3.5 Talk Back

We wish we could talk with you individually to hear your thoughts, concerns, reservations, or anticipated challenges in using the Conversations Approach. We have provided some common questions and concerns that have been shared about using the Conversations Approach and responses that may be useful to you.

1. Explaining each recommendation seems very time consuming. I don’t have that much time to communicate these important recommendations.

   Since research has reported that families are not likely to buy into the recommendations without some understanding of why they are made, not sharing this information is actually wasting valuable time. You don’t, however, have to go through each and every reason—since the Conversations Approach is a two-way process, you can ask families if they have any questions about why a recommendation is given and deal with that one or more. Also, there are two important themes that you can reference and relate to each recommendation: 1. Making sure the baby gets enough oxygen (keeping the baby’s airways open (nothing covering the face, not cut off by position of the chin on chest) and keeping the baby from rebreathing the carbon dioxide when face down; 2. Making sure the baby does not sleep so deeply that he/she doesn’t wake up if oxygen levels are getting too low. Breastfeeding, of course, has additional benefits.

2. I am not comfortable with sharing information about reducing risks when bed sharing. Aren’t we giving families permission to bed share?

   In the Conversations Approach it is important to recognize that we do not give families permission, because they don’t need our permission. They will make their own decisions. We lend our expert knowledge and ability to support families in making informed decisions. We are not authority figures who tell them what to do and expect compliance. It may feel uncomfortable at first to let go of the role of authority, but in reality it hasn’t worked particularly well. Hopefully, creating open dialogue and recognizing that families may make choices not totally in compliance with the recommendations is more in keeping with current thinking about behavior change and public health promotion.

3. Because of their culture and traditions, some families don’t agree with all of the recommendations. Should I really share all of them with all families?

   If you think about this process as information sharing, not telling people what to do, it changes the perspective. Ethically, we need to share what we know with all families. It is how we share it—these recommendations are the starting point for a conversation and as you will learn in later modules, we then must be prepared to welcome and engage with them about their concerns, reluctance or rejection of particular recommendations.

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