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On Becoming Baby Wise

I think that many of the more controversial parenting experts are just misunderstood. This is true of Dr. Ferber and his 'cry it out' approach to getting kids to sleep through the night. People who have read his book, Solve Your Child's Sleep Problems, know that it isn't just about letting babies cry all night until they learn to sleep.

On Becoming Babywise is another controversial book that has been described as 'dangerous' and that it could lead to 'poor weight gain' in babies. The AAP News magazine said that Babywise has been linked to 'dehydration, failure to thrive' and many Pediaricians and lactation consultants have come out against the book.

I have to admit that I have also been against this book and have tried to advise parents against 'doing Babywise' and trying the methods described in the book, but that I had never really read it. Instead, I was just basing my recommendation on what I had heard others say about the book.

My impression of Babywise was 'isn't that the book where they say to put your baby on a schedule and only feed them every 4 hours?', but that isn't totally true. That method is described in Babywise as hyperscheduling, and they actually recommend against doing it. Instead, Babywise recommends 'routine feedings within a preset, flexible time frame.'

The book also recommends not feeding babies 'on demand,' but they take a very narrow view of what on demand feeding is. For most parents and Pediatricians, on demand feeding involves following your babies hunger cues and feeding your baby when he or she is hungry. But that doesn't mean feeding every 30 minutes or an hour, since if you are doing so, you are likely misinterpreting your baby's crying.

The Babywise approach is called Parent Directed Feeding (PDF), and the reason it works so well for so many parents, is because it is really what most parents are already doing when they are feeding on demand and recognizing true hunger cries and cues.

I have the second edition of Babywise (and it is currently published in a 3rd edition that was revised yet again), and I think it must have some big changes from the first edition. In the section on 'How Often Should I Nurse My Baby', instead of a strict schedule, there is a lot of language about flexibility. This includes that 'you will feed your baby approximately every 2 1/2 to 3 hours', but also that there may be 'less and sometimes slightly more' time between feedings. And Babywise does recommend an average of 'eight to ten feedings a day' which is similar to the American Academy of Pediatrics recommendation of 8-12 feedings a day.

Babywise also advises about the correct number of soiled and wet diapers to look for as a sign that a child is getting enough to eat and the 2nd edition has an expanded chapter on 'Monitoring Your Baby's Growth.' The book also incudes easy to use checklists and charts to carefully monitor your child's feedings and the number of voids and stools they have each day.

I didn't like one of their examples they use of a child who was failing to thrive though. The baby, Jeffrey, was breastfeeding every 1 to 1 1/2 hours and wasn't gaining weight well. Their solution was to put him on a three hour schedule with formula feedings. But the problem was not that he was breastfeeding too frequently, but rather that he likely wasn't breastfeeding effectively, either because mom didn't have a good supply of milk or because he wasn't latching on or sucking properly.

Although he gained weight on formula, was soon sleeping through the night, and the mother was able to breastfeed her subsequent children, what she really needed was someone to help her breastfeed Jeffrey effectively. He may have needed a formula supplement if he was dehydrated, but he also needed someone to help mom get him to latch and suck properly and perhaps pump to increase her milk supply. Simply changing the child to formula feeding on a schedule was not a success for PDF and Babywise or for Jeffrey.

You should look elsewhere if you are doing Babywise and are having problems breastfeeding. The book is quick to recommend offering formula supplements and offers little help otherwise. Once you get your milk supply up and are breastfeeding effectively by getting advice from more traditional breastfeeding experts, like a lactation consultant, then consider returning to Babywise if you are really committed to it.

And maybe even consider waiting until your milk supply and breastfeeding is well established before even starting Babywise.

Babywise Cycles

One of the main concepts of Babywise is that you separate your babies activities into three basic cycles of feedings, waketime and sleeping. Other books, including Secrets of the Baby Whisperer echo this advice about seperating feedings from sleeping.

In addition to these daily cycles, Babywise divides a baby's first year into four phases, during which your child will go progressively longer between feedings and will sleep longer at night.

So what do you do if your baby isn't sticking to a schedule between feedings or is waking up at night? Babywise says to let them cry.

Crying, Crying and more Crying

Babywise is right that not all cries are cries for hunger, but when they are, you should feed your baby. And if your baby isn't hungry, but is still not quicky settling down, you should respond to their cries and pick them up. I don't think that responding to a baby's cries 'suppresses' them and leads to a spoiled baby or a child who is emotionally unstable.

Most of the Babywise advice on crying is inconsistent though. In one section they talk about that 'when you baby awakens, don't rush right in to him or her. Any crying will be temporary, lasting from five to forty-five minutes.' And in another place it says that 'there is no precise limitation for normal periods of crying.' These statements will lead some parents to think that they can let their babies cry indefinitely, or at least until they are due for another feeding.

In other parts, Babywise talks about 'picking up and holding your baby' when he is crying. And in the problem solving section discussing a 2 and 3 week old who cries 1 hour after a feeding and seems hungry, Babywise says to 'feed him.'

Babywise Controversies

I also don't think that PDF is such a 'new and major paradigm shift.' In fact, it is very similar to the EASY approach that is outlined in Secrets of the Baby Whisperer, although Babywise did come first.

And I don't like all of their bashing of attachment parenting. It may not be for everyone, but why do they think it is so harmful? Babywise should stick to its own advice and 'Remember, different opinions abound. Learn and discern what is best for your family. Then make a commitment with no excuses needed.'

The author himself is one of the other things that drives some of the controversy surrounding Babywise. Unlike most other books, you won't learn anything about Gary Ezzo's credentials from On Becoming Babywise. You would have to do some searching elsewhere to discover that he is 'an enigmatic, 50-something, evangelical Christian minister'* and that he heads Growing Families International, a for profit conservative Christian organization. I don't think that there is anything wrong with a Christian minister writing parenting books, but it should be a little clearer in the books who the authors are.

One of the main Babywise points I disagree with is that babies 'are not capable of establishing stable sleep/wake cycles on their own.' Instead, I think that they do this naturally and it is up to parents to learn not to interfere with the process, but you don't need Babywise to teach you that.

Another controversy is that many of the facts and studies presented in the books are not backed up with any scientific evidence.

If you do follow the Babywise principles, be sure to mention it to your Pediatrician, so that he or she can closely follow your baby's growth and development and perhaps schedule a few extra visits, especially in your baby's first month of life. And be sure to read the whole book before applying any of its principles or you may make some big mistakes. For example, the section on growth spurts and the need for extra feedings is in the back of the book in the Parenting Potpourri section, instead of where they talk about understanding a baby's cries. If you didn't read all of the way though and your breastfed baby wanted to eat more frequently, you might have stuck to your routine and not increased your feedings to increase your milk supply.

Should you raise your children with Babywise? That's up to you. Are you comfortable with letting your baby cry a lot? Do you believe the statement that 'Yes, you can hurt a baby by picking him or her up too much.'? If you answered yes to both or either statement, then Babywise may be for you.

Do you want to try a method that Dr. Sears, a popular author and Pediatrician, calls 'probably the most dangerous program of teaching about babies and children that I have seen in my 25 years of being a pediatrician'?*

Is Babywise dangerous? For most parents and babies, the answer is probably no. The book does do a good job of teaching parents to recognize whether or not a baby is getting enough to eat and signs to look for that might indicate that he was getting dehydrated. And some babies may get dehydrated doing Babywise, but it also happens to parents following an Attachment Parenting approach or just feeding on demand. It is unclear what the effects are of letting a younger child cry without being responded to though.

And I think that many parents who 'do Babywise' don't follow all of the advice anyway. Most simply concentrate on the 2 1/2 to 3 hour schedule, which is when the average baby wants to eat anyway. Our own surveys show that most newborns are going 2 1/2 to 3 hours between feedings, and I doubt that all of these parents are doing Babywise.

Reading the reviews at amazon.com of people who really liked the book show statements like 'use your instincts and adjust the schedule time as your baby's needs indicate', 'we didn't follow the book 100%,' 'we deviated from some of the advice in the book,' and 'of course, I don't agree with everything in the book, but it provides a framework to where you and your family can pattern your lives to predictable patterns and keep the sanity of the enitre family in check.'

Another reviewer states that 'obviously there will be days and times when things need to be altered or changed,' but Babywise doesn't say that at all.

Now you don't have to follow or believe in all of the points in every book that you read, but there is only one real concept in this book, sticking to a feeding/awake/sleep schedule even if it means letting your baby cry to stick to your schedule, and if you don't follow that, your not really doing Babywise.