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Bradenton Herald: In God’s Hands (Ezzo-based parenting under scrutiny)

A new Mom came to Debby Kearney searching for help. Something was very wrong with her new baby.

Between her first two to four months of life, she gained only two ounces. She should have put on at least two pounds, maybe even four, in that time.

A lactation consultant in private practice in Orlando, Florida, Kearney has logged thousands of hours helping breastfeeding mothers. She suggested the mother breastfeed her baby girl more frequently, common advice she’d give for a baby not gaining properly.

She was stunned when the young mother refused.

“The baby quit showing any signs of hunger. They ran this baby though every test imaginable and could not find an organic cause”, Kearney said of the case about two years ago. “I think the baby showed every sign of clinical depression.”

Something similar — although not as severe — happened again a few months later. Another mother. Another problem. Another reluctance to nurse her baby more often.

And again.

And again.

Kearney finally saw the familiar thread. All four of the women were familiar with the same religious-based parenting program. All were very concerned about their babies’ feeding schedules.

They all believed that breastfeeding more frequently would result in spoiled babies that ruled the household and later, toddlers and young children who were needy and demanding. All seemed sincere parents, wanting to do what was right.

“Medically, if you look at any textbook on breastfeeding — just pick one — you aren’t going to find one that suggests this kind of limited feeding,” said Kearney, president of the Florida Lactation Consultant Association, an organization of experts on breastfeeding.

The course, called “Preparation for Parenting”, sprang from the pen of Gary and Anne Marie Ezzo, founders of the Chatsworth, California-based Growing Families International, a ministry devoted to parenting and child-care issues.

Ministry officials estimate more than 100,000 people are enrolled in one of the Ezzo courses at any one time in the U.S. About 2,500 have taken one in Manatee and Sarasota counties, and possibly hundreds, maybe thousands, more have received their books second-hand.

The Ezzos’ courses are taught in 15 languages and 95 countries. About 40 local churches have taught one of their courses, ministry officials say.

And now, more than 10 years after the first course’s debut, health care professionals — from doctors to nurses to psychologists to child development experts — trumpet dangers of the program.

“Following their advice is dangerous in the short- and long-term and may well result in infant death — all in the name of teaching, which is inferred to be based on religious tenants” said Kathleen G. Auerbach of Ferndale Wash., who holds a Ph.D. in medical sociology and is co-author of Breastfeeding and Human Lactation, a 695-page textbook used to train health care professionals and an adjunct faculty member at Rush-Presbyterian-St. Luke’s Medical Center in Chicago.

Dr. William Sears, a California pediatrician, who along with his wife, is author of more than 20 books on infant care and child-rearing agrees: “I don’t know of any experts who have anything good to say about this program. There are people who devote their lives to studying babies. They (the Ezzos) have never really studied babies. That is the first problem.”

Sears, called “permissive” and “out of the mainstream” for his parenting views by the Ezzos, has company.

A group of more than 90 health care professionals including doctors, nurses, lactation consultants, counselors, researchers and book authors signed a letter of concern last month to the American Academy of Pediatrics asking the 53,000-member group to review the curriculum and issue warnings of its content. The matter is under review.

As for Kearney, two more mothers influenced by the Ezzo program were referred to her by physicians last week with feeding and weight gain problems.

“This happens every time I delve into this program” said Kearney, a Christian mother of four who has also taken one of their courses.

WHAT’S IT ALL ABOUT?

The Ezzos’ Preparation for Parenting course, called “Prep” for short, stresses to new and expectant parents that scheduling of a newborn’s day — from precisely when the baby should eat, sleep, play — is critical to raising well-adjusted children.

The course, which has a similar secular version marketed as “On Becoming Babywise”, rejects widely accepted medical opinion that breast-fed babies should be fed “on demand”, commonly understood as when the baby signals hunger with varying “cues” such as rooting against a mother’s breast, opening its mouth or eventually, crying.

Both books also reject a parenting style termed by Sears and others as “attachment parenting” which stresses parent-child bonding and usually includes demand breastfeeding and close physical contact.

Gary Ezzo would not agree to be interviewed for this story. He did answer several written questions with written answers.

A regional ministry official did discuss the program, but would not talk about medical issues.

Stressing that “God is a God of order” and quoting Biblical scripture that says “God is not the author of confusion” the Ezzos teach that demand feeding leads to a laundry list of problems including colic, unmanageable children and fatigue on the mother.

Responding to a newborn’s cries immediately fosters impatient children who want immediate self-gratification, the Ezzos teach. As critics point out, the Ezzos’ books offer few footnotes or medical attribution to claims that seem to run contrary to popular medical views established through years of scientific research.

Using the faith of students as the cornerstone, the Ezzos’ map the right way of parenting as clearly as a car’s owner’s manual walks its owner through an oil change. More than 80 pages of the 220-page manual deal directly with infant feeding and more than 30 to infant sleep.

Sample schedules are provided to guide parents on when to play with their baby, when to feed their baby and when to let their baby sleep. Getting out of order on those things is a no-no.

“Babies learn very quickly the laws of natural consequences. If he does not eat at one feeding, then make him wait until the next one” Preparation for Parenting teaches.

They also question the validity of mother-child bonding.

“In biblical times, a new mother did not lounge around in her bathrobe for weeks attempting to establish a bond with her child” the course states.

The Ezzos instead teach parents to put their newborns on an every three-hour feeding schedule — and to let babies sometimes cry, with the goal of having babies that sleep through the night by eight weeks.

“When your baby awakens, do not rush right in. Any crying will be temporary, lasting from 5 to 45 minutes” they say of a six week old.

They deny any human instinct exists, so responding to a baby on emotion grates against the “sobermindedness” spoken of in the Bible.

“The baby should be a welcome member of the home, not the center of the universe” they teach.

QUESTIONS, CONCERNS, FEARS

Breastfeeding experts and many health professionals are chilled by the Ezzos’ methods

Perhaps the harshest criticism comes from a 1996 report from the Child Abuse Prevention Council of Orange County, California. In reviewing the curriculum, the committee says in the wrong hands, the course could lead to abuse.

Marjorie R. Nelsen of Longwood, Florida, an early childhood development expert with more than 30 years of experience and director of the not-for-profit “Partners in Education” said the Ezzos seem to have little understanding of the natural stages of child development — crucial to a child’s healthy up-bringing.

“The first year is gaining a sense of trust” she said. “The baby is learning that ‘My food supply is there. My needs are being met. I am in a safe place.’ And the language God has given children is the cry.”

In addition to breaking down trust in the infant, some health care experts say the course rigidly applied may result in babies not getting enough to eat, and parents who are desensitized.

While the course instructs parents to feed a hungry baby and to weigh babies to make sure they are gaining properly and even providing a check-list for doing so, the text also stresses its schedule to a degree that some mothers, as the ones Kearney dealt with, may ignore other advice.

And while a formula-fed baby may do fine on a fixed schedule since formula digests slower than breast milk, experts say limiting a breastfeeding baby’s feeding time could be detrimental.

Katie Powers, a registered nurse, lactation consultant in Bradenton, Florida, and director of Manatee Memorial Hospital’s MOMMS Place, explains that a breastfeeding mother’s body responds to the baby’s needs based on supply-and-demand basis.

The more that is demanded of it, the more it provides.

Auerbach and other experts explain that because of a hormonal response that occurs when the baby nurses, the mother’s brain tells the mammary glands to make more milk. Experts say barring other complications, the more of the hormone, the more milk, particularly in the early days when the process is more hormonally dependent.

A glance at 11 parenting books on the shelves at a local bookstore — all that were available at the time — including that of popular pediatrician/authors Dr. T. Berry Brazelton and Dr. Penelope Leach, turned up every one advocating breastfeeding on demand for this reason. None suggested a feeding schedule for breastfed babies.

And Powers said the comforting aspects of the skin-to-skin contact should not be put on a time clock. “You are not only feeding the baby’s stomach, you are feeding their souls.”

The Ezzos say demand-feeding mothers often hold their babies too much.

Gary Ezzo also points out that there are cases of babies who were demand fed not gaining weight properly because mothers did not recognize the signs of dehydration.

Some of those cases ended tragically, he said. “If these children had been on our program, the parents would have recognized the warning signs within 24 hours and acted on them within 48 hours” Ezzo wrote in response to the Herald.

But professionals who deal with breastfeeding mothers for a living are concerned about the Ezzos’ book.

Ruthy Wilson, a registered nurse and lactation consultant at a Brevard County, Florida hospital, said she has identified eight babies of mothers who took the program who had feeding problems.

One, she said, was a life-threatening case when the child was not back up to its birthweight at two months old. “There shouldn’t be this many failures to thrive” she said, referring to the medical lingo for a baby who does not gain weight properly.

A breastfeeding task force in Palm Beach County, Florida is “adequately concerned” to begin investigating the course.

And as the Ezzos boast of taking their program overseas, some bemoan its arrival.

Pamela Morrison, a nurse and lactation consultant in Zimbabwe, Africa, fears the program could have detrimental effects in her country, where she said more than 98 percent of women initiate breastfeeding. A patient of hers recently showed up at her office with a copy of the book, given to her by a friend.

“Successful breastfeeding (defined as the baby thriving on mother’s milk) depends upon the baby having unlimited access to the breast” Morrison said via e-mail. “To bottle-feed one baby for one year in this country would cost a minimum of $4,000 for the milk powder alone. It would be a national disaster.”

Ezzo said surveys — so far unpublished — show 88 percent of mothers on his program initiate breastfeeding and 70 percent still doing so after four months.

MORE ABOUT THE COURSE

Gary Ezzo isn’t a physician. He isn’t a child psychologist or even the father of many children.

Graduating in 1985 with a master’s degree in ministry from Talbot Theological Seminary in California, the father of two grown daughters, along with his wife, Anne Marie led a parenting class in 1984 from their living room, a ministry official said.

Promotional materials say Anne Marie Ezzo is a registered nurse with a background in pediatric nursing. Gary Ezzo would not answer a written question requesting clarification on when and where she gained experience or where her educational qualifications were from.

At the time the classes began, Gary Ezzo was an associate pastor at the approximate 5,000-member Grace Community Church in Sun Valley, California, where he taught parents his principles in child-rearing.

The next year, 180 took the course. Then 400. By 1987-88 it was 600. The GFI ministry was founded in 1986.

Today at any one time, more than 100,000 take one of the Ezzos’ courses, which are now offered as multi-week sessions on videotape, according to Florida GFI regional director David Goode of Sarasota, Florida.

Classes meet in local churches and home groups and participants use a three-ring bound text to study and answer questions, while the Ezzos explain on the videotape.

Students pay about $15 to 25 to cover the cost of the book, while facilitators pay $149 for the entire tape series. The most popular course is by far “Growing Kids God’s Way” which is designed to train children ages 15 months to preteens, Goode said.

“The reason it’s so popular is because it works” Goode said. “I was sold when I saw a family with six kids … I saw beautiful and sensitive kids … kids that have submissiveness, but they have that spark of joy.”

The course nurtures the husband-wife relationship by putting it first and provides stability to the home, proponents say.

Goode said the course is not designed to be the only way to parent.

“We’re not out to say we have a corner on the parenting market” he said. “If you have another way that works, then great, we have two approaches that work…”

“This is a way, not necessarily the way.”

Some who have taken the course, however, say it’s not so simple.

Debra Baker, a 37-year-old mother of seven from Downingtown, Penn., said her non-denominational church revoked her membership in 1993 when she expressed concerns with the Prep program and talked openly about it to other church members. While not a decision of GFI, Baker said the rigidity of the course’s tone could lead to such a black-and-white approach.

“We were silenced in order to present only one ‘Godly’ voice concerning parenting issues” said Baker, who had attended the church for nine years.

“I would argue that silencing the only voice within the church who was both articulately advocating attachment parenting and parented enough children to look like she had the experience to back up her claims, was a little on the deceptive side.”

Some say the title of the Ezzos’ most popular course — “Growing Kids Gods’ Way” — seems to even indicate that God has endorsed Ezzos’ methods. Some say that alone is enough to control parents’ decisions.

“It (Prep) claims to be built on Biblical principles”, said David Day, a clinical psychologist at Community Christian Counseling in Pleasanton, Calif., where the courses have had longer to take root. “I think it’s based on a distortion of the Bible.”

Day, who has 21 years of experience, has seen between 20-30 parents in his practice who have had problems coping with the program in some fashion. Some tried the course and failed, leaving them feeling like failures as parents.

“They have feelings of guilt” Day said. “There is pressure exerted that everybody’s got to get with the program. Depending on the group, it can border on cult-like behavior, suppressing everyone’s questions.”

Day isn’t the only Christian with serious questions.

Focus on the Family, a popular Christian ministry devoted to family issues and founded by Dr. James Dobson, has issued a public statement saying they have reservations and will not recommend the program. The Christian publication Christianity Today , ran an article critical of the program in 1993. An ABC News religion reporter aired a critical report in 1996.

Grace Community Church, the church where Ezzo started the program, no longer teaches or sells the materials there.

IT WORKS FOR SOME

The obvious question, then, is why does anyone take the course?

Lisa Johnson, a 30-year-old expectant mother of two from Deerpark, Wash., could be the Ezzos’ poster mom. When she had her first child four and one half years ago, she tried what all the parenting books told her: respond to your baby immediately and breastfeed on demand.

“I was nursing every hour or every hour-and-a-half” she said. “I got a breast infection. My baby wasn’t gaining weight. I was worried sick.”

Ignoring the advice of her own mother who had raised 10 children, Johnson tried it the Ezzo way. She put the baby on a feeding schedule. She often let her cry, sometimes up to a hour.

“The crying was very hard” Johnson later said. “Since I had been responding on pure emotion for a month, the switch to emotion, balanced by reason was difficult. Simply put, Bekka’s cry ripped my heart out.”

.

Johnson’s second child also breastfed for a year and thrived on the schedule and she hopes, so will her third after it is born this summer.

“I’m perfectly at peace because I know it is what God has called us to do” Johnson said. “I’m at peace knowing that.”

Followers of Ezzo say the program teaches flexibility and that every parent needs common sense.

Terri Burks, a registered nurse from Nokomis, Florida, and her husband, Dr. Matthew Burks, an anesthesiologist, took the Prep course at Agape Christian Fellowship in south Sarasota during her pregnancy with their only child, now almost three.

Terri Burks knows the materials, particularly that on breastfeeding, are not what she learned in nursing school, but doesn’t mind.

“I think its pretty unfair to start a baby out and make them think they rule the family” she said. “There is a natural order and God-given authority.”

WHAT’S A PARENT TO DO?

Day, the psychologist from California, tells parents to look to more than one source for parenting help.

“Read more broadly and diversify” he said. “There are no programs that cover it all and have all the answers.”

Sears, who has also written parenting books from a Christian perspective, says look to the source.

“Suppose you were going to college to take a course in babyhood. You’d look for a professor with credentials. I think a wise shopper would look for credentials”, said Sears, who has eight children and more than 25 years of experience as a pediatrician.

“The Ezzos really don’t have any.”

For parents looking for other Christian guidance in child-rearing, they might look to books by Sears, Dr. James Dobson, Ross Campbell or Dr. Paul Warren, a Christian physician from Texas who has a series called “The Stepping Stone Series”, on child care.

Meanwhile, Katherine West, a registered nurse and lactation consultant in Sherman Oaks, California, whose part-time private practice is mainly made up of mothers in the Ezzo program, said parents intent on using the Prep course should wait until the child is 10-12 pounds before putting them on the feeding schedule.

She said the child’s natural feeding pattern by that size would likely be more conducive to spacing feedings than a small newborn.

And there is this from the Prep course itself: “Scripture has very few specific mandates for practical applications in the realm of parenting, especially infant parenting…We continue to invite parents to think for themselves….”


Reprinted with permission from Bradenton Herald Internet Plus

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