Never before has so much parenting advice been available to American mothers and fathers. A quick perusal of the "family" section at your local bookstore will offer literally hundreds of books and magazines, all chock-full of tips on how to raise a healthier, smarter, better-behaved baby and child. These tomes are, with a few exceptions, largely consistent.
However, one parenting curriculum on the market varies markedly from most other modern childrearing advice, and it's got many experts very worried. This highly controversial program, including books, courses, and videos, is produced by a fundamentalist Christian organization called Growing Families International (GFI) and has been embraced by approximately one million parents since its introduction in 1984.
The comprehensive GFI parenting curriculum, which covers every stage of pregnancy and childhood, is offered through conservative Christian churches across the country. The program was developed by nondenominational ministers Gary and Anne Marie Ezzo, who head up the Chatsworth, California-based GFI. The organization's stated goal (GFI made no reply to repeated attempts to contact them for this story) is to establish "a biblical mind-set for parenting, a mind-set that can be passed from generation to generation."
Although the majority of Ezzo parenting material has clearly identifiable religious overtones, in 1995 GFI removed all Biblical and theological references from their popular infant-care manual, PREPARATION FOR PARENTING, and repackaged it as the ostensibly secular ON BECOMING BABYWISE (Questar Publishers, 1995). Now available at most mainstream bookstores, BABYWISE has by many accounts become the fastest-selling publication of its type in the country, with many purchasers unaware of the book's source.
The specific baby- and child-care instructions set forth in PREPARATION FOR PARENTING and BABYWISE have medical professionals around the country increasingly troubled. This year, 100 physicians, nurses, and lactation consultants sent a carefully documented "letter of concern" to the American Academy of Pediatrics. These professionals expressed disagreement with many of the childrearing methods advocated by the Ezzos, and worry about the complete lack of credible scientific foundation for the program.
Why has BABYWISE raised so many red flags for informed observers?
Perhaps the most hotly debated aspect of the program has to do with the Ezzos' views on routines for young children. BABYWISE admonishes parents to establish a regular schedule for infants immediately after birth; they propose that an unscheduled baby will lead to an undisciplined and difficult child with "metabolic chaos" (a term not found in any medical literature). In the religious version of the manual, the Ezzos strongly suggest that it is God's will that infants eat, sleep, and play on an externally imposed schedule. They write that God is a "God of order." In fact, the subtitle of their parenting curriculum is "Growing Kids God's Way." The book insists that scheduling an infant will actually help his nervous system to "mature" more quickly.
In BABYWISE, the Ezzos advocate something they refer to as "parent-directed feeding," in which infants, whether breast- or bottle-fed, should be offered nourishment only every three hours or so as timed by the parents. In earlier versions of the manual, parents were urged to wait at least four hours between feedings.
After vociferous outcry from the medical community, the guidelines were modified.
Still, according to BABYWISE, "demand feeding," the method currently advocated for infants by all major medical organizations, is a faddish and child-centered practice that can only lead to unhappy babies and mothers. Both GFI infant-care manuals advise that demand-fed infants often grow into children who steal, who will be unable to handle real life, and who will "have difficulty with siblings and peers."
Dr. Robert Bucknam, the Denver-area pediatrician who co-authored BABYWISE with the Ezzos, describes this alleged phenomenon: "As they get older," said Bucknam, "every whine is an opportunity to feed. They become more demanding. They become brats."
Most child-health experts couldn't disagree more strongly. In the case of breastfed infants, the practice of limiting feeds by the clock in the early months can lead to breastfeeding difficulties, low weight gain, or even dehydration.
Jan Barger of Illinois, R.N., M.A., an international board certified lactation consultant and current editor of CLINICAL ISSUES IN LACTATION, says that many infants need to nurse more frequently than every three hours: "It goes without saying that scheduling feeds, especially the way they schedule them, is potentially dangerous to breastfeeding."
Debby Kearney, a Florida-based lactation consultant and president of the Florida Lactation Consultant Association, agrees with Barger: "If you look at any medical book on breastfeeding--just pick one--you aren't going to find one that suggests this kind of limited feeding."
In an interview with the Bradenton Herald (of Florida), Kearney discussed the experiences she had working with a number of parents who were using the Ezzo feeding program. In each case, babies were gaining weight slowly and exhibiting signs of depression. Despite Kearney's professional advice to feed the babies more often, these parents refused in accordance with the BABYWISE schedule.
The letter of concern sent to the American Academy of Pediatrics contains many other citations--by physicians, nurses, and others--about babies who failed to thrive on the Ezzo feeding schedule.
Although Jan Barger concedes that some mother-baby pairs may be able to maintain a healthy milk supply and weight gain on less frequent feedings, she points out that every situation is unique and thus "cookie-cutter" instructions on how often infants should eat cannot possibly be applied to everyone. "There are myriad factors that go into breastfeeding. Babies' needs may differ from one baby to another, while moms' abilities will differ . . . not only from one mother to the next but from one baby to the next in the same mother."
Barger cites scientific references regarding differing breast-storage capacities, infant stomach capacities, and the caloric value of human milk to support her criticisms of scheduled feedings.
Katherine Dettwyler, Ph.D., a professor of anthropology at Texas A and M University, echoes the sentiments of her peers regarding the Ezzos' parent-directed feeding program: "Regardless of one's parenting philosophy, there are limits to human physiological adaptation in terms of producing milk (on the mother's part) and growth and health (on the child's part). It is possible for some women to produce sufficient milk when nursing on a three-hour schedule. However, many, many women will not. Breast-milk production is a demand-driven system."
But professionals are concerned about more than just the Ezzos' feeding program; many child-care experts disagree with program's advice to let children cry for periods of time without responding.
Both Preparation for Parenting and BABYWISE instruct parents to listen carefully and "evaluate" a baby's cries, but never to respond based on "mother's instinct" (which they say does not exist) or emotions. By doing this, say the authors, parents will bring "God's order to your day and restful sleep to your baby's night." The program says that a primary goal of allowing babies to cry is to teach them to sleep through the night before the age of eight weeks.
In Preparation for Parenting, the Ezzos use the Christian crucifixion as justification for letting infants cry it out, writing: "Praise God that the Father did not intervene when His Son cried out on the cross."
The significant controversy surrounding these views hinges on emerging research demonstrating that night wakings by infants serve an important purpose in establishing and maintaining a mother's milk supply. Promising new scientific evidence even suggests that long and uninterrupted sleep cycles in infancy may raise the risk of SIDS.
Moreover, many child-welfare professionals have expressed concern that a parent's repeated failure to respond to the cries of a child can lead to a lack of attachment between parent and child.
In a May 1996 symposium on religious parenting programs sponsored by the Orange County [California] Child Abuse Prevention Council, religious and child-care experts reviewed GFI's parenting curricula. They concluded that Preparation for Parenting contained many disturbing elements which had the potential to lead to child abuse.
One of their cited issues was the book's promotion of parents allowing infants to cry without immediately responding: "A concern of the Committee is that the teachings on letting infants cry might lead parents to become insensitive to their baby's needs. They could miss when the baby is sick or injured if they are used to ignoring the child's cries," wrote the group. "Ignoring an infant's cries could also lead to a lack of trust in the baby. The fostering of trust is one of the most important factors in child development."
This presents no significant concern for the Ezzos, since in Preparation for Parenting, they state that, "while maternal-infant bonding may be an interesting psychological idea, research has not substantiated any such cause and effect relationship in human beings."
In fact, a mountain of peer-reviewed medical research now demonstrates the importance of maternal-infant bonding.
The Ezzos believe that crying in even the youngest infant, except in the case of clear physical discomfort, is a type of manipulative behavior which, if catered to by parents, will set up an unhealthy parent-child dynamic.
One prominent pediatrician and author has described the Ezzo approach as "tough love for newborns."
GFI's model for family life is an extremely authoritarian one in which father is the family leader and the husband-wife relationship takes precedence over other familial ties.
Lisa Marasco, a La Leche League Leader and certified lactation consultant from California who has researched the GFI curriculum, says that she finds this point of view disturbing. "I see the entire GFI philosophy as built upon a foundation that starts off with an adversarial relationship with the baby and continues constantly suspicious of manipulation and on guard lest the parent lose some degree of control and let the child feel too much power," she says.
Other advice given in Ezzo parenting books includes "playpen time" wherein babies and toddlers are left alone in a playpen for a prescribed period of time each day in order to teach them how to amuse themselves. If the child becomes unhappy or distressed, parents are not to remove them from the playpen, as this would be allowing the infant to "manipulate" the parent.
Carrying a child too often, particularly in a cloth sling, say the Ezzos, can lead to "developmental damage." After the age of eight months, children are to be discouraged from playing with their food by having their hands slapped.
Children should be ignored during a tantrum, but after the episode has subsided, the parent should calmly explain that the child will now be receiving his or her "Biblical chastisement" in the form being struck by the parent (a spanking).
These and other points in BABYWISE and other GFI materials have not only raised concern in the health-care community, but have forged deep divisions within the conservative Christian community as well. Dr. William Sears, M.D., author of many popular parenting books including one on Christian parenting, says that GFI's parenting materials are "probably the most dangerous program of teaching about babies and children that I have seen in my twenty-five years of being a pediatrician." After review of the materials, the highly conservative Christian organization Focus on the Family announced that it could not endorse the program.
With all of the controversy swirling around GFI, what is it about their books and courses that leads so many parents to try their methods? Perhaps it is the program's promise that if families will simply follow a step-by-step plan, parenting, the hardest job in the world, will become painless and easy. Babies will sleep through the night, toddlers will never step out of line, and even mealtime cleanup will become a snap.
New parents today, without the support of extended family nearby to advise them on how to best care for their children, often seek a sure and confident voice to assist them in their decision-making.
In some cases, BABYWISE, a publication whose very cover promises happy and content babies "the natural way," may simply be the first book that a parent picks up off the shelf.
In any case, tens of thousands of American parents are currently placing their faith in Growing Families International's methods, perhaps unaware that in light of the criticisms from the most credible parenting experts of the day, a better title of GFI's book might be ON BECOMING BABY-UNWISE.
To access Katherine Dettwyler's analysis of the Ezzos' program of parent-directed feeding, visit her Website at: http://www.prairienet.org/community/health/laleche/detisrael.html