Saturday, August 20, 2005

BabyWise

I definitely stand by my assertion that BabyWise is a wonderful program. But, like everything else in life, you have to use it with your mind engaged. There will be times when you deviate from the “norm” of the BabyWise routine. In fact, BabyWise explicitly states that in its pages. If you are a person who is not capable of using your brain, then I can definitely understand how you could get in trouble trying to follow ANY explicitly laid-out formula.

I believe there are basically two things you “have to do” in order to follow the BabyWise plan and the rest is negotiable. First, don’t let your baby snack all the time – make sure s/he gets a good full meal and then has a break before the next meal. Sometimes, when your baby goes through a growth spurt, the meals will be more frequent (i.e., two hours instead of three). And, guess what (?), Ezzo says that in his book. This seems to be a commonsense approach – it helps to regulate baby’s metabolism and establish healthy eating habits for later on. Plus, it allows baby to get the hind-milk which is richer in nutrients.

One more note on this – healthy babies shouldn’t be hungry less than two hours from the last feeding if they are getting “full meals.” My opinion is that moms who demand-feed tend to offer the breast a lot more frequently when their baby cries and this is often not the solution the baby needs. I feel like BabyWise has given me the confidence to stop and think about WHY my baby might be crying without simply offering the breast as a soothing device each time she starts to cry. Thus, I think that BabyWise has helped me to better meet the needs of my child. Also, it’s made Kevin and I a better “team” in problem-solving to help our baby. He has taken a proactive role in helping me to figure out what’s wrong when otherwise it would be easy for me to offer the breast each time (if I were demand-feeding) and leave him out of the loop.

The second principle of “Basic BabyWise” is to make sure your baby has an “awake time,” after each daytime feeding, before taking his/her nap. This allows baby to learn to fall asleep on his/her own without getting used to always falling asleep on the breast or being rocked to sleep. Again, I think this is commonsense. It also allows for your baby to be awake when s/he has a full belly and is more content. And, apparently, it helps baby to learn to sleep through the night when s/he is put straight to bed with no awake time. (Meredith’s sleeping five hours at night right now … still waiting for the day when it’s eight!)

That’s BabyWise in a nutshell.

As far as holding and cuddling with your baby, I just don’t understand how people can allege that Ezzo is “against” holding and cuddling with infants. Meredith and I have a lot of cuddle and play time throughout the day when she is having her “awake time.” Yes, there are many times when I rock her to sleep or even take a nap with her. But, that’s not the normal routine so that it becomes a pattern that she expects and is hard to break later on. Tracy Hogg (author of the excellent book, Secrets of the Baby Whisperer, which echoes many of Ezzo’s BabyWise philosophies – she calls it “E.A.S.Y.,” Eat/Awake/Sleep/You) states: “Start as you mean to go on.” It may be fun to rock your baby to sleep every time s/he takes a nap (and you should rock your baby to sleep now and then), but you won’t think it’s so fun when your baby demands that this be done in order for him/her to fall asleep and then wakes up and you’re forced to repeat the process. It’s healthier (can anyone argue with this?) for a baby to learn to fall asleep on his/her own. It also gives mom a break so she can tend to her other children and other obligations, etc.

I didn’t decide to blindly follow Ezzo’s teachings on baby routines. I read a lot before Meredith was born from both sides of the aisle. (Dr. Sears is basically polar-opposite to Ezzo, if anyone is interested in reading about the other point of view. He adheres to both demand-feeding and “family bed” ideologies.) BabyWise made sense to me. A friend of mine who is expecting her first child in February recently asked me about BabyWise. I replied: “Read it. If you decide you don’t want to use the concepts in it, that’s fine. You’re the parent and you have to make that call. But, at the very least … read it.”

11 comments:

Anonymous said...

Babywise advice linked to dehydration, failure to thrive
by Matthew Aney, M.D.

Expectant parents often fear the changes a new baby will bring, especially sleepless nights. What new parent wouldn't want a how-to book that promises their baby will be sleeping through the night by three to eight weeks?

One such book, On Becoming Babywise, has raised concern among pediatricians because it outlines an infant feeding program that has been associated with failure to thrive (FTT), poor weight gain, dehydration, breast milk supply failure, and involuntary early weaning. A Forsyth Medical Hospital Review Committee, in Winston-Salem N.C., has listed 11 areas in which the program is inadequately supported by conventional medical practice.The Child Abuse Prevention Council of Orange County, Calif., stated its concern after physicians called them with reports of dehydration, slow growth and development, and FTT associated with the program. And on Feb. 8, AAP District IV passed a resolution asking the Academy to investigate "Babywise," determine the extent of its effects on infant health and alert its members, other organizations and parents of its findings.

I have reviewed numerous accounts of low weight gain and FTT associated with "Babywise" and discussed them with several pediatricians and lactation consultants involved.

The book's feeding schedule, called Parent Directed Feeding (PDF), consists of feeding newborns at intervals of three to three and one-half hours (described as two and one-half to three hours from the end of the last 30-minute feeding) beginning at birth. Nighttime feedings are eliminated at eight weeks.

This advice is in direct opposition to the latest AAP recommendations on newborn feeding (AAP Policy Statement, "Breastfeeding and the Use of Human Milk," Pediatrics, Dec. 1997): "Newborns should be nursed whenever they show signs of hunger, such as increased alertness or activity, mouthing, or rooting. Crying is a late indicator of hunger. Newborns should be nursed approximately eight to 12 times every 24 hours until satiety."

Although demand feeding is endorsed by the Academy, WHO, and La Leche League among others, "Babywise" claims that demand feeding may be harmful and outlines a feeding schedule in contrast to it. The book makes numerous medical statements without references or research, despite that many are the antitheses of well-known medical research findings. In 190 pages, only two pediatric journals are referenced with citations dated 1982 and 1986.

Many parents are unaware of problems because the book is marketed as medically supported. It is co-authored by pediatrician Robert Bucknam, M.D., who not only states in the book that the "Babywise" principles are "medically sound," but also writes, "'Babywise' has brought a needed reformation to pediatric counsel given to new parents." Obstetrician Sharon Nelson, M.D., also warns: "Not following the principles of "Babywise" is a potential health concern."

The book's other author is Gary Ezzo, a pastor with no medical background. Ezzo's company, Growing Families International (GFI), markets the book as "ideally written" for "obstetricians, pediatricians, or health-care providers to distribute to their patients." (GFI promotes the same program under the title "Preparation for Parenting," a virtual duplicate with added religious material).

Though "Babywise" does say, "With PDF, a mother feeds her baby when the baby is hungry," it also instructs parents to do otherwise. In a question-and-answer section, parents of a 2-week-old baby, who did not get a full feeding at the last scheduled time and wants to eat again, are instructed that babies learn quickly from the laws of natural consequences. "If your daughter doesn't eat at one feeding, then make her wait until the next one."

Unfortunately, the schedule in "Babywise" does not take into account differences among breastfeeding women and babies. According to one report, differences of up to 300 percent in the maximum milk storage capacity of women's breasts mean that, although women have the capability of producing the same amount of milk over a 24-hour period for their infants, some will have to breastfeed far more frequently than others to maintain that supply. Babies must feed when they need to, with intervals and duration determined according to a variety of factors in temperament, environment, and physiological make-up. Averages may fit into a bell-shaped curve, but some babies will require shorter intervals. (Daly S., Hartmann P. "Infant demand and milk supply, Part 2. The short-term control of milk synthesis in lactating women." Journal of Human Lactation; 11; (1):27-37).

Examples of the many other unsubstantiated medical claims in "Babywise" include:

"Lack of regularity [in feeding intervals] sends a negative signal to the baby's body, creating metabolic confusion that negatively affects his or her hunger, digestive, and sleep/wake cycles."
"Demand-fed babies don't sleep through the night."
"A mother who takes her baby to her breast 12, 15, or 20 times a day will not produce any more milk than the mom who takes her baby to breast six to seven times a day."
"Mothers following PDF have little or no problem with the let down reflex, compared to those who demand-feed."
"Colic, which basically is a spasm in the baby's intestinal tract that causes pain, is very rare in PDF babies but is intensified in demand-fed babies."
"In our opinion, much more developmental damage is done to a child by holding him or her constantly than by putting the baby down. In terms of biomechanics alone, carrying a baby in a sling can increase neck and back problems, or even create them."
"Some researchers suggest that putting a baby on his or her back for sleep, rather than on the baby's tummy, will reduce the chance of crib death. That research is not conclusive, and the method of gathering supportive data is questionable."
My review of the low weight gain and FTT accounts associated with "Babywise" revealed several disturbing trends. Parents were often adamant about continuing with the feeding schedule, even when advised otherwise by health care professionals. They were hesitant to tell their physicians about the schedule, making it difficult to pinpoint the cause for the weight gain problems. Many elected to supplement or wean to formula rather than continue breastfeeding at the expense of the schedule. The parents' commitment can be especially strong when they are using the program for religious reasons, even though numerous leaders within the same religious communities have publicly expressed concerns.

Pediatricians need to know about "Babywise" and recognize its potential dangers. History taking should include questions to determine if parents are using a feeding schedule, especially before advising formula supplement to breastfeeding mothers or when faced with a low-gaining or possible failure to thrive baby. Lactation consultants also should be instructed to probe this area.

Efforts should be made to inform parents of the AAP recommended policies for breastfeeding and the potentially harmful consequences of not following them.

Anonymous said...

I used the baby wise method with all of my children. Six to be exact. My second born did have failure to thrive. His failure to thrive had nothing to do with scheduled feedings. It was a lack of the nutrients in my milk supply that caused him not to thrive well. I started to eat better take different supplements to build my milk supply back up. I started to drink more water. I also started to give him supplements and water. Within 7 days of starting this regiment he started to put on weight. (He weighted 11 pounds at 6 weeks at 5 months he weighted 12 pounds. When I started taking better care of myself within seven days he started to gain weight. After two weeks he gained 6 pounds. I went back to the babywise method as soon as I saw he was gaining weight. When he was not thriving I was feeding him all the time. I was WORE OUT. Then a wise mother and doctor told me what I was doing wrong about my own health situation. I loved the babywise method. It worked wonderfully. My children are very scheduled and are self motivated 24 years later. Baby Wise method allows the father to be more involved I think. The most important thing I think to remember about any method is you don't leave out the HOLY SPIRITS advice. Never quench the spirit!!!!! When my son failed to thrive we cried out to God and he showed me what to do for my child. Keep up the good work Amy!!! I pray God will bless you and instruct you and Kevin in the up bringing of this precious child he has given you to raise for His Will and Good Pleasure.

the Joneses said...

Anon #1, why did you post that long article? Amy said she'd looked into all this, and she wouldn't be defending Babywise if she didn't know what its critics say. I'm not sure you actually "heard" what she said in her post.

-- SJ

Tuckster said...

I think babywise makes for better people. It you don't do babywise, your kids are going to grow up with more problems than you know what do with.

The solution = homeschool.

Anonymous said...

"it you don't do babywise..." More like: if you aren't homeschooled, you'll grow up speaking like Tuckster...

Anonymous said...

Tuckster is a dog. The fact that typing is possible with claws and no opposable thumbs is quite the accomplishment. Tuckster's parents clearly used dogwise and homeschooled him. BGI.

TulipGirl said...

I'm thankful to hear that you and your little one are doing well, at this point, with the Babywise ideas. Objectively, however, they are not based on sound medical and child development facts. (Though I know that Gary Ezzo writes as if they are. . .) Please continue to be cautious in your application of these materials in your family.


Grace and peace,

TulipGirl said...

And for those mamas who place a priority on breastfeeding and on using Babywise, I offer these suggestions.

The mamas I've known who have been successful in breastfeeding until one year (per the AAP recommendations), have usually altered the Ezzo PDF guidelines significantly.

These are the most common modifications.

1. Never going beyond 3 hours between feedings, except for when baby is sleeping at night. (Current Ezzo materials assume it is normal for babies at 9-15 weeks be going between 3-4 hours, and be down to 4-6 liquid feedings at 4-6 months.) After losing my milk supply while breastfeeding my first, I attempted to never go beyond 3 hours when feeding my second. I still lost my milk supply, but not until 6-7 months.

2. Follow an Eat/Wake/Eat/Sleep cycle, instead of the Eat/Wake/Sleep cycle. I have seen this advocated by a Contact Mom, but can't remember who. This is what we started to do when our third son was born. (Later we went the route of cue-feeding. I was able to successfully breastfeed my third while cue-feeding, and may have been able to on an eat/wake/eat/sleep cycle.)

3. Breastfeed at night. While one of Ezzo's selling points is the promotion of "sleeping through the night" from an early age for babies, because of the way the breastfeeding hormones work, many mothers have found the best way to keep up their milk supply is to have at least one and possibly two night nursings throughout the duration of the nursing season. Experienced moms have found that this night nursing does not cut into their rest or their baby's rest as much as Ezzo warns.

4. Switching to cue-feeding, and building routine and rhythm in other areas of their infant's day.


These articles are foundational for understanding how breastfeeding works, and making decisions related to infant feeding.

How Does Milk Production Work?
by By Kelly Bonyata, BS, IBCLC

Examining the Evidence for the Cue-feeding of Breastfed Infants
by Lisa Marasco, BA, IBCLC and Jan Barger, MA, RN, IBCLC

And related to routines and breastfeeding:
But I Don't Want to Nurse All the Time OR Watch the Clock!
Establishing a Routine While Breastfeeding
Breastfeeding and the Bible


I hope this is helpful to the mamas reading your blog, Amy. *grin* And while you know I find fault with Gary Ezzo's teachings--please understand I am not finding fault with you.

I know you love your little one dearly and will be raising her in the nurture and admonition of the Lord, relying upon Him and His grace daily.

the Joneses said...

You know, Amy, I have the highest respect for you and regard you as a good friend, but I have to say this: I wish that sometimes you'd just state your opinion right out! It's gets so old trying to guess what you think on a subject! :)

-- SJ

Kevin & Amy said...

x

Lauraland said...

"not capable of using your brain" is ridiculous! Terrible article Kevin and Amy. Mothers need help and support not ignorance.