Thursday, January 21, 2010

AAP releases Warning for Ezzo's "Babywise"

Infant Feeding Advice
Take A Brochure

This printable tri-fold brochure educates parents and professionals about issues raised in Babywise & Preparation for Parenting. Permission is granted to copy and distribute.
Download here Babywise and Preparation for Parenting (also known as Let the Children Come: Along the Infant Way) have been criticized by hundreds of professionals in pediatric medicine, human lactation, psychology, anthropology, child development, and theology. Problems have been associated with these programs -- cases of slow weight gain, failure to thrive, depressed babies, even hospitalization. Its feeding recommendations were the subject of a warning sent out by the AAP.

The following are some of the concerns experts share :

Lack of expertise and credentials. The primary authors of the material, Gary and Anne Marie Ezzo, are self-proclaimed experts. Gary Ezzo has no background or expertise in child development, psychology, breastfeeding, or pediatric medicine, and holds neither an associate's nor a bachelor's degree from any college; his master of arts degree in Christian ministry was granted through a program that awarded credit for life experience in lieu of an undergraduate degree. Anne Marie Ezzo worked only briefly as an R.N. decades ago. It is unclear what, if anything, Babywise co-author Dr. Robert Bucknam contributed to that book, since the earlier religious versions are essentially the same with additional material and do not have his name on the cover.

Risks for breastfeeding mothers and babies. Breastfeeding on a parent-determined schedule (including a "flexible routine" as it is called in Babywise) may reduce a mother's milk supply and contradicts the recommendations of the American Academy of Pediatrics (AAP), which has stated, "The best feeding schedules are the ones babies design themselves. Scheduled feedings designed by parents may put babies at risk for poor weight gain and dehydration."

Poor breastfeeding information. Although it is presented as authoritative, the breastfeeding information presented in Babywise is inaccurate and substandard (compare with the AAP Breastfeeding recommendations from the 2005 AAP Policy Statement on Breastfeeding and the Use of Human Milk).

One Size Doesn't Fit All. All babies and mothers are treated alike without any respect given for individual differences in breastmilk storage capacity, rate of milk synthesis, rate of infant metabolism or stomach capacity. In actuality, the number of feedings one mother's body requires in order to supply her baby with plenty of milk each day will be quite different from other mothers around her. Similarly, breastfed babies need varying amounts milk in varying numbers and sizes of feedings, and they do not feed exactly the same way from one feeding to the next in any case. Ezzo seemingly expects all babies to respond in an identical manner. This is no more realistic than expecting adults to consume the same amounts of food on the same schedule and grow (or lose weight!) at the same rate.

A high-pressure presentation impacts parents' perception of what is at stake:

Pressure to maintain the regimen. The rules for sleep, feedings and wake time are portrayed as critical to follow in order to achieve a healthy outcome, while health and behavior problems for the baby, and sleepless nights for the parents, are predicted if the program is not followed. (Flexibility is praised but is described as small, short-term adjustments to the prescribed regimen. Parents are warned against making open-ended adaptations.)

Misplaced moral dilemmas. How well the parents and the baby adhere to the program is framed as a moral or biblical issue (e.g. permissiveness on the part of parents, uncooperativeness on the part of the baby).

Parents are reluctant to give up on the method. Health care professionals have observed that even when their babies were doing poorly on the program, parents often wanted to stick with it


Christine Hess said...

I know this blog is old and so no one may read this, but I'm dismayed by the misinformation I keep finding about the AAP's "warning" about Babywise. To the best of my research, there is no such warning by the AAP. All there is is a commentary by an AAP fellow that was published in AAP News.

Matthew Aney's comments have been quoted ad nauseam and inaccurately attributed to the AAP as a whole and stretched to say it was a "warning" or "recommendation" by the organization.

Shortly after these comments, two members of AAP refuted them. Here is one of those:

All of these comments were in 1998 and, it seems that some errors in the first edition of Babywise have been corrected.

No approach or book is for everyone, but it dismays me to see this one discounted due to misinformation and to falsely credit quotes and warnings to the AAP.

Regina said...

Christine: THANK YOU THANK YOU! I searched and searched like you did and found nothing resembling a warning from the AAP. As you say, the article in AAP News has been horridly misquoted everywhere.
After 3 months of trying to pick up my twin girls and offering the breast every time they cried, and feeding on demand all night long, I was worn ragged. It proved impossible for me to practice attachment parenting with my multiples. The advice in the baby wise book brought stability and most of all happiness to our lives. They are sleeping well, gaining weight, and simply thriving. For random blogs and sites to misrepresent what babywise is all about is just wrong.

Kristen said...

Thank you Christne! We're expecting our first in August and I'm currently reading Babywise. I recently read an online review that referenced the published commentary and I was concerned--it's so nice to see that those concerns are indeed misplaced!

Kristen said...

Thank you Christne! We're expecting our first in August and I'm currently reading Babywise. I recently read an online review that referenced the published commentary and I was concerned--it's so nice to see that those concerns are indeed misplaced!

han deluca said...

Though you are half-right, the AAP has published concerns about EZZO:

It has also been criticized by a number of experts, including Dr. Brazelton:

Cherie said...

there is the warning. didn't take much searching at all.

Cherie said...

there is the warning. didn't take much searching at all.

Catherine Valenzuela said...

Baby Wise should be called Baby Lies. The Author has no background in childhood education, nor is he a Doctor. What gives him the right to tell people when and how to feed and care for their babies. Many babies have had to be treated for dehydration and failure to thrive while following this book. Its bad news I would stay away from it

Kurston Anne said...

Kurston Anne said...

Meg said...

But even the link posted here several times isn't a "warning from the AAP" as many people are claiming. Read the article! It is a commentary--an editorial/opinion article. Not any kind of official statement by the AAP. I have also searched and searched and haven't found any warning issued. I don't agree with Baby Wise, but I do feel that this story of an AAP warning is actually a myth.

Meg said...

It drives me NUTS that people post this link and call it the recommendation by the AAP. Did these people actually read the article they posted? It is an editorial. Not a research article and it isn't written by the AAP.

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Blake Weber said...

It is interesting that several referred to a warning by the AAP (The American Academy of Pediatrics) of which 62,000 licensed Pediatricians now are members to this fine group). Because I looked on their website and the AAP has no warning at all. In fact, they have no mention of anything like you cite. So I dug all the way back 17 years to find anything that you might have been mistakingly referring to-- and here it is. One rogue doctor who was not a member of the AAP (nor does he speak for the AAP in any manner) and did his medical training in Mexico wrote one article espousing his own personal opinion which had nothing to do with the AAP. You might find the truth very enlightening about Dr. Aney: If it is individual doctor's opinions that you might value, it is good to note that over a dozen Pediatricians and other medical professionals such as R.N. C.L.E., professor of Pediatrics, Obstetrician, Pediatric Neurologist, Pediatric Cardiologist, and an international Pediatrician fully endorse Babywise on and regularly reference Babywise in their successful practices. The author himself, Dr. Robert Bucknam, M.D., is a 26 year Pediatrician and father of four. One of the great founding fathers of this great nation was John Adams and one of his quotes that he is well remembered for was, "facts are stubborn things." I hope it is helpful to have the real facts on this, I found it very interesting myself. Again, if the truth about Dr. Aney and his personal editorial that has been falsely attributed to the AAP, google the phrase "AAP Warns About Babywise" and read the link to babywisebooks.