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Parenting
with Gary & Anne Marie: Infant
Comparative Analysis of Contemporary Breast Feeding Philosophies
What Babywise and PDF bring to the table is the single most critical element for all aspects of infant care—parental assessment (PA), an acquired confidence to think, evaluate and respond to real need, not just react moment by moment. The following analysis will demonstrate why parental assessment is absolutely necessary for your baby’s welfare. At present, three feeding philosophies dominate Western culture:
- Child-led feeding (also known as cue feeding, demand feeding, response feeding, ad lib, and self-regulating feeding)
- Clock feeding (also known as scheduling)
- Parent-directed feeding (PDF)
Theory in Practice
- Child-Led Feeding: Feeding times are guided strictly by the single variable of hunger cues. The baby's hunger cue is a variable because feeding times are random. Three hours may pass between feedings, then one hour, followed by twenty minutes, then four hours. The constant of time is not considered, because the theory insists that parents submit to the baby’s hunger cue regardless of the lapse of time.
- Clock Feeding: Feeding times are guided strictly by the constant of the clock. The clock determines when and how often a baby is fed, usually on fixed intervals. The critical variable of a hunger cue is not considered. The parents’ role is to be submissive to the clock.
- Parent-Directed Feeding: Both the variable of hunger cues and the constant of time guide parents at each feeding. The parents’ role is that of mediating between the cue and clock, the variable and constant, using parental assessment to decide when to feed based on actual need.
Conflict Between the Variable and Constant
The greatest tension with feeding philosophies centers on which feeding indicator to use—the variable of the hunger cue or the constant of the clock. The standard Attachment Parenting/La Leche League doctrine insists on child-led feedings exclusively, thus, the hunger cue is dominant. The hyper-schedulist sees the fixed segments of time as the final determinant of feeding. Thus, the clock is dominant. Where does the healthy truth rest? Not at either extreme. The weakness in logic of these two views becomes obvious when placed into their respective equations. The child-led feeding equation looks like this:
Hunger Cue + Nothing = Feeding Time
Weakness in practice:
1. The child-led feeding is based on the faulty assumption that the hunger cue is always reliable. It’s not! Hunger cues only work if the hunger cues are present. Weak, sickly, sluggish, or sleepy babies may not signal for food for four, five or six hours. So exclusive cue feeding puts them at risk of not receiving proper nourishment. If the cue is not present, the baby doesn’t get fed.
2. If the cue is consistently less than two hours, it leads to maternal fatigue. Fatigue is recognized as the number one reason for mothers giving up breast-feeding. 5 Exclusive cue-response feeding had been linked to infant dehydration, low weight gain, failure to thrive, and frustration for both baby and mom. 6
3. The inconsistency of cue feeding also discourages the establishment of healthy sleep patterns as we will demonstrate later.
The Clock-feeding equation looks like this:
Clock + Nothing = Feeding Time
Weakness in practice:
1. Feeding based on fixed times ignores legitimate hunger cues by assuming each previous feeding has been successful. The child who wants to feed after two hours is put off until the next scheduled meal.
2. Strict schedules may not promote sufficient stimulation for breast milk production, leading to the second greatest cause for mothers giving up breast-feeding: low milk supply. 7
With both child-led feeding and schedule feeding, a tension exists between the variable and the constant. This tension is both philosophical and physiological. In either case, as parents are trying to serve their underlying parenting philosophy, they become enslaved to a method. To accept either of these feeding indicators as an exclusive guide to feeding is to endanger your child.
The Philosophy of Parent-Directed Feeding
The Babywise Parent-Directed Feeding (PDF) eliminates the tension of relying exclusively on the unreliable variable of a hunger cue or the insufficient constant of the clock. PDF brings into play the critical tool of parental assessment. Parental assessment takes the best of both and weds them together. It frees a mother to utilize the variable of the hunger cue when necessary and the constant of the time when appropriate. Parental Assessment is the mediator. With PDF both the variable and constant are used as companions, backups to each other, not antagonists to be avoided. Consider the PDF equation:
Hunger Cue + Clock + PA = Feeding Time
Notice how the conflict between the variable and constant is eliminated because the parent mediates between both for the well-being of the child. It is Parental Assessment that brings balance to both. Here are some of the benefits of the PDF approach:
- PDF with Parental Assessment provides tools to recognize and assess two potential problems with infant feeding: a) A child who feeds often, such as every hour, may not be getting the rich hind milk. With PA you not only respond to the cue by feeding the baby, but are alerted to a potential problem with the feedings. b) When the cue is not present, the clock serves as a guide to ensure that too much time does not elapse between feedings. It is also a protective backup for weak and sickly babies who may not demonstrate the necessary hunger cues.
- When the hunger cue is present, the clock is submissive to the cue, because the hunger cues, not the clock, determine feedings.
- In the end, PDF promotes breast-feeding, healthy sleep, and healthy infant weight gain. So we ask parents to consider which feeding philosophy makes the most sense? The one where the baby decides? The one that a clock determines? Or the one that parents assess and direct? What will it be for you?
Article
by Gary Ezzo and Anne Marie Ezzo
