Pharmacists now have to tread a fine line with parents who seek health advice on social media. Online parenting groups can foster a distrust of the health profession and so-called Big Pharma, and pharmacists have to take care to gently persuade parents to consider the benefits of evidence-based medicine. Reduced fact-checking and minimal content moderation on social media platforms can increase parents’ exposure to potentially dangerous health messages.
Sydney pharmacist and pharmacy-owner Veronica Nou says she takes care to build a rapport with new parents. She makes sure they feel welcome in the pharmacy, she listens to their concerns and tries to understand their point of view, adding that criticism of their belief in social media is not helpful. “Everybody is just trying to do the best that they can with the information that they have available,” she says.
Studies have found the vast majority of parents seek health and medical advice on social media both before and after (or instead of) consulting health professionals.
Ms Nou says she had to leave most of the online mothers’ groups she had joined when her children were born because the opinions and advice “raised my blood pressure on a regular basis”.
When she tried to offer informed professional advice on these groups, she says, “everyone with an opposing agenda then makes a concerted effort to discredit you, or accuse you of working for Big Pharma, or accuse you of wanting to change the baby’s DNA – you know, mRNA vaccines turn them Chinese before they’re born”.
She uses the “extremely underrated tool” of humour to connect with wary patients, she says, smiling and joking about the extraordinary powers of the medicine, how they would become the superhero Magneto, and have the power to pull all the coins out from under the sofa. “Sometimes if you break the ice in this way and you try to make them see the ridiculousness of it,” she says, “that goes a long way towards disarming people who have their guard up.”
A survey of 1000 Australian parents with children under five years old found 82 per cent said they had used social media to find health information for their children.
Published in October 2023 in the Journal of Medical Internet Research and titled Parents’ Use of Social Media for Health Information Before and After a Consultation With Health Care Professionals, the Australian study said almost half of all Australian adults read at a low level and 60 per cent have low levels of health literacy. “Social media health information is multimodal, combining personal stories, conversational text, videos, infographics, subtitles, and other design features that make it more inclusive for those with varying literacy levels,” the study said.
Parents sought advice from social media before consulting health professionals for various reasons, including exchanging opinions and experiences (83 per cent), because of the 24-hour availability of online information (81 per cent), for emotional support (78 per cent), because they had previous positive experiences on social media (78 per cent), and because they had friends and family who used social media for health information (75 per cent), the study found.
They sought advice after a medical consultation to connect with parents with similar experiences (69 per cent), to look for a second opinion (64 per cent), to fact-check professional health-care information (61 per cent), and to look for other treatment options (44 per cent).
The lead author of the study, former pharmacist Erika Frey, has a doctorate in public health, and she says she became interested in the quality of online healthcare advice when she saw a post from a mother who was concerned about her sons’ breathing difficulties during a dust storm in Melbourne.
The children had blue lips and although the mother had Ventolin and steroids, she didn’t want to give the medication to her children because she didn’t understand the difference between anabolic steroids and locally-administered steroids.
“The fact that both her sons were in respiratory distress, and she was on Facebook asking for opinions from mothers who didn’t know anything about the situation, really stuck with me,” Dr Frey says. She was then inspired to investigate the burgeoning popularity of health information in parenting forums for her doctoral thesis.
Both Ms Nou and Dr Frey say it is important for health authorities to provide parents with 24-hour helpline numbers and websites whey they can find reputable and easy-to-understand health advice.
Pharmacist proprietor and breastfeeding educator Mrs Jacqueline Meyer says internet-users are accustomed to instant information and that expectation has flowed into parenting. “We’re finding people coming into the pharmacy saying, ‘This is what is going on, and this is what I’ve Googled – what do you think?’ So a lot of the time we’re the second option”, she says.
Social media groups can increase parents’ anxiety because a range of different opinions and medical advice is available at the touch of a button, she adds. Sleep-deprived parents of infants seeking advice late at night find a wide range of different information on-line, she adds, and have difficulty determining what is accurate and helpful and what is not.
“I think it then creates more stress and more worry, because you’re presented then with this online information of worst-case possibilities,” Mrs Meyer says. “They’ve looked up some information, or they’ve spoken to someone (on-line) and now they’re even more concerned and even more worried.”
Trust and tribes in parenting groups
On-line parenting groups tap into peer support and shared experience, connect new parents with like-minded people on the same journey, and allow for exhaustive discussions on various topics of concern.
In these groups, Dr Frey says, parents are more open and susceptible to left-field health ideas because trust has been built with the group members, and they share a common mindset. She and her research colleagues found that parents who turn to social media “value lived experience, and often they are looking for validation and parental endorsement of health professional advice”.
Other consumers, who may have had a difficult time with Centrelink or other government services, distrust authority figures more broadly, says pharmacist Veronica Nou. She says some worry the health profession is largely driven by a profit motive rather than the greater good, so they turn to social media groups. “If they come in and they are seeing that you are selling whatever, and their impression is that you’re just there to make a dollar, why should they trust you over any random person on the Internet?” she adds.
Fads that harm
Many parents feel believe that natural remedies and health products are worth trying, Dr Frey’s research has found – but some fads can be actively harmful.
She cites the widespread use of essential oils for respiratory complaints in children. Essential oils contain volatile organic compounds that can be irritants, and some – found in eucalyptus and lavender oil – are known allergens.
“Parents are diffusing them, they’re putting them on the skin, they’re giving them to children to ingest,” she says. “This can lead to an exacerbation of symptoms and in some cases respiratory distress by triggering coughing, wheezing and shortness of breath.” According to a report in the Medical Journal of Australia in 2019, 63 per cent of all poisoning calls for children under 15 were in relation to essential oils, she adds.
Beef liver capsules have been marketed as a quick form of high protein, full of powerful anti-oxidants for pregnant and breast-feeding women and young children. Breast-feeding educator and pharmacist Mrs Jacqueline Meyer says there is little evidence for the capsules’ benefits. “It’s lacking a lot of evidence, but it’s definitely getting a lot of online traction, for sure,” she says, adding that overall, perceptions of natural health medicines had changed.
“We’re definitely seeing a shift where people want to try natural health medicines before they try traditional Western medicines,” she says. “It’s quite concerning.”