Parent-Directed Feeding (PDF): The Babywise Alternative

Flexibility & parental-assessment are key to the feed-wake-sleep method.

A more user-friendly, less-fatiguing infant feeding strategy exists

While some mothers thrive emotionally on attachment-style parenting, that is not the case for most women.

We'd like to introduce you to a more user-friendly, less-fatiguing, Babywise-alternative that exists and is known as Parent-Directed Feeding (PDF). PDF is an infant-management strategy that helps mothers to connect with their babies and babies to connect with everyone in the family.

PDF is the center point between hyper-scheduling and the re-attachment theories. It has enough structure to bring security and order to a baby’s world, yet enough flexibility to give Mom the freedom to respond to any need at any time.

It is a proactive style of parenting that helps foster healthy growth and optimal development.

For example, a baby cannot maximize learning without experiencing optimal alertness, and he can only experience optimal alertness with optimal sleep. Optimal sleep is tied to good naps and established nighttime sleep.

These advanced levels of sleep are the end result of consistent feedings. Consistent feedings come from establishing a healthy routine. PDF is the pebble that creates the ripple effect leading to all these outcomes, including true parent-child attachment.

Embedded in the parent-directed strategy is a critical element for all aspects of infant care: Parental Assessment, an acquired confidence to think, evaluate and intuitively learn what a baby needs and how to meet specific needs at specific times.

So what are the advantages of the parent-directed feeding approach? The following comparative analysis of the three common feeding philosophies answers that question and more.

Advantages of Parent-Directed Feeding

The three prominent feeding philosophies include:

  • Child-Led Feeding (also known as cue feeding, demand feeding, response feeding, ad lib, and self-regulating feeding)
  • Clock Feeding (also known as fixed-scheduling)
  • Babywise Parent-Directed Feeding (PDF)

Let's look at each of these three feeding theories in practice:

1. Child-Led Feeding

Feeding times are guided strictly by a single variable: the presence of a baby’s hunger cues (sucking sounds, hands moving toward 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 feeding” 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 to any cue that looks like hunger, regardless of the lapse of time. 

2. 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 feeding 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.

3. Parent-Directed Feeding

Both the variable of the hunger cue and the constant of time are viewed as necessary tools of assessment.

The Babywise Philosophy of Parent-Directed Feeding

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 PDF, both the variable and the constant are used as companions, backups to each other, not antagonists to be avoided. Consider the PDF equation with the inclusion of Parental Assessment (PA).

Hunger Cue + Clock + PA = Feeding Time

With the parent-directed approach, you feed your baby when he is hungry, but the clock provides the protective limits so you are not feeding too often, such as every hour, or too little, such as every 4-5 hours.

PDF brings into play the critical tool of Parental Assessment, which is the ability to assess a baby’s needs and respond accordingly. Parental Assessment frees a mother to use the variable of the hunger cue when necessary and the constant of time when appropriate. 

Benefits of Parent-Directed Feeding

Here are some of the benefits of the PDF approach:

  1. PDF guided by Parental Assessment provides tools to recognize and assess two potential problems with infant feeding:
    1. The breastfed child who feeds often, such as every hour, may not be receiving adequate Using parental assessment, parents not only respond to the cue by feeding the baby, but are alerted to a potential problem with the feedings.
    2. 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 It is also a protective backup for weak and sickly babies who may not be able to cry effectively.
  2. When the hunger cue is present, the clock is submissive to the cue because hunger, not the clock, determines

When Parental Assessment is part of the equation, parents are protected from moving to the extremes of feeding.

Parent-Directed Feeding and True Attachment

Beyond the assessment tools, the Babywise principles also facilitate parent-child attachment. This is achieved by creating an orderly environment in which growth and development are optimized.

The fact that a baby’s biological, neurological and rhythmical needs are merging with Baby’s natural capacities, means nothing is hindering the upward progress toward comprehensive attachment.

“Comprehensive” refers to the total spectrum of growth and development as measured by an infant’s attainment of his or her developmental capacities. The infant who fails to attain these basic capacities will be deprived of a healthy relational attachment. Here’s why:

Infants are born with seven capacities, that when met, provide objective markers that comprehensive attachment is being achieved. These markers include babies who:

  1. Synchronize their feed-week-sleep cycles into predictable patterns
  2. Can fall asleep without a rocking or nursing prop
  3. Sleep through the night eight to ten consecutive hours
  4. Have a predictable nap routine
  5. Have content wake-times and are adapt to self-play
  6. Are able to self-soothe
  7. Are comfortable with a variety of care-givers (fathers, siblings,  grandparents).

These indicators confirm Baby is not stressed or anxious. These are attachment markers. In contrast, Attachment Anxiety is marked by the twelve, eighteen month, or two year old, who is not sleeping through the night, not taking regular naps, unable to self-soothe, is anxious when left alone, or not adapt at self play for sustained periods.

Such underdeveloped capacities during a time when they should have been attained, reflect attachment deficits. Fortunately, there is an alternative. Babywise helps infants match attachment needs with capacities for a true comprehensive  attachment experience!

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Parent-Directed Feeding and Flexibility

We previously defined Parent-Directed Feeding as a 24-hour infant management strategy designed to help parents connect with the needs of their baby and help baby connect with everyone in the family. The two relevant thoughts contained within this definition include: “24-hour” and “management.” The first represents a baby’s day and the second speaks to Mom and Dad’s involvement in their baby’s day—they are to be the managers. But what exactly are parents suppose to manage? The short answer is the continually evolving, changing, and growing needs of their baby.

Children come into this world with basic needs for nutrition, sleep, cognitive growth, love and security. As a baby grows, these needs do not change, but how these needs are met will change.

Therein lies the challenge.

How do you establish a baby’s routine that is predictable, yet “flexible” enough to meet a baby’s growing and changing feed-wake-sleep needs?

Part of the answer comes from understanding the meaning of flexibility.

The root word, “flexible,” means “the ability to bend or be pliable.” To think of a flexible item, think of something with a particular shape that can bend or be pulled and then return to its original shape. Returning to its original shape is perhaps the most critical element of flexibility.

During the crucial early weeks of stabilization, it is important that you shape and form your baby’s routine. Too much flexibility will not allow this to happen. That is why a baby’s routine must first be established before flexibility is introduced into Baby’s day.


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Summary of Parent-Directed Feeding and the Babywise Method

One of many advantages of parent-directed feeding is the success mothers have with breastfeeding. Knowing your baby’s nutritional needs are being met in an orderly fashion provides greater confidence. While confidence is a positive thing, do not become complacent when it comes to monitoring your baby’s growth.

Knowing what to expect in the first week (and beyond) and knowing what nutritional indicators to look for can make all the difference in the world, particularly when it comes to your sense of confidence and baby’s welfare. These indicators provide Mom with guidance and feedback on how well she and her baby are doing. They confirm that things are going well and they warn of any condition that needs your immediate attention. (Anytime you notice unhealthy indicators, call your pediatrician and report your objective findings.)

The Parent Directed Feeding method reinforces flexibility and the importance of parental assessment. PDF supports you as a parent while also providing the structure baby needs.


Excerpted with permission from On Becoming Babywise by Gary Ezzo, M.A. and Robert Bucknam, M.D., copyright Parent-Wise Solutions, Inc. You can learn more and purchase the book here.


This post provides content and discussion related to health, wellness, and related subjects.  The words and other content provided in this blog including links, should not be considered medical advice and should not be construed as such. Any health/wellness information should not be considered an alternative or replacement for information given to you by a licensed physician. If the reader or any other person has a medical concern, he or she should consult with a licensed physi­cian.

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