected Death in Infancy or Sudden Infant Death Syndrome

• Supine (baby on back, not side or tummy – very important). You can find out about this here.

• Bedsharing in a way that minimises risk which for some families is all they need. You can read about bedsharing here if you're breastfeeding, and here if your family is using formula in the night.

• Bassinet, cot or side-car in the same room as parent. Most families move through a range of sleeping arrangement options in the night. You can read about baby sleep place and safety here.

Other stuff that is sensible and useful for life with your new baby

• Breastfeeding bras + soft pads

• Portable nappy change mattress

• Heavy rug or quilt for when you want to try lying baby down on the floor

• Bag for carrying nappies, change of baby’s clothes and other items

Products which you're unlikely to need and why not

Breastfeeding

Item promoted to help with breastfeeding	Why you're unlikey to need it
Breastfeeding chair	Solid arms of most breastfeeding chairs can undermine breastfeeding success, because solid chair arms often interfere with fit and hold
Nipple creams	May worsen risk of nipple pain and damage due to moisture associated skin damage
Nursing pillow	Commonly undermine breastfeeding success, because pillows on the lap interfere with fit and hold
Hakaas/ladybugs	Traditional hakaas may disrupt fit and hold when applied during breastfeeding; the ladybug versions less likely to. Silicone applications to the nipple and breast over a period of time risk of nipple pain and damage due to effects of moisture
Breast pump	Rent or buy a double-pump after the birth if you need it; by then you’ll have a better feel for the kind of pump that is necessary or for what you want

In my research papers, I have other lists of products which are recommended to breastfeeding women and which earn a great deal of money for those businesses, but which have been shown not to work!

Sleep

Item promoted to support sleep	Why you don't need it
Swaddling muslin or love-to-dream jumpsuits	Babies don’t necessarily sleep better overall when wrapped or swaddled, despite what you might hear. Startling is normal in young babies and won’t interfere with sleep when the baby’s sleep regulators are working well. Babies need to be unwrapped for breastfeeding; wrapping baby up again may cause disruption at night without benefit
Sleep positioners, pillows, and cot bumpers	Increased risk of Sudden Unexpected Infant Death
Snoo	Multiple reasons - please see full article here.
White noise machines	The belief that sleep associations improve infant sleep misunderstands the actual stimulus for sleep, which is high sleep pressure. You can find out about white noise here.
Low sensory environment around the cot	May make baby more unsettled since babies need rich sensory nourishment to stay dialled down

Sensory motor development or to settle the baby

Item promoted to settle baby	Why you don't need it
Activity gyms and mobiles	Only occupy babies for very short times inside the house – babies need much richer sensory experiences overall (but of course, you're likely to try out a range of these anyway because they can work for a time. It's just not having unrealistic expectations, that's all!)
Bumbo floor seats	Possible negative (motor) developmental effects
Jolly jumpers	Possible negative (motor) developmental effects

• You can find out your baby's sensory motor needs and sleep here.

• You can find out about plagiocephaly and steps you might take to try to prevent plagiocephaly here and here.

• You can find out about protecting your baby's motor development here and here.

Products which are information packages and services

Primary healthcare in Australia is a small business model, so health professionals and providers, whether traditional healthcare provision or complementary medicine practitioners, are competing for the parent dollar in order to make a living or accrue wealth. This competition for your attention is dramatically amplified by social media.

I recommend you ask yourself the following when it comes to the various programs and providers you see being marketed.

• Is this approach genuinely supported by research? That is, has this approach been detailed as a theoretical framework and then evaluated in peer reviewed and published studies?

• If the person has done their own research, promoting themselves as a researcher in the absence of a university role or postgraduate qualifications, be aware that the program is likely to be one person’s cherry-picked selection of strategies, rather than genuine translation of existing evidence into a clinical program or education package, which is then evaluated

• If the person providing the program promotes themselves an educator, check out that they actually have qualifications as a teacher

• If the program looks very much like an older pre-existing program, but the pre-existing program isn’t acknowledged, ask yourself why. Any ethical provider, educator or researcher acknowledges pre-existing work. Failure to acknowledge sources is driven by the desire to make money and is unethical

• How aggressive is the business’s marketing practices? How ethical?

• Who benefits financially from this program?

Of course, there’s no problem with someone aiming to make a living from offering a program or service – it just helps to be aware of context as you make decisions. I hope these thoughts are useful as you decide what things and programs to buy!