|Do the Ezzos recommend putting a baby on a dangerously strict feeding schedule?
Nothing could be further from the truth. The Ezzos recommend a very FLEXIBLE feeding "routine" for babies-not a rigid schedule. The routine is adjusted to the individual baby's needs and can be suspended altogether if the situation calls for it. In addition, parents are admonished to ALWAYS feed a baby whenever they think their baby is hungry, regardless of the routine:
- "With PDF [Parent Directed Feeding], a mother feeds her baby when he is hungry, but takes advantage of the first few weeks to guide the baby's hunger patterns by a basic routine" (Babywise p. 38). (A basic routine is defined as feeding a baby every two and a half to three hours on average.)
- "If your baby is hungry, feed him or her. If the child routinely shows signs of hunger before the next scheduled feeding, then find out why, rather than letting the baby cry it out" (Babywise p. 145).
- "Hunger cues, not the clock, determine feedings" (Babywise p. 112).
- "Hunger is always a legitimate reason to feed in less than two hours" (Babywise p. 115).
- "Crying is a late signal of hunger" (Babywise p. 65).
Contrary to what is claimed by the critics, it is not a feeding routine that is dangerous to babies, but the practice of feeding a baby with NO regard for a routine that can put a baby at risk - that is, the mother is not aware of exactly when she last fed her baby, but is just watching the baby for signs to show he is hungry before feeding him again. Many babies (especially weak and sickly babies) do not show the typical signs of hunger, and without some kind of a feeding routine there is nothing to insure that the baby is getting adequate nutrition.
"How often you should feed your baby depends on the baby's age. As a general rule, during the first two months you will feed your baby approximately every 2 1/2 to 3 hours from the beginning of one feeding to the beginning of the next. Sometimes it may be less and sometimes slightly more, but this time frame is a healthy average." Babywise, p. 74
The AAP recommends approximately
8 to 12 feedings in a 24 hour period, which equates to a feeding approximately every two to three hours. Babywise
recommends that for newborns, parents work toward establishing a flexible routine, feeding (on average) every 2 1/2 to 3 hours. Taking into account all of the warnings in Babywise
to use flexibility and to feed the baby WHENEVER the baby shows signs of hunger, a mother using the PDF plan has the complete freedom to feed the baby as often as every two hours or even more frequently if that individual baby requires it. The suggested time frames are referred to as a "healthy average" but are certainly NOT set in stone. So you can see that a parent following the Ezzos' PDF plan with their newborn would be well within the AAP recommendations. For a detailed chart comparing Babywise
recommendations with those of the AAP, click here
It is sad to see that journalistic ethics have sunk to the point that in almost every negative news report or story that is written about the Ezzos, the words "strict feeding schedule" invariably appear...the reporters obviously parroting what they have heard from others (primarily from the Internet)--and not verifying the facts because the Ezzos clearly teach nothing of the kind! But don't take our word for it. Here are samplings of some of the direct quotes from the Ezzos' Preparation for Parenting
curricula. (Similar quotes can be found in On Becoming Babywise
.) We are mystified as to how anyone who has actually read the Ezzos' infant materials can say that they promote following a rigid "feeding schedule" to the detriment of babies.
"It is our experience that both baby and mom do better when a baby's life is guided by a flexible routine . . . It [PDF] has enough structure to bring security and order to your baby's world, yet enough flexibility to give mom freedom to respond to any need at any time." (PFP Sixth Edition, P. 43, emphasis ours)
"Common sense and the American Academy of Pediatrics dictate that newborns be nursed whenever they show signs of hunger; putting fist toward mouth, making sucking motions, or whimpering. Remember, you do not have to wait for your baby to begin crying before feeding. Crying is a late sign of hunger." (PFP, Sixth Edition, P. 76, emphasis ours)
"The mother who insists on watching the clock to the minute lacks confidence in decision making. The clock is in control, not the parent. The hyper-schedulist insists on a strict schedule, often nursing her baby no more often than every four hours. Enslavement to the clock is almost as great an error as a mother who is in bondage to thoughtless emotions." (PFP, Sixth Edition, P. 98)
"There will be times when a situation will dictate a temporary suspension of the [PDF] guidelines. Remember you are the parent, endowed with experience, wisdom, and common sense. Trust these attributes first, not an extreme emotion or the rigidity of the clock. When special situations arise, allow context to be your guide." (PFP, Sixth Edition, P 114-115, emphasis ours)
"Most of your day will be fairly routine and predictable, but there will be times when you may need more flexibility due to unusual circumstances. Your life will be less tense if you consider the context of each situation and respond appropriately for the benefit of everyone." (PFP, Sixth Edition, P. 116, emphasis ours)
"Remember, unplanned disruptions will come into your day. Count on it. But also take comfort in knowing that flexibility is a natural part of a healthy routine." (PFP, Sixth Edition, P. 196, emphasis ours)
|Has the American Academy of Pediatrics (AAP) ever issued a warning against the Ezzos' teaching or the Babywise book?
No. Contrary to what the critics would like to believe, the AAP has never issued a warning of any kind regarding the Ezzos or their teaching in Babywise
or Preparation for Parenting
or any of their other books or curricula. Indeed, they would be hard-pressed to justify such a warning, since the Ezzos' recommendations on infant care echo the recommendations of the AAP on just about every point. (Read the comparisons of Preparation for Parenting
to the AAP recommendations.)
Dr. Bucknam, co author of Babywise, is board certified in pediatrics and is a member in good standing of the AAP. His chief critic, attachment parenting advocate and pediatrician Dr. Matthew Aney
at the time of this writing is neither board certified, nor a member of the AAP. To read more about how an old opinion article by Dr. Aney is often used to attempt to prove that the AAP has issued warnings against Babywise and the Ezzos' PDF plan, visit our Dr. Aney page
. Pediatricians all over the country are using Babywise in their pediatric practices with great success. To read a few of testimonials from physicians, visit our Physician Testimonials
The AAP has issued is a generic warning against "scheduled feedings," or using the clock alone
(hyper-scheduling) to determine when a baby is fed. This is a wise caution and one that is echoed in Babywise and Preparation for Parenting. Hyper-scheduling is not at all what the Ezzos and Dr. Bucknam teach, (see question #1 above).
|Are the Ezzos' recommendations on feeding babies detrimental to a mothers' ability to produce breastmilk?
Not at all. In fact, those mothers who follow the PDF plan recommended by the Ezzos are as likely or more likely to be successful with breastfeeding as those mothers who "cue" feed their babies. Informal studies cited in Babywise confirm this, as does our own personal experience. All 5 of our babies were nursed, and all but one was nursed to a year or well beyond. The one child who was not nursed to one year was our third (and last) "attachment parented" baby, and our decision to discontinue nursing was at least partially a result of the parenting philosophy we had been following, which produced demanding behavior in our children and a thoroughly exhausted and frustrated mother. Most of the Babywise/PDF mothers we know have chosen to nurse their babies, and most of those have nursed to a year, and often beyond.
Babywise offers a great deal of advice and encouragement to breastfeeding mothers, including suggestions for more frequent feedings to help improve milk production. For those mothers who may be concerned about whether their milk supply is adequate at any point, Babywise also offers practical helps for determining whether the baby is receiving adequate nutrition. The "Healthy Baby Growth Chart" gives a mother a detailed plan for determining if milk production is sufficient for the needs of the baby.
|Is there a higher risk of developing Failure to Thrive (FTT) babies with the Ezzo PDF recommendations?
No. This is an unsubstantiated claim made by the some supporters of the attachment parenting
philosophy. There is a very small group of parents who follow this philosophy who are openly antagonistic toward the Ezzos' ministry, and they are discussed further on the critics
page. Rather than provide empirical evidence and compare it to the known statistics, they are content to take pot shots with anecdotal evidence and give the reader the false impression that the Ezzo program is responsible for the world's "failure to thrive" (FTT). Nothing could be further from the truth. As a matter of fact, a review of applicable research finds that a true "demand feeding" or "cue" feeding philosophy (where no routine is followed--basic tenant of attachment philosophy) such as the La Leche's League recommends seems to be responsible for most of the cases of FTT in the U.S.
In 1995, ABC's 20/20 (1/20/95) aired a story dealing with demand fed, dehydrated infants. The segment showed a child with an amputated leg due to the lack of proper assessment of the real need - adequate nutrition. The parents followed the La Leche League recommendations that to produce more milk, just feed more often. This story was so significant that it was aired twice. The Wall Street Journal also reported on a child with irreversible brain damage due to the mother trying to feed on demand. Similar reports appeared in Time (8/22/94), and Primetime Live (8/4/94). According to the Wall Street Journal article (7/22/94), nearly 200,00 infants a year are diagnosed with "failure to thrive," most of which were fed on the cry cue, and not necessarily on need. La Leche League responded to the Wall Street Journal essentially refusing to accept any responsibility for the "just feed more often" advice but charged the mothers with "mismanagement." However, follow-up interviews confirmed that mothers had contacted La Leche League counselors and lactation consultants, and had followed the advice that had been given. All this to say that there is more to the story than what meets the eye, or the ears. We do not condemn those who choose to NOT use any kind of routine to feed their babies, and would hope that flexible routine adherents would get the same respect from them. Parenting involves a lot of different choices and we all are responsible for the outcome of those choices.
In addition, "failure to thrive" situations have been the subject of much research over the years. FTT is a world wide problem that is not so uncommon. Dr. Peter Sullivan from the John Radcliffe Hospital, England states that the prevalence of FTT ranges from 1.3% to 20.9%, depending on the definition of FTT that is used. There are a whole lot of variables that can contribute to a FTT baby, including genetic and environmental considerations. For an interesting analysis of the FTT issue as it relates to those who criticize the Ezzos' infant teaching, click here
The Ezzos, Dr. Bucknam, Dr. Sears, or anyone else for that matter, can only be responsible for the content of their teaching, not how people choose to implement the teachings. Gary Ezzo and Dr. Bucknam have been very forthright in making the necessary changes to their teaching for the sake of clarity. They have listened to their physician advisory board as well as other respected individuals with constructive advice (including critics!), clarifying where needed, and making adjustments so that the teaching is as clear as it can possibly be. Their recommendations on infant feeding parallel those of the AAP, and consequently the Ezzo materials are supported by many pediatricians all across the county.
Incidentally, it is common practice in most major hospitals in the country when a "failure to thrive" baby is brought into the hospital to immediately place that baby on a (usually 3 hour) feeding schedule - they do not just watch the baby for signs of hunger and feed the baby on "cry-cue" alone. Why? A good friend who is a former NICU nurse confirms that it is because feeding a baby on a "routine" is the best way to ensure that the baby is taking in adequate nutrition - and frankly - from the perspective of the medical professionals who deal with struggling infants day in and day out - it works! So if a feeding "schedule" or routine is the method of choice for helping FTT infants gain weight and begin to grow, it stands to reason that a "flexible routine" (which makes allowances for different babies' hunger patterns and differences in mothers' milk production) makes good sense for feeding healthy babies as well.
|Do the Ezzos teach parents to let their babies "cry it out" and not pick them up and respond to their needs?
No, they do not. The fact is that ALL babies cry. And even the best, most nurturing and most attentive parent could not prevent all crying in their newborn infant--even if they wanted to. That is why the Ezzos devote an entire chapter in both Babywise
and Preparation for Parenting
to the various normal and abnormal cry periods of infants, and help parents learn to distinguish between them and respond to them sensitively based upon wisdom and understanding, not just emotions.
The Ezzo/Bucknam recommendations on crying echo those of the American Academy of Pediatrics, which says in it's book Caring for Your Baby
, "Many babies cannot fall asleep without crying and will go to sleep more quickly if left to cry for a while. The crying shouldn't last long if the child is truly tired." In the same book, they also state, "Sometimes you may think your baby is waking up when she's actually going through a phase of very light slumber. She could be squirming, startling, fussing, or even crying--and still be asleep. Or she may be awake but on the verge of drifting off again if left alone. Don't make the mistake of trying to comfort her during these moments; you'll only awaken her further and delay her going back to sleep. Instead, if you let her fuss and even cry for a few minutes, she'll learn to get herself to sleep without relying on you." They go on to say that, "some babies actually need to let off energy by crying in order to settle into sleep or rouse themselves out of it. As much as fifteen to twenty minutes of fussing won't do your child any harm. Just be sure she's not crying out of hunger or pain, or because her diaper is wet." (Caring for Your Baby
, pp 36, 188-189)
Nowhere do the Ezzos or Dr. Bucknam teach that a parent should ignore their baby's cries or not deal senstively with a crying baby. A baby's cries are always attended to, though sometimes the response will be just to listen and wait, and see if the baby settles himself down, as in the case of drifting off to sleep, given above. Some attachment parenting
critics who believe that babies should always be nursed to sleep and never allowed to fuss or cry to settle themselves, take issue with these recommendations. However that difference of opinion does not give them liberty to misrepresent what the Ezzos actually teach and attempt to make it sound abusive, because it clearly is not. Having used both the "nurse the baby to sleep" and "let the baby learn to fall asleep" philosophies in our own family, we found the latter far more effective and beneficial to the baby, both short and long term. That is not to say that the former method would not work well for some families, however each parent should be free to make that decision based upon a true understanding of the short and long term costs and benefits.
|Do the Ezzos somehow manipulate parents into thinking that the "Ezzo" plan is the only "right" way to parent?
No. The Ezzos and Dr. Bucknam do make a strong case for their conclusions about infant parenting, as do all other authors who write on the subject. However, they also acknowledge that a parent has a God-given responsibility to research the different parenting philosophies available, and come to their own (hopefully prayerful) conclusions about what is right for their family. Here is what the Ezzos actually say about infant parenting philosophies:
"Preparation for Parenting is based upon the belief that child-rearing is a responsibility given by God to parents. Parents are to guide, nurture, and discipline their children. This resource serves as a guide to help accomplish that task. As was the case in previous editions, this curriculum is not intended to provide the reader with all he or she will ever need to know about the process of nurturing a newborn. Scripture has very few specific mandates for practical applications in the realm of parenting, especially infant parenting. It provides the spiritual goals of parenting but not the exact or specific how-to's. It offers no specific statement as to when a child will be fed, cuddled, or put down for nap, or how these activities are to take place in your home. Therefore, parents guided by the Holy Spirit have the ultimate responsibility and duty to research the parenting philosophies available today...review all the parenting options available. Examine carefully the alternative theories and their approaches, and specifically observe the end results. Determine which parenting stratagem is right for you...." PFP, Sixth Edition, P. 17
|Do the Ezzos use the crucifixion of Christ to justify letting a baby cry?
Absolutely not. You can read what the Ezzos themselves say about this absurd claim on their website
. It is worth reading. If you read the quote in the context in which it is given, it is a point well-taken.
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