Jan Barger, RN, MA, IBCLC

May 6, 1998

I read Dr. Bucknam's commentary in the May issue of the AAP News with amazement and disbelief. Regarding the book, On Becoming Babywise" which he "co-authored," — if he has seen no problems due to Babywise principles, why is he going to the trouble and expense to respond to 'critics' and change the book?

In the commentary, he stated, "Actually, it is not demand feeding that we oppose..." That statement absolutely floors me! For the benefit of readers who may not have had the opportunity to read Babywise, the book compares two children, Chelsea and Marisa. It notes that "Chelsea's mom follows the principles of PDF [parent-directed feeding]" while "Marisa's mom is following a demand-feeding approach." (P. 42, 43).

On p. 43 it is stated: "The erratic nature of the demand-feed (or free-feed) theory negatively impacts Marisa's metabolism." Further down the page, it says that "...lack of regularity sends a negative signal to the baby's body, creating metabolic confusion that negatively affects his or her hunger, digestive, and sleep/wake cycles." Where are the references for any of these statements? Is there a single article in the medical literature that discusses metabolic confusion secondary to demand feeding? A Medline Search of over 2,000 articles found none. Or is this a new theory, developed for the purpose of this book sounding medically authoritative to the uninitiated parent?

On page 45-6, it gives a list of the benefits of PDF; again comparing Chelsea with her demand-fed cousin. "Chelsea's metabolism is stable...Chelsea's digestive system will have fewer problems with colic-like symptoms when compared with her demand-fed cousin... at week 12 [Marisa] will still be waking twice in the middle of the night and is apt to continue in that pattern for the next two years." The book goes on to say the "stimulus barrier" of a demand-fed child does not mature quickly, and the child experiences restlessness and startles easily at the slightest sound, both during the day and the night. A demand-fed child is dependent and becomes hysterical at being removed from her mother. Learning disorders are associated with nonstructured styles of parenting [as in demand-feeding] including deficiencies in sitting, focusing, and concentrating. On p. 47, a list of benefits of PDF for the mother are noted as the two children are compared. "Marisa's mom tends to be "strung out" emotionally....is in bondage to her daughter's unpredictability...the nature of demand-feeding forces Marisa's mom to provide numerous periods of snack feeding. Many moms who feed their babies on demand are so tired that they prematurely give up breastfeeding....nursing so often that sometimes let-down is delayed...or may not occur at all...postpartum depression, [a] condition not unusual for mothers whose bodies are worn out from the absence of structure...not in the mood for seeing anyone...Chelsea's mom has less maternal anxiety...Marisa's dad is not part of the management team..."

On p. 52 it is announced that "demand-fed babies don't sleep through the night." That is going to come as a surprise to the thousands of parents who feed their babies on demand and whose babies sleep through the night when appropriate for that individual baby. On p. 55 it states that "with the way Marisa is being fed, any programmed stability will be a matter of chance. That's why Marisa will probably take two years before she sleeps through the night, and why she is a candidate for sleep-related problems in childhood.">

After all of these statements which are directly attributed to demand-feeding, Dr. Bucknam can then say that he doesn't oppose demand-feeding? Perhaps just one more quote, this one from the June 2, 1997 Ft. Lauderdale Sun-Sentinel entitled "Time to Eat?" will give the readers a sense of how Dr. Bucknam really feels about demand feeding: "Babies fed on demand, by contrast [to parent-directed feedings], quickly grow used to immediate gratification. Buckman says: 'As they get older, every whine is an opportunity to feed. They become more demanding. They become brats." In essence, what Dr. Bucknam has said is that following the new AAP Breastfeeding Policy and Recommendations will produce a nation of brats. I'm sure the AAP Workgroup on Breastfeeding will be thrilled to hear that.

Jan Barger, RN, MA, IBCLC