Saturday, April 10, 2010

The Center Point Between AP and Hyperscheduling

Of the many lies in this book, today's blog entry takes a deeper look at perhaps the biggest, most misleading lie of all:  that author Gary Ezzo offers a nice, healthy balance between two parenting extremes:

Attachment Parenting  vs. Hyperscheduling 

In his book, the author describes Attachment Parenting as
 - exhausting for the mother,
   - chaotic for the family, and
- confusing for the child.

On the other hand, a too-tight "hyper"schedule is one that is too restrictive
- offering no regard for the baby's or mother's needs. (pg 31)

His book, of course, offers the solution: The Parent-Directed Feeding plan. 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.

From the above statement, we know "hyperscheduling" is extreme. We learn more from 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 more 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 scientific formulas invented to replace human milk.
  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.
Presumably, the Babywise program will show the reader how to avoid the problems associated with hyperscheduling. 

But does it?

Factor number 1. What does Babywise have to say about an infant’s developing emotions and feelings? Does Ezzo agree that an infant might have emotions and feeling that need attention?

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. (Infers more experienced (ie 'better') parents can ignore it) With a bit of help, you can [know what to do].  He then tells you what to do - which amounts to nothing other than listening to the crying to get accustomed to its sound!(pg 138)
  • 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   [*Note: the words "blocking" and "suppressing" are used to describe a parent's desire to console their crying infant.](pg 139) 
  • 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.  [Crying at naptime represents an “illegitimate” {ie. emotional} need, so is disregarded in order to “train” the child] (pg 143)
  • Identifying and knowing your baby’s cry patterns and disposition will help you learn to discern real needs.  [Here he says to simply listen to the crying and note how long it lasts so you can consider it "normal" for your baby! (pg 146) 
He gives examples from his own grandchildren: 
  • 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) [Baby cries every day at naptime 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.  [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 calm and soothe her. Crying was shrugged off as simply her disposition.] (pg 146)
  • 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 basic need to feel loved and safe?] 
  • 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 every 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 decided to ignore crying, your nine-weeks-old baby comprehends this and won’t feel abandoned.

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

Factor number 2. What does Babywise have to say about the 2nd problem with hyperscheduling:  “…feelings went unrecognized, over-ruled by specific and controlled care.” 

Because AP mothers generally feed their babies whenever they seem to need/want it, Ezzo believes these families lack any kind of structure in their lives, keeping parents "in bondage" to the baby’s demands.  Hyperscheduling is the equally extreme in the opposite direction, being overruled by specific and controlled care.

Is Babywise really “the center point” between these two extremes?
Or does Ezzoactually 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 routine. (pg 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 do? (pg 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)
  • A sample schedule to fill out is provided in the book. He even calls it a schedule, though he uses the word “routine” throughout the rest of the book. (pg 117)
  • 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 rules the day in Babywise, just as in Ezzo's own description of the "extreme" he calls Hyperscheduling.

Factor number 3. How does Babywise avoid the third problem with hyperscheduling… 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, (pg 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) 
  • 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 control.(pg 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 nine feedings in 24 hours.
  • Teaches that crying is mainly indicative of tiredness. Tired babies are put in bed, unfed.
  • 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 naptime crying until baby exhausts himself and falls asleep.
Suppose baby wakes during his scheduled "Sleep-time" because he is HUNGRY from the energy he expended while crying?  
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 to teach baby "it's naptime." Baby is rooting and mouthing and active and then crying but parents do not SEE this behavior because  they are "teaching the skill" of sleep by ignoring this fussing. Hunger signs are missed, baby falls asleep again, and must wait until scheduled feeding time.

After feeding, he is happy and enjoys waketime for a short time, then he is put down for a nap... just as he is starting to get hungry. He cries. Nobody comes, because he has to "learn the skill of sleep"
Crying exhausts him and he falls asleep.
But he wakes up an hour later because he's still hungry!
Only, it's still "naptime" according to the clock. So he is ignored to "teach" him how to sleep on schedule.


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