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T A B L E++T A L K

Private vs. public schools: Debate whether where you send your kids makes a difference over the long haul in the Mothers area of Table Talk

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R E C E N T L Y

A thigh of relief
By Mollie Brownstein
Summertime -- and the livin' is easier if your legs don't rub together
(08/05/98)

One step at a time
By Lori Leibovich
Why some stepfamilies flourish and others fail
(08/04/98)

Crossing borders
By Rigoberta Menchú
The famed Mayan activist whose mother and brother were tortured and killed reflects on the family -- and village -- she lost in Guatemala
(08/03/98)

Lusting after "Lolita"
By Justine Brown
A lifelong affair with "Lolita"
(07/31/98)

Reality bites
By Karen Grigsby Bates
By making the irrelevant Mike Tyson case a big PR issue, NOW demonstrates again that it's run by imperious, out-of-touch white women
(07/30/98)

BROWSE THE MOTHERS WHO THINK FEATURE ARCHIVES

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Mamafesto
By Camille Peri
Why it's time
for Mothers Who Think

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GETTING WISE TO "BABYWISE" | PAGE 1, 2, 3, 4, 5
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Without any major promotion other than word of mouth, the explosive popularity of "Babywise" has quietly turned GFI into a publishing industry phenomenon. However, as more parents like Lori and Theo Rivas speak out about their negative experiences with the advice contained in the books, "Babywise I" and "II" have also become the most controversial American child-care guides in 20 years or more. In response to the books' radical departure from current pediatric and psychiatric advice, scores of concerned medical, lactation science and child development experts are speaking out against what they see as potentially dangerous child-care guidance, being offered up with little in the way of credible supporting research.

In 1997, approximately 100 health-care providers, including nationally known experts and 20 fellows of the American Academy of Pediatrics, sent a "letter of concern" to the AAP regarding Ezzo's child-care advice. In February, the Wall Street Journal reported on the growing controversy, and in April, the AAP's own District IV Chapter Convention passed a resolution calling on the AAP to investigate "Babywise" and its effects on infant health. In the same month's issue of the AAP News, Dr. Matt Aney, a California pediatrician, wrote an editorial in which he discussed having personally reviewed dozens of medical records of infants with health problems ranging from low weight gain to dehydration to symptoms of depression that developed after parents had followed the feeding advice contained in "Babywise." The nation's largest professional organization for lactation professionals, the International Lactation Consultant Association, has become so alarmed by growing numbers of parents using Ezzo's "infant management program" with poor results that, at its recent international conference in July, the group offered a presentation to a standing-room-only audience on how to deal with "rigid approaches to care giving" in the clients that they see. In the past, "Babywise" co-author Robert Bucknam has suggested that criticism of GFI's child-care programs is based on prejudice against Christians. However, a highly placed source within the AAP says that the fact that the controversial "Babywise" books are produced by a large Christian organization has actually prevented the AAP from taking an even stronger public position against the popular books.

The great controversy stems in large part from the fact that the "Babywise" approach represents a harsh throwback to decades-old and widely discredited child-care manuals in which mothers were advised to watch the clock rather than their babies' signals in determining when breast or bottle should be offered. Today, in response to extensive research into infant nutrition and growth, experts strongly advise against "scheduling" and in favor of feeding, preferably breast-feeding, according to a baby's cues. In recent months, the American Academy of Pediatrics issued a "Media Alert" in which the organization emphatically "reaffirms its stance that the best feeding schedules for babies are the ones babies design themselves." The alert went on to say that "scheduled feedings designed by parents may put babies at risk for poor weight gain and dehydration."

"Parents shouldn't try to put their healthy infants on feeding schedules," says Susan Baker, M.D., chairwoman of the Committee on Nutrition for the AAP and an associate professor at the Medical University of South Carolina. "Babies' feeding needs are extremely variable. You should nurse your baby when she's hungry or shows signs of being hungry, no matter when she last ate."

Ezzo disagrees. With a self-coined term, "Parent Directed Feeding (PDF)," Ezzo continues to advocate feeding-by-the-clock, suggesting, among many other things, that infants breast-fed in the manner advocated by Dr. Baker are "confused," "uncomfortable" and insecure." Further, Ezzo recommends that night feeds should generally be phased out by approximately 8 weeks of age, as infants of this age should be sleeping seven or more hours at a stretch if his program has been implemented properly. Ezzo writes that "Between seven and nine weeks, parents [who have followed "Babywise" recommendations from birth] can expect [baby's] nighttime sleep cycles to be a continuous 7-8 hours. After three months of age, that time is extended to 9-11 hours each night. This nighttime sleep is in addition to ... regular nap times during the day. This means bliss for everyone. Mother. Baby. Father. Siblings. Perhaps even the family pet."

Not true, says Dr. Richard Ferber, director of Boston's Center for Pediatric Sleep Disorders at Children's Hospital and the author of the bestselling "Solve Your Child's Sleep Problems" (Simon and Schuster). "Parents shouldn't expect babies to sleep that long that early, although a very few will on their own and in that case, you may sometimes need to actually wake them to feed them," says Ferber. "There is no good evidence that babies that young can go that long without a feeding."

According to Ferber, any ill-informed child-care advice that suggests that very young infants should be sleeping through the night has the potential to leave new parents frustrated as they wonder what's "wrong" with their own baby.

Medical textbook co-author Kathleen Auerbach, Ph.D., a nationally known International Board Certified Lactation Consultant (IBCLC), concurs. "This is completely out of keeping with how infants sleep and eat. An 8-week-old infant gets approximately 30 percent of all food volume in the hours between midnight and 8 a.m. To deny babies fully one-third of their total food volume by 2 months of age is asking for trouble," says Auerbach.

Although Ezzo's PDF is not recognized (or even mentioned) in any recent peer-reviewed medical literature, "Babywise" boldly informs new parents that "PDF is a new and major paradigm shift for the [lactation science] industry and not all [lactation] consultants have a working understanding of routine breast-feeding dynamics." In fact, leading lactation consultants say that it is Ezzo, Bucknam and their supporters who lack a basic understanding of lactation science. Among other things, "Babywise" states that feeding a baby too frequently can actually decrease breast milk production and even "compromise a child's health." According to Kathleen Huggins, R.N., M.S., and an International Board Certified Lactation Consultant, as well as author of "The Nursing Mother's Companion" and "The Nursing Mother's Guide to Weaning" (Harvard Common Press), this information is simply wrong.

"The more often a woman feeds her baby, the more milk she will make. The less often she feeds her baby, the less milk she will make. This is an established aspect of human physiology," says Huggins, who has herself worked with several families who saw their infants lose or fail to gain weight after following the feeding advice in "Babywise," including one pair of newborn twins who were diagnosed with "failure to thrive." Huggins says that she was able to convince the babies' mother to respond to their cues and feed them more frequently, leading to a quick recovery. "Some women may be able to maintain a good milk supply with a feeding schedule, but many, many will not, particularly after the first few months," adds Huggins.

Katherine Dettwyler, Ph.D., an associate professor of anthropology at Texas A&M University and one of the world's foremost authorities on biocultural perspectives on infant feeding, says that human infants were designed to eat frequently and at their own pace, which may vary markedly from baby to baby. "The composition of human milk is similar to that of other primates, with low fat and protein levels typical of a continuous contact species," explains Dettwyler. "Babies are designed to be fed very frequently for the first few months of life ... To cloak 'convenience for parents' in the guise of a rigid feeding schedule being 'best for the baby' is really misleading."

Dr. Carl Hays, a Burlington, Iowa, obstetrician and a member of what GFI calls its "medical advisory board," concedes that PDF does not have widespread medical support, but says that he promotes it anyway. "Too-frequent feeding doesn't allow the breast to refill. Although it is true that this is not what the research currently says, nothing is carved in stone. I think you are going to see some interesting studies on this very soon," he says. He declined to predict where or when these studies would be published.

N E X T+P A G E: Leave that crying baby alone