Michael & Michelle Hsieh4325 127th Pl. SEEverett, WA 98208(425) [email protected]
AN OPEN LETTER REGARDING
THE DANGERS OF PREPARATION FOR PARENTING (BABYWISE)
The following is Matthew Hsieh’s history as described by his parents, Michael & Michelle Hsieh,April 1999.
The purpose of this letter is to generate public awareness about yet another child who has surely
suffered due to following a Christian parenting program entitled Preparation for Parent-ing/Preparation for the Toddler Years
(secular versions marketed in stores as On Becoming Baby-Wise 1
) by Gary and Anne Marie Ezzo1. We hope that knowledge of his case can be used to pro-mote existing and future efforts to inform communities of the extremely serious dangers associated withfollowing the Ezzos’ program, even in its newest editions. It is our hope that, as awareness grows,popularity for its teachings will diminish to the extent that most churches will no longer promote orchoose to be affiliated with them.
Initially, we would like to qualify a couple of points. We are both college graduates from prestigious
universities. Michelle has a business degree with an accounting concentration from the University ofWashington (a rigorous and highly acclaimed program), and Michael has a mechanical engineering de-gree from the University of California, Berkeley. He currently works in international sales in the high-tech industry, while Michelle is currently a full-time mom. We point this out to say that we are not un-educated, fly-by-night, take-whatever-we-hear-as-gospel types of people. In fact, we have alwaysprided ourselves on possessing strong common sense, thinking things through in an analytical manner,and distinguishing between right and wrong. Secondly, we want to stress that the classes we attendedwere, and still are as of this writing, the most up-to-date versions of the program. For instance, the pro-gram’s infant feeding schedules have been revised to suggest feeding every two-and-one-half to threehours and to incorporate “flexibility,” yet the overall message is indeed the very same as in earlier edi-tions (it was shocking to us to learn what they used to recommend!). Major problems still exist withfollowing the Ezzos’ parenting program.
Matthew was born March 26, 1998. Just prior to his birth, we took the first parenting class, Prepa-
ration for Parenting
), in a series of what was promoted to be the most Christian-based, medi-
1 The BabyWise
books list Gary Ezzo and Robert Bucknam, M.D., as authors, but their content is virtually the
same as Gary and Anne Marie Ezzos’ books Preparation for Parenting
and Preparation for the Toddler Years
, withreligious references removed.
cally accurate parenting information. We took the second class, Preparation for the Toddler Years
acouple of months later. As first time parents, we were excited about applying the principles, therebyraising our children to be both loving and obedient. The messages were strong and clear, and theboastful claims of thousands of parents correctly applying the principles with only
optimum results leftlittle room for debate or need to question the material. A couple of times we remember hearing therewas controversy regarding the program, but we were encouraged to dismiss it as coming from parentsnot using good judgement or incorrectly applying the principles, or as simply “secular” society’s attackdue to the program’s Christian affiliation.
Other than his first week, Matthew’s first two months went rather smoothly. His first week was
tough, and, looking back, it should have been our first indication not to follow the feeding schedule wewere taught in Prep
. We should point out that Matthew was a small newborn. Although he was full-term and healthy, he was just under six pounds at birth, possibly due to low amniotic fluid levels, which,although not significantly alarming, prompted the obstetrician to induce labor eleven days early. (Induc-tion is a relatively common practice, and Matthew was still considered full-term.) Matthew was born ona Thursday; we were discharged on Friday, and yet, during that first week of life, we were back at thehospital every day but one. In his third day, he already appeared to be losing a little too much weighttoo quickly, and he was getting increasingly jaundiced. His before/after nursing weights indicated that hewas getting adequate amounts of breastmilk, even though he was found to be an extremely efficienteater—normally five minutes on one side, and he was done. However, telling the lactation consultantsand nurses that he was fed every two-and-one-half to three hours gave them the intended
message thathe was being fed on demand. Yet, “we knew better”—demand feeding was unhealthy, and we wereusing the Ezzos’ parent-directed feeding (PDF) approach.
Tuesday his jaundice was severe enough to require hospitalization, and while there our pediatrician
also had mother-baby compatibility tests performed to see if his body was rejecting Michelle’s milk—tests were normal. We were sent home the following day but continued on home photo-therapy for thefollowing couple of days. This required a daily visit from a nurse. Michelle remembers them telling us 1)to be sure to feed on demand, 2) not to press beyond the two-and-one-half- to three-hour mark, and3) to monitor (actually document) all feeding times and wet/poopy diapers. Again, we chose to ignorethe feeding on demand advice due to our “medically supported training,” but we did make sure to feedhim in the time frame suggested, as this went right along with PDF.
Ignoring this advice to feed on demand (or cue) was our FIRST BIG MISTAKE. However, de-
spite our scheduled feedings, Matthew’s jaundice did clear up, and his wet/poopy diapers met theminimum number, although they did seem fairly “weightless.” As new parents having no experience tocompare it against, we assumed infants just eliminated very tiny amounts fairly often. Things continuedthis way through his two month appointment, where his weight registered in the twenty-fifth percentile.
Although his nursing continued to be short in length, the milk supply seemed adequate, and Matthewwas fairly content.
Things slowly began to change at this point. Matthew became more fussy/irritable and Michelle
found herself always questioning her milk supply, wondering if he had colic or excess gas (we tried My-licon Drops) or was just overtired. She began pumping regularly, hopefully to ensure sufficient milk sup-
ply, and also tried supplementing with a bottle, but he repeatedly and vehemently refused, becoming soupset that he would even refuse the breast at that feeding. Many times Michelle’s intuition told her thatMatthew was hungry before the scheduled time, yet she chose to ignore those signals and instead com-fort him back to sleep, due to the Ezzos’ scheduled feeding philosophies, which had been drilled
intous. Our training specifically said that regularly feeding him sooner than our schedule would interrupt hishunger, digestive, and sleep/wake cycles, causing him to be a snacker, and this would just be unhealthyfor him (and us) overall. We had no reason to argue with this supposed medically-backed advice. Onvery rare occasions, Michelle would exercise “flexibility” and feed him before “time” due to his uncon-trollable cries, but most often he would “submit” to her comforting him to sleep.
It was at Matthew’s three-month (possibly between three & four months) check-up that we discov-
ered his weight, in terms of percentiles, had plummeted. He had dropped off the charts altogether. Tosay the least, we were very alarmed, as he was soon diagnosed as “Failure to Thrive” (FTT). Again,when asked about nursing frequencies, we answered every two-and-one-half to three hours and of thelack of success in getting him to supplement with a bottle. We were told that as long as we had alwaysfed on demand, Michelle’s supply should meet his needs. We were told to continue as we were, and tocome in for frequent weight checks between well-child appointments. During this time Matthew’s tem-perament had evened out a bit, and once again he seemed fairly content. What we now believe, in fact,to have been the case was that Matthew had become resigned to taking only small amounts of milk—not nearly close to what he needed to “thrive.”
We began introducing solid food, which Matthew took to very eagerly. We hoped this would help
him to put on some more weight. We again followed the strict suggestions for proper training from ourparenting class, and encouraged Matthew to keep his hands down while we spoon fed him. He didNOT like this, but we were encouraged to persevere, as our training had indicated that he could andwould learn to keep his hands down and out of/away from his food.
This was our SECOND BIG MISTAKE. He did, in fact, learn to submit to keeping his hands
down (or our holding them down), but his interest in food was quickly diminishing. At six months, weknew beyond a doubt that he was still getting far below adequate amounts of milk (we rented a highlyaccurate scale and did before- and after-feeding weights to get his total intake for twenty-four-hour pe-riods), and felt we had no other choice but to keep feeding him solids as well. His growth had not im-proved, and he was still off the charts.
More and more, Matthew was losing interest in nursing, while still refusing outside supplementation
by bottle or cup. It was obvious that nursing was not a “comfort” to him, as Michelle had always readand heard it to be for other babies (a trust issue). It was increasingly common for him to arch his backand display other obvious signs that he did not want to nurse any longer—just a couple of minutes everyfour hours or so, and he had enough. His back arching was interpreted as a possible sign of acid reflux,so we tried Zantac but experienced no change in behavior.
If we had rigidly been following the Ezzos’ advice in this scenario, we would have punished him for
his defiant arching. However, Michelle was unwilling to punish Matthew for this, in fear that it wouldcause him to reject nourishment even more. At this time (still about six months) Michelle was placed on
Metaclopramide, a generic form of Reglin, to increase her milk supply. It worked wonders. It was ob-vious through pumping that she now had plenty of milk. However, Matthew’s behavior about nursingdid not change. For so long he had resigned himself to small amounts, we believe he had learned
to feelfull on that insufficient amount of milk.
Things continued like this until Matthew was nine-and-one-half months old. He was learning up
through this time to supplement breastfeeding by taking formula from a cup, but again, extremely smallamounts of maybe an ounce or two. His spoon-fed and fingerfoods were, however, on the decline tothe point where he would refuse to swallow the spoon-fed food we did get in, and wanted nothing to dowith fingerfoods. Then, within a two-day period, Matthew stopped nursing altogether (apparently due toMichelle becoming pregnant, which changes breastmilk flavor). Over the next week he became in-creasingly dehydrated, with a fever above 103-104 degrees. He would take perhaps eight ounces offormula over the whole day, and, still to his dislike, we continued to spoon feed him until he would pro-test too loudly or stop swallowing. We felt we had no choice but to push the baby foods, as we were soconcerned with his lack of formula intake. With his continued rapid decline in energy/health/weight, hewas admitted to Children’s Hospital to begin naso-gastric (NG) tube feedings. He was released fromthe hospital after 4 days but has remained on the NG tube.
To say the least, these last months with him on the NG tube have been the hardest ever. There were
times that he was throwing up so much we didn’t know if he would make it. However, with the properamounts of nourishment, his weight has begun to climb dramatically, along with his energy and disposi-tion. At the beginning of the tube feedings, he was almost ten months old and weighed a mere fourteenpounds, eleven ounces. (If he had continued following the curve he set in his first couple of months, hewould’ve been just shy of 20lbs at this point.) At twelve months, he showed significant progress,weighing in at a wonderful eighteen pounds (still off the charts, but getting closer).
During this time, we spent a lot of time reflecting on what brought a perfectly healthy baby boy to
this state of complete food aversion/infant anorexia. He has undergone every test (a grueling process) torule out medical problems, which left us with an unexplained “behavioral” diagnosis. It was then that achance reading of an article warning against Babywise
in a local paper led Michelle to do a little moreresearch into the Ezzos’ parenting program that we had been so sold on.
What we found was astonishing. Matthew is just one of hundreds who have been diagnosed with
improper weight gain or “Failure to Thrive” associated with this program. We were not just looking forsomewhere to put the blame. We had complete respect for the Ezzos and their methods. Friends havefollowed through with the program with only “success.” In our hearts, we just knew, as we looked backover his history, analyzed medical reports and other articles, that this program indeed was the
significantreason for his problems.
We cannot begin to explain the feelings of anger, guilt, and remorse that accompany the realization
that due to some very improper and unsound medical advice and child-rearing techniques, our son hashad to endure so much. “Unpleasant” doesn’t even come close to describing how it feels to force thisunnatural tube down our son’s nose as he is held there screaming, only to have to do it again if he pulls it
out or, worse, throws it up. And to think that it has been recommended and is quite probable that wewill have to proceed with the invasive surgery for the more permanent stomach tube.
It is our firm opinion that the Ezzos lack the background and, therefore, the authority to be preach-
ing about step-by-step methods for raising an infant into a thriving toddler. They allow no room for indi-vidual temperament, size (premies, low birth weight babies, etc.), stomach capacity and digestion speed,along with a variety of other factors. When their program doesn’t work just right, or they are notified ofcases of low weight gain, the Ezzos immediately seem to attribute it to the parents (a guilt trip) for eithernot following teachings correctly, or following them too rigidly, which is contradictory. It has beenproven that there is a 300% variation among mothers for storage capacity of breastmilk2. Those withlarger capacities can more often nurse at longer intervals, whereas women with smaller capacities needto nurse much more frequently. Most importantly, it was noted that all
women in these studies had theability
to produce plenty of milk over twenty-four hours; what varied was the maximum amount theycould deliver at one sitting. It is also known that if an infant is fed on demand, more appropriately titled“cue feeding,” during the first couple of months, the mother is much more likely to establish appropriatemilk quantities. We were taught to ignore those “cues.” Yes, we were told to incorporate some “flexi-bility” when the child was obviously hungry (like crying to be fed), or when it was to suit our own needs.
However, the Ezzos’ definition of demand feeding as feeding a baby only when it cries is simply wrong.
In fact, demand feeding is actually recognizing the child’s hunger cues
(before crying, as crying is often alate sign of hunger3) and feeding them accordingly. We remember those cues vividly, and yet ignoredthem and tried to pacify Matthew in other ways until his “appropriate”
feeding time. How very sadlywrong we were.
How obviously wrong we were again to choose to follow the seemingly medical and biblical advice
of the Ezzos in Preparation for the Toddler Years
. Here we were taught to teach our child appropri-ate “highchair manners” of holding his hands down while he was being fed, and again it was said all chil-dren can learn obedience in this area. Health and medical professionals in the feeding therapy arenawould all say this is actually one of the worst
things one can do. A child naturally wants to touch, ex-periment, etc.—this is a developmental stage/activity all children should be allowed to experiment with.
Is avoiding a messy floor or table to teach compliance worth the possible costs? Yes, some infants andmaybe even most will learn to be happy to let you hold their hands down while spoon feeding and thento let them experiment after with finger foods. But, it can be argued, is this really success? Or, is successworth the possible cost of later food aversion? Let us tell you, it most definitely is not! We rememberheartily laughing at a friend who, having not taken the parenting program offered by the Ezzos, often hadto give her six-month-old a bath after a feeding. “How do you keep him from exploring with the foodand keep it out of his hair?” she would ask. We would simply think how much extra work she was cre-ating for herself by allowing her child to be, as the Ezzos might describe, “out of control and sinful.” Herchild is now a healthy, well-behaved one-year-old, and that laugh was sadly at our own expense.
2 See “Examining the Evidence for Cue feeding of Breastfed Infants” by Lisa Marasco, BA, IBCLC, and Jan Bar-
ger, MA, RN, IBCLC at http://www.fix.net/~rprewett/evidence.html.
3 See “Breastfeeding and the Use of Human Milk (RE9729),” the December 1997 statement of the American
So, did we have success with the parenting program? Obviously not. Do others have success?
Some think they do, as their children learn to be fed on schedules, sleep through the night, and other-wise be “obedient.” However, is there a long term cost of this obedience? Have bond and trust areasbeen unknowingly damaged? We really wonder. There are plenty of good parenting books and classes,but any one of those that comes across as if theirs is the only good way (for it is God’s way, right?), notonly has a lot of nerve but should be questioned in other areas as well. If readers take the time to dothis, we are confident that they will find not only that many of the Ezzos’ ideas on parenting are beingwidely questioned as unreliable and outright wrong, but that deeper issues of integrity, accountability,and honesty are also in question. And, contrary to what we were told about “secular” criticism, much ofthe questioning has come from within
the Christian community.
Please, don’t just take our word for it. Do your own research. When you are finished, we believe
you will draw the same conclusions we have. We thought we were following sound parenting informa-tion and doing what was proclaimed to be in the best interest of our son. We could not have been morewrong, and we will always live with that knowledge. We now believe nursing on demand, especially inthe early months of life, is among the most critical
things one can do for the long-term health and well-being of their child. The harm that has been associated with the Ezzos’ parent-directed feeding sched-ules is not always easily undone, and is simply not worth the potential risks. No other child or parentsdeserve to endure what we have suffered.
It is our sincere prayer that as awareness of the controversies and problems with the Ezzos’ Prepa-
ration for Parenting
and Preparation for the Toddler Years
(On Becoming BabyWise
, books 1 &2) programs increases, the followers will decrease.
For more information, you may contact us at the address, phone number, or e-mail given below. Hereis also a short list of the many articles/commentaries regarding the Ezzos’ parenting programs. A fullbibliography of information relating to this subject may be found at the following website:http://www.mailing-list.net/redrhino/Ezzo/Files.html
Michael & Michelle Hsieh4235 127th Pl. SEEverett, WA 98208(425) [email protected]
• “Babies in Danger?” by Jenny Deam, Ladies Home Journal
, April, 1999, pp. 102, 104, 106,
• “Getting Wise to ‘Babywise,’” by Katie Allison Granju, Salon
, August 6, 1998.
• “More than a Parenting Ministry: The Cultic Characteristics of Growing Families International,” by
Kathleen Terner and Elliot Miller, Christian Research Journal
, April-June 1998, pp. 11-19, 27, 43-45. Synopsis and ordering information: http: //www.fix.net/~rprewett/CRI.html Publisher: Christian Re-search Institute, (888) 7000-CRI, http://www.equip.org
• “Babywise advice linked to dehydration, failure to thrive,” by Matthew Aney, MD, AAP News
• “Examining the Evidence for Cue Feeding of Breastfed Infants,” by Lisa Marasco, BA, IBCLC
and Jan Barger, MA, RN, IBCLC. http://www.fix.net/~rprewett/evidence.html
N E O N A T A L A B S T I N E N C E S Y N D R O M E Handling drug misuse in the neonatal unit Neonatal abstinence syndrome (NAS), a syndrome of newborn drug withdrawal, is increasing inincidence across the developed world. To optimally manage the infant with NAS an integratedmultidisciplinary approach is necessary, spanning the intrauterine and postnatal period. Such anapproach should incorpor
plantas. Cada planta tiene su manera de ser, igual que tú tienes la tuya y yo tengo la mía. R: No. Pero sospecho que una planta que no le gusta el cobre no lo va a absorber y siEntonces si tú la respetas le vas a sacar buen provecho. Por eso que yo no haría unalo absorbe, en vez de ser un verde pálido será de un verde oscuro. No sé cuál será el efectoselección artificial, porque esto