Fort Worth, Texas,
26
August
2014
|
04:36 PM
America/Chicago

‘The Newborn Sleep Book'

8 myths you should know

The anger and subsequent anxiety I felt after hearing about “The Newborn Sleep Book” surprised me. I am not a “crunchy” pediatrician by any means. I have taught families to sleep. This is why the feeling I got in my stomach is unexpected.

The book is written by two pediatricians in New York who happen to be brothers, Lewis and Jonathan Jassey. The premise is that, through proper training, you can space a newborn’s feeds out to every 4 hours, resulting in them being able to sleep through the night. Their recommendations include: allowing them to cry until their scheduled feeding time, using Benadryl® for sleep disruptions and increasing feeding volumes during the day to enable skipping nighttime feeds. It’s not the fact that they recommend sleep training; it’s their method that I find upsetting.

This goes against everything you are likely to hear from your pediatrician (certainly me), including the American Academy of Pediatrics. The AAP says some newborns feed as often as every 1.5 hours, while others about every 3 hours. The AAP also says breastfed newborns will feed 8-12 or more times per 24 hours once a mom’s milk has come in.

Oh and here’s something else important from the AAP: “If your baby isn't waking on his own during the first few weeks, wake him if 3-4 hours have passed since the last feeding.”

So that’s a group of 62,000 pediatricians’ recommendations who I tend to agree with on most things and two pediatricians who I couldn’t agree with less.  But I’m not finished making my case. Here are 8 myths I found particularly bothersome in the book:

1. MYTH: The authors have “continually researched and practiced (their) method, adjusted, and practiced some more.”

FACT: The best report of their results is this: a “ballpark estimate is that, since we started coaching parents …over 15 years ago, nine out of 10 parents who have followed through have been successful.” My scientific mind is not satisfied and neither should yours. I am not asking for a randomized, double-blind placebo trial, a simple survey would have been better than a “ballpark” estimate.Very few things in medicine have a 95 percent success rate. So, if you have the research, prove it … if not, it would not be that hard to get.

2. MYTH: Their method is the best way to get your child to sleep through the night.

FACT: The results I do see reported in the book are underwhelming. Their testimonials of patients who began to sleep through the night, included children with ages ranging from 6 weeks to 3 months.  A 2010 study in Pediatricsshowed that 37 of 75 babies were sleeping through the night during their third month. If you took testimonials of parents from that study (which are often the best case scenario), I would imagine you would find plenty of babies who would be sleeping through the night just as early as the Jassey families, many with no fancy plan.

3. MYTH: The authors are Ok with saying that their method may not work for everyone.

FACT: They go on to say later, “sleep training is by no means selfish on the part of the parents. In fact, since its benefits to both baby and family are undeniable, we might say that not sleep training…is a more selfish choice.” First of all, “undeniable?” Not so fast. That is still up for debate. I guess everyone has the right to make their own choices, even if they don’t mind making selfish choices, by not sleep training their children. It’s like saying; there really are no dumb questions, unless you ask a dumb question.

4. MYTH: Scheduling, even from a very early age poses no risk to babies.

FACT: Scheduling from birth as they suggest is dangerous and puts babies at risk, period. Not feeding on demand puts moms at risk for lactation failure. Their recommended 8-12 feedings (for 1-2 days) on demand is not enough for many moms to establish good milk supply. Ask any lactation consultant or pediatrician who understands milk production and they will either laugh or cry at the suggestion that scheduling this early will not affect milk production. In addition, infrequent feeding places babies at risk for increased weight loss and more severe jaundice, which requires further treatment and testing. If you are my patient, please do not schedule your baby from birth!

5. FACT: Crying babies are not all hungry (I actually agree with them, up to a  point …)

MYTH: You should never feed a baby before the time you have scheduled for them.

FACT: The authors state that our first response to a crying baby should not always be to feed them (again, I agree). However, I feel that we can go through our usual steps to comfort them (change diaper, pacifier (if a family chooses), rocking, etc.) and if they do not work, it is reasonable to attempt to feed.

6. MYTH: The authors state that they do not endorse formula feeding over breastfeeding.

FACT: Their method involves careful measuring of volume to ensure your baby gets enough each day don’t “have” to feed at night. Breast feeding simply does not work this way. A breastfeeding mom can’t simply feed a little bit longer… when the breasts are empty, they’re empty. So, while they may not endorse formula feeding, their method could push families toward formula feeding.

7. MYTH: If your baby’s sleep is disrupted for any reason (teething, vaccines, etc.), a combination of Tylenol®, Benadryl® and Motrin® will help to “reset their clock.”

FACT: Uhhh, not for my patients. If your baby is fussy and you think it might be pain from teething, I am Ok with giving a dose of Tylenol or Motrin, but not along with Benadryl. The benefit is slim and the risk of an adverse event (whether appropriately or inappropriately dosed) is too high. Of course, they also mention using teething gels and you should know how I feel about them. There is no reason to treat a normal developmental stage with medicine.

8. MYTH: Feeding your child on their schedule means they will not “become hungry at inconvenient times-like 2 a.m.”

FACT: Parenting is about facing inconveniences. are ways to help your child fit into your life better than others, the very premise of this statement offends me. I’m sorry if your little baby woke up and tried to bother you at night for something to eat. I hope it wasn’t too much of an inconvenience.

The authors do address a concern in their book. It happens to be about co-sleeping, but that’s not important to them:

“We are inherently suspicious of any parenting technique that is so obviously weighted to the parents’ wants over the potential benefits to the child.”

Huh? Me too. This is why I would never recommend their book to my parents.

 

About the author

 Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.

Comments 1 - 3 (3)
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Heather Fuller
26
August
2014
Thank you for this article. All of these books about how to get your child to sleep, through scheduling, drive me nuts. I wake up in the middle of the night, thirsty, and I don't ignore my thirst. The one place I did find issue with your article is when you stated "A breastfeeding mom can’t simply feed a little bit longer… when the breasts are empty, they’re empty." Breasts never truly empty, the flow will slow, but they always have some milk. However, you can't force a baby to eat when they're done and a baby may get annoyed with slow flow and be done.
Justin Smith (The Doc Smitty)
26
August
2014
Heather,I understand what you are saying about the mechanics of breast feeding. The statement was a figure of speech to say that you can't just "tank" a baby up when you are breastfeeding by giving them an extra ounce or two. The only reason you can do that with a bottle is because you can continue to dump milk in their mouths through the nipple. The mechanics of breastfeeding just don't work that way as you mentioned in your comment.
Siobhan mulligan
27
August
2014
Perhaps these authors (pediatricians?!) should do some research into attachment and trauma. The idea of ignoring an infant's cries in order to 'train' them is reprehensible. And to give an infant Benadryl simply to make them sleep through a biological need? Ridiculous! Babies give voice to their bodies' needs by crying....ignoring that is like second-guessing nature. What if they are going through one of the oh-so-frequent growth spurts where their bodies are trying to stock up?