There are three feedings philosophies when it comes to babies: Child-Lead Feeding, Clock Feeding, and Babywise Parent-Directed Feeding.
One of the biggest misconceptions I hear about Babywise is that it is solely focused on the clock when it comes to feedings. This is where the idea that children "fail to thrive" through Babywise, because they are only fed on a strict clock schedule regardless if they're hungry or not. This is actually the Clock Feeding philosophy, which is NOT part of Babywise.
Let's break down each of these philosophies.
Child-Led Feeding
Feeding times are guided strictly by a single variable: the presence of baby's hunger cues (sucking sounds, hands moving towards mouth, slight whimpering or crying). The hunger cue is considered a variable because feeding times are random and unpredictable. For example, 3 hours may pass between feedings, then 1 hour, followed by 20 minutes, then 4 hours. It might also be "clusters of feedings" such as five short nursing periods in 3 hours, followed by a long stretch of no feedings. Either way, the time between feedings is not considered important because the theory insists that parents submit any cue that looks like hunger, regardless of the lapse of time (On Becoming Babywise; Chapter 2; p. 44).
The problem with this philosophy:
Hunger Cue + Nothing = Feeding Time
"Plus Nothing" means there are no other factors considered that determine when baby is fed except the hunger or crying cues of an infant.
Babies, especially in the early stages of life, are constantly changing and growing - this can lead baby to engage in behaviors that may appear as hunger cues when they are not. A baby may put their hands in their mouth out of hunger, but they also may due to teething or discovering their hands. A baby may cry because they're hungry, but they also may cry due to needing a diaper change, being too cold or too hot, overstimulated, overtired, and an endless amount of other factors. And if a baby is weak, sickly, sluggish, overly sleepy, etc., they may not show traditional hunger cues for 4, 5, 6, hours which could put baby at risk of not receiving proper nourishment.
Clock Feeding
Feeding times are guided strictly by the constant of time, as measured by the clock. The clock determines when and how often a baby is fed, usually on fixed intervals of time. Looking for hunger cues is not considered important, since feedings times are always predictable. The clock thinks for the parent (and the baby), and the parent's role is to be submissive to the clock (On Becoming Babywise; Chapter 2; p. 44).
The problem with this philosophy:
Clock + Nothing = Feeding Time
"Plus Nothing" in this equation, means nothing but the clock determines when a baby is to be fed.
In my opinion, this philosophy is the one that has the highest risk of causing a "failure to thrive," because it does not take into account growth spurts which necessitate increased feeding. One day a baby may be totally fine feeding every 3 hours, but when they hit a growth spurt they may need to eat every 1-2.5 hours. If you are strictly relying on a clock, not taking into consider any other factors, this could lead to unnecessary hunger - and unnecessary crying, sleep disturbances, etc., that could easily be remedied. A strict clock schedule may also not promote sufficient stimulation for breastmilk production, leading to the second greatest cause for mothers giving up breastfeeding: low milk supply (the first is mother fatigue).
Babywise Parent-Directed Feeding
(On Becoming Babywise; Chapter 2; pg. 45-47)
Both the variable of the hunger cue and the constant of time are viewed as necessary tools of assessment. Parent-Directed Feeding eliminates the tension of relying exclusively on the unreliable variable of a hunger cue or the insufficient constant of the clock.
With Parent-Directed Feeding, both the variable and the constant are used as companions.
Hunger Cue + Clock + Parent Assessment = Feeding time
With the Parent-Directed Feeding approach your feed you baby when he is hungry, but the clock provides the protective limits so you are not feeding too often, such as every 30 minutes-1 hour, or too little, such as every 4-5 hours. Parent-Directed Feeding brings into play the critical tool of Parental Assessment, which is the ability to assess a baby's needs and respond accordingly. After all, no one knows your baby better than you! Parental Assessment frees a mother to use the variable of the hunger cue when necessary and the constant of time when appropriate.
Parent-Guided Feeding guided by Parental Assessment provides tools to recognize and assess two potential problems with infant feeding:
A breastfed child who feeds often, such as every hour, may not be receiving adequate nutrition due to milk supply, milk quality, poor latch, etc. Using parental assessment, parents not only respond to the cue by feeding, but are alerted to a potential problem with the feedings.
When the hunger cue is not present, the clock serves as a guide to ensure that too much or too little time does not elapse between feedings. It is also a protective backup for weak and sickly babies who may not be able to cry effectively.
When the hunger cue is present, the clock is submissive to the cue because hunger, not the clock, determines the feedings.
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