If you are interested in an app we are developing for helping parents to get their babies on a routine, please sign up for my Newsletter. The release of the app will be announced there.
On Becoming Babywise is not a general self-help book about how to deal with babies. Instead, it offers pragmatic advice on how to create a sleep-feed-waketime routine for you and your baby. Especially my partner -- who is a software engineer -- liked the book, because for him all the lessons learned from the book can be transferred to patterns and algorithms. The book has lots of actionable items, doesn't have much fuss, and doesn't repeat itself too often. It's a clear step by step guide, which shouldn't be followed too ambitiously, because in the end your baby decides what's best for him or her. I don't really want to give any opinion or advice about how to handle a baby her - this is just a brief summary of my lessons learned from On Becoming Babywise.
Disclaimer: I am not affiliated with On Becoming Babywise. It's the first book I have read about parenting and I cannot wait to apply (some of) my lessons learned in real life. However, as many parents told me, parenting a baby cannot be planned, it's chaos :-)
There are various parenting styles for babies: La Leche League, Attachment Parenting, Babywise ... Decide which one fits best for you, your partner and your baby. It may be possible to mix different styles for certain areas as well. If you have friends with babies, watch how they apply their parenting styles and evaluate it yourself: How do their kids behave and how content are the parents with the parenting situation? "Look at the fruit and trace it back to its seed source." There is no best parenting style, so decide what fits best to your lifestyle and objectives.
The three influences that shape a babies destiny: the genetic disposition inherited (physical/psychological potential) from the parents, the babies temperament which shapes its personality, and the home environment. While it's not possible to change the genetic inheritance or the temperament, the home environment is something parents can put much effort into.
The partnership (belongs to home environment) of a baby's parents has a great influence. If partners don't work together as a team, these gaps in a relationship will be picked up eventually by their baby. "The more parents demonstrate love for each other, the more they saturate their child's senses with confidence of a loving, safe and secure world." A baby is not able to rely on intellect and reason to measure its home environment.
If you schedule time with your partner, for example just to talk about your day, let your child have toys on the side while still being visible for him/her. Act as role models for your kid. Your relationship with your partner will reflect on your child eventually.
Life doesn't end with a kid for parents: Continue to date your spouse, continue to show loving gestures, communicate with your partner, laugh and work together, and resolve conflicts with mutual respect. A friend of ours once told us: "Your baby needs to fit into your life, not the other way around."
There are three feeding philosophies. First, the Clock Feeding (based on philosophy of behaviorism) which follows a strict feeding schedule (e.g. every 4 hours). If the baby shows signs of hunger (e.g. crying), it was left to "cry it out". The clock determined when to feed and not the baby...
Second, the Child-Led Feeding (based on philosophy of neo-primitivism) (somehow related to Attachment Parenting) which derives from the assumption that "babies in the womb have a perfect "emotional" relationship with their mothers, but lose emotional attachment during the birthing process. This leads to a second assumption: that every newborn has a lingering, subconscious desire to return to the security of the mother's womb. Since that cannot happen physically, the mother is to create and mimic an artificial womb-like environment, and maintain it long after birth. All of her efforts are aimed at reversing the psychic shock brought on by the trauma of birth."
That relates closely to the advice I have heard from people when I have been shopping for a baby bed or a baby wrap, because in a bed a baby shouldn't have too much open space to make it more cozy and womb-like, and in a baby wrap it should be closely attached to the parent. However, when I continued to read about this philosophy, it again turned into extremes: "The baby should be endlessly cradled, sleep with the mother, be breastfed well into the second or third year. The child is to be the center of the family universe, where all practices minister his comfort and minimize his anxiety."Following this advice, a baby should be constantly nursed, carried by his/her mother, and co-sleep with her all night. While many mothers thrive on this attachment parenting style, this "secure attachment of a child" will often lead to emotionally-stressed, high-needy, and insecure babies (and tired parents).
As a reasonable human being, we know that extremes often don't lead to perfect results. "While Behavorists emphasize outward structure and not the inner person (feeding indicator = clock), the Neo-primitivists emphasize the inner person at the expense of outward structure (feeding indicator = hunger cue)." Parent-Directed Feeding (based on Babywise), the third philosophy, tries to find the common sense of both philosophies. "With the parent-directed approach you feed your baby when he is hungry, but the clock provides the protective limits so you are not feeding too often, such as every hour, or too little, such as every 4-5 hours."
This feeding philosophy is the pillar of the whole routine Babywise wants to create for your baby (feed-wake-sleep) which has the following objectives:
- baby synchrones his/her feed-wake-sleep cycles into predictable patterns
- baby can fall asleep without external support (e.g. rocking, nursing prop)
- baby sleeps through the night for 8-10 hours
- baby has a predictable nap routine
- baby has a content waketime
- baby is able to adapt to self-play and self-soothe
- baby is able to find comfort with other caregivers (e.g. father, family, friends)
"Training your baby to sleep through the night is not the final goal of parenting, but it does provide a good foundation for everything else that follows."
On a side note, I know that the book has lots of critics, which may be caused by earlier editions, however, I feel like it often emphasizes that a routine doesn't equal a schedule. The baby has the first priority and not the routine. That said, let's continue with the lessons learned.
Sleep for your baby is important, because good or bad sleep has a ripple effect on your baby's well-being and therefore intelligence. A baby with a good sleep has an improved alertness during waketime and thus has a greater chance to learn new things. Sleep is important is as important for children as it is important for adults. (see study by Dr. Marc Weissbluth)
On Becoming Babywise says that "full-term babies are born with the capacity to achieve 7-8 hours of continuous nighttime sleep between seven and ten weeks of age and 10 to 12 hours of sleep by twelve weeks of age.". The primary key to achieve this objective is the baby's feed-wake-sleep routine. It's essential that the feed happens after the sleep. To achieve this routine, each feeding needs to be a full feeding which usually lasts from 20 to 30 minutes. Avoid to have your baby doze off while feeding.
According to Babywise, there are two reasons why this leads to a routine: "First, babies have an innate ability to organize their feeding times into a predictable rhythm [...]. Second, the hunger mechanism (digestion and absorption) response to routine feedings with a metabolic memory. Routine feedings encourage Baby's hunger metabolism to organize into predictable cycles."
Parent-Directed Feeding (Babywise) was performed in a study with 520 babies of which 380 were exclusively breastfed. The result for the breastfed babies (similar results for formula-fed babies):
- Girls: 86.9% slept through the night at 7-9 weeks. 97% were sleeping through the night by age of 12 weeks.
- Boys: 76.8% slept through the night at 7-9 weeks. 96% were sleeping through the night by age of 12 weeks.
Even babies with medical conditions like reflux, colic, viral infections and premature delivery were able to sleep 8-9 hours through the night between week 13-16.
Babies who suffer from lack of sleep develop chronic fatigue which leads to fussiness, daytime irritability, crankiness, discontentment, hypertension, poor focusing skills, and poor eating habits. In contrast, babies with a healthy sleep are optimally alert to interact with their environment.
Babywise advices against sleep props like nursing a baby to sleep, motions or vibrations (e.g. driving with a car), and bed-sharing. It shouldn't be necessary to put an already sleeping baby in the crib. Instead, the baby should be awake when put into a crib, and should be able to soothe itself to sleep.
As mentioned earlier, as one of the key principles, Babywise encourages full feedings about every 2 1/2 - 3 hours instead of cluster feeding (small feedings subsequent each other) which don't synchronize with a baby's hunger rhythm. If your baby is on the sleep-feed-wake routine, after a sleep cycle babies usually wake up with a sucking sound and other hunger cues. If these cues are visible, be proactive with the feeding of your child before it bursts out into a full cry. "The hunger cue should always trump the time on the clock."
A full feeding goes for 10-15 minutes per breast. It's recommended to have the baby on both breast for one full feeding to stimulate the milk production. This already starts with the first feeding after birth, so don't forget to stimulate both breasts if possible. Once a baby is sucking on a breast, two hormones get released: prolactin and oxytocin. While the former is necessary for milk production, the latter supports the release of the milk. If the right or left breast starts with a feeding cycle, the mother can alternate the starting breast from cycle to cycle. Another trick is having the baby on a 10-10-5-5 minute alternation between both breasts for a more effective stimulation. Studies have shown that babies can empty a breasts effectively in 7-10 minutes per side.
When breastfeeding the mother's food intake is as important as during pregnancy. Eat a balanced diet with wholesome fruits, vegetables, grains, proteins, and calcium rich foods. And don't forget to stay hydrated. In addition, hygiene is important when dealing with a baby, but especially for the feeding. Make sure to wash your hands prior to each feeding.
The nursing position requires a baby's entire body facing the mother's breast. If the head is twisted, the baby cannot be fed efficiently. Once the baby is aligned, there is this great trick to stroke a baby's lower lip downward for a feeding stimulus.
It's best to measure the time from the beginning of a feeding to next cycle's beginning of a feeding. Usually, a baby shows hunger cues every 2 1/2 - 3 hours which averages between 8 - 10 feeding cycles a day. Even though this varies from baby to baby, it's too easy to get into shorter intervals, so try to stretch if possible.
Still, sometimes your baby shows hunger cues sooner than 2 1/2. Often, this happens at so called "growth spurts" where your baby needs the nutrition for physical growth. During these times, a baby can wake up 40 - 50 minutes earlier from his/her nap with a great appetite. Usually, a growth spurt lasts 1 to 4 days. Are growth spurts predictable? While some people say growth spurts happen ten days after birth, followed by three weeks, six weeks, three months and six months, others believe it just varies from baby to baby. You may want to set your calendar times at the former times for a "likely growth spurt".
If your baby gets sleepy while feeding, which should happen less often after a sleep cycle, try to keep it awake by gently stroking it, talking to it, or rubbing his or her feet. Alternating breasts can help as well. A full feeding is essential to avoid cluster feedings.
Burping after feedings or when alternating breasts helps your baby to release air which it got in while sucking. With a gentle tapping on the back and the right position, your baby will be happy to get rid of the air for a better sleep. If the baby doesn't burp during the first week of life and is more interested in sleeping, gravity (e.g. raise its head over the rest of the body) does wonders (e.g. reflux) when putting your baby in the crib. Except for the late feedings and middle of the night feedings, placing a baby in an infant seat for 10 - 15 minutes helps to keep the milk in. Another way to support passing gas: place your baby in a knee-chest position.
You should end up with 5 to 7 wet diapers per day after his/her first week and 3, 5 or more yellow stools daily for the first month. This and consistent weight gain (not directly after birth, because then they can also loose weight) show a healthy and sufficient food intake for your baby.
Should you start the feeding routine from day one? No. After birth, take 7 - 10 days for just you and your baby without worrying about any routines. The single goal should be to provide a full feeding for your baby. This normally leads to a natural transition of a consistent 2 1/2 - 3 hour routine. Officials recommend to feed your baby with breastmilk for 1 year.
If you start with bottle feeding, either to supplement for formula or to give other care takers the chance to feed your baby with breastmilk, make sure to get the right nipple size for the bottle. While a too little hole keeps you awake with a hungry baby, a too large hole forces the baby to drink too much and makes it swollow more air.
How to get a baby on the feed-wake-sleep routine if the routine needs to be flexible enough to adapt to a growing newborn? As mentioned earlier, one cycle lasts 2 1/2 - 3 hours whereas in the very beginning, feed and wake cycle share the same time of ~30 minutes (more when including hygiene). The remaining time is sleeping time (2 - 2 1/2 hours). These are roughly 8 - 10 cycles a day.
However, with a growing baby, the waketime exceeds the sleeping time more and more and the sleeping time shifts more into the nighttime. So whenever you feel like you have established a routine, you need to make space for flexibility to adapt the routine to your baby's needs as well.
In order to get into a routine, see what time fits best for your baby in the morning for its first feeding. This time can be 7am or 9am, it doesn't matter, but once you pick a time which is best for your baby, you should try to stick to it within a 20 minute threshold, because once your morning feeding time changes, it's unavoidable that the whole day routine shifts as well.
With a growing baby, the waketime will get longer and the naps will get shorter during the day. Since the baby will sleep longer during the night (hopefully) and is awake for longer periods of time throughout the day, you need to make adjustments to your sleep-feed-wake cycles.
The objective is to get a baby from 8-10 feed-wake-sleep cycles a day as a newborn down to 3 cycles a day (whereas the feed cycle is breakfast, lunch, dinner) as a 10 - 12 months old. The technique used to reduce cycles over time (from 9 to 8, from 8 to seven, and so on) is called merging cycles.
There are some guiding principles that govern the merging: First, the principle of capacity and ability. While a newborn neither has the ability to sleep through an 8 hour night nor the capacity to make it through the night without food, a 10 months old child should be able to make it.
Second, the principle of time variation: With a growing baby, the cycles may shrink or stretch from 2 1/2 hours to 3 1/2 hours depending on your child's age, unique needs, and time of the day.
Third, the principle of individuality: While one baby experiences sleeping 8 hours through the night at 6 weeks, another baby makes it to this merge at 10 weeks.
And fourth, the principle of two steps forward and one step back: A merge of two cycles doesn't happen over night. It's a slow process which mostly takes around 4 to 6 days. So while the merge is happening, stay flexible.
On Becoming Babywise goes through all the merges step by step, that's why you should get it yourself, but I want to illustrate at least one merge from the book, the first merge between week 3 and 6, here: "Most babies start out with two feedings during the middle of the night. For example, let's say 2:00 a.m and 5:00 a.m. Sometime between weeks three and six, PDF (parent directed fed) babies beging to stretch their middle of the night sleep, from 3 hours to 3 1/2 to 4 hours. Consequently, they begin to merge the 2:00 a.m and 5:00 a.m feedings into a single 3:00 a.m "middle of the night" feed."
Fortunately, there are no other adjustments to make for this first merge for the rest of the cycles, but this isn't the case for every merge that's coming during the next weeks and months. If you continue this way, the next merge will drop the "middle of the night" feed between weeks 7 and 10 when parents will be allowed to sleep through the night again.
A good rule of thumb: If you are wondering how many hours a baby can sleep a night without lacking food, you can calculate a babies capable hours of sleep by 1 hour for each week when it's getting older than 5 weeks. This means a 5 week old is able to sleep 5 hours and a 7 weeks old is able to sleep 7 hours. If a baby sleeps longer than it should, it's okay to wake it up.
"Most days will be fairly routine and predictable, but there be times when flexibility is needed due to unusual or unexpected circumstances. Life will be less tense when parents consider the context of a situation and respond appropriately for the benefit of everyone."
As mentioned earlier, a baby's waketime as newborn is mostly there for feeding and hygiene (diaper, use water instead of commercial wipes, cord hygiene, bath time without soap). Once a baby grows, the waketime stretches and can be filled in with parents time or alone time to discover his/her own world.
Activities for Mom/Dad/Baby during Feeding:
- gaze into your baby's eyes
- talk to your baby
- gently stroke your baby's arms, head and face
Touching is the first language of your baby! It gives the baby a secure and loving feeling from you and your family members.
Other Activities for Mom/Dad/Baby:
- singing: shows your baby different techniques to use words
- reading: (see singing), but also explorable books (for touch sense and hearing sense) are great
- bath time (not during first week with attached cord stump, go easy on the soap, because it makes dry skin, trim your baby's nails after bath time)
- playing (e.g. cuddle, smiling, cooing, giggles)
- walking with a stroller or baby sling
Activities for Baby:
- sitting in infant seat or bouncy seat while watching parents preparing food, doing laundry, or other activities (fully reclined)
- tummy time (best time after feeding) on the blanket (start with 5 - 10 minutes, then go up to ~30 minutes or longer) when baby is able to hold his/her head up (happens between 12 and 16 weeks)
- Exersaucer for coordination
- Bumbo Seat for longer sustained waketimes while baby isn't able yet to sit by himself/herself
- a structured learning center (e.g. Playpen)
- mobiles (not before 3rd to 4th month, because baby is not able to focus)
These activities can be done during alone time for the baby. This doesn't mean that the baby isn't observed by its parents, but it should get the freedom to explore its own world without being constantly entertained by the parents.
Newborns are able to sleep from 17 - 19 hours a day. If a baby shows sleep cues, like rubbing eyes or yawning, it's time to put him/her down for a nap. By week 4, the waketime becomes a distinct activity which is fully developed by 8 weeks. While at 3 months a baby's length of naps starts to fluctuate (e.g. 1 1/2 - 2 hours), the daytime sleep during the day will decrease between 6 to 8 months.
If your baby doesn't have any health issues, has a fresh diaper and is fed, it's still normal for a baby to cry when it's put into a crib. A few minutes of crying will not undo all the care-taking you have done so far. Most often, babies will soothe themselves when they cried for a few minutes. "Think of the little crying as investment toward a lucrative gain."If the baby wakes up with a crying and it shows hunger cues, don't prevent it from its food even though it's not feeding time. You should feed your baby and instead look out for issues why it may not have enough nutrition.
If the baby has problems sleeping, try to find out what disturbs him/her. The most common cases are a hunger (e.g. insufficient breastmilk, no full feeding), being uncomfortable (e.g. unclean diaper, diaper rash, too cold/hot), tummy trouble (try it with burping), health issues (e.g. fever, new tooth, bug bites, toe tourniquet, reflux) issues with the environment (e.g. room too dark (light sensity emerges at about 3 months), overstimulation by mobile, overstimulated waketime, flickering of TV) or re-positioned itself and doesn't know how to get back. Another reason could be the routine which just merged two cycles, had a previous short waketime, or has a too flexible first feeding of the day. If it's not one of the common cases, check for patterns: For example, does the baby cry or is it unsteady during every nap or just every late afternoon nap? Does it happen for only a sequence of ~4 days (see growth spurt)?
Babies are ready for solid foods after 4 to 6 months. A good indicator is a hungry baby waking up during a normal nighttime sleep between 5 to 6 months, which indicates that the nutritions are not sufficient. Research shows that holding off solid foods until 5 to 6 months may decrease food allergies. Introducing a new solid food should happen with one item at the time every 3 - 5 days to exclude food allergies. If you start to introduce a new food item, do it in the morning, so that you are able to observe your baby during the day.
"Besides crying when hungry, babies have their own wat of singing the blues when tired, wet, sick, bored, frustrated, out of their routine, or fed too often; sometimes it is simply because that is what normal, healthy babies do. No parent finds pleasure in hearing that sound, especially if you are a first-time parent."
"Think of the crying as a signal, not a statement against your parenting." As a parent you will soon be able to distinguish a cry for help (abnormal) or a normal cry (e.g. boredom, before sleep, afternoon fussiness). Cries during feedings (e.g. improper latching, poor milk release), immediately after feeding (caused by gas, mother's diet, milk-quality problem), and in the middle of a sleep (see previous section) require attention. If parents hear a so called "abnormal cry", they should take action as well. If the cry is high pitched or a piercing cry, look out for external/internal body injuries.
Research shows that babies who were allowed to cry were better problem solvers at an age of 1 year. In contrast, babies with suppressed cries had problems. When parents surpress all crying, they deny all learning patterns (e.g. cry -> wet diaper -> change, cry -> hungry -> food) that are associated with them.
"Many babies cannot fall asleep without crying and will go to sleep more quickly if left to cry for a while. The crying should not last long if the baby is truly tired." A baby will learn how to sooth itself without a parent's intervention. Crying in a crib can last from 5 minutes up to 15/20 minutes, or a 35 minutes on and off cry. However, be sure that it's not because of a wet diaper, hunger or something else. If it's nothing from the latter, pat your baby on the back, maybe hold it for a while, but then put it back in the crib. Research goes as far to say as that babies need to release energy by crying to fall asleep.
Similar to other books about parents, Babywise has its extremes as well, so I guess you need to pick what fits best for you while mixing other parenting styles in there as well. However, it gave me a first introduction into how to create a routine for my baby. If you want to learn more about the weekly routines form Babywise and how you have to merge the cycles, you should read the book.