Babywise Feeding Advice

Babywise and Preparation for Parenting have been criticized by hundreds of professionals in pediatric medicine, human lactation, psychology, anthropology, child development, and theology. Problems have been associated with these programs -- cases of slow weight gain, failure to thrive, depressed babies, even hospitalization. Its feeding recommendations were the subject of a warning sent out by the AAP.

Summary of Concerns

The following are some of the concerns experts share :

• Lack of expertise and credentials
  
  • Professional: The primary authors of the material, Gary and Anne Marie Ezzo, present themselves as experts but Gary Ezzo has no background or expertise in child development, psychology, breastfeeding, or pediatric medicine, and holds neither an associate's nor a bachelor's degree from any college. His master of arts degree in Christian ministry was granted through a program that awarded credit for life experience in lieu of an undergraduate degree. Anne Marie Ezzo worked briefly as an R.N. decades ago.
  • Personal: The Ezzos raised two daughters but have been estranged from them for nearly a decade.
  • Co-author: It is unclear what, if anything, Babywise co-author Dr. Robert Bucknam contributed to that book, since versions of the book for the Christian market are essentially the same (with added religious material) and do not have his name on the cover.

• Risks for breastfeeding mothers and babies. Breastfeeding on a parent-determined schedule (including a "flexible routine" as it is called in Babywise) can reduce a mother's milk supply and contradicts the recommendations of the American Academy of Pediatrics (AAP), which has stated, "The best feeding schedules are the ones babies design themselves. Scheduled feedings designed by parents may put babies at risk for poor weight gain and dehydration."
  
  
• Poor breastfeeding information. Although it is presented as authoritative, the breastfeeding information in Babywise is inaccurate and substandard (compare with the AAP Breastfeeding recommendations from the 2005 AAP Policy Statement on Breastfeeding and the Use of Human Milk).  Babywise itself contains an oblique warning that breastfeeding mothers may experience difficulties feeding their babies in the long term.
  
  
• One Size Doesn't Fit All. All babies and mothers are treated alike without respect for individual differences in breastmilk storage capacity and rate of milk synthesis on the mother's part, or differences in metabolism, stomach capacity, rate of growth, thirst and fluid intake needs, etc, on the baby's side.  Breastfed babies need varying amounts of milk in varying numbers and sizes of feedings based on fluctuating factors. Similarly a woman's milk production is variable from day to day and differs on an individual basis from one woman to another.

• A high-pressure presentation impacts readers' perception of what is at stake:
  
  • Pressure to maintain the regimen. The rules for sleep, feedings and wake time are portrayed as critical to follow in order to achieve a healthy outcome, and health, behavior problems and sleepless nights are predicted if the program is not followed. (Flexibility is praised but defined as small, temporary deviations from the prescribed regimen. Parents are warned that open-ended adaptations will cause problems.)
  • Misplaced moral dilemmas. Adherence to the program is framed as a moral or biblical issue (e.g. failure to stick to the regimen is portrayed as lax permissiveness on the part of parents, and uncooperativeness on the part of the baby.)
  • Parents are reluctant to abandon the method, even when it's not working out. Health care professionals have observed that even when their babies were doing poorly on the program, parents often wanted to stick with it.

Essential Reading:

AAP Media Alert | PDF version
This media alert was issued after the AAP evaluated On Becoming Babywise.

"Examining the Evidence for Cue Feeding" -- PDF file
by Jan Barger, RN, MS, IBCLC and Lisa Marasco, MA, IBCLC

"Babywise Advice Linked to Dehydration, Failure to Thrive"
by Matthew Aney, MD, AAP News

For Further Information

Critiques, reviews and professional analyses of Babywise and Prep
Heath Care Professionals Quoted in News Reports
News reports and media coverage
Comparisons of Ezzo and AAP Advice
Personal stories of former Babywise users
Frequently Asked Questions

Child Development in Babywise and GKGW

Critics who have evaluated Growing Kids God's Way, Childwise, Babywise, Reflections of Moral Innocence (the Ezzos' sex ed curriculum) and other Ezzo books and curricula have shared several concerns about the expectations of child behavior these books promote.

Summary of Concerns

• Lack of age appropriateness. Requirements of child behavior do not consider age appropriateness or basic principles of child development.
  
  
• May support parental failings and selfishness. Warnings against being "child-centered" are insufficiently balanced by acknowledgment of the extent to which parenthood involves self-giving and self-sacrifice.
  
  
• Lack of proportion. Big issues and small are treated as equally urgent matters over which parents must have control. Insisting on tight control over all matters can lead to power struggles.
  
  
• Limited interpretation of behavior. Behavior is viewed through the lens of obedience/disobedience without adequate consideration of factors such as teething, illness, developmental stages, and emotions such as fear, loneliness, etc, that might cause or influence the behavior.
  
  
• Undermines the developing relationship between parent and child. The level of control required by the program tends to create an adversarial relationship between parents and child, which may interfere with attachment.  Experts regard attachment as the foundation of mental health and say it develops as parents respond to the baby's cues, rather than in the context of parental control.

Biblical and Theological Concerns

Christian critics of Ezzo's material span the spectrum of denominational backgrounds and parenting styles, but they present similar concerns.

Summary of Concerns

• exhibits/encourages tendency toward legalism (even while advising parents not to be legalistic)
• uses prooftexting and scripture twisting to give weight and urgency to ideas presented
• confuses biblical principle and application, so that the Ezzos' favored applications are presented as moral standards in and of themselves.
• derides other parenting approaches as unbiblical or holding a lower moral standard.
• emphasis on the moralism of good behavior -- often defined by cultural ideas of proper etiquette -- rather than on hearts turned toward Jesus

Critics acknowledge that Growing Kids God's Way and other material by Gary Ezzo contains some practical and biblical ideas. However, the presence of the above dynamics make it difficult for parents to freely glean the good, and may contribute to an overly eager or rigid way of applying the ideas.

Essential Reading:

"More than a Parenting Ministry"
by Kathleen Terner and Elliot Miller, Christian Research Journal, Christian Research Institute

"The Ethics of Ezzo"
by Tony Payne, The Briefing, Matthias Media (despite the title, the article is about how Ezzo uses the Bible in his presentation.)

"An Evaluation of Ezzo Parenting Programs"
by Dr. Kent McClain

"Growing Kids the Ezzo Way"
by Dr. Philip Ryken, 10th Presbyterian Church, Philadelphia

Growing Kids God's Way - Not Ezzo's
by Pastor Bob Bixby, Pensees

"A Critique of Growing Kids God's Way"
Biblical Discernment Ministries

Christian Leaders & Organizations Voice Concerns - An Incomplete List

For Further Information:

More Critiques, Reviews and Analyses