Book Review: Newborn Sleep Book

From the time it was released, I’d heard lots about the Newborn Sleep Book by Drs Lewis and Jonathon Jassey.  Most of what I heard was negative, given that most people I know are not really into sleep training (neither am I).  However, I decided it wasn’t fair to condemn the book without actually reading it, so I reserved it at the library and just finished reading it.

First for the positives.  I appreciated the humor in the book so it read very quickly.  In fact, I finished it in a single day.  I also appreciate that they do not actually condone Cry It Out (CIO). It is also apparent that these doctors truly wish the best for babies, and they rightly remark that parenting should be joyful. Unfortunately, that might be the extent of my praise for the book. Let me note now that I do not think these doctors or the parents who follow their advice are selfish or bad parents or anything of the like.

It is a sad fact that pediatricians are not required to know much about breastfeeding, and these pediatricians appear to have a lot of misinformation when it comes to breastfeeding as a result of that. For example, the comment was made that feeding on demand may lead to the baby feeding more and more often and may lead to the mother running out of milk (p15). However, breastfeeding works on a supply and demand basis, so if the baby is feeding more often, the mother will make more milk, not run out of milk. The Jasseys claim that nighttime feeds are unnecessary (p5), yet prolactin levels are highest at night and early morning. The claim is made that even breastfed babies can eat only 5x/day once the milk has come in, yet that would be detrimental to the supply of many, myself included.

Besides the breastfeeding misinformation, the advice given simply doesn’t work well with exclusive breastfeeding.  For example, they say that babies need roughly 2.25 ounces of milk per pound of body weight (p14), but since breasts don’t come with measurement lines, breastfeeding mums don’t know exactly how much milk their babies are getting. Later they do say that 15-20 minutes per side should give that amount, so they do try to accommodate breastfeeding mothers in that way, but I’d like to know how to make a baby feed longer if he doesn’t want to do so.  On page 24, they say you can achieve a full night’s sleep in part by adding 0.5 ounces to the final feed of the day – again, breastfeeding mums don’t know the exact amount the baby is taking, and it really is impossible to make a breastfed baby nurse longer than he wants.

I also definitely disagreed with the authors’ opinions on self-soothing. To them, it is an essential skill that should be learned as early as possible. I found some of their reasons to bolster this opinion to be no better than scare-mongering. In the introduction, for example, the claim is made that babies who don’t learn to self-soothe have more trouble sleeping alone, potty-training, being away from parents, etc (p xxviii). No studies are given to support that (indeed, most of the book is based on anecdotal evidence from their practice, not studies). To give my own anecdotes, I did not make my children “self-soothe,” but have been on schedule or early for milestones.

The claim is also made that if babies are demand-fed and not made to self-soothe, they will be spoiled and never learn to handle hearing “no.”  In fact, they insinuate that most spoiled individuals probably were demand-fed, though they admit they can’t prove that. I see all this as nothing more than scare-mongering since there is no proof of their claims. Besides that, the American Academy of Pediatrics recommends feeding on demand.

Now, the main theme of the book is, of course, sleeping. Specifically, it’s about getting the baby to sleep for seven hours in one stretch at night. Why seven hours? I’m not really sure. When I was looking for how sleeping rough the night was defined, I found anything from five/six to eight+ hours. I didn’t see any objective basis behind the times given. Of course, even adults aren’t necessarily meant to sleep in one eight-hour block, as historians have pointed out that, prior to the Industrial Revolution, we had two blocks of sleep lasting three-four hours, with about an hour of wakefulness between those.

The Jasseys rightly speak of the dangers of chronic sleep deprivation and the importance of sleep for the whole family. However, they then claim that you must sleep train for that to happen. Co-sleeping is derided as something purely for the parents (p80) and that is dangerous (p82) and will ruin intimacy (82). Co-sleeping can indeed be dangerous – if done incorrectly; similarly, cot-sleeping can also be dangerous if done incorrectly. Done correctly, though, it is every bit as safe. While I fully acknowledge that co-sleeping isn’t for everyone, it is a way to ensure everyone gets needed sleep for those who wish to co-sleep, while also facilitating nighttime breastfeeding.

In the end, then, I personally see no reason to endorse this book. While the authors mean well, the information on breastfeeding is woefully wrong, which could mislead mothers. In fact, the last chapter is patient testimonials and I noticed that the women who remarked that they were breastfeeding did not end up exclusively feeding, but supplemented with bottles, which I find telling. The lack of peer-reviewed studies to back up the assertions is also concerning. I know they were trying to ensure the book was accessible to all, but they could do that and still cite studies. Given that their breastfeeding advice contradicts the AAP guidelines, I do hope the AAP respond to the book.

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