Reprinted with permission from care book could be dangerous (Child magazine, August 1998).
Babywise advice linked to dehydration, failure to thrive ("AAP News," April 1998).
A Tough Plan for Raising Children Draws Fire: "Babywise" Books Worry Pediatricians and Others (Washington Post, February 27, 1999).These startling headlines refer to the top-selling and highly controversial childcare guides "On Becoming Babywise" and "Babywise II," written by Gary Ezzo, a self-described Christian pastor, and endorsed by Robert Bucknam, a pediatrician. Chances are you've heard of these books; since it was published in 1995, "On Becoming Babywise" reportedly has sold more than 290,000 copies. "Babywise" is recommended for parents of babies up to 5 months old, and "Babywise II" addresses parents of children 5 to 15 months old. Soon to be released is "On Becoming Childwise," a guide for toddlers through 8-year-olds.Ezzo, who has no formal theological or medical training, is executive director of the for-profit organization Growing Families International (GFI). With his wife, Anne Marie, Ezzo runs church-based classes for parents who wish to give their children a rigid religious upbringing. Although few readers know it, the "Babywise" books are the secular versions of Ezzo's original parenting program, which includes guides such as "Preparation for Parenting" and "Growing Kids God's Way" (GKGW). The content of these guides is based on GFI's own unpublished, self-conducted studies. The studies have not been subjected to peer review, which means there has been no independent, professional evaluation of the studies or their findings, the usual method of verifying the worth of scientific studies.Despite the fact that Ezzo has a large and growing following--reportedly more than a million families in 93 countries, with his books translated into 17 languages--distress over his program is also growing. What are doctors, lactation specialists, and child development experts--some of whom are Christians--concerned about? Ezzo's self-designed, strictly regimented feeding program, called Parent-Directed Feeding (PDF), which has a parent put the newborn on a strict feeding / waking / sleeping schedule. Rather than feed a baby when he shows signs of hunger--a technique known as demand feeding--parents are instructed to feed by the clock. The goal? Ostensibly to establish routine in your baby's life from day one and stick to it no matter what.A recent outcry from medical and child development experts persuaded Ezzo to revise his 1998 version of "Babywise" to say that babies should be fed when they're hungry. However, the book still instructs otherwise: Parents are told that if their baby doesn't eat at a scheduled feeding, he must wait until the next one.Distress among doctors and childcare professionalsAbout six years ago, alarm bells went off when doctors began seeing more and more infants who were showing signs of failure to thrive, poor weight gain, and dehydration. When questioned about their feeding practices, many of the parents admitted they were following Ezzo's PDF program. And though they could see something was drastically wrong with their infants, the parents found it hard--sometimes impossible--to blame PDF. After all, they were following the advice of a Christian pastor and a pediatrician. How could such experts be wrong?Members of the American Academy of Pediatrics (AAP), the highly respected body of primary care pediatricians, have found a great deal wrong. In fact, in April 1998, after receiving a letter signed by a hundred doctors, lactation specialists, and childcare professionals exposing a number of Ezzo's statements as unsubstantiated and false, the AAP issued a Media Alert. In it, the AAP directly contradicted Ezzo's advice on scheduled feedings, and instead advised parents that "newborns should be nursed whenever they show signs of hunger, such as increased alertness or activity, mouthing, or rooting. Crying is a late indicator of hunger. Newborns should be nursed approximately 8 to 12 times every 24 hours until satiety."The AAP is currently reviewing several parenting programs, including Gary Ezzo's, and within the next couple of years will publish guidelines to help parents evaluate the programs. For more information, visit the AAP Web site.Doctors and Christians part company with "Babywise"Matthew Aney, M.D., a Christian pediatrician and member of the AAP, worries that the advice in "Babywise" doesn't allow for individual differences among breastfeeding mothers and babies. He points out that while some parents may be able to follow the PDF method, Ezzo offers no alternative for those who can't. It's a one-size-fits-all prescription that can leave parents who "fail" the program feeling guilty and filled with doubt about their parenting skills. Aney found parents were often reluctant to admit they were following the PDF schedule, especially if they had a strong religious commitment to the program.Aney points out at least 35 unsubstantiated medical "facts" in "Babywise." Here are three examples: