PART ONE BABY WISE


Part One January 2000

BabyWise? BeWary!
WHO IS GARY EZZO AND WHY DO BABY AND CHILD CARE
PROFESSIONALS FIND HIS ADVICE SO DISTURBING?

     Attend any baby shower these days and you’ll probably be introduced to the book On Becoming Babywise by Gary Ezzo. You’ll probably also hear passionate testimonials to its effectiveness in getting babies to sleep through the night.
     But fundamentalist minister Gary Ezzo, author of the book and champion of his own “parent-directed feeding” plan (PDF), is not so popular among child development experts, pediatricians, and lactation consultants—secular or Christian.
     When T. Berry Brazelton, M.D., professor emeritus of pediatrics at Harvard Medical School and world renowned author and lecturer on baby and child development was asked his opinion of the Babywise parenting books during an interview with the Cincinnati Enquirer, he responded, “I’m horrified. I’m absolutely horrified.”

Who is Gary Ezzo?
     Though you’ll never find it in his secularly packaged book, On Becoming Babywise, 51-year-old Ezzo spent most of his career as a minister in independent, evangelical churches. He has no credentials in child development, healthcare, breastfeeding, or baby care. In fact Angelo Gary Ezzo never finished an undergraduate degree. In 1983 Ezzo graduated from Talbot Theological Seminary with a Master’s of Arts in Ministry degree through a special degree plan offering Bible courses to ministers without college degrees.
     Today Ezzo is executive director of Growing Families International, with the stated goal of raising “a godly generation to the glory of God and not the glory of man.”

The Rise of Growing Families International
     In 1984 Ezzo and his wife Anne Marie, reportedly a “nurse with a background in pediatrics” (the Ezzo’s have yet to release her credentials publicly), began teaching parenting classes through the huge Grace Community Church in Sun Valley, California. With an emphasis on strict obedience and the promise of rearing morally upright children, the classes grew.
     At some point Ezzo decided that his techniques were more than just his opinions, they were, in fact, “God’s way” of raising children.
     With this bold proclamation and the extensive resources offered by Grace Church, Ezzo began publishing books, tapes, and videos on child rearing, including Growing Kids God’s Way, Preparation for Parenting, and Preparation for the Toddler Years. The curriculum was soon being taught in churches across the country.
     In 1989 Ezzo’s rapidly expanding ministry, Growing Families International, became a for-profit corporation.

Controversy Grows
     Despite its popularity among parents, not one documented professional organization devoted to baby and childcare — evangelical Christian, liberal Christian, or secular — supports Ezzo’s unorthodox views and many openly oppose them.
     Frequently the controversy has focused on Ezzo’s philosophy that “God’s plan” is for babies to be “taught” how to sleep through the night through carefully scheduled feedings (“parent-directed feedings”), playtimes and naps; and by refusing to rock or feed babies who cry when they “ought” to be sleeping.
     Mothers were told, “When your baby awakens, don’t rush right in to him or her. Any crying will be temporary, lasting from five to forty-five minutes.”

Parent-Directed Feeding (PDF)
     Parent-directed feeding is based on Ezzo’s idea that “(babies) are not capable of regulating their hunger patterns. They need parents to do this for them;” and Ezzo’s belief that PDF is an important first step in establishing parental authority over a child. “Consider the alternative,” he asks in Preparation for Parenting and Babywise, “Is it the parent’s job simply to respond to an infant’s demands? When, then, would this concept switch over to allow the parents to direct the child? The toddler years? Preteen or teen years? Hardly. By then you’ve missed the boat”
     Ezzo is particularly opposed to “demand feeding,” recommended by the American Academy of Pediatrics, in which parents feed infants based on the infant’s signs or “cues” of hunger.
     Though Ezzo frequently states PDF is “flexible,” his response to the “problem” of a two-week old infant falling asleep at the breast was: “You need to keep your baby awake during feeding time. Babies learn very quickly from the laws of natural consequences. If your daughter doesn’t eat at one feeding, make her wait until the next one. Don’t feed her between routine mealtimes; otherwise, you are teaching her to snack, not eat.” (Prep., p.193) Such comments have alarmed doctors and lactation consultants alike.

Underweight Babies and PDF
    According to evangelical Christian pediatrician Dr. Matthew Aney, there are reasons to be alarmed by Ezzo’s approach. Some babies on Ezzo’s parent-directed feeding plan began returning for pediatric rechecks seriously underweight — some to the point of being diagnosed “failure-to-thrive” (a condition of severe undernourishment). “Yet, parents are often adamant about continuing with the feeding schedule,” says Aney, “even when advised otherwise by healthcare professionals.”
    Aney, an American Academy of Pediatrics candidate fellow, and pediatrician at Kaiser Pediatric Urgent Care Unit in Orange County, California, has investigated at least 200 cases, nationwide, of poor weight gain and failure-to-thrive infants associated with Ezzo’s plan. Matthew Hsieh was one of those cases.

Matthew’s Story
     Michelle and Michael Hsieh took Preparation for Parenting through their church before Matthew was born. After birth Matthew lost weight rapidly in his first week. Michelle hedged questions from the lactation consultants and nurses, “They wanted us to ‘demand feed’, but we knew better,” says Michelle ruefully. “Demand feeding was ‘unhealthy.’ We were using Ezzo’s parent-directed feeding method.”
     The baby’s weight, though low, stabilized for a time, but as Matthew neared eight weeks — the age Ezzo says night feeding stops — he became increasingly fussy and irritable.
     “Many times my intuition told me that Matthew was hungry before the scheduled time,” says Michelle. “Yet I chose to ignore those signals and instead would comfort him back to sleep. Our training specifically said that regularly feeding him sooner than our schedule would interrupt his hunger, digestive, and sleep/wake cycles (causing, Ezzo says “metabolic confusion”). We had no reason to argue with this supposed medically-backed advice.”
     Following his four month check up, Matthew was diagnosed “Failure to Thrive.”
     The Hsieh’s began supplementing Matthew with solid food as he had little interest in nursing and wouldn’t take a bottle or cup.
     Unfortunately the Hsieh’s continued with GFI material, believing its claim as “God’s way,” and when Matthew ate they implemented Ezzo’s “High Chair Manners.” (In Preparation for the Toddler Years, known secularly as Babywise Book Two, Ezzo recommends hand slapping, hand squeezing and isolation for babies who commit such “wrong behaviors” as putting their hands in their food, dropping food off the tray, or banging their plates or utensils.)
     Though Matthew initially took solid food eagerly, he did not like keeping his hands away from the food. “He did learn to submit to keeping his hands down (or our holding them down),” states Michelle, “but his interest in food quickly diminished.”
      By 9 1/2 months Matthew Hsieh stopped eating altogether. He was hospitalized, fed through an NG (naso-gastric) tube, and given a battery of tests to determine if his eating problem was related to a physical abnormality.
     Matthew’s tests all came back normal.
     Michelle was taught how to intubate Matthew at home and, after leaving the hospital, he remained on the feeding tube for five months.
     Michael and Michelle Hsieh, filled with “anger, guilt and remorse” finally began to question Ezzo’s philosophy and credentials.
     Today, at 20 months, Matthew is off the feeding tube, but has yet to gain weight. The Hsiehs have become activists, warning other parents of the dangers of Ezzo’s philosophies.

Evangelical Professionals Speak Out
     Dr. James Dobson, an evangelical Christian with a Ph.D. in Child Development, and his ministry Focus on the Family, issued a public statement of non-support of Ezzo’s work due to “numerous letters from parents, pastors, midwives, physicians, and lactation professionals regarding cases of failure-to-thrive in infants subjected to the Ezzo’s program.”
     Dobson was particularly critical of Ezzo’s use of scripture to support leaving a baby to cry: “Praise God,” wrote Ezzo, “that the Father did not intervene when His son cried out on the cross.”
     Dr. Georgiana Rodiger, graduate of Fuller Theological Seminary (Evangelical) with an M.A. in theology and a Ph.D. in psychology writes, “I am appalled by the psychological and theological irresponsibility of the Ezzos.” The Ezzos are leading many families astray...”
     Barbara Francis, Psy.D., MFCC, a Christian counselor and outspoken critic of the Ezzo’s, writes, “The message is clear.” GFI is good; all other parenting techniques, including those endorsed by well-respected Christian experts, are bad. If you choose to follow God, you will follow GFI.”
     Yet, despite mounting concerns, the Ezzo’s empire grew— and quietly expanded.

The Secret Birth of Babywise
     In 1995 Ezzo did something relatively unheard of in Christian publishing: he took his book Preparation For Parenting, stripped it of all religious language, added a “co-author,” Colorado pediatrician Robert Bucknam (whose contribution appears limited to the foreword), and, without a single reference to his status as a minister, marketed it secularly under the title On Becoming Babywise.
     With a promise that the book “successfully and naturally trains children to sleep through the night before the age of eight weeks,” the book’s popularity skyrocketed. An unsuspecting public embraced the Babywise claim of being a “strategy for responsible parenting,” unaware of its philosophical roots, its controversies or its dangers.

Leah’s Story (names changed)
     Dr. William Moore read Babywise when his daughter, Jan, gave him a copy before his first grandchild, Leah, was born. Babywise had been recommended to Jan by friends at church and was sold in her church’s bookstore.
     “I was shocked at the medical misinformation in the book,” says Moore, “but when I tried to talk to my daughter she was adamant that the information was not only correct, it was ‘God’s plan’.”
     Visits to the family were difficult for Moore and his wife as Jan often responded to Leah’s cries with a glance at the clock and a statement such as, “She’s got to wait another 30 minutes.” But, when it was “time” for the scheduled feeding, Leah had often given up and fallen into an exhausted sleep. Jan would then try to awaken Leah following Ezzo’s recommendations of undressing the baby, and wiping her face with a wet washcloth. But the exhausted baby often nursed poorly.
     Soon Jan’s milk supply, not adequately stimulated by the tired, weakened baby, began dwindling. By Leah’s 6-week check up she was a pound below her birth weight.
     “In addition to weight loss,” Moore states, “Leah’s muscle tone was poor, she appeared listless, would not make eye contact, and was rapidly losing even her sucking reflex.” All signs of severe malnutrition or Failure-to-Thrive.
     For several days Leah’s pediatrician directed Jan to feed Leah using a syringe and a small tube until the baby gained enough strength to suck.
     Despite the baby’s serious medical problems, Jan and her husband deny that Ezzo’s PDF was the cause. Though they have since followed their pediatrician’s advice to feed their baby on demand, they are still committed to the GFI parenting program that, in Moore’s opinion, almost killed their baby.

Grace Community Church Disavows Ezzo
     In 1995, the elders of Grace Community Church, met with Ezzo to outline four significant concerns they had about the GFI material. Ezzo responded by resigning as an elder and leaving the church. In 1997 the church publicly stated that it no longer supports GFI or sells its materials. In addition to two theological issues, the church criticized Ezzo for:
     1. A blurring of the line between that which is truly Biblical and what are simple matters of preference. “Portraying scheduled feeding as the true Biblical practice, GFI strongly implies that demand feeding should be regarded as an unbiblical, humansitic — even sinful — approach to caring for infants. As elders, we see no biblical basis whatsoever for GFI’s dogmatism on this issue.”
     2. A tendency to isolationism. “GFI parents tend to insulate their children from other children — including Christian children — who are not a part of the GFI “community,” i.e., those not indoctrinated in GFI principles. GFI parents have been known to sever all relationships with non-GFI families. To some degree, GFI teaching is directly responsible for encouraging this attitude.”

Is GFI a Cult?
     About this same time The Christian Research Institute, well respected in the evangelical community as a “cult-watch” organization, was deluged with requests for information about GFI.
     Kathleen Terner, M.B.A., research associate at the Christian Research Institute, spent two years investigating GFI. The results were published in the Christian Research Journal (spring, 1998). According to the Institute’s criteria, GFI was not characterized a cult because, “it affirms the fundamental doctrines of historic Christianity.” However, Terner found that “GFI does indeed exhibit five cultic characteristics”:
     1.Scripture twisting and de facto assertion of extrabiblical revelation.
“Teachings not found in the Bible (on child rearing) are accorded the status of divine revelation.”
     2. Authoritarianism. “The Ezzo’s word on parenting seems to close the matter irrespective of the evidence.”
     3. Exclusivism. “The Ezzos are considered virtually the only ones who are teaching biblical truth on their subject.”
     4. Isolationism. “Members of the GFI ‘community’ have been shielded from teachings and opinions contrary to the Ezzo way.”
     5. Physical and emotional endangerment. “As an unintended, but natural consequence of following GFI teaching, babies are sometimes left to cry for hours and some newborns are underfed and underdeveloped.”

Why Does Babywise ”Work” for Many Babies?
     Babywise seems to work because many babies’s natural schedule fits the basic schedule recommended in Babywise. Demand, or schedule fed, these babies would probably sleep through the night by eight to ten weeks.
     “Yes, there are averages that may fit into a bell-shaped curve model,” write lactation experts Jan Barger, RN, MA, IBCLC, and Lisa Marasco, BA, IBCLC, in their paper Examining Evidence for Cue feeding of Breastfed Infants, “But by definition,” they add, “there will also be babies who fall on either side”
     For the babies who don’t fit in the bell curve, there is another, more serious reason Babywise “works.” Dr. Barbara Francis, in her critique of Babywise, states: “Research (of families) and observational studies of institutionalized children, consistently indicate that there are two types of babies who cry the least: those with highly responsive parents who respond quickly and consistently, and those babies who learn that their cries will go unheeded, and so give up hope. (Dennis, 1973; Provence and Lipton, 1962).

The High Cost of Letting Babies Cry
     In Babywise, parents are assured that “There is no evidence to prove that an immediate response to every cry teaches a baby anything about love, just as there is no evidence to prove that a little crying fosters feelings of insecurity.”
     On the contrary, there is much medical evidence that prolonged crying is harmful for babies. Emde, Harmon and Metcalf in their journal article “Stress and Neonatal Sleep,” report that the hormone cortisol is released into the bloodstream during prolonged crying and that such crying affects weight gain as it burns calories and drains energy leaving babies “too weak or too sleepy to nurse.”
     Additionally, as Barbara Wright, M.A., L.P.C., Certified Child Development Specialist with Hillcrest Center for Women’s Health, says, “The main psychological work in the first year of life is to learn to trust, love, and attach. If a baby’s cries are not responded to, the baby learns that she can’t trust, that her needs won’t be met.”

Why Has Ezzo Gained Such a Following?
     “People follow Ezzo because they want to believe they can have both a new baby and a good night’s sleep,” says Dr. Aney, adding, “For many people it never enters into the realm of possibility that if it’s in print, it could be untrue — especially when their churches promote it.”
     For more information about the facts stated in this article or to report a condition of poor weight gain or failure-to-thrive associated with Babywise or Preparation for Parenting, contact Matthew T. Aney, MD, e-mail: Aneybody@aol.com
     For more information about the controversy surrounding Babywise check the following websites:
http://www.mailing-list.net/redrhino/Ezzo/
http://www.babycenter.com/refcap/8369.html

Cindy Webb, B.S., worked professionally in the field of child development and parenting for ten years (five of those years at the prestigious Child Study Center in Fort Worth, TX.), before becoming a free-lance writer. She and her husband, a Presbyterian minister, have two children.
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Additional Baby Wise Articles:
1. Part One: BabyWise? BeWary! Who is Gary Ezzo and why do baby and child care professionals find his advice so disturbing?
2. Part Two: BabyWise? BeWary! What Ezzo Doesn’t Know About Child Development May Hurt Your Baby
3. Is Gary Ezzo's Babywise Method Right for You?





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