Breaking Down Babywise ~ Part III

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Please read Part 1, an intro to Babywise and it's authors, and Part 2, discussing the compatibility of using Babywise while breastfeeding.

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And now we come to sleep. Babywise is subtitled "Giving Your Baby the Gift of Sleep". One of the first questions the Ezzos ask as they begin discussing the subject of sleep is: "Who wouldn't want their baby to sleep through the night?" It's meant to be rhetorical, and the answer would seem to be "I don't know, who wouldn't want their baby to sleep through the night?"

ME!

Not as early as they say anyway, and not by their definition. But first, let's talk about why babies wake up during the night.

1. Hunger. Growing babies need food. For the first 3 to 4 months, babies need to eat very frequently, they're growing like crazy, then tossing in extra growth spurts every couple of weeks, it's pretty obvious that they need calories around the clock. Around 3 to 4 months they might naturally start "sleeping through the night" something that the Ezzos and the American Academy of Pediatrics agree on. BUT, the Ezzos define sleeping through the night at 12 weeks old as 11-12 hours of sleep. The medical definition and the expectation is 5 hours.

2. Brain development. Babies have two sleep stages. Their bodies and brains rest during the deep sleep stage, but during the lighter, REM sleep stage is when the baby is forming all of their brain connections and cementing into place everything that they have learned that day. They need the lighter stage of active sleep in order to develop. As they move around they will sometimes wake themselves up. This has a purpose too, because...

3. SIDS risk reduction. Although no one knows for sure what really causes SIDS, one of the current theories is that the baby falls into the deep sleep stage and, for whatever reason, can't and doesn't return to lighter REM stage; the brain continues resting and sleep continues to deepen until the brainstem ceases to function and breathing stops. Waking during the night for some babies is a necessary part of moving from deep sleep to REM sleep.

Waking during the night is developmental issue. For the first 6 months (even longer for some babies) night waking is just what their brain does. While there are factors that play into a good night's sleep - being overtired, too much stimulation during the day - your baby will sleep through the night when he or she is ready to sleep through the night, physically and mentally.

Now, Babywise...

At first glance the Babywise method seems like just another cry-it-out (CIO) method. But when you take a closer look you find that it's more than that and can lead to some pretty serious consequences.

The Ezzos say that some crying is expected and is normal and may last anywhere from 5 to 45 minutes. This is fine, sometimes babies just need to cry. The AAP agrees to an extent saying that a baby may average about 3 total hours of crying over a 24 hour period.

Acknowledging that, some babies will cry no matter what they do, and you also have to consider what prolonged crying does to the baby. I'm not talking about emotional health here, I'm talking about physiologically. Prolonged crying raises the amount of the stress hormone, cortisol, in the baby (and parents too). Elevated cortisol levels can cause restless sleep, failure to reach a deep restful sleep state and has long term effects of high blood pressure and heart problems. Anyone who has cried themselves to sleep as an adult can describe to you exactly how well they slept that night and how they felt the next morning; like you didn't sleep at all and someone ran over you with a Mack truck. How is this productive in developing truly healthy sleep habits?

The Babywise technique takes the baby through his naptime routine, that somehow should be devoid of any sleep props (pacifiers, nursing, rocking), lays him down in his own bed and leaves him to fall asleep alone, no matter how hard he cries. It is based on the belief that any child can be trained to sleep. Whatever happens, Baby remains in his crib until his 1.5 - 2 hour naptime is up, and heaven forbid he finally fall asleep with 15 minutes to go, because he doesn't get to decide when his nap ends; he'll be up in 15 minutes when his Babywise Mom gets him up so that he stays on schedule.

If baby wakes up during his nap or during the night, parents are instructed to poke their head in the room, but don't get Baby out of his crib, let him cry and he'll figure things out, just monitor him.

Babywise does not give any credence to differing personalities, or the fact just like adults, infants are going to have their own sleep patterns. Babies have personalities that affect everything they do and how they are parented. Each child is unique.

To recap: Babies SHOULDN'T be sleeping through the night (7-8 hours) a 7 weeks old, like Babywise says they should, they still need calories around the clock and need to wake to return to REM sleep so their brains develop correctly. Babies will sleep through the night when they are developmentally ready, "training" them to do so earlier poses risks to development and health. In allowing Baby to CIO in the Babywise manner, there is a risk of short term and long term health problems from the elevated stress hormone levels.

Even with all of that, we still haven't reached my main gripe. My biggest problem with how Babywise handles sleep is that it places the responsibility of a child's sleep patterns directly on the parent. If Baby isn't sleeping through the night, then you, as the parent, are doing something wrong. There is no other explanation, and that's what led to this story:

A few months back a Babywise parenting friend of mine posted on Facebook that for several nights her 4 month old had started waking up nearly every hour. He had been sleeping through the night. I offered the suggestions of sick, teething, growth spurt, but was drowned out by several Babywisers who encouraged her that it was just a phase and he needed to work through it. She decided to go with "tough love" and let him cry it the several times he woke that night. 

The next day, she decided to take him into the ER and found out that the baby had pneumonia and an ear infection. I was livid. I know she did what she thought was best, but her's is not the only story I've heard where illnesses have gone missed for days because the parents thought the sleep disturbances were training issues instead of recognizing them as a sign of something else.

This is my conclusion for now with Babywise (unless I get a ton of requests for a review of the Biblical/Spiritual issues). I could go on for another two weeks about discipline, older infant/toddler feeding, play time, parental roles....

For now I'll leave you with this, some babies thrive under a schedule, however, under the full schedule of Babywise there is an extremely high risk for both long term and short term health problems, if you are considering Babywise, please don't. Consider another form of baby scheduling and above all watch and listen to your baby, he or she didn't read the book...

If you'd like to read more about the Ezzos and Babywise I recommend this website and this handout.

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