Background Information for Leaders
from LEAVEN, Vol. 34 No.
2, April - May 1998, pp. 20-21
by Cyndi Sherar
LLLI Board of Directors
See also "Counseling Challenges: Helping Mothers Handle Conflicting Information" from the April-May 1998 issue of LEAVEN.
Q What if I think the mother is following a particular parenting program but I'm not sure?
A Use active listening skills to focus on the mother's feelings and concerns. Ask if what you are saying sounds right to her or if it is different from information she has heard or read elsewhere. Respond in a thoughtful way to her specific questions or concerns. Once you have developed a rapport with her, she may feel more comfortable telling you about a particular parenting program she is following.
Q What if I strongly disagree with the parenting program the mother follows?
A Although some programs and individuals have criticized LLL, our philosophy and the parenting choices we discuss, it is important to keep in mind that we help an individual mother, regardless of what parenting program she follows or what she believes about us. Providing accurate information about breastfeeding and LLL in a respectful manner is our goal regardless of the person's belief system. If we express indignation or fall into an argument we cannot effectively communicate the information that may be needed.
Q What do I say if the mother is critical of "attachment parenting" or indicates her baby spends significant time alone?
A Keeping baby with you (carrying in a sling, co-sleeping) are aspects of a parenting style some refer to as "attachment parenting." There are many forms of attachment parenting and each is a personal choice; not all mothers or LLL members practice this kind of parenting. Although these practices can help mothers implement LLL recommendations to keep baby close and breastfeed often they are not essential to effective breastfeeding.
However, if baby sleeps alone, sleeps through the night or spends awake time alone, we will also want to tell the mother about early hunger cues such as squirming, grimacing, hand-to-mouth movements and rooting. Crying is a very late feeding cue. It is therefore important that a mother respond quickly so her baby is not too frustrated to latch on. (See American Academy of Pediatrics Policy Statement.) [Found at the end of "Counseling Challenges: Helping Mothers Handle Conflicting Information"]
Q How can I help a mother realize that a strict feeding schedule can put her baby at risk?
A Discussing adequate intake and weight gain is essential, as is stressing the importance of keeping in close contact with a health care provider. You may need to ask the mother direct questions such as, "Do you feel your baby is gaining well on this feeding schedule? Has the baby been weighed regularly by your health care provider?" It is important to make sure there are no other underlying health problems.
Information on growth spurts and increasing milk supply should also be discussed. The mother may have been told that in order to increase her milk supply, she should nurse less often so that the baby will eat more at each feeding. Just telling the mother to nurse more often not be helpful if she has been misinformed or does not understand the role of supply and demand in establishing and maintaining an adequate milk supply.
Q Strict schedules, teaching children that their needs are secondary to parental needs and regular time alone don't sound like loving guidance to me. How can I address these issues?
A As in any helping situation, if questions of scheduling, discipline or "appropriate" behavior come up, it's helpful to share information about typical development. Leaders can also state LLL's concept on loving guidance, giving examples of other mothers' experience.
If the mother wants to discuss these issues, some Leaders have found it helpful to suggest that the mother apply the baby's schedule to herself. How would she feel about eating only at scheduled intervals, enjoying contact with loved ones only at scheduled times and so on?
Q If a mother seems uncertain about what she has read or heard, what can I tell her to help her read critically?
A Some questions you can ask include: What studies are cited? Who sponsored them? How does her own experience confirm or conflict with this information? How far removed from the source is this information? Is the information based on one opinion/study or several? (See the section on "critical reading" in the LEADER'S HANDBOOK.)
Q What is the LLLI policy on this parenting program?
A LLLI does not have a policy on this or any other parenting program. We are experts in breastfeeding management and have more than 40 years experience to back up that expertise. Many, if not most, of the breastfeeding management techniques our experience has led us to are now supported by scientific research. There is concern, however, when a baby is not breastfeeding adequately or not gaining weight well. These are the primary issues for Leaders to address, while urging the mother to keep in close touch with her health care provider.
Ed. Note: The Babywise Parenting Program/Growing Families International (GFI) was founded by Gary and Anne Marie Ezzo. Health care providers, including those associated with LLL such as William Sears, Kathleen Auerbach, Lawrence Gartner and Marianne Neifert, have publicly expressed concern about the potential risk to infants caused by strict adherence to the program. The Orange County California (USA) Human Services and James Dobson of Focus on the Family have also raised questions about this approach to infant feeding and parenting.
In October 1997, Grace Community Church, Sun Valley, California, USA, where the program originated, publicly distanced itself from GFI on the grounds of the program's "confusion between biblical standards and matters of personal preference."
In December 1997, the American Academy of Pediatrics issued a policy statement that describes breastfeeding a baby whenever the baby shows signs of hunger as one of the most important "recommended breastfeeding practices." (See American Academy of Pediatrics Policy Statement.) [Found at the end of "Counseling Challenges: Helping Mothers Handle Conflicting Information"]
Parents who attend a Babywise Program may be told that:
- Babies need order, routine and structure from birth on. Feeding time / awake time / sleep time are scheduled in that order.
- Feeding intervals: Newborn - 2.5 hours from the end of one feeding to the beginning of the next. Three months of age - 3.5 to 4 hour intervals.
- Regular playpen time is necessary for baby to learn to entertain himself, concentrate and learn creativity within boundaries.
- Late afternoon and evening crying is a baby's way of releasing energy. If other reasons for crying have been eliminated, baby may need to cry.
- Babies need to learn to go to sleep on their own. Babies should not be nursed or rocked to sleep.
- The marriage relationship is the primary family relationship; children are to be integrated into the existing family structure.
- Attachment parenting, feeding on demand and meeting the child's comfort needs through breastfeeding are discouraged.
How to Know Your Healthy Full-term Breastfed Baby Is Getting Enough. LLLI 1994. Publication No.457.
Mohrbacher, N., Stock, J. BREASTFEEDING ANSWER BOOK. Schaumburg, Illinois: LLLI 1997. Especially Chapter 3 "Breastfeeding Basics," Chapter 6 "Weight Gain," Chapter 18 "Making Adjustments as a Couple."
THE WOMANLY ART OF BREASTFEEDING, Schaumburg, Illinois: LLLI 1997. Especially Chapters 5, 6, 7, 10, 17, 18 and Selected References pages 430-54.
Williams, N. A challenge to LLL. LEAVEN May/Jun 1993; 43.
Williams, N. A challenge to our beliefs. NEW BEGINNINGS Sept/Oct 1993; 149-50.
Other LLL Resources
Lawrence, R. Breastfeeding: A Guide for the Medical Profession, 4th ed. St. Louis: Mosby 1994.
Rhodes, V. Learning from a differing parenting curriculum: an opportunity to sharpen our helping skills. Ten Gallon Tidings, LLL of Texas Area Leaders' Letter, Summer 1996; 6-9.
Riordan, J., Auerbach, K. Breastfeeding and Human Lactation. Boston and London: Jones and Bartlett, 1993.
Stuart-Macadam, P, Dettwyler, K. Breastfeeding: Biocultural Perspectives. Hawthorne, New York: Aldine de Gruyter, 1995.
American Academy of Pediatrics Policy Statement on Breastfeeding and the use of Human Milk. Pediatrics December1997; 100(6):1035-39.
Anderson, G.C. Risk in mother-infant separation postbirth. IMAGE: J Nurs Sch 1989; 21:196-99.
De Carvalho, M., Klaus, M., Merkatz, R. Frequency of breast-feeding and serum bilirubin concentration. Am J Dis Child 1982;136:737-38.
De Carvalho, M. et al. Effect of frequent breast-feeding on early milk production and infant weight gain. Pediatrics1983; 72:307-11.
Griffith, K. "Raising babies God's way may not be the best right way." Bradenton Herald Apr 26, 1997: 8-10.
Gunther M. Instinct and the nursing couple. Lancet 1955; 575-78.
Kippley, S. Raising your family: contradictory ideas. Couple to Couple League Family Foundations Mar/Apr 1997; 14-15.
Tuohy, P. Babywise Reviewed. Little Treasures Feb/Mar 1998; 65:59.
http://www.aap.org/policy/re9729.html Policy Statement on Breastfeeding and the Use of Human Milk of the American Academy of Pediatrics.
http://www.fix.net/~rprewett/fam.html Resources and Articles of Interest to Christian Families Includes "A Statement Regarding Gary Ezzo and Growing Families International" by Grace Community Church.
http://www.fix.net/~rprewett/evidence.html Examining the Evidence for Cue Feeding of Breastfed Infants December 1997, Marasco, L., Barger, J.