My Day

By Danelle Day © 2010


Slowly throughout the day my thoughts have been formulating into somewhat comprehensible words...

You see, as peaceful parenting gains more and more readers, we also gain more and more feedback. Which is great! Wonderful! I am so utterly thankful that this community of peaceful parenting moms and dads has formed - to support each other, encourage, empower, listen, share, and equip each one with resources to make a difference in their own circle of influence. We cannot change the world for all babies out there - but we can make a difference to ONE who is close to us. And each of us has a different 'one' that we know of right now. It is for this baby that I know now, that I work.

However, something has been happening as of late that I should have expected -- and really, should already be immune to. You see, the vast majority of feedback on any given peaceful parenting article is positive - encouraging. In fact, most is quite educated and reflective. Questions arise on occasion, and this is wonderful because it gives us an opportunity to dive deeper into answers that exist.

And with more readers comes more *love* -- but also more disdain. There are the occasional few who are very offended by any given subject matter that we deal with here at peaceful parenting.

There are those who believe circumcision will save the world (literally) and cite every debunked myth, and every Brian Morris and Edgar Schoen article out there, to support their pro-cutting stance.

There are people who believe that artificial baby feeding is superior to breastmilk because, after all, 'experts' have manufactured formula to be perfect. Right?

There are those who believe that children need to be hit - young, hard, and often - in order to learn a lesson. Or they will surely cause problems later in life.

There are people who believe that babies should sleep through the night by the time they are just weeks old, or something is wrong with them and they must learn now!

There are those who feel the 1-in-3 c-section rate is just fine and dandy, and after all, they are all emergencies! These women (myself included) are rescued from birth. Right? Pitocin doesn't do a thing. What domino effect? Epidurals are like candy for babies. It's all good.

There are people who feel that whatever the AAP or CDC or their doctor or their friendwhoisanurse or their mother tells them, is fact. Cold, hard, data that empirical science dare not mess with, or counter, or it surely is blasphemy!

And there are many, many, many who love, love, love to comment on articles before they actually READ the article. Or before they know anything more about the subject than their infallible doctor or friendwhoisanurse or mother has told them...

With such a wide audience, there is nothing that can be posted on peaceful parenting that someone, somewhere, will not take issue with it. No matter what the subject, and no matter how it is presented, there will be at least one person who gets thrown into a tizzy because of the post.

And, to put it simply, I got a little worn out this week from skimming over the *junk* that is sent my way as a result of the soaring popularity of this site.

As I mentioned, I thought I'd be immune to such reactions by now. I taught Human Development & Sexuality for many years - and this is one subject that everyone seems to think they know everything about. Just try to talk scientifically with someone about their sexual health - or the developing sexual well-being of their child. It is likely to be one of the more challenging areas of science. In fact, the same is also true of psychology (another graduate degree I indulged in). And when it comes to parenting...well, everyone knows someone who doesn't fit 'the rule' so this must mean that anything goes and nothing matters - or so I am told. And I am reminded of this often -- "Well, with MY babies we did such-and-such and they are just fine! So this research is bunk!" Hmmm. Yup. Must be.

If there is one thing I have learned, it is that you cannot argue logically with individual perceptions of reality. Humans, in general, are tightly bound to conventional wisdom - the "body of assertions and beliefs that is generally recognized as a part of a culture's common knowledge" (Ruane & Cerulo 2004). Conventional wisdom is as powerful as it is flawed, is central to modern day American society, and is more often than not the source of our beliefs, attitudes, and behaviors. It takes what C. Wright Mills called, "the sociological imagination" to move beyond our individual, (forgive my bluntness - but occasionally delusional), perceptions of reality, private views, personal experiences, and intimate beliefs, and to come to terms with those that are grounded in empirical, research-based evidence and humanity-wide experience. Readers of peaceful parenting require sociological imagination to reflect introspectively and evaluate their personal realm in light of broader social/cultural, historical, and scientific arenas. In fact, any time you delve into scholarly material in any area, sociological imagination is necessary. So, I understand. I'll choose to forgive the ignorance and the lashing-out via anonymous comment posts. The 'delete' button is just a finger's reach away.

In any event, my feelings as of late have been compounded by the fact that there was one baby (boy) born a few weeks ago who I failed to save. He was cut up at birth so as to carry the scars that match his father's. And, also, because his mother thought his amputated little baby penis would be easier to clean than an intact, whole penis. Obviously no research had been done (though ample amounts were sent their way). Clearly there were no discussions with parents who have both circumcised and intact sons -- or they would be ready, willing and able to share the facts of this matter. An intact infant is 'cleaner' and easier to care for any day or night of the week than one who has been subject to surgical amputation after birth.

In addition, there will be another boy born shortly to parents I also know personally. Those who, again, refuse to read into the matter -- beyond the Googled pop media coverage on MSN, Yahoo headlines, and the Morris-and-Schoen sponsored websites (why DO these sites have to pop up first in Google searches?!). In this case Mom doesn't care one way or another about her son's well-being. (Which honestly, trips my brain just a tad -- how can you grow a baby within for 40+ weeks and not care about whether or not he has his one of his most prized body organs painfully chopped apart after birth?! Where does the mothering instinct to PROTECT above all go in cases like this??) So this little one will be cut -- again, to match his father. And no one cares much to pay attention to what is being taken from him. How he will be impacted. What his first days on earth will be like. What this will do to him. How he will respond to such trauma. And what he may have liked to have as a choice as an adult with a fully functioning body. But, after all, newborn babies don't have basic human rights. Do they?

We received word last night that a few of the articles here on peaceful parenting that we were granted permission to post about several months ago are now going to be re-sold as for-profit print publications. As a result, they can no longer be posted here. Those who own the copyright are certainly entitled to this, but it is unfortunate as they are frequently read articles - those which help and encourage many parents out there. Needless to say, I was kind of bummed. $$$ always trumps - even here at pp I guess.

So, with all this festering in my mind, today I took a break from the world.

My cell phone was turned off.

No emails were read.

No messages answered.

No responses formed.

Articles went unedited.

Proposals were left lonely on my desk.

Books begging to be reviewed had to wait.

Instead, my son (17-months & 35-pounds of pure joy!) and I went out on a day-long adventure together.


Our first stop was the National Aquarium. We sat and watched the turtles and the fish and the alligators romp and swim and play. My son ran around and led me to the best aquarium animals to see - with glowing excitement on his face each time he found a new *favorite*. We climbed up on the ledges and peered over railings. We imagined we were fish. S~w~i~m~m~i~n~g. No cares in the world but when we'd get that next tasty morsel to eat. It was a great day to lose myself in the watery world of imaginative toddler play.


Next we ventured over to the White House -- or, more specifically, the park in front of the White House. This is another favorite of my son's because the squirrels here are hand-fed by the war protesters who camp out in front of the White House 24-7. As a result, they are ubber friendly and chatter away as they run up and over your feet begging for a squirrel-scrumptious treat.


My son ran and played and chased the squirrels and we were asked several times if we could pose for a picture with foreign travelers snapping images of the White House. I'm not sure how well my son does at representing the 'average U.S. toddler'... but if that is what they want a picture of, he is happy to oblige with a friendly spirit and a big ol' smile on his face.


After the fish and the squirrels we stopped by Whole Foods (a favorite) for a bite to eat. For some reason Whole Foods is one of very few stores around D.C. where I really feel at home. Not sure if this says something about me. Or something about the store. Maybe a little of both. There is a big sign in the elevator right now with pictures of cattle in a field, that encourages patrons to "learn where your food comes from". Something I, too, feel is very important. I hope to raise children who participate in the process of growing and harvesting and really think deeply about why and how the item they are about to consume is on their plate. To digest not only the food, but the process, from field or animal, to harvest or slaughter, to fridge or stove, to plate and mouth. There is too much that goes on in-between that matters - that which we are not in the habit of learning and contemplating.

After our snack of grapes and an apple and steamed asparagus and black beans (I'm thankful my son prefers vegetables) and a couple jalapeno poppers (my indulgence), he snoozed while we ventured back to our neighborhood. Upon arrival, it was raining. And where there is rain - there are puddles! And where puddles and toddlers meet, there is laughter and fun to be had.


So we tromped out of our vehicle and took a much needed rain walk.

The goal? To see who could splash THE BIGGEST. The smallest. The most. The fastest. The s-l-o-w-e-s-t.

To experiment - does a stick make different ripples than a rock?

Does the wet grass feel different on my feet than the wet sand?

These are the things that toddler minds are made of and ours was on full throttle learning.

Our rain, our puddles, our water, was just what I needed. It served to wash away the crud that had built up over the past weeks as a result of negative things beyond my control.


I sometimes need to let go. Even when it is hard to do. Even when it hurts like crazy and breaks my heart into pieces.

Because, unfortunately, as much as I would like to have the ubiquitous power to do so, I am not in a position to save everyone. From my meager little position in life, I can only do so much.

Ah, yes, I wish often that I had 72 hours in every day. That I had my own personal jet to fly off and answer each and every pressing question that is passed my way. Or to help in times of call or crisis. I wish I had Oprah's influence to end MGM and provide all human babies with human milk. And speaking of Oprah - I wish, too, that I had her money to buy every new parent a co-sleeper/side-car, a subscription to Mothering, The Baby Bond, a Moby Wrap, and an Ergo. I wish I could stay up all night, every night, to feed and rock and comfort your baby - so that you could sleep and no tears would be shed from anyone at your house. Sometimes, I wish so much...

As my son and I rounded the corner for home - soaking wet from head to toe and filled to the brim with love and laughter from our wet winter walk - we paused to get the mail from our box.

Now, on any other day this would be an insignificant event and there would be no reason to tell you. But today, there was something special in the mail that I've never before received - a little treasure that instantly changed the world in a small way.

You see, there was a card from one of you -- from someone I've come to know only online as a result of peaceful parenting. It was from a mother who has requested before that I send a "Prepuce & Circumcision Information Pack" to her friend about to birth a boy. She lives in rural town, USA, where she sometimes feels alone in her gentle mothering ways. Her words touched my soul as I read of how encouraging it has been for her to become a part of the peaceful parenting community. She thanked me for providing this opportunity to get to know the rest of you. My heart smiled. There are few things I love more than connecting people to each other. Sometimes us crunchy parents could really use another one in our pack.

As if her grateful words of kindness were not enough, this mother's card contained something else, too.

She said that she was sending a little $ to reimburse me for the cost of the pack that I had sent to her friend. (Circumcision information packs are $10 each for printing and DVD materials - a bill which adds up quickly with all the requests we receive when people are unable to pay for them, and one I have repeatedly broke my bank account to pay for, because I feel that EVERY baby boy is worth $10).

But as I opened the check, I couldn't keep the tears from rolling down my face when I realized the amount she was sending was much, much more than the cost of her friend's pack. Her gift is enough to provide information packs for many more families out there. It is enough to change countless lives through education. Generations will be impacted by this mother's gift when the babies to be born are protected at birth, peacefully parented, grow up to become gentle fathers and mothers, who in turn protect their own babies.

Just as I was losing hope -- feeling very much like "I can't do this all alone!" -- encouragement arrives in a way I never imagined. And it tells me for sure that there are many of you out there who care just as much as I do. You who are willing to put your own time and resources and energy and anything it takes on the line to make the world a little more friendly to live in. To save just one more - and impact life forever. In her outstanding book, Why Love Matters, Sue Gerhardt describes how her research in neurology and psychology led her to believe something I, too, have found true throughout my years of study. "If the will and resources were available, the harm done to one generation need not be transmitted to the next: a damaged child need not inevitably become a damaged and damaging parent," (Gerhardt 2004).

Gerhardt goes on to use the analogy of a house that has been poorly built. We can continue to pour money into this house, and the problems that arise may be temporarily curtailed. But nothing changes the fact that the house was not well built, with a solid foundation, and one that would otherwise hold up to the storms that surmount. The poorly built house will always be high maintenance and will never function as optimally built houses are meant to. "Likewise with human beings whose foundations have not been well built," writes Gerhardt. "Although expensive repairs may be undertaken later in life, the building stage - when adjustments can be made - is largely over. For prevention to be effective, it needs to be targeted at the point when it can make the most difference," (Gerhardt 2004). And these foundations -- by far thee most important times of a developing human's life -- are the first 3 years on this earth. It is at this time that the brain is shaped and built. Emotions and social style are learned. And the next generation is woven together. Parenting matters! Big time. And as a result, our efforts to empower and inform and equip those around us is vitally important - to that mother or father, to their baby and child, and to the future we will see unfold around us.

So tonight, as my day draws to a close and I tuck my son into (our) bed with stories and love and momma milk, I have a heart that is refilled with hope for a peacefully parented world.

Thank you, Jesse, and all the others who have encouraged me along this journey.





References

Gerhardt, Sue. (2004). Why Love Matters: How Affection Shapes a Baby's Brain. Routledge: NY.

Ruane, Janet & Cerulo, Karen. (2004). Second Thoughts: Seeing Conventional Wisdom Through the Sociological Eye. Pine Forge Press: Thousand Oaks, CA.



~~~~

Night Waking Protects Against SIDS

By Dr. William Sears, M.D.
Excerpted with permission from New Beginnings, Vol. 16 No. 3, May-June 1999, pp. 68-70.


Sudden infant death syndrome (SIDS), also known as crib death, is one of the most tragic of all nighttime crises. A healthy infant is put to bed and is later found dead for no apparent reason. Parents are devastated, left wondering why, and while medical research has produced a number of theories about SIDS, it still cannot explain exactly what happens when an infant dies unexpectedly during sleep.

Newer studies, however, suggest that various factors that are under parents' control influence SIDS risk. While you cannot guarantee that your baby will not become a SIDS victim, you can lessen the chances. I have come to believe that practicing the attachment style of nighttime parenting is one of the most important things you as a parent can do to lower the risk of SIDS in your baby.

SIDS and Breathing Mechanisms

Because the infant dies during sleep, SIDS can be thought of as a sleep disorder. The infant who becomes a SIDS victim may be unable to control his breathing automatically during sleep or to arouse from sleep in response to a breathing problem. In order to understand this theory of SIDS causation it is first necessary to understand how the infant normally continues breathing while sleeping.

In order for the body to function there must be a balance of just the right amount of oxygen and carbon dioxide in the blood. In order to maintain this balance, tiny sensor cells called chemoreceptors are located along some major blood vessels. During sleep, the body is particularly dependent on these chemoreceptors to keep breathing going.

In the first few months, the infant's automatic breathing mechanisms are immature. When watching a sleeping baby breathe, you will notice that his breathing lacks a regular pattern. Periodically he appears to stop breathing, sometimes for as long as ten to fifteen seconds, and then self-starts without any apparent problem. This is called periodic breathing and is normal for the tiny infant. The younger or the more premature the baby, the more irregular the breathing pattern and the more noticeable the periodic breathing. As the baby matures (around six months), breathing patterns during sleep become more regular and periodic breathing lessens. The episodes when the baby stops breathing are called apnea. Sometimes they are prolonged for more than fifteen to twenty seconds, and the heart rate drops significantly (greater than twenty percent). As a response to this sleep apnea, either automatic start mechanisms click on or the infant awakens. Either way, normal breathing resumes.

Sometimes the apnea is prolonged, and breathing fails to start again. Infants who are hooked up to apnea monitors show signs that the oxygen in the blood is at a dangerously low level: the heart rate becomes alarmingly slow, and the infant turns pale, blue, and limp. An observer must intervene and arouse the infant. Sometimes a simple touch will trigger the self-starting mechanism; sometimes the infant must be aroused from sleep in order to breathe; sometimes mouth-to-mouth resuscitation is necessary to initiate breathing again. Infants who have experienced an apnea episode that required outside intervention to restart their breathing are called near-miss SIDS. In other words, they would have died had someone not intervened. Tragically some infants stop breathing permanently, succumbing to SIDS.

SIDS as a Sleep Disorder

The peak incidence of SIDS is around three months, which coincides with the time most babies begin to sleep “better,” that is, to spend a larger percentage of sleep time in quiet sleep. During quiet sleep, infants are less responsive to the breathing-stimulating effects of low oxygen and increased carbon dioxide (Harper 1982).

In addition, studies of near-miss infants and siblings of SIDS infants show that these babies have fewer night-waking episodes. In the first few months, infants normally have frequent periods of night-waking as they ascend from quiet sleep to active sleep and back into quiet sleep. Researchers have suggested that arousal from sleep may be essential for resumption of breathing in babies who have less effective self-starting mechanisms (Harper 1981). Difficulty with waking up may place infants at higher risk for SIDS. Infants presumed to be at high risk for SIDS also show more frequent episodes of sleep apnea and periodic breathing (Guillemmault 1981). This apnea occurs most frequently between 1:00 AM and 6:00 AM and within ten minutes of awakening. The infants who woke most often at night had fewer episodes of apnea. Active sleep guards against SIDS. Sleep studies have shown that the onset of active sleep (REM sleep) stimulates breathing and heart rate. On the basis of their studies, researchers hypothesized that active sleep “protects” human infants from SIDS. The peak risk period for SIDS coincides with the rapid decrease in active sleep between two and three months of age. By six months of age, cardiopulmonary compensatory mechanisms in quiet sleep are more mature and the risk of death (from failure of these mechanisms) is reduced (Baker and McGinty 1977).

In other words, infants are not designed to sleep through the night until they're mature enough to do so safely.

SIDS and Breastfeeding

For many years, SIDS researchers maintained that there was no difference in the incidence of SIDS between breastfed and artificially fed babies, but newer studies have shown that infants who were never breastfed may have two to three times the risk of dying of SIDS. Breastfeeding's protective effect has been confirmed by research in New Zealand (Mitchell 1991), England (Fleming 1994), and the United States (Hoffman 1988). There are a number of possible explanations for the lowered risk of SIDS in breastfed babies. Breastfeeding protects infants from respiratory and gastrointestinal infections, and these have been shown to contribute to SIDS risk. Human milk enhances the development of the central nervous system, providing vital nutrients for the process of myelination, the development of an insulating sheath around nerves. Better brains may provide babies with better respiratory control during sleep. Breastfed babies sleep less soundly than artificially fed infants and are more likely to sleep with their mothers; thus, they may be more easily aroused when they experience a stop-breathing episode. While SIDS does occur in breastfed babies, breastfeeding is one way of lowering the risk.

How Parenting Style Can Decrease the Risk of SIDS

What are the practical implications of this research for nighttime parenting? In the 1984 edition of NIGHTTIME PARENTING I proposed the following hypothesis:

In those infants at risk for SIDS, natural mothering (unrestricted breastfeeding and sharing sleep with baby) will lower the risk of SIDS.

This was a new idea at the time, one that I based upon my reading of SIDS research and my understanding of the close relationship between a breastfeeding mother and her baby. My hope was that publication of this hypothesis would stimulate more scientific research in this area. Fifteen years later, in 1999, I am happy to report that the body of evidence available to support my original idea is growing, and experts are beginning to understand how a mother's presence with her baby during sleep can help to prevent SIDS. Here's the reasoning behind my theory - and the evidence and ideas that support it.

Sharing Sleep May Lower SIDS Risk

If SIDS is related to a diminished arousal response during sleep in some infants, it follows that anything that increases the infant's sensitivity or the mother's awareness of her baby may decrease the risk of SIDS. This is exactly what sharing sleep and night nursing do.

As a father of several all-night nursers, I have noticed that mother and baby often stir or awaken briefly at the same time. The nursing pair have a heightened awareness of each other. A study of mothers and babies co-sleeping in a sleep laboratory has documented the shared awakenings of co-sleeping, breastfeeding mothers and babies (McKenna 1994). When one stirred, coughed, moved, or changed positions, so did the other. The researchers also demonstrated that co-sleeping mothers and babies were often in the same stage of sleep during the night. Clearly, the presence of each affects the other.

Interestingly, anthropological studies have shown that the rate of SIDS is approximately three to four times higher in cultures where mothers do not sleep with their babies. More extensive research is needed on exactly what happens when mother and baby sleep close to each other. It seems odd that science demands proof that co-sleeping is good for babies, since mothers and babies sharing sleep has been the norm through most of human history, but there is still much to learn about how mothers help their babies develop. Meanwhile, I have to ask, if there were fewer cribs, would there be fewer crib deaths?

Babies Breathe Better When Sharing Sleep

My interest in the relationship between shared sleep and lowered risk of SIDS led me to arrange a study involving our daughter, Lauren, when she was eight weeks old. Using sophisticated monitoring equipment in our home, a technician and I monitored Lauren's sleep on two separate nights. On one night, my wife, Martha, slept beside Lauren. On the other night, Martha nursed Lauren to sleep in our bed, but slept in an adjacent room. We found that Lauren's heart rate and her breathing were more regular during shared sleep, with far fewer low points in blood oxygen levels. Monitoring another mother-infant pair produced similar results.

Obviously, this was a very small sample group, from which it is impossible to draw statistically valid conclusions. However, it does suggest a theory that needs further testing: a baby who sleeps next to mother is likely to experience fewer apnea episodes and thus may be at lower risk for SIDS. While again, this is not scientifically tested evidence, I have had many breastfeeding and co-sleeping mothers in my practice tell me that they have noticed that their infants breathe more rhythmically lying next to mother in bed than they do in a crib. One mother, whose baby was monitored with an apnea monitor during sleep because of breathing difficulties, found that the alarm went off frequently when the baby slept alone, but not at all when the baby slept with mother.

If SIDS is related to a baby’s inability to arouse himself from sleep, it follows that babies are simply not designed to sleep through the night until they are mature enough to avoid respiratory failure during quiet sleep. Parents need to be aware that studies which show that babies sleep through the night at a given age were performed in artificial settings: a sleep laboratory, a hospital, or some other nighttime environment in which baby sleeps alone. Sleeping alone is considered the norm, so babies are studied sleeping alone in cribs. The conclusions drawn from these studies of “normal” sleeping infants are that infants begin to have a higher proportion of quiet or non-REM sleep and sleep in longer stretches ("through the night") by three months of age - incidentally, the peak age for SIDS. From erroneously set-up experiments come erroneous norms. Parents (and doctors) should not use these norms as a justification for training babies to sleep through the night at a given age.

One study suggests that the sleep norms extracted from these studies that babies sleep through the night by six months of age may be attributed to the early weaning and separate sleeping practices of Western culture (Elias,1986). Researchers compared sleep/wake patterns in infants reared with two different parenting styles. One group consisted of sixteen mother-infant pairs, called the standard care group, who breastfed but tended to wean earlier and sleep separately. The other was made up of sixteen mother-infant pairs from La Leche League. These pairs breastfed more frequently throughout the day, weaned later, and usually slept together. Sleep/wake patterns developed differently in the two groups of infants. The sleep periods of the infants in the standard care group increased in duration from a median of 6.5 hours at two months to 8 hours at four months of age. The sleep periods of infants in the La Leche League group never increased from the median of four hours; they continued to awaken at night throughout the period of study.

These researchers also showed that the combination of nursing and sharing sleep had the greatest effect on sleep patterns. Babies who nursed and shared sleep with their mothers slept shorter stretches at a time; those who nursed but did not share sleep slept longer; and babies who neither nursed nor shared sleep slept the longest.

The human infant is meant to be a continuous contact species. The composition of milk of each species gives a clue to the infant care practices natural to that species. Animals who leave their young for extended periods produce a milk high in fat and protein which satisfies the young for a relatively long period of time between feedings. Human milk is relatively low in fat and protein, necessitating frequent, seemingly continuous nursing. The human infant is meant to be carried in arms during the day and nestled with mother in bed at night - not trained into a separate sleeping arrangement before he is ready.

A Final Word

While I believe that there is much parents can do to lower the risk of SIDS in their infant, I do not mean to suggest that parents of a baby who dies of SIDS are in any way at fault. SIDS is a terrible tragedy, and it is not entirely preventable.


For additional information on how attachment parenting can lower the risk of SIDS, see Dr. Sears' book, Nighttime Parenting, published by La Leche League International.

For more information on the research of healthy baby sleep, see the links on this page.

Good Baby Sleep Books


References

Baker, T. L. and McGinty, D. J. 1977. Reversal of cardiopulmonary failure during active sleep in hypoxic kittens: Implications for sudden infant death. Science 198:419.

Carpenter, R. G. and Emory, J. L. 1977. Final results of study of infants at risk of sudden infant death. Nature 268:724.

Elias, M. F. 1986. Sleep-wake patterns of breastfed infants in the first two years of life. Pediatrics 77:332-39.

Fleming, P J. 1994. Proceedings of the Fourth Annual SIDS Alliance National Conference, Orlando, FL, November 9-12.

Guillemmault, C. et al. 1981. Sleep parameters and respiratory variables in near-miss sudden infant death syndrome infants. Pediatrics 68:354.

Harper, R.M. et al. 1981. Periodicity of sleep states is altered in infants at risk for the sudden infant death syndrome. Science 213: 1030.

Harper, R. M. et al. 1982. Developmental patterns of heart rate and heart rate variability during sleep and waking in normal infants and infants at risk for the sudden infant death syndrome. Sleep 5:28.

Hoffman, H. et al. 1988. Risk for SIDS: Results of NICHD SIDS cooperative epidemiological study. Ann NY Acad Sci 533:13-30.

Keens, T. G. and Van der Hol, A. L. 1984. Use of hypoxic and hypercarbic arousal responses in evaluation of infant apnea. Perinatol Neonatol 8:32.

McKenna, J. J. and Mosk, S. S. 1994. Sleep and arousal, synchrony and independence, among mothers and infants sleeping apart and together (same bed): An experiment in evolutionary medicine. Acta Paediatr Suppl 397:94-102.

Mitchell, F. A. eta1. 1991. Results of the first year of the New Zealand cot death study. NZ Med 104:7.

How Spanking Changed My Life

The following is Beth Fenimore's open letter to, Roy Lessin, author of the book, Spanking: Why, When, How.

Fenimore's father illustrated Lessin's 1979 book, and her family attended the church where Roy Lessin preached. Her parents regularly exchanged babysitting care with the Lessins, and Beth was, as a result, spanked by Lessin's wife, Charlene, when she was in her care.

In this letter, Beth describes the many ways in which Lessin's "loving correction of the rod" changed her childhood, development, and life as an adult in monumentally negative ways. Beth was impacted, as are many children, by the long lasting psychological, emotional, mental, social and physical detriments of being spanked in "Lessin" fashion.


Dear Roy,

After 19 years I have found the courage to write you this letter declaring how your choice to teach and write about spanking has affected me. My purpose in writing you this open letter is to share with you and others that the spanking approach you recommend is harmful. My parents both know my view on this issue. I have talked to them, as well, about how their decision to implement your spanking recommendations affected me. I have a mission. My mission is to warn new parents who are innocently trying to raise happy, healthy children. Should just one parent spare their child the kind of pain that I endured at the hands of my parents implementing your spanking recommendations, my pain will have more meaning than it does now. I want to begin by talking about your spanking approach so that we'll both be using the same language. In your book, you describe a process by which a parent performs a spanking on their child.

The first step is to use the right instrument; if a parent uses their hand, the child might become fearful of the parent's hand.

The second step is to spank promptly.

The third step is to find a private place in which the parent can conduct the spanking.

The fourth step is for the parent to explain to the child why they are going to be spanked.

The fifth step is to get the child into a good spanking position (when my parents and other adults - such as your wife, Char - spanked me, the ritual involved removing the child's clothing); you recommend bending the child over a bed, or bending a smaller child over the parent's lap.

The sixth step is to hit the child on the buttocks with a stick or other spanking implement.

The seventh step is to continue spanking until the child yields a broken cry, which indicates a broken will.

The eighth step is reconciliation. You recommend that parents comfort the child until sufficient time has passed, and then ask the child to stop crying. You recommend that parents spank a child who displays a "wrong attitude" by continuing to cry too long after a spanking.

The language in your book is much more "sugary" than what I've just written. But my description does not come close to what it feels like to receive a Roy Lessin spanking. So I'll describe what a Roy Lessin spanking is like.

My first spanking was when I was six months old. My mother spanked me for crying after she put me to bed. She had to spank me repeatedly to teach me to not cry when she put me down. I know about this incident because my mother used to tell all new mothers about how young I was when she started spanking me. My last spanking occurred when I was thirteen years old. The Roy Lessin spankings that I remember most vividly took place between the ages of three and seven, because I hardly went a few days without a spanking at that time. I'd like to share with you, and others, what it was like receiving a Roy Lessin spanking.

The moment I found out I was going to get a Roy Lessin spanking, I felt physically ill. Because the Roy Lessin spanking is a ritual, the ordeal could take a long time. (When I refer to a spanking ritual, I'm referring to the steps you outline in your book.) This was hard for me because I had a child's sense of time. The dread bubbled up and consumed me, and stayed with me until the spanking ritual was over. My parents usually sent me to a private room, such as my own room, and there I would wait until one of my parents came. (My dad spanked me the most, so in my illustration let's assume my father is conducting the Roy Lessin spanking.) My father would explain the reason for the spanking. This was an excruciating process because I had to listen while knowing what was coming. Since I might face back-to-back Roy Lessin spankings, I had to be careful not to be disrespectful in my listening to my father. I had already developed irritable bowel syndrome (IBS), and would feel my guts cramp up with anxiety during his speech. Then he would ask me to take off my pants and underwear. I would feel deeply embarrassed because my father was not supposed to see me naked. (My family had a high standard for modesty.) My humiliation and fear would grow immeasurably as I leaned over the bed, my father's knee, or whatever was around. My private parts were helplessly exposed as my dad laid his hand on my back. Trying to pull away and defend myself would only mean that the spanking would be longer, or I'd get a back-to-back spanking. The stick, paddle inscribed with scripture verses, or belt would swish violently through the air before slapping painfully on my buttocks or thighs. I would scream in pain and anguish. I cannot remember a moment of thinking of resisting, rebelling, or trying to "win" anything, as you recommend parents should watch for as they hit their children. I just tried to survive the best way I knew how. The screaming, the hitting, and the pain would continue for unknown amounts of time. When the gruesome pain ended, I would begin to battle with my emotions and my body. I knew that crying too much could mean that my father would start a Roy Lessin spanking ritual all over again to correct my "wrong attitude."

My parents were never concerned about the marks they left on my body. We never talked about the painful marks on my body, or how clothing, baths, chairs, etc. hurt. The message was clear: there was no pain. Pulling up my pants was incredibly painful, and so was sitting on my father's lap. Because "there was no pain," I had to pretend my buttocks and thighs didn't hurt even though they did, while my father would wrap his arms around me and "comfort" me. I was not like the idealized children you describe in your book, not knowing the difference between the spanking implement and the parent. My father caused me that pain - not a stick! My father's arms scared me, and I feared my father like I've feared no other man. His touch repulsed me. I was the same with my mother. (To this day, I cannot physically tolerate either parent touching me. I feel physically ill at their touch.) My father would pray, and I could hardly go along but for fear of yet another Roy Lessin spanking. After we prayed, it was time for me to be happy. But my insides would be a mess. Tears would threaten to come back and cause me more pain and anguish. I had to pretend that I wasn't sad, and that I wasn't in pain. This would be my greatest lesson: to be happy no matter how I felt inside. It would take me a few back-to-back spankings, but I would learn. It would be a lesson I'd learn for life - being falsely happy regardless of how my body felt.

One aspect of receiving a Roy Lessin spanking is the sexual aspect. It's taken me years to even begin to allow myself to speak of this aspect. You see, as a child I had no idea what sex was. I just had this funny sensation that came and went during the Roy Lessin spanking ritual. To my great dismay, I learned that sexual stimulation can be cross-wired with the painful ritual of spankings. This cross-wiring was a real problem for me. Because I couldn't cope with the double message of love and pain, I avoided developing an intimate relationship with a man for a very long time. It took years for me to find a healthy sexuality outside the memories I have of the Roy Lessin spankings. I struggled with this double message as a child. I feel a deep sense of shame as I remember hitting and torturing my dolls and Barbies when no one was around. I needed some way to express the fear, pain, and sexual confusion I felt inside; yet my childish mind couldn't comprehend the significance of what I was doing.

My parents were your "A" students. They followed your eight steps occasionally reducing the entire Roy Lessin spanking ritual to a few swats - not very often, though. My butt and thighs would sting for a long time after a Roy Lessin spanking ritual, so I'd go into the bathroom and use my mother's mirror to look at my behind. I remember seeing red stripes crisscrossing my buttocks and my thighs. At times, I had old marks underneath the new marks. My parents conducted several Roy Lessin spanking rituals a day when I was a young child. I remember a teacher at school asking me one day why I didn't just sit still. I couldn't tell her that it was because the marks on my butt hurt so bad sitting in the little wooden chair.

Now that we've established what a Roy Lessin spanking is and what it felt like to receive one, let's move on to wrong attitudes. I'd like to begin by telling you a story of what it was like having an adult, in this case your wife, address my "wrong attitude."

One day my parents were moving. I was four, and woke up to a house that I no longer recognized. I asked my mother what was happening. Whatever answer she gave, I didn't understand. She sent my brothers and me to your house, where your wife Char was to baby-sit us. On the way out the door, I saw our small parakeet Chirpy sitting in his cage outside our house near some bushes. Now, Chirpy wasn't supposed to be outside. A dark feeling of dread came over me. I was frightened as I walked to the car, looking at Chirpy frantically chirping in his cage next to a stack of boxes. At some point, at your house, Char put all of us down for a nap. The confusion and fear filled me, and I wondered if I'd ever see my home again. When the room was quiet, my emotions burst out of me. I cried. Char came in and told me to stop, and I couldn't. So she performed one of your spanking rituals. I went back to my napping spot. I lay there for the remainder of my nap - unable to sleep, afraid to move, filled with emotions of dread and fear so large I thought I'd explode. But I had to make Char believe that I was cheerfully obeying her. I put on whatever face I could to convince her, and pretended to be asleep. I had to pretend I felt different than I did inside.

There are two points I'd like to make about bad attitudes. The first is that, as you can see above, adults do not have "powers" that allow them to read the minds of children. My parents made this mistake over and over again. They weren't much better at reading my mind or how I felt than your wife was that day I stayed at your house. You see, parents make mistakes. There's no getting around this. But when a parent uses a force as violent as a Roy Lessin spanking, mistakes are truly damaging, especially when the spanking ritual involves breaking the child's will - or breaking any part of a child's psyche!

The second point about "wrong attitudes" is that you tell parents that their children will be happy with your mode of discipline, or even prefer being spanked. I want to say that I didn't experience that joy. I built myself a cheerful, obedient shell. I lived in that shell, only peeking my head out when I felt safe, for 30 years. It took me another seven years to actually try taking the cheerful, obedient shell off - only to run back into it when something felt like the "old fears of my childhood." I have not been happy living in this shell, constantly pretending to be happy when I felt miserable inside. When I think of a happy child, I think of a child who feels free to express their ideas, thoughts, and emotions. I think that a parent's job is to teach a child how to express their emotions, not hit them with a stick until the child displays the emotion of the parent's choosing.

You write about parents disciplining children for disobedience. It seems pretty simple. The parents set up some rules and the children follow them. When disobedience is based on a child doing or behaving just as the parent asks, following those rules becomes much harder. As your teachings played out in my growing-up years, I found that I violated more rules than I could keep track of. Not only that, one of the rules was to follow through without my mom or dad asking a second time. So perfection became the rule, and perfection was something I failed at miserably. Even in the cheerful, obedient shell, I was not completely safe. The life lesson I took away was that there is no such thing as second chances. I took this lesson to school, and found that I was afraid to try. Not that my parents didn't encourage me - it was just that if the encouragement didn't work, which it often didn't, they'd spank me for getting letters backwards, words wrong on spelling tests, and so forth. Basically, they spanked me for not trying hard enough. I haven't even mentioned the hundreds of other issues they spanked me for. I learned how to live helplessly. Not only did I face my own internal disappointment at not getting something correct, I faced a Roy Lessin spanking at home when I wore out my encouragement. I grew up thinking that I was mentally handicapped. Later, as a grown adult, I found out that I'm dyslexic - something a Roy Lessin spanking would never cure.

For most of my life, I worried that I'd remembered all this wrong. About eleven years ago I called Char and asked her to listen to while I recalled a Roy Lessin spanking for her. I described to her in as much detail as I could remember the beatings I endured again and again. Char told me that my memories were exactly what you and she had taught my parents. I had not remembered wrong!

I read your book a few weeks ago. I was again surprised to realize I knew and remembered your teachings very well. After the years of growing up around your family and hearing you preach at Outreach, your book brought back your painful teachings and the painful memories I've been trying so hard to live with. I kept wanting to grab my cheerful, obedient shell because to this day I feel scared when I think of all the Roy Lessin spankings and teachings.

Both Char, during my call with her, and you, in your first book, talk about spankings having a higher purpose in saving the soul. You reference Proverbs 20:30: "Blows that wound cleanse away evil; strokes make clean the innermost parts." Those "blows" left horrible marks on my body that made sitting difficult and bathing with soap sting horribly, and they terrified my spirit.

Feeling terrified isn't the only outcome I live with. Ten years ago a gastroenterologist diagnosed me with IBS, a condition I've had since I was around three years old. Because of the fierce anxiety I felt because of the Roy Lessin spankings, I had terrible chronic stomachaches and diarrhea while I was growing up and as an adult. Five years ago my psychiatrist diagnosed me with post-traumatic stress disorder (PTSD), and I began to work through my deeply rooted fears of my parents and the Roy Lessin spankings. Later a physician associate (PA) diagnosed me with asthma and severe allergies from a poor immune system, a result of my chronic anxiety. The same PA told me that I'm at high risk for colon cancer because of the years of IBS as a result of my anxiety. Roy, these problems are all due to my parents implementing your teachings using Roy Lessin spankings to correct a multitude of childhood blunders and attitudes. I can't imagine why a parent would want these outcomes for their child. I may have looked happy and acted lovingly towards my parents, but I was emotionally and physically sick inside! Your teachings gave me no option but to live a horrible lie of looking happy when I was miserable.

For almost every day of my life, I fear people. If people like my parents, and friends of my family such as you and Char, would hurt me this badly, what horrible things would others do to me? I was supposed to be safe with my family and friends growing up! I especially fear men in authority roles. I occasionally look even at people I know, and who I know to be safe, with terror just because they've spoken in a tone that reminds me of those early times. I fear making mistakes. I choose not to have children of my own because a child's screams scramble my insides.

Remember all those sermons at Outreach that you, Don Leetch, Dean Kerns, and a few others delivered? I still hear children screaming as their parents spanked them outside the church sanctuary during Sunday morning service during those sermons. I remember the screams of my siblings. I remember on a Friday night, someone was preaching and a dad took a baby outside for a spanking, and a neighbor called the police. We stopped the church service, and you went out with your bible to explain to the officer why it was fine for the parent to spank their baby. All of us inside prayed that the officer would understand and not take the baby away.

As a grown woman I still fear Roy Lessin spankings. I sometimes wake up in the middle of the night begging my husband to "not let them get me."

My father and I have talked several times about Roy Lessin spankings. He has asked for forgiveness, and is horrified by what he has done. These conversations have been incredibly painful for both of us, and I'm now 37 years old! I believe that he thought he was doing the right thing. You were a leader in the church he believed in, and you were his friend. Our families socialized together. This was not some teaching he picked up somewhere, and then went off to make the best of it.

I hope that by this point you begin to see how your simple, sweet words about raising children are actually harmful. Perhaps you're wondering if I want to have a dialogue with you, and talk about what you really meant by your early book. Perhaps you've adopted a policy of grace, and now recommend that parents spank less and not on bare skin? The truth is, I don't want to know. If I needed justification or reasoning for your teachings, I could use your book as a reference. What I'd like you to do is reconsider your position after carefully looking at how your teachings affected me. Would a loving parent really want to raise a child to fear people, to wear a cheerful and obedient shell, or to live with PTSD and other ailments? I hope the answer you come to is No. I hope that you realize that hitting a child for any reason is not loving. Then, I hope, you join the cause to end corporal punishment in the homes of children. I came into this world a happy, healthy baby. For no other reason than the Roy Lessin spankings, I now fight for my physical and mental health. Please help others and me so this doesn't happen to any more children. Help end corporal punishment. Help end child abuse. If Jesus said, "Whoever causes one of these little ones who believe in me to sin, it would be better for him if a great millstone were hung round his neck and he were thrown into the sea," (Mark 9:42), I can't image that God would condone such behavior in people who claim to be loving parents.

Sincerely,
Bethany A. Fenimore

Beth, as a child

"I was on the watch for the moods and emotions of others. I was usually distracted with anxiety wondering if I had done anything wrong that would cause me to get a Roy Lessin spanking...I remember knowing my mother was watching me and telling me to smile for the photographer. I felt intimidated by my mother to smile. No matter what facial expression I had, my eyes seemed to show my anxiety. Looking at this photo now, I feel deeply sad."




Related Reading:

Why Love Matters: How Affection Shapes a Baby's Brain [book]

The Science of Parenting: How today's brain research can help you raise healthy, emotionally balanced children [book]

The Continuum Concept: In Search of Happiness Lost [book]

Our Babies, Ourselves [book]

The No Spanking Page alternative ideas to spanking

Why Do We Spank Our Babies?


Infant Pain Impacts Adult Sensitivity

Early Spanking Increases Toddler Aggression, Lowers IQ
 

Spanking Decreases Intelligence? 

Project No Spank


Dr Sears: 10 Reasons Not to Hit Your Child


Gentle Discipline Book Collection 

~~~~

The Case for Cue Feeding

By Lisa Marasco, BA, IBCLC and Jan Barger, MA, RN, IBCLC
posted with permission
Talk with other breastfeeding moms and IBCLCs at The Breastfeeding Group: FB.com/groups/Breastfed



It is now commonly accepted that infants, most especially breastfed infants, thrive best when allowed to feed as they indicate their needs. Breastfeeding is, after all, a dynamic process between every unique mother-baby dyad, for which man cannot possibly do a better job than God in designing how infant feeding should work.

This has not been the general consensus throughout the twentieth century, however. Even in the late nineteenth century, there were those, mostly male physicians, who began to believe that infant feeding should be regulated by the clock. As artificial baby milk became all the rage in the twentieth century, both formulations of this milk and schedules to feed babies came into popularity. These schedules often stretched feedings to 3 or 4 hour intervals, and though they apparently worked for bottle fed infants, they did not work so well for breastfed infants.

During the seventies and eighties, as breastfeeding again resurged through a grass roots movement first sparked by La Leche League, many mothers have returned to demand feeding, finding the most breastfeeding success when following baby's cues rather than the clock. The medical establishment lagged behind, and has followed suit only after its own research was undertaken to prove the wisdom of cue feeding-for breastfed babies.

The Evidence

Production and storage capacity.

Until recently, it was believed that the majority of the milk was made at the time the mother sat down to nurse and/or pump, as a result of the prolactin surge that occurs during feeding. We also knew that some milk was made between feedings, as some of the nonfatty constituents collect passively in the sinuses behind the areola to form foremilk. Knowledge of this process has been changed by the work of Peter Hartmann.

Dr. Hartmann is a researcher in Perth, Australia, specializing in human milk production. In his laboratories, Dr. Hartmann has studied mothers before and after nursing sessions by making topographical-type maps of lactating breasts using video cameras and computer equipment in order to analyze changes. Their accuracy has been assessed at +/- 5%, an excellent percentage for this type of work. Dr. Hartmann has discovered, through this work, that the breast does not make all of the milk at nursing time, but rather is making milk around the clock. The rate of milk production between feedings varies according to the degree of fullness of the breast; the fuller the breast, the slower the milk production rate, and conversely the emptier the breast, the faster the rate of production for replacement.

Even more fascinating, Dr. Hartmann has also quantified differences in the maximum storage capacity of women's breasts, identifying at least a 300% difference between the most one woman could store versus the most another could store in his study. Further, Dr. Hartmann noted that the women who had larger storage capacities often nursed at longer intervals, whereas women with smaller storage capacities nursed naturally at more frequent intervals [Comment: breast size appearance is not always a good predictor of production or storage capacity]. Most importantly, it was noted that all of these women had the ability to produce plenty of milk over 24 hours; what varied was the maximum amount that they could deliver at one sitting.

The implication for scheduled feeding is quite evident, as noted in one of Daly and Hartmann's papers:
"At an historical level the typical four hourly breastfeeding schedule that was once widely favoured in the western world [citations removed] may not have caused problems for women with larger storage capacities but might have had disastrous consequences for women with smaller storage capacities. Such women, who needed to breastfeed more frequently, would have been aware that their provision of milk was inadequate on a four hourly breastfeeding schedule. However, rather than dispensing with the schedule, it is clear that such mothers more often doubted their ability to provide milk for their infants and instead introduced artificial milks."
Endocrine vs. Autocrine control theory

There is also a second level of potential problems with scheduled feedings. It was well known that prolactin, the milk-producing hormone, was very important in the early months for good milk production. Yet, research also shows that prolactin levels decline to a lower plateau over the first few months postpartum, less important later than early on. This apparent contradiction has been explained in part by the theory of endocrine versus autocrine control. Endocrine control refers to the idea that hormones--namely prolactin and oxytocin--are the major drivers of milk production. This appears to be established shortly after parturition, and can be inhibited by retained placental fragments or other hormonally related health problems that mother may have. Endocrine control seems to be primary for approximately the first three months or so, until prolactin levels diminish.

It is now believed, partly due again to Dr. Hartmann's work, that another process referred to as autocrine (local) control takes over at about this time. Under the theory of autocrine control, the body continues milk production at a more local level that has been set during the early period. What appears to affect successful long term lactation is the proper development of adequate prolactin receptors during the endocrine control period, which in turn appears to be correlated with frequency of feedings: the more frequent the feeds, the greater the stimulation of receptor development (DeCarvalho, et al; Perry WA & Jacobs, LS).

In studies of women who are relactating after a period of non-lactation with a naturally born child, it has been noted that it is far easier to bring a milk supply back during the first three months postpartum than further down the line. The body produces many milk-making cells during pregnancy, then seems to pare these down over some months after delivery, efficiently keeping only the number necessary plus a few extra "off-line" cells that can be called back into production in a pinch; this natural process is called involution.

Many women claim success in schedule-feeding their breastfed babies during the first couple of months. However, they also have an unusually high rate of milk supply failure around 3-4 months, as evidenced by babies slowing down in growth below acceptable standards, requiring supplementation, and/or involuntary weaning as baby rejects the slower flowing lower volume breast for a more copious bottle.
In light of Dr. Hartmann's work, it becomes clear as to just why some babies never thrive on 3-4 hour schedules, some thrive for the first few months before falling out, and why some succeed the whole duration of lactation. It has everything to do with individual physiology plus breastfeeding management (schedule vs. cue), and nothing to do with proper following of an arbitrary or even 'average" routine/schedule. Mothers who have not succeeded in combining breastfeeding with schedules have been told that they lacked the physical ability to produce enough milk, or else that they were not implementing the curriculum correctly, and are bearing a far too heavy burden of guilt and inadequacy!

Crying and satiety

Katherine Dettwyler, an anthropologist specializing in infant feeding, has recently co-edited a book called Breastfeeding: Biocultural Perspectives. In the chapter entitled "Baby Controlled Breastfeeding: Biocultural Implications", noted and respected lactation researcher Michael Woolridge writes about baby's crying, and how cultural beliefs often affect interpretation of a baby's cry. Most notable of Woolridge's comments was on satiety, the feeling of fullness and contentedness that is felt when the body is properly nourished:
"I still feel that we have yet to appreciate the "currency" of this appetite control-this is likely to be calories, but may, more particularly, be fat. I suspect that in the public perception volume intake is regarded as the critical factor, so invariably it is assumed that any woman whose baby remains unsettled after feeding has inadequate milk volume to satisfy her baby's needs. Much more specifically there may be a small but critical shortfall in her baby's fat or caloric intake with the result that satiety is not reached............ In this context, a critical difference between breastfeeding and bottle-feeding is that a bottle of formula is of uniform caloric density, so that nutrient intake bears a linear relationship to volume intake. In contrast, breastmilk increases in caloric density during the feed as the volume available diminishes, so that calorie intake shows a curvilinear relationship to volume intake, with the later stages of the feed making a disproportionate contribution to the baby's intake of calories. Concomitantly, restriction of milk volume removal from the breast results in disproportionate caloric restriction. Though there are likely to be many explanations, including those operating at an emotional level, this is a potential physiological explanation for why unsettled behavior is perceived more commonly for the breastfed than for the bottle-fed infant [additional citations in original]."
These comments are very telling. Proponents of schedule/routine feeds often also place time restrictions upon babies as to how long they should feed, and while unusually long feedings can indicate other difficulties, Woolridge's analysis serves as a warning against the practice of applying arbitrary limits on feeds, lest we also in the process limit fat/caloric intake at the end of feeds.

Further in his chapter, Woolridge pinpoints the two items he considers most important for good breastfeeding management:
"To prevent any potential calorie restriction two critical facets of breastfeeding must be correctly managed: the quality of mouth to breast apposition throughout the feed, and the absence of time restrictions on feeding"............. "I do not feel we can afford to ignore the most direct physical cause of genuine symptoms of undernutrition--caloric restriction--nor blame the mother for interpreting these symptoms by a culturally prescribed set of criteria [emphasis mine]. "
Much attention has rightly been paid to the first facet, good latch, but the second facet has still not been completely settled. Of special importance is Woolridge's observation that time restrictions on feeding may be connected to inadequate fat intake, and yet parents may interpret baby's resulting cry of insatiety via their culture, which would blame the mother's body but not the feeding management which was also culturally proscribed.

Fat and feeding intervals

Supporters of schedule/routine feedings believe that longer intervals make for hungrier babies who will demand more aggressively and who will obtain the necessary higher fat available at the end of a feeding. Woolridge, however, has yet another interesting observation that contradicts at least in part this belief:
"Prefeed fat is inversely related to the length of the interfeed interval, which means that feed frequency influences milk fat concentration. Thus feed frequency, one of the key parameters of feed patterning, shows a direct relationship to milk fat concentration and so would appear capable of exerting a direct influence on milk quality...
"Overall, the fat concentration of milk taken at feeds would appear to be maximized both by increasing feed frequency and milk volume removal (which itself is a combination of unrestricted feed duration and optimal positioning), yet in Western hospitals it has been common in the past to impose restrictions on both feed frequency and feed duration to the likely detriment of the baby's fat intake. Such restrictions may well have resulted in iatrogenic problems of breastfeeding, which would include fat restriction (resulting in unsettled behavior), symptoms of breast milk insufficiency, and underfeeding."
One notable problem with feeding schedules and routines is that they often consist of what is considered "longer" intervals of 3 or 4 hours, rather than 2 to 3 hours or even more often, as young babies especially need. The standard definition of a feeding interval is from the beginning of one feeding to the beginning of the next, and not from the end of one feeding to the beginning of the next, as in On Becoming Babywise.

Babywise

Authors Gary Ezzo and Robert Bucknam have misleadingly redefined the term and thus smoke-screened the issue. Babies need to eat or drink when they need to, and that is as individual in intervals and duration as the infinite variety of humankind. Yes, there are averages that may fit into a bell-shaped curve model, but by definition there will also be babies who fall on either side, requiring very short or needing only longer nursing intervals. Temperature, activity, teething or health may also affect these needs and patterns. No schedule, not even a "flexible routine", allows for this variation, because the base premise is that parents, by virtue of being adults, know better than baby what the baby's needs are at every point in time. A baby's cries, his most dramatic expression of need, are instead routinely interpreted through an artificial filter that precludes the possibility that many babies are not going to behave like THE average baby and may actually have needs that we have not anticipated. Thus, we lose our ability to understand what is truly "good" for our baby because we are no longer open to learning from him, but only to "teaching" him--imposing upon him--how to be a culturally model baby.

Feeding cues and delayed feeds

A baby readying to feed displays cues even before he may awaken (Anderson, GC). At first, baby may wiggle, toss and turn, or be restless in his sleep. If his hand is near his face, he may begin to root towards it, and even attempt to suckle it or anything else near his mouth. If these early cues are ignored, the baby may begin to "squeak" and fuss lightly; and if this is also ignored, he will eventually work up to a full cry to express that he is now overdue for his needed nourishment. An experienced breastfeeding mother with baby nearby usually quickly discerns baby's needs and puts him to breast early in this sequence of cues, avoiding the fretting and crying entirely. For the mother who is scheduling her baby and/or sleeping apart from him, however, it is much different.

A newborn who is left to cry for even a few minutes can become very disorganized and have a more difficult time latching on and suckling correctly (Anderson, GC). This has often been observed by mothers in the hospital; the nurse will rush the baby in, saying "He's really ready to eat, he's been crying for the last 10 minutes!," but then as soon as mom attempts to put him to breast, he falls asleep and does not breastfeed well. As a result, he often does not take as much as he needs, and if this scenario is repeated, mother's milk production will decrease over time. This stands in opposition to the belief that a baby who is made to wait for his feeding based on a clock is going to 'signal the breast to produce more milk" by sucking more strongly out of his hunger. Rather, the opposite quite often occurs. Circumventing the natural cues of a baby by attempting to breastfeed earlier or by waiting past those "golden moments" simply doesn't work well. While a good nursery nurse can "make" a baby take a bottle on a schedule by forcing the rigid nipple into his mouth to elicit a sucking reflex, it is virtually impossible for even the best lactation consultant to "make" a baby breastfeed.

Furthermore, crying has been found to be physiologically detrimental to the new infant. Large fluctuations in blood flow occur during extended crying periods, decreasing cerebral oxygenation and causing an increase in cerebral blood volume. As a result, rising blood pressure increases intracranial pressure, putting baby at risk for an intracranial hemorrhage. Meanwhile, oxygen-depleted blood flows back into the systemic circulation rather than into the lungs (Anderson, GC). Overall, crying in the newborn resembles the adult valsalva maneuver (straining with stooling) by obstructing venous return in the inferior vena cava, which temporarily reestablishes fetal circulation within the heart of the newborn.

In an attempt to prevent excessive crying and also keep baby on track, some proponents of infant schedules promote the use of pacifiers to delay feedings and/or eliminate non-nutritive sucking at breast. Such interventions are not without risk, however. Barros and Victora, et al, have documented that pacifier use is associated with a shorter duration of breastfeeding, while Victora et al note that mothers who utilize pacifiers for their infants frequently exercise a higher degree of behavioral control while breastfeeding, often leading again to shorter duration of breastfeeding overall. This should be of concern to both parents and health professionals as the duration of breastfeeding in the United States currently falls well below the recommendations of the World Health Organization (Baby-Friendly Hospital Initiative) and the Surgeon General.

Eating patterns

Physicians and dietitians have long decried the American way of eating three big meals a day. They have often said that six smaller meals would be more beneficial for our digestive systems, growth and development. Given this, then, why should anyone try to cut back a baby's feeding frequency to only four a day by twelve weeks, as the Ezzos promote? Unlike adults, who need only to keep their weight stable, babies need to double their birthweight in 5-6 months and triple it in a year.

Taking that into consideration, observe adult patterns of eating. Most adults have something in their mouths (unless they are actively dieting) on average every 90 minutes during waking hours-- breakfast, coffee breaks, lunch, snacks, dinner, gum, candy (Linda Smith, IBCLC; unpublished study). We nibble; we get thirsty; we get a drink of water; our hunger and thirst changes from day to day according to the weather and our activity level. We are not trying to gain weight, let alone double or triple it; why would babies need fewer feeds a day than we take, given their circumstance? The average need of a baby is to feed 8 - 1 0 times a day, and up to 12 - 14 times a day during growth spurts (Mohrbacher and Stock); schedules simply do not adequately allow for such unpredictable variations.

The immune factor

Nutrition is often the focus of breastfeeding, but there are other reasons that babies ask for the breast as well. Most people are aware that breastfeeding confers immunological advantages upon the baby, but few understand the dynamics of this process.

A normal baby is born with an underdeveloped immune system that takes from two to six years to completely mature (Goldman, AS). One of the lesser-understood roles of human milk is to supplement the young child's immune system until he fully matures. For the newborn, colostrum is densely packed with antibodies and immunoglobulins to give baby a "booster shot' right after birth. As baby grows older, human milk continues to pass on antibodies for all those organisms to which the mother has developed her own immunity. Even more amazing, if a baby contracts an illness that mom has not been exposed to previously, he will transfer this organism through his saliva to the breast, where antibodies are manufactured on site and then sent back to baby via the milk to help him cope. Science does not come even close to duplicating this feat! Babies who are sick will often increase their nursing frequency, and researchers now believe that they do so not only for the comfort that it brings to a miserable little being, but also to increase the baby's intake of antibodies and immune factors available through mother's breast (Dettwyler, website). Babies seem to "know" when they have been exposed to a virus or bacteria, and know when they need to breastfeed more frequently to help them fight it off; most importantly, they sense it before parents realize that an illness is developing. There is no system in existence that is as sensitive and accurate as this one, and it is not under parental control. Mothers who wean their babies from the breast during the first and even second and third years of life often notice that their child becomes sick more than before, or for the first time; the immunological advantage of human milk does not disappear after a set period of time and also cannot be scheduled.

Conclusion

The evidence is very strong that arbitrary (defined as set by external influences, such as averages) scheduling of breastfed infant feedings is inadvisable for any mother who desires to breastfeed successfully, most especially for the recommended longer periods of up to a year or more. Individual storage capacities of mother's breast is one major factor in the determination of which babies can be fed at long versus shorter intervals, and the proper development of adequate prolactin receptors is another major factor that favors more frequent feedings. Coupled with the evidence that suggests that frequency of feeds--unrestricted--may influence the fat content of milk in a positive correlation, it appears as overwhelmingly good sense to allow baby to feed whenever he signals the need to, ala "on demand" or "on cue."

Moreover, it would appear that this is nature's design, and for those who acknowledge a Creator, really God's design, for breastfed infants and their mothers. When parents ignore the natural, God-created system of cues between baby and mother, it can result in disorganization of baby's suckling and resulting low intake and milk supply. In addition, the unnecessary extra crying that results from putting a baby off can actually cause unhealthy stress to his body. Immunologically, limiting a baby's feeds to a particular schedule may thwart a baby's attempt to fight a developing illness, reducing his intake of vitally important antibodies and immunoglobulins.

It can be argued that bottle-fed babies should be exempt from the need for demand feeding, but even though the composition and availability of their milk is relatively stable and without the immunity factors of human milk, they, too, may benefit from being allowed to eat when hungry, rather than being forced to take in possibly larger amounts on less frequent intervals in order to meet their daily caloric needs, stretching their stomachs unnecessarily in the process.

Empirical and theoretical evidence combined continue to support current recommendations of the American Academy of Pediatrics that babies, most especially breastfed babies, need to be fed on cue and should be allowed to set their own routine, rather than placed into a predetermined schedule. It is our further conclusion that practices which interfere with respecting babies' cuings have been responsible for low weight gains, failure to thrive, milk supply failure, involuntary early weaning, and possibly even some cases of colic, not to mention infant regression and depression due to lack of parental responsiveness to baby's frantic cues.


For more on Babywise, the Ezzos, and the dangers of PDF (parent directed feeding):

American Academy of Pediatrics Statement about Babywise

Pediatric Nurse and Former Ezzo Parent
Confessions of a Failed Babywiser
Become Wise to Babywise
Adventures in Ezzoland
Dr. William Sears on Growing Kids God's Way/Babywise

Ezzo Information Website
List of Resources on Baby Sleep
List of Resources on Sleep Training, CIO, controlled crying
List of Resources for Breastfeeding Mothers
List of Resources on Babywearing



Babies' bellies are tiny - the reason they must eat so very often. 

References

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Daly, et al. "The Determination of Short-Term Breast Volume Changes and the Rate of Synthesis of Human Milk Using Computerized Breast Measurement," Experimental Physiology (1992), 77,79-87
Daly, Steven and Peter Hartmann. "Infant Demand and Milk Supply. Part 1: Infant Demand and Milk Production in Lactating Women." Journal of Human Lactation I I(l) 1995; p. 21-26.
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Neifert, Marianne. "Early assessment of the breastfeeding infant." Contemporary Pediatrics, Oct. 1996, p. 2-16.
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Stuart-Macadam, Patricia and Katharine Dettwyler. Breastfeeding: Biocultural Perspectives. Aldine De Gruyter, 1995: Hawthorne, NY. p. 217-242, chapter by Michael Woolridge
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