Unsubstantiated Medical Statements

There are numerous medical statements made throughout `Babywise' without any references or research backing it up, many of these are the antithesis of well known medical research, even though Dr. Bucknam claims that Babywise contains "medically sound principles" (p. 14). A few of these examples by Mr. Ezzo and Dr. Bucknam follow. Some of the statements contain the names of fictional examples, Chelsea - a parent directed fed baby, and Marissa - a demand-fed baby.

• "Attachment parenting theories are not well grounded on an impeccable body of evidence" (p. 38). [2001: "attachment parenting theory...is driven by an interesting but unproven philosophical assumption--birth trauma." The paragraph equivocates by adding that "theories of attachment" are actually the "generally accepted truth that infants are born with the capacity and need for warm, loving, and intimate relationships. When these relationships are secured from loving parents, the foundation for all future emotional bonds is established."(p 32, 2001)]
• "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" (p. 43). "Parent-directed feeding provides necessary guidance. It establishes for baby a rhythmic structure which helps hunger cycles synchronize with planned wake and sleep times....In contrast, erratic feeding periods confuse an infant's young memory....there is no chance for the hunger/wake/sleep mechanism to stabilize. Baby is confused, uncomfortable, perhaps insecure. This absence of routine for baby typically breeds unhealthy sleep patterns."
• "Medical authorities know that when you deal with life-and-death situations, babies thrive better when fed on routine as compared to nonroutine feedings" (p. 44).
• "A breast feeding mom is more likely to be successful with a daily infant plan than with random feeding periods" (p. 44). [2001: "Chelsea's mom feels healthier as a result of her established feeding routine." (p. 44, 2001)]
• "Chelsea's digestive system will have fewer problems with colic-like symptoms when compared with her demand-fed cousin" (p. 45).
• "Between the third and eighth week, her [Chelsea's] mom can expect her to begin sleeping seven to eight hours straight through the night. Chelsea will probably sleep ten to twelve hours per night by week twelve" (p. 45).
• "Learning disorders associated with nonstructured styles of parenting-including deficiencies in sitting, focusing, and concentrating-are minimized with routine" (p. 46).
• "Mothers who are constantly attentive by way of baby slings, shared sleep, and demand feeding, all in hopes of fostering security, too often accomplish the opposite" (p. 46).
• "Marissa's mom tends to be "strung out" emotionally. . . in a sense is in bondage to her daughter's unpredictability. . . many moms whofeed their babies on demand are so tired that they prematurely give upbreast-feeding. . . Marissa's mom nurses her baby so often that sometimes her let-down is delayed, frustrating her child. Or worse yet, her let-down may not occur at all. . .Marissa's mom had a terrible bout with postpartum depression. Her condition is not unusual for mothers whose bodies are worn out from the absence of structure. . .Chelsea's mom and the other mothers who follow PDF have less maternal anxiety thanmothers who choose to demand-feed" (pp. 46-47).
• "Demand-fed babies don't sleep through the night" (p. 52).
• "Healthy, full-term newborns have a predisposition for continuous nighttime sleep by the eighth week. Newborn sleep cycles do not stabilize until hunger and digestive patterns are stabilized. Routine parental interaction helps stabilize hunger patterns. Inconsistent parental interaction fosters irregular hunger patterns, thereby creating instability in the child's sleep/wake cycles" (p. 53).
• "Babies know when they are hungry, but they are not capable of regulating their hunger patterns. And yes, babies know when they are tired, but they are not capable of establishing stable sleep/wake cycles on their own. Parental guidance is necessary" (p. 54). [page 47 in Babywise 2001]
  
• "Erratic feeding periods confuse an infant's young memory. Since the parental response changes from day to day, often hour to hour, there is no chance for the hunger mechanism to stabilize. With the way Marissa is being fed, any programmed stability will be a matter of chance. That's why Marissa will probably take two years before she sleeps through the night, and why she is a candidate for sleep-related problems in childhood" (p. 55).
• "Whether feeding is accomplished by a bottle or the breast is not as important as the gentle and tender cuddling you give him during feeding" (p. 63).
• "A mother who takes her baby to her breast twelve, fifteen, or twenty times a day will not produce any more milk than the mom who takes her baby to breast six to seven times a day" (p. 65). [reiterated in Babywise 2001 using 12/15/20 contrasted to 8/9 p 67]
  
• "Too many snack feedings (with too little time between feedings) may reduce proper stimulation; too few feedings (too much time between feedings) reduces milk production" (p. 66). [reiterated p 68]
  
• "Consistently feeding sooner than two and one-half hours can wear Mom down, causing a decrease in milk production" (p. 67). [reiterated using 1.5 to 2 hours--p 74]
  
• "Mothers following PDF have little or no problem with the let down reflex, compared to those who demand-feed" (p. 68).
• "Demand-fed babies tend to snack all day. PDF babies have a complete meal at each feeding. The child who nurses frequently and takes in fewer ounces of milk will naturally be hungry more often. In contrast, the child on PDF takes in more ounces of milk at a feeding, thereby causing the digestive and absorption processes to take longer" (p. 69).[reworded: Breast milk is digested faster than formula, but that doesn't justify unlimited breast-feedings to try and play catch-up. Rather than comparing breast milk to formula, it's more useful to look at the amount of breast milk consumed at each feeding. The AP style of demand-feeding does not distinguish between snack time and mealtime. For these mothers, a feeding is a feeding. The child who nurses frequently and takes in fewer ounces, especially of foremilk, will naturally be hungry more often. PDF moms look to deliver full meals at each feeding.--p70]
  
• "Between nine and twelve months, the nutritional value of breast milk drops and food supplements are usually needed" (p. 73). [p. 79]
  
• "Formulas these days have properties closely matched to those of breastmilk, including the proper balance and quantity of proteins, fats, and carbohydrates" (p. 76). [p. 82]
  
• "The average number of feedings in a twenty-four-hour period [for a newborn to eight week old] will be seven to eight before your baby is sleeping through the night, and six to eight feedings afterwards. Although you will be dropping the nighttime feeding at this point, you will not be reducing your baby's caloric intake, just rearranging the time of intake" (p. 102).
• "There are some little ones whose internal clocks get "stuck" at the nighttime feeding. Parental guidance can help reset that clock. If you have a digital timepiece and notice that your baby is waking at nearly the same time each night, that's a strong indicator that his or her biological clock is stuck. To correct the problem, wait for a weekend when no one has to get up early for work. (You may want to sleep in if your sleep is disturbed by your baby's crying during the night .) When your baby awakens, don't rush right in to him or her. Any crying will be temporary, lasting from five to forty-five minutes. Remember, this will be temporary! Some parents fear that failing to respond right away will make their baby feel unloved or insecure. On the contrary, it's cruel not to help your child gain the skill of sleeping through the night. Taking the baby into bed with you will delay the learning process" (p. 112). [Mostly reiterated in Babywise 2001 p 124]
  
• "There may be a brief period of fussing or crying when you put the baby down for a nap. Don't be deterred from doing what is best for the child. Crying isn't the terrible beast that some of the last generation of medical practitioners thought it was. Some crying is a normal part of a baby's day and some babies will cry a few minutes in the process of settling themselves to sleep. The future trade-off will be a baby who goes down for a nap without fussing and wakes up cooing. Crying for 15-20 or even 30 minutes is not going to hurt your baby physically or emotionally. Your baby will not lose brain cells, experience a drop in IQ, or have feelings of rejection that will leave waking hours with a few minutes of crying. On the other hand, if you want a fussy baby, never let him cry, and hold, rock, and feed him as soon as he starts to fuss. We guarantee you will achieve your goal" (p. 118-119).
  "Seventy percent of PDF babies drop the middle-of-the-night feeding on their own. The remaining thirty percent need a little nudge. This may involve some crying, which might continue for as little as five minutes or last as long as one hour, off and on. It usually takes three days to establish unbroken sleep cycles at this age" (p. 120).
• "Immediate-gratification training negatively impacts a child's ability to learn the skills of sitting, focusing, and concentrating" (p. 128). ["Research has clearly demonstrated that immediate-gratification training negatively impacts a child's ability to learn, affecting the skills of sitting, focusing, and concentrating." p.141]
  
• "It is commonly observed that babies under the parent-directed-feeding plan tend to cry less in the long run than babies who are demand-fed"(p. 129). ["Babies under the parent-directed feeding plan tend to cry less in the long run than babies who are demand fed." -p 141]
  
• "With demand-fed babies, cries are unpredictable, leaving mom and dad guessing and anxious" (p. 130).
• "Because Marissa is not on a routine, she is much more likely to be a fussy baby" (p. 135). ["Since Marisa lacks routine in her life, she is much more likely to be considered a fussy baby." p. 149]
  
• "Colic, which basically is a spasm in the baby's intestinal tract that causes pain, is very rare in PDF babies but is intensified in demand-fed babies" (p. 135). [Changed to: "There is much disagreement as to the true origin of this overused condition. In Dr. Bucknam's medical practice and in testimonies from hundreds of former demand-feeding mothers, bouts of colic-like symptoms are substantially reduced with PDF. The last thing you should put into an irritated stomach is food.....If your child does suffer from colic, the best thing you can do is to keep that child on a routine. This allows his or her stomach to rest between feedings".--p. 149-150]
• "Although some women find themselves depressed and weepy several days after giving birth, not all women experience postpartum depression. Many who do have certain traits in common-they're not on a routine, they nurse frequently, and they are up several times during the night--all of which leave them in a perpetual state of exhaustion. Each of these symptoms can be traced back to the strain that lack of routine puts on a mother" (p. 156). [p. 186]
• "If you use a sling, do so thoughtfully. In our opinion, much more developmental damage is done to a child by holding him or her constantly than by putting the baby down. . . In terms of biomechanics alone, carrying a baby in a sling can increase neck and back problems, or even create them" (p. 159-160). [ "In terms of biomechanics alone, carrying a baby in a sling may increase neck and back problems, or even create them"--p190]
• "Some researchers suggest that putting a baby on his or her back for sleep, rather than on the baby's tummy, will reduce the chance of crib death. That research is not conclusive, and the method of gathering supportive data is questionable" (p. 166). [Changed to: Today research strongly suggests and the American Academy of Pediatrics recommends that putting a baby on his or her back for sleep, rather than on the baby's tummy, reduces the risk of SIDS. What is not conclusive is whether back sleeping is the primary or secondary factor in the reduction of risk. Does the supine position (wholly on the back) remove the child from soft surfaces and gas-trapping objects(mattresses, pillows, crib liners), which could be the actual risk facto, or is ti actaully the biomechanics of tummy-sleeping? MOre research is need to answer that question. Meanwhile, we suggest you speak to your health care provider if you have any questions concerning SIDS and the positioning of your baby. Parents ask us if back positioning will interfere with the establishment of healthy sleep. The answer is no."--p 196]
• In a question and answer section:
  

  Question: "My two-week old daughternurses on one side, then falls asleep. Two hours later, she wants to eat again. What should I do?

  Answer: You need to keep your baby awakeduring feeding time. . . Babies learn very quickly from the laws of natural consequences. If your daughter doesn't eat at one feeding, then make her wait until the next one. That will probably only happen once. Don't feed her between routine mealtimes; otherwise, you are teaching her to snack, not eat" (p. 180).[Reworded and changed to:

  If she is hungry, feed her, but work on keeping your baby awake to take a full feeding from both breasts. Here are some ideas: Change her diaper between sides; undress her; rub her head or feet with a cool, damp washcloth. Do what you must to keep her awake. Then finish the task at hand. Baby must eat. If you allow baby to snack, she won't argue with that. Babies learn very quickly to become snackers if you let them. If your baby increasingly becomes characterized by snacking, you must work on stretching the times between feedings to make the 2 1/2 hour minimum. p 175]
  

• Again, in a question and answer section:
  

  Question: "My baby is eight weeks old and has not yet slept through the night. What should I do to eliminate the middle-of-the-night feeding?

  Answer: If he is waking every night at basically the same time, then he is waking out of nighttime habit and not out of need. If that's the case, you may need to help him eliminate the feeding period by not physically attending to him. Normally it takes three nights of some crying before the habit is broken. He will never remember those three nights, nor will they have any negative effects on him" (p. 182). [Reworded on page 178, example changed to 10 week old baby, other options listed, and the statement "nor will they have any negative effects on him" has been changed tot, "Helping baby learn this behavior has positive long-term benefits on you both."]