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Parenting
with Gary & Anne Marie: Infant
Myths and Misconceptions - Babywise Authors Set the Record Straight
With its parent-directed feeding philosophy, On Becoming
Babywise (Babywise) holds
the centrist’s position among contemporary parenting theories. It stands
between two theoretical extremes of the parenting spectrum: hyperscheduling
at one end and attachment-parenting/La Leche League at the other extreme. In
the last ten years, Babywise has gained momentum in its growing popularity
and is now printed in twelve languages. That is great news for parents around
the world, but its success has not come without presenting challenges to its
authors.
A book such as On Becoming Babywise does not reach world prominence
without having raised doubts regarding the wisdom and promised outcomes of
other infant management approaches. This in turn, fuels much internet contention
and numerous accusations about Babywise that are, for the most part,
commentaries starkly at odds with reality. Fortunately, the Babywise community
can take refuge in the following statistic. When you have two million parents
and twice as many children that have successfully utilized the parent-directed
feeding recommendations of Babywise, it is very difficult to make
a logical argument against the book’s successful track record. If one
wanted to add to this statistics, the Ezzo’s Preparation for Parenting program,
the advocacy group would nearly double. A combined six million (or ten million)
plus advocacy group of parents and children represents a rather persuasive
force. You cannot get to this point without a very healthy track record.
Nonetheless, such popularity
and public favor does engenders various forms of prevarication and denigration,
and a campaign of misinformation by those who feel the displacement of their
influence and advice. We invite every parent to read On BecomingBabywise for
him or herself. When we separate fact from fiction, the roar against Babywise drops
to a murmur. Here are a few of the more widely spread myths and misconceptions
circulating about the Babywise message.
Misconception
#1: Babywise teaches
schedule feedings, meaning that infant feedings are determined by strict
schedules.
This is false. Hunger,
not the clock, determines feedings with Babywise.
Here are some examples taken directly from On Becoming Babywise.
- When the hunger cue is present, the clock is submissive to the cue, because
hunger cues, not the clock, determine feedings.
- “With PDF, a mother feeds her baby when he is hungry, but takes
advantage of the first few weeks to guide the baby’s hunger patterns
by a basic routine” (p. 38). (A basic routine is defined as feeding
a baby every two to three hours.)
- “If your baby is hungry,
feed him or her. If the child routinely shows signs of hunger before the
next scheduled feeding, then find out why, rather than letting the baby
cry it out”(p. 145).
- “Hunger cues, not the clock, determine feedings” (p.
112).
- “Hunger is always a legitimate reason to feed in less than two hours” (p.
115).
- “Crying is a late signal of hunger” (p.
65).
Misconception
#2: Babywise runs contrary
to the recommendations of the American Academy of Pediatrics (AAP) when it
comes to feeding.
On the contrary, the Babywise principles
are in harmony with all major recommendations of the AAP in every category
of concern. This includes newborn and infant feeding, crying, and common
warnings offered to new parents. As a long-standing member of the AAP, Dr.
Bucknam regular reviews the literature and advisory updates for changes in
feeding recommendations. Babywise continues
well within the AAP guidelines. See AAP Babywise Recommendations
and Comparison.
Misconception
# 3: “Babywise teaches
that parents should simply ignore a baby’s cry to keep him or her
on a schedule.”
This is silly. Gary Ezzo and coauthor pediatrician Dr. Robert Bucknam devote
an entire chapter of Babywise to the subject of crying. Their emphasis
is on prudent parental assessment as to why the baby is crying, and
not on simply stopping the cry. It is helpful to point out what the AAP) advises
parents about infant crying. (From Caring For Your Baby)
- “Many babies cannot fall asleep without crying and will go to sleep
more quickly if left to cry for a while. The crying shouldn’t last
long if the child is truly tired” (p. 36).
- “All babies cry, often without any apparent cause. Newborns routinely
cry a total of one to four hours a day...No mother can console her child
every time he cries, so don’t expect to be a miracle worker with your
baby” (p. 37).
- “Pay close attention to your baby’s different cries and you’ll
soon be able to tell when he needs to be picked up, consoled, or tended to,
and when he is better off left alone” (p. 34).
- “Initially, your infant doesn’t know the difference between
day and night... But even at this age, you can begin to teach her that nighttime
is for sleeping and daytime for play” (p. 37).
Babywise States:
All the information above is also given in Babywise. Other statements
include:
- “Some children cry fifteen minutes before falling asleep. Others
vary the duration of their cry from five minutes at one naptime to an off-and-on
thirty-five-minute cry at another. If your baby cries longer than fifteen
minutes, check on the baby” (p. 147).
- “Some crying is normal. You need to expect it. However, you also
need to stay alert to certain identifiable cries...” (p. 142).
- “Unless you sense your baby is in danger, take a moment to listen
and assess his crying. After a brief assessment, take the appropriate action” (p.
150).
Crying, such as when an
infant is settling down for a nap, should be assessed carefully. If this
is the context of the baby’s cry, we join the AAP
in suggesting that the child should be give opportunity to settle himself.
All such recommendations are consistent with the AAP guidelines and are well
within the controlled crying methods commonly applied across the United States.
Misconception
#4: “Babywise methods
can be linked to poor weight gain and failure-to-thrive .”
Beware of the fallacy
of this “slippery slope” argument.
It can equally be stated that demand feeding, attachment parenting, or strict
schedule feeding can be linked to poor weight gain and failure-to-thrive
(FTT), and in fact, they are. Statistically, a small percentage of FTT will
always exist regardless of which feeding methodology a mom follows. Failure
to thrive is a nutrition issue. Either a mother is not supplying sufficient
nutrition to her baby, or her baby is not sufficiently processing the nutrition
(The later can be due to a number of medical factors.) It is less likely
to occur when a baby is fed every two to three hours, and more likely to
occur when a baby is fed more often than every two hours. An FTT baby is
much more likely to result from a fatigued breastfeeding mother, whose milk
supply is nearly non-productive due to exhaustion and unlimited feedings
around the clock.
In 1998, the president of the American Academy of Pediatrics, Joseph Zanga,
personally invited Dr. Robert Bucknam to publish the Babywise findings
in the AAP News. In an article published in (May 1998), Dr. Bucknam
noted “no pediatrician in the Babywise peer review group had
seen any cause and effect relationship between feeding a baby every 2 to 3
hours, as advocated by Babywise, and FTT. In his own practice of 2000
children, FTT is rare. In light of this, we would like to see what critics
used as criteria to substantiate a link between FTT and Babywise and
question if this is the same criteria used against other feeding models.”
To date, the anecdotal evidence claimed thus far from Babywise detractors,
are highly suspect and moreover, filled with inconsistencies. Additionally,
the infrequent to non-existent occurrence of FTT among the pediatric practices
utilizing Babywise also raises serious doubts about the anecdotal
reliability of random FTT reports.
More good news exists in support of the PDF principles as
a healthful feeding philosophy. In the same article, the AAP News published
the weight gain statistics of Babywise. The question posed was “Can
faster weight gain be attributed to a particular method of breastfeeding (PDF
or demand)?” A
retrospective study of 400 infants (200 demand fed and 200 PDF from four different
pediatric practices) revealed the following:
- While there was no significant difference between the two groups, Babywise breast-fed
infants overall gained weight slightly faster than those fed ad-lib.
- Even when these babies
began sleeping 8–10 hours at night, there
was no significant change in weight gain performance.
- That on average, the breastfed babies slept through the night before formula
feed babies.
Misconception #5:Babywise discourages
successful breast-feeding.
On the contrary, for breastfeeding moms Babywise has
proven to be an attractive alternative to the more extreme La Leche League
ad lib model. Consider the facts. Despite numerous benefits to breast-feeding,
the American Academy of Pediatrics notes that “in 1995, 59.4 percent of women in the
United States were breast-feeding exclusively or in combination with formula
feeding at the time of hospital discharge; only 21.6 percent of mothers were
nursing at six months, and many of these were supplementing with formula.” (Pediatrics,
December 1997, pp. 1036–1037). This is 2004 and not much has statistically
changed since 1995 except in the positive results of Babywise and
breastfeeding.
A retrospective survey of more than 240 mothers following the PDF principles
demonstrated that 88 percent of mothers who start with the program breast-feed;
80 percent of those moms breast-feed exclusively; and 70 percent of those moms
are still breastfeeding after six months. Babywise success far exceeds
breastfeeding social norms and that is good news for children. When you add
to these statistics the benefits of uninterrupted nighttime sleep, it is easy
to understand why so many mothers find their way to Babywise.
Conclusion
For more than twenty years, the PDF principles have served young parents
well. Today the principles of parent-directed feeding continue to enjoy enormous
favor around the world. We are very confident that when one strips away the
internet gibberish, a very clear, caring, and centrist philosophy on infant
care emerges.
Article
by Robert Bucknam, M.D. and Gary Ezzo, M.A.
