EAT, WAKE, SLEEP...

Making Babywise Work For Your Baby

When you utter the word “Babywise” you’ll get a variety of responses from your friends, family, and even strangers. I followed the Babywise method with my 3 boys, and I learned fast that you don’t talk about “Babywise” with anyone!  It shouldn't be this way. But it is. So what is Babywise, and why is it so controversial? In this blog post you will learn what the heck “Babywise” is, and how you can make it work for your baby and your family. 

What is Babywise?

The Babywise method is a philosophy of parent-directed child rearing. The first book, On Becoming Babywise, written by Gary Ezzo and Robert Bucknam MD, provides a solid foundation of structuring your baby’s day to maximize feeding and sleeping patterns. Ezzo has other books that dive into solid feeding (Babywise 2), toddler behavior (Toddlerwise), and even older children (Childwise). But we will just focus on the first book in this blog post. (And I don't necessarily agree with the content in the subsequent books!)

The Babywise philosophy relies on the motto: “Start as you mean to go on.” What this means is that it is beneficial to start with healthy feeding and sleep habits from the very beginning, instead of trying to fix things later when your infant is older and more set in their ways. The book proposes that you can avoid much of the sleep issues a baby goes through by focusing on getting enough calories in your baby during the day, and ensuring that your baby falls asleep on his own. Now whether that’s true or not is really up to the individual baby, their temperament and the temperament of the parents (how closely they are able to adhere to the method). As I’m sure you have heard, babies aren’t robots. And no blanket advice is going to work for every baby (or parent). There’s a discrepancy in interpretation of the book, plus your baby is a human being that can be quite unpredictable. However, as a sleep consultant I do recommend checking out the Babywise method to see if it may be right for you and your baby. There are absolutely universal truths in the book that, when implemented, really will help you start on the right foot with your baby’s sleep. 

What’s the Controversy?

The Babywise book has been around for decades (since 1993 to be exact). Misinterpretation of the book by parents, exacerbated by a vocal “demand-feeding” and “attachment parenting” crowd led to many myths. The fact that Babywise causes “failure to thrive” is a myth that could possibly have come from the interpretation of the first book. The history of newborn/infant feeding has actually swung back and forth between rigid feeding approaches, and a demand-feeding free-for-all. When Babywise was first written it may have taken too much of a scheduled feed approach based on the pediatrician recommendations during the time it was written. But the good news is that the updated versions do an AMAZING job of correcting these misinterpretations. The book spends a great deal of pages at the beginning diving into what “Parent-Directed Feeding” looks like, and how it differs from demand feeding and scheduled feedings. Because the truth is that yes, if you try to make a baby wait for their feedings because it isn’t “time” yet, then this could cause issues. 

Don’t listen to the inaccurate information that others say about Babywise, particularly that the AAP advises against it. The AAP does not advise against Babywise, but rather it advises against rigid feeding approaches. There was one pediatrician who wrote a letter about Babywise causing failure to thrive, but since then the AAP has made a statement that this was not the stance that the AAP takes regarding Babywise. 

Society is also very vocal about sleep training and crying in general. People assume you will be leaving your baby to “CIO”, regardless of what your baby may need. However, the book actually takes a pretty conservative approach, suggesting that you allow your baby to cry (I believe it states for “15 minutes”) then if your baby is still not asleep/back asleep then go into investigative mode. Is it gas? Is it hunger? Is a piece of hair wrapped around your baby’s toe? (it’s a thing!) Is your baby using something to fall asleep like rocking or a pacifier and it’s time to remove this sleep prop? This helps the parent become a detective and get to the root of the crying instead of just assuming your baby is hungry and sticking a boob or bottle in their mouth, which is not always meeting the true need. Knowing why the book is controversial can help you take a deep breath and separate opinion and misunderstanding of the book from the facts and strategies that may very well work for your baby and family.

Eat, Wake, Sleep

A big focus in the Babywise book is the idea of “Eat, Wake, Sleep”. You’ve heard it also as “Eat, Play, Sleep,” or the E.A.S.Y. method coined by Tricia Hogg, The Baby Whisperer. I am a huge advocate of the Eat, Wake, Sleep routine that Babywise outlines, as long as you do it the right way. 

Eat, Wake, Sleep (EWS for short!) means just that… Baby eats, Baby is awake/plays, Baby sleeps. The feeding comes at the beginning of the cycle, when Baby wakes up in the morning/from a nap. The reason that the feeding comes at this time is two-fold: first because that feeding will not come right before sleep, which causes a sleep association, and second, because Baby (in theory) will be awake and alert, rather than sleepy and fussy, and take a better feed. Let’s break this down a bit more. 

In my sleep plans it is imperative that the baby follows this EWS cycle. One of the hardest sleep associations to break is a feed/sleep association. This association is formed when a baby falls asleep or even gets drowsy while nursing or bottle feeding. It can also be formed if the act of eating occurs right before sleep as one of the last things that happens before being laid down, regardless of whether the baby stayed awake during the feed or not. So to fix this, we establish an EWS routine. This way we know that there’s lots of activities between feeding and sleep. Baby is also more inclined to stay awake more fully while feeding, avoiding that sleep association. Another perk to the EWS cycle is that Baby is more likely to take a full feeding since sleep won’t trump hunger during a feeding. With hunger out of the mix of variables as to why your baby is fighting going down for nap or bedtime, or waking up mid-nap, you can focus on other reasons for these sleep disruptions, such as a wake window issue, or a sleep prop (ie. rocking to sleep, pacifier use). 

Of course you will probably call me on the statement that Eat, Wake, Sleep is for every baby. And that’s true, sort of. As I mentioned above, babies aren’t robots. They don’t always take in the amount of ounces needed to sustain them for a full wake window for one reason or another. But there’s a work-around to this. I always suggest to my clients that they are welcomed to feed their baby if Baby acts hungry during a wake window. We do want to avoid snacking (having lots of smaller feeds throughout the day rather than bigger, more consolidated feeds), but I encourage my clients to focus on the “main” feeding at the beginning of a wake window, and a “snack” feeding if needed during the wake window, no less than 30-45 minutes before a nap. Make sure your baby stays WIDE AWAKE during this snack feeding, and have some play time after so as not to go straight from feeding to nap/sleep. If you find that your baby then decreases the amount of ounces during the next feeding, you might want to take a second look at whether the extra feed in the wake window is truly needed and serving its purpose. Often a baby who has multiple feeds in a wake window actually does not get more ounces in during a 24 hour period, because they will adjust their feedings due to not being hungry enough for a full feed. 

Eat, Wake, Sleep is pretty easy to attain if the math is right. For example, during a 3 hour EWS cycle, your baby may eat and stay awake for 90 minutes, then sleep for 90 minutes. When Baby awakens from the nap it’s time for a feeding and you start the EWS cycle again! But what if your baby only naps for 45 minutes? These short naps are so common and can be attributed to many different reasons. For the most part you can still follow an EWS routine, however you will just be feeding your baby a bit earlier than you might prefer. This usually is not a problem at all! Often Baby will make up for the lost sleep on a later nap. Or you might have early bedtime or an extra feed in the day with an extra nap. The time between feedings may vary based on your baby’s nap lengths, from 2 hours to 3.5-4 hours. This is perfectly fine, as long as by the end of the day you have at least the appropriate amount of feedings per day that your baby needs. (for example 5 feedings a day at 12 weeks old is perfect.) 

How to be an Eat, Wake, Sleep failure is to set your feeding times, at least if your baby is under 6ish months old. Why? Because your EWS cycle will eventually turn into WES, (“wake, eat, sleep”) which is what we are trying to avoid! If you do need to wait just a bit before feeding your baby (maybe baby isn’t hungry yet!) then wait 20-30 minutes before feeding your baby after a short nap, as long as you know your baby isn’t hungry, and have some play time after the feeding. Try not to go longer than that 20-30 minute window. If your baby is over 6 months you may find that set feedings are just fine because the wake windows are long enough to where that feed isn’t too close to nap. As long as you are feeding a hungry baby you’re good!

So to recap: 

1. Follow an Eat, Wake, Sleep routine during the day where you feed your baby a full feeding upon waking, have some play time, and put your baby down for a nap without feeding right before sleep. 

2. If your baby needs an extra feed during the wake window, no problem! Feed your baby, keeping him wide awake. Try to end this feed no less than 30-45 minutes before the nap and have some play time after the feeding. It seems to work best if this extra feed is more of a snack feeding.

3. If your baby wakes early from a nap, do not hold off on feeding your baby, especially if your baby is showing hunger cues. It is okay to feed your baby sooner than expected. If your baby is not hungry after waking from a short nap then wait 20-30 minutes, feed, then have play time after. (Eat, Play, Sleep, Play, Eat, Play, Sleep! Haha say that 10 times fast!) 

Independent Sleep

This topic is a doozy! And honestly I don’t feel like Babywise goes into exactly how to achieve this giant feat of baby falling asleep on her own. You could do everything right… but the truth is that there’s a big possibility that you will lay your baby down and your baby does not drift peacefully off to sleep, but will cry and fight sleep. That’s when you have to know how to respond to this crying in order to encourage your baby to fall asleep without anything external such as rocking, pacifier, or feeding. So please know that YOU ARE NOT DOING ANYTHING WRONG if you follow Babywise to a T and your baby does not immediately fall asleep on their own, without crying. When the time is right, this is what “sleep training” is for. Though the Babywise method is a form of sleep training, it doesn’t always produce the results of a “tear-free” put down when the time comes for sleep. In fact, there isn’t any sleep training method that can guarantee that. So just know that if your baby cries when you put her down for sleep the only way to teach your baby how to fall asleep more confidently (with less tears) is to go through the crying instead of avoiding it. Crying is a natural physiological response to a need. What is the need when a baby is tired? The need is sleep. And research says (1) (2) that infants who know how to fall asleep on their own without the help of anything external get longer and more restorative sleep. Teaching this skill, helping your baby unlearn ways of falling asleep that are less helpful now that he is not a newborn, and developing new associations with sleep, will help your baby become more confident in his ability to sleep when placed in the crib awake. 

The Babywise book only mentions briefly to let your baby cry for 15 minutes. Then it recommends going in and assessing your baby. Does your baby need to burp? Is your baby hungry? The book gives a long list of reasons why your baby may have trouble falling asleep or staying asleep. But in all honesty, the main reason is just that your baby needs practice falling asleep on her own. That struggle is uncomfortable for us as parents, who hate to see our little ones unhappy. The good news is that the bond and attachment you have with your baby creates a resilience in your baby that will get her through those tough experiences of learning something new, such as sleep. (and note: a baby does not learn sleep, as sleep is biological, but a baby does have to learn a new way to fall asleep… shake off the old associations of when he was a newborn and learn new ways to soothe.)

So what do you do then when your baby cries when being put down for nap time or bedtime? First, you will have ruled out hunger, following the Eat, Wake/Play, Sleep routine and focusing on full feedings. That’s the perk to Babywise!! So let’s break it down. You know that your baby is tired and that is why your baby is crying. You know that rocking or bouncing your baby to sleep may help your baby fall asleep initially, but not stay asleep. You can give your baby some time and space so that your baby’s natural self-soothing abilities will be triggered. For a baby 3-5 months this may look like sucking on his fist and kicking his legs up and down. For a baby 6+ months it might look like rolling around or rocking back and forth. But the baby will not automatically kick into these soothing methods if their brain associates soothing and sleep with something external such as using a pacifier or rocking, which is why giving your baby just a little time on their own helps encourage their brain to seek out those other ways of soothing. You can absolutely still be there for your baby during this process. You can stroke your baby’s face, rub or pat your baby’s tummy/back, and shush your baby or speak loving affirmations. Eventually your baby will fall asleep. And each time your baby falls asleep using their own internal self-soothing methods the association gets stronger and stronger so that it becomes a natural response when it’s time to sleep.

I’ve digressed just a bit on the Babywise focus… Sorry!! You get me started on this topic and it’s hard to stop! Back to Babywise! Your goal with Babywise is to set up an environment that is conducive to sleep and to encourage proper feedings. If everything falls into line (Babywise + the temperament of the baby is such that they don’t protest much) then you probably won’t have to have to deal with sleep training, at least not until a bit later when your baby decides they would rather practice their skills than sleep! But IF you have a baby that just doesn’t like to be put down and go to sleep, ya know.. one of those Nosy Nancys for example (Ain’t nobody got time for sleep! Too much to see and do!) just know that you have still done a great job of setting the stage for the next step which is moving through the crying to get to the other side, which is a baby who is more confident in falling asleep independently. 

How to View Babywise

Babywise is a mindset. And the fundamentals of Babywise are to be applied when your baby is ready and when you are ready. (as in, a baby dealing with severe reflux may not be ready for some parts of Babywise, but you can still follow certain principles!) And I’m going to say this… please don’t say “I just followed Babywise and my baby started sleeping through the night!” I know you did a lot of work, but don’t assume that the next Babywise mom didn’t do that same work, they are just working with a different baby and a different set of obstacles. 

If you are having difficulties following the Babywise method, PLEASE reach out! THIS IS MY SPECIALTY! I’m passionate about helping parents apply these principles to their unique baby and going from head knowledge after reading the book to experiential knowledge as they confidently apply the method to their baby’s days and nights. And if you’re not a fan of Babywise, don’t worry. Though there are some fundamental truths to sleep training that we must follow, there’s also flexibility and grace! I bet we can find something that works for both your baby and your family!