At 09:19 PM 5/21/98 -0500, Eve, Seth and Amina Switzer wrote:
>Anyone else been getting into discussions (especially with parents)
about
>the book "On Becoming Babywise" by Ezzo? I read an article
in AAP news
>about the link between this parenting book and dehydration, failure
to
>thrive.
>Eve H. Switzer, M.D.
I saw the same article and it was the first I'd heard of
"Babywise". Fortunately, nobody has asked me about it yet. Of
course I don't know if some families are following it and not discussing
it. Based on the information in the article, I'd agree that it could be
concerning if a family followed the advice too strictly.
It somewhat reminds me of what I tell families who want to put neonates
and young infants on a "schedule". I ask, "What if the
baby cries before their scheduled feeding time?", and they always
answer, "We'll feed him." And if the baby sleeps past the
scheduled feeding time, "We'll let him sleep." Well, if
they're not going to stick to the "schedule" that they, as
parents, have decided their newborn should conform to, then it's not much
of a "schedule", is it? Usually they get the point, but if
there's a pushy grandparent or an old-fashioned baby nurse involved, look
out.
But once you've given parents carte-blance to tend to their newborn's
every need, you need to be prepared
to discuss modifying this behavior as the infant ages. I think there's a
difference between demand feeding in a neonate and sleep problems in an
older infant. I have not read either "Babywise" or Richard
Ferber's "Solve Your Child's Sleep Problems" cover-to-cover as
Adriana Samargia Kaufman has, but what each book is advocating (as I
interpret it) is, essentially, discipline. I think you can define
discipline as applying an appropriate consequence in response to an
undesirable or inappropriate behavior in the hopes of discouraging future
similar behaviors. And, of course, we all have our own idea of what is
considered undesirable or inappropriate behavior (as well as having our
own ideas of what is an appropriate consequence). We all would agree (at
least I'd hope) that a toddler biting or a pre-schooler running amok in a
grocery store are behaviors which need to be dealt with and should not be
tolerated.
Sleep training is an issue with a lot of emotions on all sides (I
remember the thread from a number of months back). A newborn who is
demand feeding every 1-1/2 to 3 hours is not only exhibiting normal, but
physiologically necessary behavior. I think a 6 to 12 month old getting
up 3 or 4 times at night to eat is exhibiting a behavior which, at least
in the United States, is considered unacceptable by the majority of
parents (and a sleep-deprived parent, in most cases, is a less effective
and less happy parent).
Night feeding in older infants is a psychological want, not a
physiological need (IMHO). Night waking in a six month old may be just
as "normal" as a tantrum in a two year old. But just like
it's O.K. to tell a screaming 2 year old, "No, you can't have that
candy no matter how much you cry", I think it's O.K. to tell a
screaming 6 month old, "No, at 2 am you can't have a feeding no
matter how much you cry."
There comes a time in every child's life when they will learn that,
although they will be given what they
need (and much of what they
want), they don't get
everything they
want. I don't think
that six months is too young to start learning this . Families who say
at six months, "But he needs those middle of the night
feedings" are frequently the same ones saying "But he needs all
that juice" at age two, "But he still needs his bottle" at
age three, and "He needs to run free" in the restaurant at age
four. There's a name for children who are not given age appropriate
discipline: spoiled brat.
I'm a little sensitive to lack of discipline now. A four year old in my
practice probably has ambylopia but will not cooperate for the
ophthalmologist because, according to his mother, "he doesn't want
to." This child has been a terror his whole life, I don't think the
word "NO" has ever passed his mother's lips, and the child is
the one who has suffered because of it. She finally admitted at the
most recent visit that, well, maybe, he's a little spoiled. Well, it's
never too late to start appropriate discipline, but by age four this
child has already developed a pattern which would be
really hard
to reverse even by a parent who does have a backbone.
Michael Sachs, M.D.
General Pediatrician
Michael Sachs, M.D.
General Pediatrician