Amongst the mass of parenting books featured in online stores or on shelves at your local library and bookstore, are many promising the Holy Grail: a baby who sleeps through the night.
One book particularly stands out from the crowd, by offering to give your infant the gift of nighttime sleep!
Originally published in 1990 as ‘Preparation for Parenting: Bringing God's Order to Your Baby's Day and Restful Sleep to Your Baby's Night', (Christian edition written by Gary and Anne Marie Ezzo), the book was rebranded in 1993. It became known as ‘On Becoming Babywise' and Robert Bucknam MD replaced Anne Marie Ezzo as co-author.
Today, Babywise is just one of a franchise of books – 10 in total – taking you from Birthwise to Teenwise! Millions of copies have been sold world-wide.
Yet the book is also one of the most controversial of its type. A mix of unsubstantiated statements, out-dated references and their own case-studies presented as evidence, leaves many questions unanswered. The author’s invention of ‘parent-directed feeding' is presented as being the compromise between child-led feeding (responding to infant feeding cues) and clock-feeding (scheduled feed times).
The Babywise Book – Not So Wise
Despite the unprecedented level of research into human lactation and infant sleep in recent decades, the out-dated concepts in this book are being supported with out-dated evidence — and opinion is presented as fact.
Very few other books have websites dedicated to warning others against their use.
So, let’s look at just some of the Babywise ‘wisdom':
BabyNotSoWise #1: Feeding Philosophies
A large part of the second chapter is spent discussing a confusing link between something called ‘birth-trauma theory' from 1929, as well as attachment parenting, which became popular in the 1980s.
‘Attachment Parenting' is a term coined by world famous paediatrician, Dr William Sears, to describe a parenting philosophy based on the principles of attachment theory. The term ‘attachment parenting' has nothing to do with the “neoprimitivistic” school of thought that hopes to ‘undo birth trauma', as suggested in this book.
Babywise says: “Sad to say, the recommended attachment parenting protocols required to manufacture a ‘secure attached child' too often produce the opposite: an emotionally-stressed, high-need, insecure baby and one tired mom.” Yet again, Babywise offers absolutely no evidence or research to support their claim.
Attachment parenting is an approach to raising children, rather than a strict set of rules. It's about learning to read the cues of your baby and responding appropriately to those cues. Learn more about attachment parenting here.
BabyNotSoWise #2: Babies and Sleep
It takes several months for a newborn baby to begin establishing a pattern in their sleep cycles. Even then, regular disruption is inevitable, as rapid neurological and physical development in the first years interrupts newly-established patterns. In fact, one study investigating infant sleep duration found that 27% of babies had not regularly slept from 10pm to 6am by the age of 1 year.
Yet, Babywise claims: “… healthy, full-term babies are born with the capacity to achieve 7-8 hours of continuous night time sleep between seven and ten weeks of age, and 10-12 hours of sleep by twelve weeks of age.”
Again, no scientific evidence is offered to support this claim, which is not surprising, given there is a multitude of evidence-based research to disprove it! See Baby Sleep Myths: 4 Major Myths Busted for more information. It's also important to be aware that SIDS (Sudden Infant Death Syndrome) peaks between 2-5 months of age. Being able to wake is an important part of baby's survival.
After several paragraphs cautioning against the dangers of bed-sharing, Babywise acknowledges it might be convenient to have the baby sleep in the parents room for the first two to three weeks. But it then states, “Sharing a room after four weeks can postpone a baby’s ability to sleep through the night upward to four months.” No evidence is provided to support this claim.
Around the world, recommendations to reduce the risk of SIDS include sharing the same room as your baby for up to 12 months of age. For more information about co-sleeping safety, see our article, Sleeping With Baby – Is Co-Sleeping Safe?
BabyNotSoWise #3: Facts on Feeding
Babywise cautions against ‘demand feeding' – terminology no longer used by organisations like the Australian Breastfeeding Association or Le Leche League International, who use the more accurate terms “cue feeding” or “baby-led feeding”.
But it's not only breastfeeding organisations who support feeding babies this way — this view is shared by the World Health Organization and the American Academy of Pediatrics. Cue-feeding recognises that breastfeeding is much more than just getting food into a baby’s stomach.
Yet Babywise claims: “Responding promptly to a newborn’s hunger cue is central to both cry-feeding [cue-feeding] and parent-directed feeding, but there is a major difference. The PDF approach encourages full feedings about every 2 ½ to 3 hours rather than a cluster of small feedings. Working to achieve full feedings is a key to PDF success. “
By trying to make your baby take a bigger feed than they need, you are overriding their natural appetite control. Individuals who are satiety responsive, matching their intake of energy to need, are more likely to be a healthy weight.
Cluster-feeding is normal, natural and allows the baby to regulate their milk intake over a period of hours. Breastmilk composition varies throughout the day and throughout each feed. It's likely that cluster feeding is simply how our babies manage their intake. Here are 7 Tips For Coping With Cluster Feeding.
BabyNotSoWise #4: Managing Your Baby’s Day
Older babies and toddlers grow to have a predictable pattern to their day, with waking times, meals, naps and bedtimes occurring at similar times each day. Families can follow this rhythm to structure their routines – such as outings, mealtimes and household tasks – to best suit their needs.
However, strict schedules don’t allow for the flexibility of growing children, and are totally inappropriate for young babies whose feeding and sleeping patterns are still evolving. At some points, Babywise sounds more like an army boot-camp than a way to nurture a baby who is fresh from the womb (read more about the fourth trimester):
“During the crucial early weeks of stabilization, it is important that you shape and form your baby’s routine. Too much flexibility will not allow this to happen. That is why a baby’s routine must first be established before flexibility is introduced into baby’s day.”
Babywise goes to great lengths to explain a complex process of ‘merging' your baby’s feeding, sleeping and waking cycles. Rather than adjusting their own lives to the temporary variations which come with having a baby, parents are told they must set out a detailed schedule which needs to be followed. No sooner has this schedule been implemented when it is time to begin working on adjusting it, due to the “continuing evolving, changing and growing needs of their baby”. At times it almost seems as though the routine is managing the parents!
“Remember you are not managing an inconvenience, you are raising a human being.” — Kittie Franz IBCLC
The Australian Breastfeeding Association explains: “The only true way to know how many feeds your own individual baby needs is to feed him when he needs to feed. That is, by watching out for and responding to his feeding cues. The number of feeds in a 24-hour period depends on many factors.”
The American Academy of Pediatrics states: “Some newborns feed as often as every 1.5 hours, while others feed about every 3 hours. Breastfed newborns will feed 8-12 or more times per 24 hours (once your milk has come in).”
Yet, Babywise says: “For a newborn, the duration of time awake, including feeding, burping, diaper change, cuddles and kisses, will be approximately 30 mins. Sleep follows the feeding and that takes up the next 1 ½ to 2 hours. When adding it all together, the entire feed-wake-sleep cycle averages 2 ½ hours until the cycle repeats itself.”
There are many concerns about the impact of Babywise on breastfeeding outcomes.
Renee Kam, BellyBelly’s Breastfeeding Editor and IBCLC explains:
“If a baby is fed according to a schedule, or if things are done to get them to sleep through the night when they are not ready to, this could lower a mother's milk supply, and hence may mean a baby doesn't get enough milk. This is because the rate at which more breastmilk is made is determined by how full or 'empty' the breast is. Note that 'empty' is in inverted commas because lactating breasts are never fully empty. The emptier the breast, the faster the rate that more milk is made. Whereas the fuller the breast, the slower the rate that more milk is made.
So, over time, the length of time between breastfeeds is unnaturally extended (e.g. by scheduled feeding) then this could have the effect of causing the breast to remain fuller for longer (at least initially). This gives the message to not make as much milk, and hence overtime, supply can drop.”
She continues, “Also, different mothers have different storage capacities. A mother with a smaller storage capacity will need her baby to feed more often (which they will naturally do if fed according to need) to make sure her baby gets enough. Whereas a mother with a bigger storage capacity may not need to feed as often to ensure her baby gets enough. Scheduled feeding or doing things to make a baby sleep longer when they are not naturally ready to, doesn't take individual mothers' storage capacities into account.”
For mothers whose goal is to exclusively breastfeed their baby should consult with a lactation consultant (ideally an IBCLC), breastfeeding counsellor or breastfeeding support line before following the Babywise program.
Note: All parents have the right to choose the parenting style that best suits them. However, all babies have the right to be cared for with respect and understanding of their individual needs. Finding the balance is important, and doing so means making informed decisions based on accurate, evidence-based information, which is without personal bias or religious over-tones. Babywise continues to cause concern amongst parents, health professionals and others.