12 August 2011

Breaking Down Babywise ~ Part II

Please read Part 1 of Breaking Down Babywise, an intro to the method and the authors. It'll help explain some of the terms I use or reference in this post.
Babywise and Breastfeeding: Compatible?

It depends. Maybe if you apply some ideas and leave out others, but then, that's not really the Babywise method. As presented in Along the Infant Way, you take it all or you're not really using the method effectively or as intended and can't be promised the same results.

It's my belief, along with the Academy of American Pediatrics (AAP), most pediatricians, all lactation consultants, and nutritionists that a child should be breastfed for at least 1 year. If you have to put them on formula then it's not time to wean! Furthermore, if milk is such a critical part of a 1 year-old's diet as the pediatricians and AAP recommend it to be, then you'd probably do best to keep that oh-so-important milk coming from within the species. At the child's 2 year old appointment, when all of the sudden the Dr is suddenly worried about them drinking too much milk, then you might think about cutting things back and moving on. (This is assuming that mom has the ability to breastfeed.)

That said, tonight I met the first person I have ever known to successfully breastfeed longer than 8 months without using formula supplements and while using the Babywise method. And I know alot of people who use Babywise. Congrats! Thank you tweeps for helping me find her! So there are a few examples out there that it can work. But I think that in making it work moms are treading on some very dangerous ground.

If you use Babywise, you might also want to check the edition of your book, the most current edition is from 2006. This newest edition does cut out some of their stricter rules and deletes some paragraphs entirely, without addressing the disappearances. This worries me in and of itself. If the method is really so great, so effective, and so irrefutably good for family and baby, then why these drastic changes? It would seem that in the face of criticism the Ezzos are much more ready to water things down to sell a few more books than stick by their original statements.

To the point.

I'm just going to work my way through Chapter 4 to begin with. "Facts on Feeding."

Right, facts. In Chapter 4 the Ezzos state that bottles are as good as the breast when it comes to feeding. Well, they get the food to the baby's mouth alright, but it is documented that feeding from the breast is necessary for the proper development of baby's jaw muscles, jaw alignment, and palate formation. So, braces anyone?

It also assumed and implied that breastfeeding is strictly nutritional. Except that a study of basic physiology and hormones shows us otherwise. Breastfeeding is a calming and connecting event. The hormones and pheromones released during breastfeeding give physical and mental benefits to mom and baby. These particular hormones and pheromones reduce stress, promote bonding, and increase milk supply. Yes, just being near your baby and breathing his scent can encourage milk supply. If it were strictly nutritional then why would let down often occur at the very cry of a baby and not always wait until appropriately stimulated by baby at the nipple? Comfort nursing is just as important as nutritional nursing to both baby and mom at emotional and mental levels.

We have now reached a point that I have nearly over-researched. Foremilk and Hindmilk.
Page 67 of Babywise
"...snack  feeding provides baby only a partial meal consisting of the lower calorie foremilk and not the higher calorie hindmilk essential for growth."
Page 43 of Along the Infant Way
"...the lower caloried foremilk that too frequent of feedings produce."

These statements show a basic lack of knowledge about foremilk and hindmilk. These books teach a mom that her baby gets foremilk anytime he starts a new feeding. But that is not always true. Foremilk is not "made." It is the milk that is left in the ducts after the last feeding. The fat in the foremilk has risen back towards the glands and is let down as the glands contract after the baby has started nursing off the leftover, watery milk from the last feeding. The amount of foremilk is largely based on how much storage space the mom has in her breasts. The shorter the time between feedings, the LESS foremilk a mom has and the more fat and calories the baby will get in his meal.

Then we get to supply and demand.
Page 67 of Babywise
"A mother who takes her baby to her breast 12, 15, or 20 times a day will not necessarily produce any more milk than the mom who takes her baby to breast 8 or 9 times a day." 

Even the Ezzos themselves negate this when they instruct a mom struggling with supply to pump between feedings to increase her supply. One of the ways a baby signals to his mother's body that he has grown and needs more milk is to eat more frequently. More nursing sessions = more milk!

Later in Babywise (pg 103), moms with a questionable supply are told to either put the baby on a schedule or supplement with formula. Interesting.

According to the Ezzos there are only 3 "correct" ways to nurse. The cradle hold, the football hold, and side-lying. According to Babywise and Along the Infant Way, anything that varies from these positions will inevitably cause poor latch and result in poor feeding. Ladies, I'm sorry if your breasts are too small or too large for these positions to work for you comfortably, I guess you're just up a creek without a paddle.

Ideally, according to Babywise, your newborn will eat on a 2.5 - 3 hour schedule. It one part of the book they say to be flexible, but in another part they advise to let a 2 month old experience "natural consequences" of not eating enough at the previous meal and instruct the mom to force the baby to wait until the next scheduled feed. They put forth the use of a pacifier to hold off a baby until the next feeding. However, they fail to address that the act of sucking on that pacifier releases hormones in the baby that cause drowsiness. So baby is sleepy and doesn't eat a full meal, but then is forced to wait until the next mealtime by using the same pacifier. A cycle and recipe for dehydration and malnutrition.

When it comes to weaning, early editions of Babywise state "No one can say for sure what age is ideal." Except that actual doctors have determined that at least 1 year, but 2 is ideal according to the World Health Organization. Which is probably why this statement was struck from the 2006 edition.

The Ezzos also encourage moms to listen to their pediatrician's advice over that of any lactation consultant. Because we all know that pediatrician's receive years of training specifically on breastfeeding. (PLEASE read that with the sarcasm it was intended to be read with.) They also imply that you should refrain from telling an LC about the schedule the baby is on until you find that she is in support of the Babywise method; only then are moms encourage to be fully forthcoming about exactly how and when they are feeding their baby.

Some final thoughts.

The AAP has expressed concern over Babywise and the reports they've received connecting the method to dehydration, malnutrition, slow growth, and slow development.  (Here and Here) Remember the Ezzos said to trust your pediatrician over a lactation consultant...

Two quotes from page 213 of Babywise:
"Competent doctors have your best interests in mind."
"More lawsuits against obstetricians and gynecologists today are forcing them to exercise conservative, lower risk treatments."
These two quotes were referring to C-sections and how having one should be seen as a possible and even probably birth outcome; but it reflects a knowledge that doctors will do what they have to to protect themselves and either ignorance or naivete that those same doctors will still have the patients best interest in mind. Ummm, right.

Monday I'll break down "The Gift of Sleep" that Babywise promises. Find Part III here.

Share your thoughts, positive or negative, and come join me on Google+, Facebook, and/or Twitter so you don't miss when the rest of the series is published!


  1. Great post!

    The snacking and feeding position alone would make it impossible for me to follow Babywise. My daughter has always preferred to nurse sitting up and straddling me since developing the ability to do so, which works perfectly for us (is this because of baby wearing, I wonder?)

     She has also always been a frequent snacker/comfort nurser. Since she is a little on the small side, and probably has her father's metabolism, I have often thought that her nursing style is her way of maximizing calories.

    Either way, we are a happy nursing pair, why fix what isn't broken just because a book tells me to?

  2. Great post! I was saddened by their suggestion that a 2 month old should experience the "natural consequences" of not eating enough at
    the previous meal..." While unthinkable to me now, unfortunately, when I first had my daughter, I may have given credence to such a statement. Then, after all, I knew very little about the dangers of scheduling feedings. I didn't really believe in a schedule, but I thought, like the Ezzos essentially are advising, that as parent, I knew best when to feed my daughter. What a mistake. After a visit to a lactation consultant at seven weeks prompted by my daughter's slowing weight gain and my drop in supply, I changed completely. And I think it was only because I changed that we were able to continue breastfeeding as long as we did. 

  3. Glad ya'll were able to get things worked out! Eating is definitely one of those things where (most) babies know best!

  4. My Pediatrician gave me a copy of Babywise sometime around my daughter's 2-month checkup, with the warning that I wouldn't agree with everything in the book, but to glean what I could from it, especially chapter 1 where it tells you to get your priorities straight: 1 God, 2 Spouse, 3 Children. Honestly, I thought both the Breastfeeding advice and the Cry-It-Out sleep method a load of tosh, but I DID get a huuuuuuge benefit from the schedule. I wasn't "training" my daughter, though, I was training myself. From memory, the biggest thing I learned was that around 2 months, babies settle into a natural "eat, awake, sleep" cycle every 3 hours or so, and you can watch for signs of sleepiness, rubbing eyes, yawning, etc. and put them down for a nap then. Honestly, this was revolutionary for me! I was feeding my fussy daughter "on demand", but I didn't even take into consideration that she might be fussy because she was tired! The "every 3 hours" feeding schedule was never, ever EVER strict with us, and if she refused to sleep, I would definitely feed her again. But she definitely had needed more naps than I had been giving her before I read the book. It was also a relief to know that I had just fed her and she would be ok with Daddy if I needed to go to the store for an hour. She also used a pacifier to go down for her naps, but she would wake up and tell me when she was hungry! So even though Babywise is inaccurate, uneducated and even dangerous in parts of it, I definitely got something good out of it in my realization of my daughter's need for frequent sleep, if nothing else.


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