Saturday, April 10, 2010


On Becoming BABYWISE  by Gary Ezzo 1998

Of the many Lies in this book, today's blog entry takes a deeper look at Lie number 12: the lie that the Gary Ezzo's Parent-Directed Feeding (PDF) plan offers a healthy balance between "Hyperscheduling" and Attachment Parenting.

In the book, the author claims that Attachment Parenting is exhausting for the mother, chaotic for the family, and confusing for the child.  On the other hand, a too-tight schedule offers no regard for the baby's or mother's needs. (pg 31)

Finally, on page 37 Ezzo reassures the reader with the following statement:

PDF is the center point between hyperscheduling on one extreme and attachment parenting at the other. It 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.

What do we know about "hyperscheduling"? From the above statement, we learn that it is extreme. We also learn, according to page 30:

In the early years, the first theory was introduced by a group of scientists called behaviorists. Their belief was that a child was molded by his or her environment. The infant’s developing emotions and feelings went unrecognized, over-ruled by specific and controlled care. Such outward structure, behaviorists believed, produced in the child controlled emotions. This was considered desirable.
Based on this theory, American mothers in the 1920’s were introduced to a feeding practice called hyperscheduling or clock feeding the baby. 

From this paragraph we learn three factors:
1. The infant’s developing emotions were not recognized. Behaviorists did not believe that babies were capable of having feelings or emotions. As a result, many of our grandparents were told that babies cried simply to exercise their lungs.
2. The baby’s care was very specific and controlled. Schedules were essential to the new science of baby care, along with sterilization techniques and formula. (Formula was just that: a scientific formulation calculated to meet an infants nutritional requirements, based on the knowledge at the time.)
3. A firmly structured environment would theoretically control behavior. Presumably if life were a predictable regime of order, then the child would naturally become orderly.

How does the Babywise program avoid the identified problem with hyperscheduling?

1. The infant’s developing emotions and feelings went unrecognized” 
What does Babywise have to say regarding to an infant’s developing emotions and feelings? Does Gary Ezzo recognize an infant might cry for reasons other than physical needs?
If so, how is the parent to meet these needs?

child-centered beliefs have encouraged exaggerated concerns about a child’s momentary feelings and emotional well-being pg 35
likely, newborns have zero memory of birth, let alone the ability to recall anxiety pg 35
• …he is not as emotionally fragile as attachment theorists believe.. pg 38
On an airplane your infant daughter begins to fuss. You fed her just two hours earlier. Yet failure to act will stress you, not to mention the entire jet full of people. Your solution is simple: consider others. pg 116 [No mention of the baby’s stress!]
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. pg 123
Some parents fear that failing to respond right away will make their baby feel unloved or insecure. On the contrary, it’s cruel not to help your child gain the skill of sleeping through the night. pg 123
When settling for a nap, crying for 15 to 20 minutes is not going to hurt your baby physically or emotionally. Your baby will not… have feelings of rejection... pg 131
Crying… simply because that is what normal, healthy babies do. pg 137
We can assure you of this truth: you will not take pleasure in hearing that [crying]sound, especially if you are first–time parents. (Inferring that more experienced (ie 'better') parents can ignore crying) With a bit of help, you can [know what to do]. pg 138 (He then tells you what to do - which amounts to nothing more than listening to the crying to familiarize yourself with it)
Does the lack of immediate, ten-second response time create irreversible latent effects on personality development which surface years later, according to attachment theorists? We believe the answer to this question is no. 
Will blocking baby’s cry be good for him? The answer to this question also is no. [In AP] greater value is placed on suppressing a child’s cry than teaching good sleep habits. pg 139 [Note use of the words "blocking" and "suppressing" used to describe a parent's loving desire to console.]
Yes, you can hurt a baby by picking him or her up too much. …There is no evidence proving that crying fosters insecurity. pg 141
“Trainable” cry periods such as those times when you put your baby down for a nap… [don’t] come about due to legitimate need. pg 143 (crying at naptime represents an “illegitimate” {ie. emotional} need, so is disregarded in order to “train” the child)
Identifying and knowing your baby’s cry patterns and disposition will help you learn to discern real needs. pg 146 [Here he says to simply listen to the cry so that you get to know what is typical for your baby - but don’t respond! He gives examples from his own grandchildren as follows]
Our grandchild, Ashley… just five minutes of crying by four weeks of age. Whitney, Ashley’s sister… would wail ten minutes, stop… and wail ten minutes more, then whimper, then sleep. That lasted twelve weeks. pg 146 [Crying occurs every day for several weeks and all he does about it is note how she cries, not why.]
Whitney didn’t have any more or less nutritional or love needs in her life, but she did have by nature a greater disposition for crying. pg 146 [No attempt was made to adapt to a different baby who cried a lot more, nor was any effort made to find out what might help soothe her. Crying was shrugged off as simply her disposition.]
Some children have a greater propensity to cry. This is not necessarily a signal that their basic needs are not being met. [What about a child's emotional need to feel loved and accepted? Isn't that a basic need?]
• Katelyn…would climb rapidly from a whimper to a wail, like an F-16 heading into the stratosphere…. Her cry times averaged ten minutes in length at naptime for the first month.
• After three months, crying at naptime was rare for all three grandchildren. [Three months of crying at naptime was not considered harmful or unusual]
With the goal of teaching good sleep habits, some temporary crying is preferable over long-term poor sleep skills.
• Some children cry fifteen minutes before falling asleep. Others vary… from five minutes at one naptime to …thirty-five
pg 147
Remember, you aren’t training your child not to cry, but training him or her in the skill of sleep. This may be the only time in your baby’s day that the practice of non-intervention is best. pg 148
Mother’s decision without assessment can be dangerous… They should not be driven by their emotions. pg 150
Blocking your child’s cry because you can’t handle it should not be up for consideration. pg 152
Normally it takes three nights before the [middle-of-the-night feeding] habit is broken and is usually accompanied by some crying. Be assured your baby will not remember those nights. pg 179
Be prepared for some crying. In moments of parental stress be comforted in knowing your baby won’t feel abandoned because you have decided that the best thing for him is learning how to fall asleep on his own. pg 210

Read that last statement again.
He claims that because YOU have made a decision, your 9 week old baby somehow comprehends this and won’t feel abandoned.

In Conclusion:  
 1."The baby’s feelings and emotions are unrecognized" in the Babywise method, just as in hyperscheduling.

The second part of the statement on hyperscheduling says “…feelings went unrecognized, over-ruled by specific and controlled care.” 

Ezzo believes that AP families lack any kind of structure, with parents "in bondage" to the baby’s demands.  Hyperscheduling is the opposite extreme, being overruled by specific and controlled care.

Is Babywise really “the center point” between these two extremes?
Or does Ezzo advocate specific and controlled care?

Day one. There’s no better time to begin thinking about your baby’s routine. pg 107
Since most babies do not have the ability to organize their own sleep into healthy patterns, parents must take the lead. pg 107
[Babies] are not capable of regulating their hunger patterns. They need parents to do this for them. Babies also know when they are tired, but they are not capable of establishing stable sleep/wake cycles on their own. Here the parent asserts guidance in place of an infant’s inability to establish his or her own order. pg 47
With the Babywise method a mother is … proactively leading and directing his wake times, nap times, and the rest of his little life. pg 65
If you feel your baby has a need for non-nutritive sucking, a pacifier can meet the need without compromising your 76
What is flexibility? ...think of something with a particular shape that can bend and then return to its original shape. Returning is perhaps the most crucial element of flexing. During the critical first weeks of stabilization, you are giving your baby’s routine its shape. Too much “flexibility” in these weeks is viewed by a baby as inconsistency. pg 109
For baby, the stabilization of hunger metabolism as well as stabilized sleep/wake cycles are primary goals. pg 111
Parental intervention is necessary to help stabilize the baby’s digestive metabolism pg 112
… baby is awake and crying. Another thirty minutes are left before his next scheduled feeding. What should you dopg 116
In following your feeding, wake, and sleep routine for your newborn, you should plan that the last 1- to 1½ hours of your 2½ hour cycle will be for a nap. When moving to a 3-, 3 ½ -, and in time, a 4-hour routine, your baby’s naps will range anywhere from 1 ½ to 2 ½ hours. pg 130
• Page 117 gives a sample schedule to fill out. He even calls it a schedule, though he uses the word “routine” throughout the rest of the book.
Your baby’s first year is divided into four basic phases… In this chapter our focus is confined to feeding times and activities related to feeding. In the next chapter we will focus on waketime activities and naptime. pg 110
Start at one month of age with the playpen. pg 130
Once parents have their infant’s eating and sleeping under control, it’s time to do the same with waketime activities. This goal is best accomplished by using the playpen, an invaluable piece of equipment…. pg 190
Playpen time may begin as soon as the baby has alert waketimes of fifteen to thirty minutes. At least one of those waketimes each day can be spent in the playpen. By two months of age, the playpen should be a well-established part of your baby’s routine. pg191
Rule 1: Mom, not baby, decides when the nap starts. Rule 2: Mom, not baby, decides when the nap ends. pg 133

Conclusion 2: Specific, controlled care and parental control rule the day in Babywise, just as in Hyperscheduling.

3. A final look at Mr. Ezzo’s comment about Hyperscheduling… Behaviorists… Their belief was that a child was molded by his or her environment. The infant’s developing emotions and feelings went unrecognized, over-ruled by specific and controlled care. Such outward structure, behaviorists believed, produced in the child controlled emotions.”

Unfortunately, we have already seen that Ezzo’s program: a) does not recognize emotions and feelings because
b) emotions are over-ruled by specific and controlled care. Now we will see how Ezzo, like the behaviorists he criticizes as being too rigid, also believes that 
c) “this outward structure will produce in the child controlled emotions”.

One day people will stop you on the street, at the grocery store, and in the church nursery to comment, “Your baby is so content.” Then they will insult you with the following statement: “You are so lucky to have such an easy baby.” Luck has nothing to do with [it] – right parenting does. - From the book’s Preface, page 16.
Chelsea learns from the start that giving is equally as important as receiving… She is a joy to have around… understands she is a member of a family team… has a sense of belonging and purpose for her life… a sense that she belongs to something bigger than herself fosters close and loving relationships which endure the test of time… bears the self-control and moral awareness need to govern herself… achieves a sense of affirmation with herself. Those around her find joy in her presence, further enhancing her well-being… wisdom, self-control… are trained into her as prerequisites for building friendship…. From established order that gives family relationships meaning and purpose. – From Chapter 2’s comparison to Marisa.
Children with healthy sleep patterns clearly had higher IQ’s than children who did not sleep well.. pg 53 Nobody would argue this. Except that the book does not deal with school aged children, it deals with infancy. Ezzo does not differentiate between them.
Children who have healthy sleep habits are optimally awake and optimally alert to interact with their environment. These children are self-assured and happy, less demanding, and more sociable; they have longer attention spans, and as a result, become faster learners. pg 53 (Where's the data to back this statement?)
Healthy sleep positively effects neurologic[sic] development and appears to be the right medicine for the prevention of many learning and behavioral deficiencies pg 54
With parent-directed feeding, your baby wins the ribbon of confidence knowing that you indeed are in 108
PDF babies move naturally from dependence to independence because the nature of the program fosters relational security. pg 139
We are not trying to express an inevitable cause-and-effect relationship between a fat baby and a fat adolescent later on. However, poor eating habits in infancy may result in eventual obesity. Overfeeding or disregarding healthy eating patterns early on could be to blame. pg 140
Infants on a routine grow confident and secure in that routine. Their lives have order, and they learn the lesson of flexibility early in life. Babies who settle into regular and predictable rhythms of activity develop greater tolerance to frustration and learn to use modes of communication other than crying. pg 141

CONCLUSION: Gary Ezzo, despite his promise of offering a perfect compromise between two extremes, actually promotes the type of hyperscheduling he criticizes as being too rigid and controlling, with little regard for the infant’s emotional health.

Babies’ physical health has suffered from the Babywise method, too. The American Academy of Pediatrics issued a statement warning parents of the dangers of strict scheduling resulting in poor weight gain. The policy statement issued in 1997 when Babywise was gaining popularity says,

"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 eight to 12 times every 24 hours until satiety.”

Unfortunately for the Babywise babies, Ezzo’s program

  • Does not allow any more than 9 feedings in 24 hours.
  • Teaches that crying is mainly indicative of tiredness. Tired babies are put to bed, not fed, and certainly never allowed to nurse to sleep.
  • Makes it difficult to see those signs of hunger such as increased alertness, mouthing, rooting, because these behaviors are most likely to show up during the "sleep" portion of the eat/play/sleep cycle, when baby is being ignored. 
How does this happen?
Baby is supposed to be learning how to fall asleep and stay asleep. Parents are supposed to be "teaching the skill of sleep." This is accomplished by ignoring the crying and letting baby exhaust himself. Baby eventually tires and falls asleep.
Suppose baby wakes during his scheduled "Sleep-time" because he is HUNGRY from the energy expended while crying himself to sleep?  
Remember, if baby is waking up cranky or crying, he is most likely not getting enough sleep. Even though he may cry, your baby will probably go right back to sleep in ten minutes for another thirty to forty minutes of rest.  pg 134
Parents are ignoring crying because it's naptime. Baby is rooting and mouthing and active and crying but parents will not SEE this behavior because it's naptime and they are "teaching the skill of sleep" by ignoring this fussing. Hunger signs are missed, baby falls asleep again, and must wait until feeding time.
After feeding, he is awake for a short time, then put down for a nap. He cries. Crying uses up calories and exhausts him; he falls asleep.
But wakes up an hour later because he's hungry!
Only, it's still naptime. So he gets ignored.


1 comment:

  1. Wow! That's a great guide! I know an added article from The Sleep Doctor that that will supplement your topic on developing healthy sleeping habits for your child. I hope this helps.