For grandparents · One-page reference
Then vs Now — 12 practices that changed.
Most of what changed in childcare in the last 30 years was driven by clear evidence. This sheet lists the twelve practices where the difference between then and now matters most — with the mechanism that drove the change, not just the new rule.
A note before you read. The previous generation got many things right — extended-family care, breastfeeding norms, baby-wearing, oil massage. The list below is not about any of that. It is the small set of practices where new evidence has made a meaningful difference to baby safety. Where a practice has changed, the reason is named in the last column.
| Practice | Then (1970–95) | Now | Why it changed (mechanism) |
|---|---|---|---|
| Sleep position | Stomach or side sleeping was common — believed to reduce choking on spit-up. | Back to sleep, every sleep, until 12 months. | Stomach sleeping multiplies SIDS risk 2–13×. The "Back to Sleep" campaign (1992) cut SIDS by ~50% in every country that adopted it. |
| Honey before age 1 | Common ritual — honey on the tongue at birth, or given for cough later. | No honey under 12 months. | Honey can carry Clostridium botulinum spores. The infant gut cannot neutralise them yet. Infant botulism is entirely preventable. |
| Kajal / surma in the eyes | Believed to strengthen the eyes and ward off the evil eye. | No kajal or surma in or near the eyes. | Many traditional preparations contain lead. Lead absorbs through the conjunctiva and skin, accumulates in bone, and is neurotoxic. There is no safe lead level for an infant. |
| Prelacteal feeds (ghutti, honey, water) | Given in the first hours/days before mother's milk "came in". | No prelacteal feeds. Direct breastfeeding from the first hour. | Colostrum is the correct first food. Prelacteals introduce infection risk, displace colostrum, and reduce successful breastfeeding establishment. |
| Water before 6 months | Water given on hot days to "hydrate". | No water until 6 months — breastmilk or formula only. | Excess water dilutes sodium in the infant bloodstream (water intoxication / hyponatraemia) and can cause seizures. Breastmilk is 88% water and self-adjusts for heat. |
| Starting solids | Solids often started at 3–4 months — rice water, ragi porridge, mashed banana. | Solids at 6 months, with readiness signs present. | Before 6 months the gut barrier and oral-motor coordination are not ready. Early solids increase allergy risk and reduce breastmilk intake without nutritional gain. |
| Cow's milk as a main drink | Often given from 6 months as a replacement or supplement. | No cow's milk as the main drink before 12 months. Then max 500 ml/day. | Cow's milk before one year causes iron loss through tiny gut bleeds and can lead to iron-deficiency anaemia. The protein load also stresses immature kidneys. |
| Walkers | Considered helpful for early walking. | No walkers. IAP and AAP discourage them; Canada has banned them outright. | Walkers do not help walking. They cause head injuries (stairs, threshold falls) and delay normal weight-bearing development. |
| Oil in ears, nose, navel | Mustard or other oil applied to ears, in the navel, or to clear the nose. | No oil in ears or nose. Saline drops for congestion. Navel kept clean and dry. | Oil in the ear canal can cause infection and obstruct examination. Oil in the nose can be aspirated, causing lipoid pneumonia. A damp navel delays cord separation and invites infection. |
| Massage technique | Vigorous oil massage — sometimes including "moulding" the skull shape. | Gentle oil massage is fine and beneficial. No moulding of the skull, no pressure on the fontanelle. | The fontanelle stays open until 12–18 months — pressure on it can injure. Gentle massage supports bonding and sleep; moulding has no benefit and real risk. |
| Fever management | Alcohol or cold-water sponging; over-bundling to "sweat it out". | Paracetamol or ibuprofen by weight. Tepid sponging only. Light clothing. No alcohol. | Alcohol is absorbed through infant skin and can cause hypoglycaemia. Over-bundling raises core temperature further. Fever itself is a defence response, not the disease. |
| Vaccines | Schedule was much smaller — BCG, DPT, OPV, measles. | Today's IAP schedule is significantly broader — Hep B, Hib, Pneumococcal, Rotavirus, MMR, Varicella, Hep A, and more. | Vaccines added are for diseases that killed or disabled children in the previous era. Hib meningitis, pneumococcal sepsis, and rotavirus diarrhoea were leading killers — vaccines have changed that. |
About "we did it that way and you turned out fine". The statement is true of you, the speaker — you are here to make it. It is not true of your generation as a whole. India's infant mortality rate was ~115 per 1,000 in 1980; it is around 25 today. That change is driven almost entirely by the practice updates above. Survivors over-represent because the children who did not make it are not in the conversation.