Peaceful Parenting: โ€˜Babywiseโ€™ Linked to Babies’ Dehydration, Failure to Thrive

By Matthew Aney, M.D.

THE OFFICIAL NEWS MAGAZINE OF THE AMERICAN ACADEMY OF PEDIATRICS
Volume 14 Number 4

“Expectant parents often fear the changes a new baby will bring, especially sleepless nights. What new parent wouldnโ€™t want a how-to book that promises their baby will be sleeping through the night by three to eight weeks?

One such book, On Becoming Babywise, has raised concern among pediatricians because it outlines an infant feeding program that has been associated with failure to thrive (FTT), poor weight gain, dehydration, breast milk supply failure, and involuntary early weaning. A Forsyth Medical Hospital Review Committee, in Winston-Salem N.C., has listed 11 areas in which the program is inadequately supported by conventional medical practice. The Child Abuse Prevention Council Of Orange County, Calif., stated its concern after physicians called them with reports of dehydration, slow growth and development, and FTT associated with the program. And on Feb. 8, AAP District IV passed a resolution asking the Academy to investigate โ€œBabywise,โ€ determine the extent of its effects on infant health and alert its members, other organizations and parents of its findings.

I have reviewed numerous accounts of low weight gain and FTT associated with โ€œBabywiseโ€ and discussed them with several pediatricians and lactation consultants involved.

The bookโ€™s feeding schedule, called Parent Directed Feeding (PDF), consists of feeding newborns at intervals of three to three and one-half hours (described as two and one-half to three hours from the end of the last 30- minute feeding) beginning at birth. Nighttime feedings are eliminated at eight weeks.

This advice is in direct opposition to the latest AAP recommendations on newborn feeding (AAP Policy Statement, โ€œBreastfeeding and the Use of Human Milk,โ€ Pediatrics, Dec. 1997): โ€œNewborns should be nursed whenever they show signs of hunger, such as increased alertness or activity, mouthing, or rooting. Crying is a late indicator of hunger. Newborns should be nursed approximately eight to 12 times every 24 hours until satiety…โ€

Although demand feeding is endorsed by the Academy, WHO, and La Leche League among others, โ€œBabywiseโ€ claims that demand feeding may he harmful and outlines a feeding schedule in contrast to it. The book makes numerous medical statements without references or research, despite that many are the antitheses of well-known medical research findings. In 190 pages, only two pediatric journals are referenced with citations dated 1982 and 1986…”

 

…My review of the low weight gain and FTT accounts associated with โ€œBabywiseโ€ revealed several disturbing trends. Parents were often adamant about continuing with the feeding schedule, even when advised otherwise by health care professionals. They were hesitant to tell their physicians about the schedule, making it difficult to pinpoint the cause for the weight gain problems. Many elected to supplement or wean to formula rather than continue breastfeeding at the expense of the schedule. The parentsโ€™ commitment call be especially strong when they are using the program for religious reasons, even though numerous leaders within the same religious communities have publicly expressed concerns.

Pediatricians need to know about โ€œBabywiseโ€ and recognize its potential dangers. History taking should include questions to determine if parents are using a feeding schedule, especially before advising formula supplement to breastfeeding mothers or when faced with a low-gaining or possible failure to thrive baby. Lactation consultants also should be instructed to probe this area.
Efforts should be made to inform parents of the AAP recommended policies for breastfeeding and the potentially harmful consequences of not following them.

Dr. Matthew Aney is an AAP candidate fellow based in Lancaster, California.

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Here is the chat we had about this article on my Facebook Wall:

Those books should be burned…
THE OFFICIAL NEWS MAGAZINE OF THE AMERICAN ACADEMY OF PEDIATRICS Volume 14 Number 4 Expectant parents often fear the changes a new baby will bring, especially sleepless nights. What new parent wouldnโ€™t want a how-to book that promises their baby will be sleeping through the night by three to eight…

Likeย ยทย ย ยทย Shareย ยทย Monday at 8:57pm
  • Sheila Stubbs,ย Christina Binkleyย andย 2 othersย like this.
    • Kathryn Redd Trippย I always buy them from thrift stores and then I throw them in the garbage. That is where they belong!

      Yesterday at 4:24amย ยทย Likeย ยทย ย 2 people
    • Jenny Hatchย Great idea, I personally know several people whose children had to be hospitalized for dehydration…did you know the author practices here in Louisville? Several ladies in my ward use him as pediatrician and they are the ones whose breastmilk dried up quickest…

      Yesterday at 6:38amย ยทย Like
    • Lisa Paul Middlemasย ยท Friends withย Kathryn Redd Tripp

      Hee hee. . .Kathryn! You sneaky mom, you. . .! (And, way to go!!!!)

      Yesterday at 7:11amย ยทย Likeย ยทย ย 1 person
    • Helen Rehart Fagerburgย Ugh. He should definitely loose his medical license. That doesn’t get rid of the book, but it’s a start.

      Yesterday at 7:37amย ยทย Likeย ยทย ย 1 person
    • Kathryn Redd Trippย He practices in Louisville? And some of your ward members use him as a pedriatrician?!? How many? That makes me feel sick and angry and oh so many things! ARGH!!! Mostly just sad.

      Yesterday at 9:21amย ยทย Like
    • Jenny Hatchย I should be more careful, I am friends with a bunch of ward members on facebook! But they all know how I parent. I try not to get in anyones face about it, we all have to live and learn by our own experience to know the bitter from the sweet, but I get mad when new Moms are all excited about using him as their ped, tell me they want to breastfeed, and then it all comes crashing down when they follow his pathetic advice, I wish a group of parents would sue him for malpractice.

      Yesterday at 9:44amย ยทย Like
    • Janet Edwardsย New parents should remember mercy to those who can’t care for themselves.

      Yesterday at 12:08pmย ยทย Like
    • Jenny Hatchย Not Ezzo, it is Bucknam that has the practice here. Just look at this article from Boulder Weekly ( note the date )

      Yesterday at 1:11pmย ยทย Like
    • Jenny Hatchย http://www.rickross.com/reference/gfi/gfi3.html

      www.rickross.com

      A new parenting book, co-written by a Louisville doctor, is stirring up contr…See More
      Yesterday at 1:11pmย ยทย Likeย ยท
    • Kathryn Redd Trippย I will.

      Yesterday at 1:17pmย ยทย Like
    • Sheila Stubbsย This is where I blog against babywise lies.http://unbecomingbabylies.blogspot.com/2010/04/sleep-training-natural-way.html

      unbecomingbabylies.blogspot.com

      It is very unbecoming behavior to tell lies. When someone tells lies that harmย …See More
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Stand and Deliver: Breastfeeding History Moment: LDS Sacrament Meeting 1871

Rixa has an interesting post from Mormon History:

“From this illustration I learned several things about the culture and practice of breastfeeding at this time & place (probably Utah):

1) Public breastfeeding was accepted as normal in mixed company and during worship services.
2) LDS women breastfed in public without a cover or blanket.

3) The norms of dress at the time meant women unbuttoned their dresses at the chest area to nurse. In the closeups below, you’ll see that the collar of the dress remains buttoned up at the neck.”

I nursed my babies in church, most often in the mothers nursing room, but if it made sense to stay where I was, I just nursed in Sacrament Meeting. ย I had a couple of Motherwear Dresses and always used my sling for privacy, and usually only my hubby knew the baby was latched.

Jenny Hatch

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My Unassisted Childbirth Story and Video

When Faith Endures

by Jenny Hatch

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Benjamin

I had many contractions during my pregnancy but five days before Ben was born things changed and I had some contractions that came every five minutes that were really hard and opened my cervix enough that I started to pass some mucous plug with lots of bloody show. I was excited and felt happy that after so many years of hoping for another baby, my empty arms would soon be filled.

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That afternoon my contractions picked up and I thought I was in true labor. Physically they took all of my energy. Emotionally I found that I had a battle on my hands. The battle can be summed up as a type of spiritual warfare. It was not just my battle. My husband Paul also experienced five days of his own fight. For him, the fears swirled around his issues with the powers that be. We had an unassisted birth six years before that resulted in a transfer to the hospital.

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The most critical post birth complications are Baby not breathing and Mom bleeding. With that birth we had both problems crop up, and decided to call 911 for assistance. I am grateful for the help we had after our birth, and for the learning that resulted from not having things go well. Had everything gone perfectly, we would have missed a great opportunity these past six years, the opportunity to learn more. I did much research on bleeding issues and Paul took an infant CPR class. These efforts comforted us and helped us to feel more prepared this time around.

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Even with these preparations and our deep religious faith, the five days before Benjamin’s birth was a time of trial. Our faith in natural childbirth and unassisted birth in particular was put to the test.

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After the birth Paul said he thought those five days were for him, to battle it out in his mind. To determine the type of life we were going to live, and whether or not we would cave to the pressure – mostly internal pressure (but based upon a fearful reality) to conform to society and live a mainstream life. Or if we were going to overcome our fears of being labeled and/or prosecuted as “medical neglecters” by doctors and social workers and live the life we have felt guided to with home birth, home school and what I term “Family Sovereignty” as the ideal for our family.

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Happily our battle resulted in a perfect outcome on all levels; emotionally, spiritually, and even though I had a difficult time physically – I was much more concerned about the long term affects of this birth on my psyche, my marriage, and my relationships than I was on the short term physical pain.

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I hope my insights will be helpful to those of you who are preparing for an unassisted birth. We must understand that Laura Shanley is right, and it is our beliefs as mothers that largely affect our birth outcomes. Our husbands and families beliefs also deeply affect us, as well as anyone else we decide to invite into our home to assist us with the labor.

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Because I can’t control how others feel about birth and only have control over my own mind, I was drawn to unassisted birth as a means of SAFELY welcoming my children without having to deal with other people’s fears. I felt this negativity during my three hospital births, especially from the medical people around me. I studied Quantum Mechanics in college and didn’t understand why these so called scientists hadn’t embraced these same truths in their physics classes. But perhaps their obstetrical educations had deprived them of the truth surrounding belief.

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If I learned nothing else during my first solo birth, I learned that birth for me was easy, unhindered, and smooth when I was alone. (I called Paul up to help me during Andy’s birth in 1996 only after I had pushed out his head).

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JennyOn Sunday night, October 20th 2002, my contractions completely stopped and we enjoyed a quiet spiritual evening with our older children. We talked to them about birth and told them stories from their own labors that illustrated the true nature of natural childbirth with its many stops and starts. We sang and prayed together and all went to bed excited, but willing to wait.

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The next day, I again had a long period of pre-labor that lasted for hours. I passed more mucous plug and felt the contractions really getting strong. It had been a full moon that night and I enjoyed watching the moon go down out of my west facing bedroom window as I contracted in the birth pool during the early morning hours of Monday. I heard the children start to wake up and felt things slow down and then I fell asleep in the water. When I woke up everything had stopped.

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That day I went about my normal routine but Paul decided to work from home. He ended up working from home all week. This was one of the happiest weeks we have ever had. We decided to let the children take the week off from schoolwork and spent hours playing at the park, walking, and cooking/eating together. On Monday night I walked to my exercise class and as soon as I sat down on my mat, my water broke. It was all over my pants and the mat, and I decided to go home. Once home, I again felt excitement/nervousness that my baby would mostly likely come soon. None of my previous labors had started with the water breaking and so this was new for us.

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I was surprised how much fluid spilled out of me over the next 72 hours. It was a lightly tinged green color and smelled alive, like a fresh rain on autumn leaves. I noticed that each time I ate, drank, or walked the fluid came out in a gush. I used cloth diapers to catch it and was really surprised that my body could leak so much without going into labor. I mourned the loss of my water birth. With the membranes ruptured and water leaking all over the place I knew it would not be wise to get into the pool. I really focused on staying well hydrated, nourished, upbeat, and rested. I also asked my doula to come give me a few massages and bring me wheat grass juice. I used the juice to help keep my blood clean, hematocrit up, and to nourish the baby.

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My daughters gave me a raindrop therapy each of those three days. (If you want to order the raindrop therapy kit go to Young Living and use my member number 29526 to get this fabulous aromatherapy kit!) This is an essential oil treatment that is an overall boost to the body. I did it to help prevent infection and to give me energy. We made the decision not to tell anyone that my water had broken. We told the kids, but asked them not to share the news, and they didn’t.

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I had a few contractions but nothing regular for the three days my water was broken and that was a blessing as the uterine activity of Sunday had really tired me out. I took lots of naps and spent most of my emotional energy working on my thoughts, keeping them pure. It was very powerful for me to run the lyrics to some of my favorite songs through my mind. I will share the words from one of these songs. The music helped me to stay focused on my child and not get lost in fear, the greatest of which was the fear of a prolapsed cord.

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Paper Dream – Reprise 2 (From the musical Saturday’s Warrior)

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I take some paper in my hand, and with a pencil draw a man,
The dream of what I’d really, really like to be.
A man with courage in his brow, whose licked his doubts and fears somehow,
A Warrior of great nobility.
But who am I? Just a wandering kid, a cipher on the wall,
Not even brave at all.
And where’s my dream like his that I would fight for?
And where’s my cause like his that I would die for?
But still the paper’s in my hand and every day I sketch the man,
The dream of what I’d really like to be.
A man with courage in his brow, whose licked his doubts and fears somehow.
A Warrior of great nobility.
A brave and noble fiery youth, who’s not afraid to die for truth
Whose tall and straight but best of all he’s free,
He’s free.

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I ran the words to this song through my mind a hundred times over those three days, and each time they gave me strength and courage. I also sang hymns, quoted myself scripture and belief suggestions and realized that during this time it was crucial that I stay mindful of my thoughts every waking moment. Each time the fear would come into my heart; fear of infection, fear that I would never go into labor, fear of prolapsed cord, and fear of someone learning that my water had broken and might try to convince me or force me to be induced, I would just switch the negative thoughts to positive and run the words through my mind, usually the words to the above quoted song. A few times I went down to my piano and played the music of this song, and each time I started to cry as I thought of my warrior son who was soon to be born. It was a comfort to me to cook and clean and stay focused on my housework as a way to distract myself from the reality of the situation (two full weeks overdue and water broken). The day before I went into labor I found myself cleaning under my stove and scrubbing it all over. I thought about deep cleaning my oven, but I decided to save that task for another day.

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The day I went into labor was just a normal day. I went for a walk, had a massage, tended my nephew and cooked and cleaned. We took a few pictures and my visiting teachers stopped by. About 5PM I came downstairs to make a milk shake with calcium/magnesium and minerals and then I decided to check my emails. I was writing to my friend Veronika Robinson when contractions really picked up. As I typed out my email to her, I told her I thought I might be going into real labor, and once finished I headed upstairs to my bed. I laid down in a semi reclining position with lots of pillows supporting my back, my arms and legs. I contracted for two hours with little noise, but as things picked up in intensity, I started to vocalize loudly. As the contraction would start I would start a low moan that gradually became a loud AHHHHHHHHH! This very effectively moved all of the energy in my uterus up out of my body through my mouth and made it so I was able to handle the first five hours of this six hour labor very effectively on my own.

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Paul and the children were in and out of the room a few times asking me if I thought this was really it, I was in my own space and was rather vague about my progression. Paul did bring me a couple of hot, wet cloth diapers to place on my bottom and I used my oils; Gentle baby, Valor, Panaway, and Myrrh to help my body stretch and prepare.

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At one point I was all alone as Paul had fallen asleep in the children’s room on the floor while reading them stories, and one by one they also fell asleep. I used the toilet a few times to keep my bladder empty but always returned to my position on my back on the bed. At one point I sang the song “When you Believe” from The Prince of Egypt out loud. I had chosen this song to be the theme song of the Unassisted Childbirth movement back in 1998. The words are perfect, powerful and were a great strength to me as I approached transition. I was battling a fear that one of the reasons I bled so badly with my last birth was because I had squatted during pushing, and so I was determined to push the baby out on my bed in the semi reclining position. I continued to gush amniotic fluid during the labor and focused on staying well hydrated with a water bottle by my side.

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During transition, which only lasted a few minutes, the contractions were one on top of the other and I was VERY loud with my vocalizing. Paul woke up during this time and came in and asked me how things were going. He wanted to know if he could do anything to help and I asked him to sing me hymns. So he sat down on my rocking chair and pulled out the hymnbook and started singing. He sang for the first hour of my pushing. I cannot emphasize enough how powerful an activity this was. It had the combined effect of inviting the spirit of the Lord into our home and calming my spirit. Paul sang “When Faith Endures,” which was the hymn that I had chosen to be the theme of our 2001 Unassisted Childbirth conferenceโ€ฆ.

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I will not doubt, I will not fear. God’s love and strength are always near.
His promised gift helps me to find, an inner strength and peace of mind.
I give the father willingly, my trust, my prayers, humility.
His spirit guides, his love assures that fear departs when faith endures.

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I was starting to get tired after an hour of pushing on the bed and I prayed and asked God which position would be best for me to effectively push the baby out. I felt that I should stand and squat during my contractions. In prayer I expressed my fear of bleeding and I felt a calm assurance that I would not bleed too much. So I stood up. As the next contraction came on I squatted down deeply by my bed and pushed! I felt the baby inch slowly down with each push. In between contractions I sat on my birthing ball and rested. As his head moved down, I felt an increasing pain in my back, hips and pelvis. I have had three painless vaginal births and so this was new for me. I have determined that the difference was pushing with the water bag intact compared to not having much water gushing along with that fifteen inch head. It was like birthing a brick. As his head worked its way down I felt so much pain I wondered if I could do it. Never did I even consider going to the hospital or using drugs, but I did have a few moments of self doubt, wondering how big the baby was, and what if it was breech or posterior? I continued to have the fear of a prolapsed cord and as this fear worked in me, I just felt determined to get my child born.

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I pushed with everything I had using the Bradley technique of breathe in, breathe out, breathe in, breathe out and then deep breath inโ€ฆput chin on chest, hold breath and PUSH!! It was very effective combined with the full squat. During the last few contractions I felt this heat overtake my body and sweat was just pouring off me. I asked Paul to turn on the ceiling fan and then he poured water all over my head and back. I told him to put some Panaway on my back and he tossed about 30 drops of it all over my back and hips. Then he rubbed my lower back during the contractions in a very effective counter pressure. It didn’t take the pain away but it did make it possible for me to do it. On the third to last contraction I felt Ben’s head all of a sudden move in a big way through the birth canal and I reached down and felt his head crowning. I was concerned about tearing, and thought about asking for a hot compress, but decided I wanted Paul behind me ready to catch rather than in the bathroom getting me a cloth. Paul pulled out the bulb syringe and prepared himself.

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With the second to last contraction I pushed out his head, and then with the final one out came his body. These contractions were closer together and he was born quickly from the time he crowned. Paul sucked out his nose and mouth before he was completely born and then caught him. As he passed Ben to me through my legs I turned to look at him and saw him leaping for joy. I have heard of many men fainting in the delivery room, or having a fear of fainting while their wives give birth, but I have never heard of a father jumping for JOY when the baby is safely born. Paul did and it is my favorite memory of the birth.

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Jenny and Benjamin seconds after the birth

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I passed the placenta within fifteen minutes with a large plop, and then bled a little. We used prayer and blessings during this time to help with my pain and various post birth symptoms. The children started to wake up, and one by one they came into our bedroom. We took many pictures and had a joyful three hours bonding with our 9 and ยฝ pound boy. Then the children all went back to bed and Paul and I fell asleep on our bed with Benjamin nestled on his chest.

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After our wedding day, this day was the happiest, most fulfilling day of our life!

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Paul and Ben
Paul and Ben
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The Hatch Family
The Hatch Family

Portrait of Benjamin by Susana Fierro-Baig.

 

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Kittie Frantz is interviewed by Kelly Wagner: Your baby knows

LLL_podcast_2007_LLLIConf_Kittie_Frantz_Your_Baby_Knows

From La Leche League Podcasts

Kittie talks of her early days in La Leche League and in the field of breastfeeding medicine/research, and of her and Chloe Fisher doing paper in Israel, become reprint #11. They discuss her new position at USC and helping educate the medical community, the new video “Getting To Know Your Baby”, medical education videos about breastfeeding and baby Self-attachment

ABC News: Baby Feeding by Moms Friends

Baby Feeding by Moms Friends
Comments on this article
My Comment:

“I was tandem nursing my two year old son and my newborn when A mother in my church community adopted a very ill newborn. He had multiple surgeries to heal his damaged heart and bowell, and when released from the hospital, was not doing well on formula. A woman in our congregation convinced his mother to let some of us breastfeed him to supplement his formula feeds.

Five mothers helped breastfeed him for a few weeks while he recovered from surgery. He had a big turnaround with his health and lived two more happy years before he died at the age of two from his heart condition. This was a very sweet experience for all of us. Nobody pumped, we just latched him on and he nursed like a pro.

I also tried to nurse my best friends baby once when I was tending him, and he used his two new little baby teeth to bite me so hard I bled.”

Jenny Hatch
Babytalk Poll: 45 Percent Say Cross-Nursing is ‘Disgusting’ or ‘Weird’
By ANN PLESHETTE
July 28, 2008 โ€”
Breast-feeding, what many believe to be the most intimate act between a mother and child, is also generally believed to be an act exclusively between a mother and child.
According to experts, however, there is a growing trend of cross-nursing, in which a mother will allow another woman to breast-feed her baby.

Continue reading “ABC News: Baby Feeding by Moms Friends”