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July 16, 2005

Babywise and Breastfeeding: The Realities

Dr. Matthew Aney a practicing pediatrician in California, states:

"On Becoming Babywise, has raised concern among pediatricians because it outlines an infant feeding program that has been associated with failure to thrive (FTT), poor weight gain, dehydration, breast milk supply failure, and involuntary early weaning. A Forsyth Medical Hospital Review Committee, in Winston-Salem N.C., has listed 11 areas in which the program is inadequately supported by conventional medical practice.

. . .

I have reviewed numerous accounts of low weight gain and FTT associated with "Babywise" and discussed them with several pediatricians and lactation consultants involved.

. . .

This advice is in direct opposition to the latest AAP recommendations on newborn feeding (AAP Policy Statement, "Breastfeeding and the Use of Human Milk," Pediatrics, Dec. 1997):

"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."

Ezzo-related delayed growth, slow weight gain and Failure to Thrive is sadly common. Our son was one of those babies who seemed to do great with Babywise and then was diagnosed Failure to Thrive. Lori's son was hospitalized when he was less than a month old due to dehydration and FTT.

For every Failure to Thrive diagnosis, there are many undiagnosed examples of delayed and slowed growth. If you spend any time among Ezzo mothers, you'll commonly hear reassurances that it is common for babies to thin out, be "petite", slow their growth rate, be smaller than their peers. And yes, while half of babies are below the 50th%--this common pattern of Ezzo mothers are seeking reassurance for their small babies is disturbing.

Chapter Four of Along the Infant Way (the "new" Preparation for Parenting and "Christian" Babywise) is titled "Facts on Feeding." That title implies that the material contained within that chapter is factually accurate. On the contrary, it is mostly comprised of Ezzo's opinions, the Parent Directed Feeding "philosophy," partial-truths, and medically unsupported claims about breastfeeding the PDF way.

Sadly there are just enough actual breastfeeding facts scattered about the chapter, that a new mother with limited knowledge of breastfeeding will assume the rest is accurate. Without more experience or knowledge, it can be difficult to discern Ezzo's faulty feeding "facts."

I recommend to all mothers, both those who are planning on using Ezzo's ideas and those who have rejected them, to read the following carefully-documented articles about how breastfeeding works:

How Does Milk Production Work?
by By Kelly Bonyata, BS, IBCLC

Examining the Evidence for the Cue-feeding of Breastfed Infants
by Lisa Marasco, BA, IBCLC and Jan Barger, MA, RN, IBCLC

While what Ezzo teaches about feeding may line up with the needs and supply of some infant/mother nursing dyads, there is a hard-to-ignore pattern of Ezzo's parent-directed feeding undermining mothers' milk supply. This collection of case studies was documented by a then-GFI supportive breastfeeding counselor who was volunteering as an Ezzo Contact Mom.

The mothers I have known who have breastfed while using the ideas presented in Babywise have usually struggled with milk supply, typically around 4-5 months, and often transitioning early to formula feeding. It is also common to hear Ezzo moms discussing starting solids earlier than the AAP recommended 6 months because their babies seem hungry and unsatisfied with breastmilk. Again, these situations are common among mothers who are very supportive of Babywise and are seeking advice among other pro-Ezzo parents.

Of course, Gary Ezzo will disagree with the breastfeeding information provided in this post--and he does in this article on the GFI website, "Myths and Misconceptions". Gary Ezzo can be persuasive--but look closely at what he writes. Does he really back it up with medical documentation or simply make assertions based on his opinions?

This post is part of the Ezzo Week 2005 series focusing on Gary Ezzo's parenting teachings.


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You know this is really weird, I completed the course Growing Kids God's Way and not once throughout the entire thing was this silly idea even mentioned. To me as a mother to feed babies on a routine is ridiculous, when they are hungry they're hungry and the only thing that's going to stop that is to feed them. I'm certainly not sure where he gets the idea from that routine feeding is acceptable. btw thanks for the comment at my blog.

Posted by: Aimz at July 16, 2005 11:40 PM

Hee hee and then there are my FTT, non-Ezzo baby and my thinning out, DEFINITELY non-Ezzo baby.....

(But I've seen too many case studies to know that you're right on...just wanted to share how it's definitely possible to have a FTT baby while not doing Ezzo. :-D )

Posted by: Kirstin at July 17, 2005 07:46 PM

just wanted to share how it's definitely possible to have a FTT baby while not doing Ezzo.

You are absolutely right, Keer. And this is the main defense that Ezzo makes--that it's not just Ezzo babies that are FTT.

The concern, however, is how very common insufficient-calorie FTT is and how very common milk supply struggles are, among Babywise moms. Not to mention how easy it is to see how his lousy breastfeeding advice is linked to it (once you know what to look for!)

Hi, Aimz! Good to see you here. Gary Ezzo teaches that Babywise/Along the Infant Way are the best "foundations" for his GKGW/Along the Virtuous Way courses. Overall, he's shown himself to be a teacher of questionable credibility.

Posted by: TulipGirl at July 17, 2005 07:56 PM

GFI was popular for a short time in a church I used to attend (not through the church, just moms passing information around). And while breastfeeding was pretty much the way to go in that church, I noticed more than a few moms switching to formula at 3-4 months, even moms who had successfully bf an earlier baby.

It took me a bit to figure out what had happened. They had done Ezzo routine/schedules in the early days and the consequences showed up. I was so sad for them.

I never did any Ezzo type parenting, and have always tried to learn more so I could share the dangers with my friends. I am so glad to have found all this information.

But then I'm one of those marsupial moms, with a bf almost 17 mo and no plans to wean yet. I do everything wrong, according to Ezzo, but my kids seem to be coming along all right. I'm trying to grow them up the way God said - in His Holy Word, not according to a man who has serious character issues.

Posted by: Tracy at July 18, 2005 12:49 AM

My mother fed the three youngest of her six children on a schedule. It worked great. The point is *not* to starve them, as TulipGirl seems to think. The point is to get them on a regular pattern of eating and sleeping so that their bodies function normally. Having a schedule doesn't mean that you don't always feed a baby when he's hungry. It means that you get him into an eating pattern that's good for him--in other words, one that nourishes him. It's not good for babies to have irregular eating patterns any more than it is for us. When a baby's body is in a regular pattern of eating and sleeping, everything goes much more smoothly.

And for the record, my brother and sisters ate after sleeping, not right before, and had none of the feeding problems that you talk about. And they learned to sleep through the night in a timely manner. Neither did my mom neglect them when they cried, but she learned not to jump every time they did. Sometimes babies cry just because they are tired or don't want to be in bed. Mom often knew by their cry if they really needed something.

When a baby is on a schedule, you know exactly when he should be hungry and tired. So if he just ate, and just slept, and he's crying, you don't have to guess as much what the problem is. This is better for mom and baby. A baby may always be happy to be fed, and he will accept food because he likes it even if it's not what he was crying about. Then feeding can become something he depends on for his security.

Posted by: KM at July 26, 2005 09:06 PM

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