A Review and Commentary of Preparation for Parenting
an infant management program developed by Gary and Anne Marie Ezzo
by Heidi Bingham
©1998 Heidi A. Bingham. All rights reserved. This information is
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I have hesitated to write on this issue since so much has already been
written and is available on the Web
http://www.mailing-list.net/redrhino/Ezzo/Files.html, much of it by people
far more qualified than I to evaluate the materials. However, after much
study and prayer, I have become convinced that I need to add my voice to
those who have expressed concern with this program
_Preparation for Parenting_ (PFP), (subtitled: Bringing God's Order to Your
Baby's Day and Restful Sleep to Your Baby's Night) is a step-by-step guide
to parenting an infant through the first 5 months of his life. It is
authored by Gary Ezzo and his wife Anne Marie, and is published by Growing
Families International (GFI) of Chatsworth, California. This material is
also offered as _On Becoming Babywise, I_. This is a nearly identical
secular version of PFP, the main difference being the removal of all
Scripture references and Biblical support. It is coauthored by Gary Ezzo
and Dr. Robert Buckman. Although my comments on the use of Scripture in
PFP will not be applicable to _Babywise_, my comments on the medical
claims of PFP will be.
The Ezzos' purpose in writing the program is commendable. They wish to
guide parents in caring for infants in a godly fashion. They encourage
parents to make the baby a welcome member of the family and not the
center of it. "Democratic parenting," they write, "the idea that reduces
parents to an equal status with their children, was never God's intention.
"(page 31)*1. They speak out against child-centered parenting, a
practice that caters to a child's every whim and teaches them they can
get their way with their parents. I agree, and fully appreciate why
the Ezzos felt it necessary to create this program. Unfortunately, in
his attempt to avoid child-centered parenting, Mr. Ezzo errs in the
opposite extreme. PFP is a parent-centered program that insists adults
are more important than children and encourages parents to selfishly put
their own desires ahead of their newborns. In doing so, they give out
what appears to be sound medical advice, but is unsubstantiated by
medical literature. They deliberately disparage other parenting styles,
using the extremes to show how they fail rather than the norms which
show their success. They justify their methods by covering themselves
with Biblical arguments. These are frequently tenuous and occasionally
even twist the Scripture to support their own opinions.
It doesn't take long for Mr. Ezzo to misinterpret the Bible. In Chapter 1,
"Your Baby Needs a Family," Mr. Ezzo discusses the creation account in
Genesis 1 & 2. Mr. Ezzo finds it significant that when God declared that
"it was very good" (Genesis 1:31), children were not present. He believes
that since children were not present they are not necessary and treats
them accordingly. From this one point, he develops four "Principles to
Guide Your Family." These are (pages 30-32):
1. By God's design, the husband-wife relationship is the first social
relationship established in Scripture.
--Here, they correctly point out that the first 2 humans created
were a husband and a wife. Other relationships, such as
parent-child, sibling, etc., came later. The point?
2. By God's design, the husband-wife relationship is primary in the
network of dependent relationships.
--The husband-wife relationship is primary in that is was first,
but that was covered under the first principle. Mr. Ezzo's
point here seems to have more to do with the "dependency"
than the "primacy." Mr. Ezzo points out the what God created
on one day was dependent on what he created during the
previous days. Mr. Ezzo believes this theory of dependency
applies equally to relationships, therefore the relationships
that came second are dependent on that which came first. I
find this Biblical comparison to be a leap of logic. Also,
I do not agree that the dependency is necessitated. If a mother
is widowed during pregnancy, does the non-existance of the
husband-wife relationship mean the relationship between
mother and child is non-existant? Of course not, but that is
the logical conclusion of such statements of dependency. The
parent-child relationship does, in fact, exist outside of the
husband-wife relationship. The husband-wife and parent-child
relationships greatly affect one another, but to assert that
one is dependent upon the other is a logical fallacy. It is also
Biblically unsupported.
3. The husband-wife relationship must be viewed as the priority
relationship in the family.
--I have a real problem with this. Yes, the husband-wife
relationship must be maintained, but nowhere in Scripture do
I see any evidence that it is a "priority" relationship,
somehow more important than other relationships. This type of
reasoning sets up a false dichotomy in society, giving us
excuse to designate "adult activities" and ignore children
when it is not convenient for us. The prevailing emphasis
throughout the Bible is on complete family units. As a matter
of fact, the parent-child relationship, more specifically
the father-child relationship, is repeatedly used as an
analogy for the relationship we have to God. I think
the Ezzos make a serious Biblical error in elevating the
husband-wife relationship above others. This error drastically
taints their entire program with an adult-centered view.
4. Since marriage is the priority relationship, all other relationships
must be subject to it.
--Here, Mr. Ezzo correctly asserts that parents have authority
over their children, he also correctly defines authority as the
God-given right to rule, but this does not come about because
the parent-child relationship is subject to the marriage
relationship. Parents do not have authority over their children
because marriage is a priority relationship, but because *God
assigned that authority to the parents*. This may seem like a
minor point, but I believe a correct assessment of where the
authority comes from is essential in applying Biblical
principle to parenting and keeping our attitudes straight.
When we understand that our authority comes from God, we get
a sense of the immense responsibility that comes with it, as
well as our accountability to God in carrying out our
responsibilities. By asserting that parental authority comes
from a supposedly primary relationship, Mr. Ezzo misses the
context of the authority, centers it on human relationships
instead of the origin of that authority, and creates a
situation of power for the parents. This is apparent in the
overly controlling methods he advocates in his materials.
I am astonished that Mr. Ezzo can draw these four "principles" (I use
quotes because I do not agree that they are Biblically sound
principles) from the creation account and 4 words from Genesis 1:31.
They are not consistent with the whole counsel of Scripture and come
across as Mr. Ezzo looking for justification for his personal belief
in the primacy and priority of marriage over other family
relationships. The specific applications he draws include insisting on:
1. A weekly date night ~ a night away from baby designed to strengthen
the marriage relationship. No where in Scripture do we find even a hint
that the presence of a child hinders the continued growth of a strong
marriage. This is an idea embraced by our adult-centered society.
The Bible teaches that children are a blessing and puts no conditions
on it. It would be more consistent to believe that children bless
the marriage relationship rather than interfere with it. Also, the
weekly date night necessitates supplemental bottles in the routine
of breastfed babies. I believe breastfeeding is God-ordained and
should not be interrupted for anything less than emergency reasons.
In my article, Breastfeeding by Design
http://www.geocities.com:80/Heartland/Ridge/1989/famtopics/brfding.html,
I present a Biblical argument for breastfeeding without supplemental
formula. Even if the bottle contains breastmilk, the basic
supply/demand of breastfeeding is interrupted unless mom wants to
take time away from her date to pump. This is not consistent with
God's design. I am not against dates between spouses, but there's
no reason a small baby can't come along. Save the babysitters for
when the child is older and can understand his parent's absence and
return and will not need to breastfeed while mom's away. This
overemphasis on getting away as a must to maintaining the marital
relationship comes from the secular view that children are a burden,
not the Biblical view that children are a blessing and a reward
(Psalm 127:3).
2. Couch time ~ 15 minutes at the end of the day where mommy and daddy
get to talk uninterrupted. It is to take place when the child is awake
to demonstrate togetherness. Mr. Ezzo suggest the parents explain,
"this is Mom and Dad's special time together. Dad will play with
Ryan afterwards, but Mom comes first." (page 36). First, there is
*no* Biblical reason to believe mom (or dad) comes before the family
as a whole. Second, the Bible no where dictates such minute details
of our lives as a 15 minute period of time after work. Although
Mr. Ezzo includes this in his manual as a "suggestion," in practice
it is an essential to the PFP program. Third, try explaining to a
lonely 2 month old baby that "this is Mom and Dad's special time
together" (remember this suggestion is in a book designed for
parenting infants up to 5 months old). He just does not have the
capacity or the ability to wait. That comes later in his development.
The infant left alone is not a welcome member of the family, but a
spectator observing the "all important" marriage relationship. Again,
the insistence on setting children aside stems from the belief that
children are a nuisance. This is society speaking, not God! The Bible
teaches that "God sets the solitary in families." (Psalm 68:6). Some
translations use "lonely." I think this, and the overall themes of
Scripture treating families as units, carries much more weight than
Mr. Ezzo's assertion that these 15 minutes will somehow provide the
infant with a sense of security about his parents' love for one
another and, at the same time, provide essential relational time for
mom and dad.
Mr. Ezzo is incorrect in his assertion that the marriage relationship
must take priority over the parent-child relationship. Although this
concept attempts to establish parental authority, it skews the Biblical
idea of the family and misses the context of proper parental authority.
In this situation, children are not welcome members of the family,
but appendages to the *important* relationship. It creates a false
dichotomy of adult world vs. child world. Marriage primacy and the
adult/child dichotomy is secular in origin. Family unity and an
inclusive society is Biblical. Those who embrace the Biblical reality
that children are blessings will not set them aside as unnecessary
additions to be tended to when the important matters are concluded,
but will include their children as part of the whole.
By far the most distressing misuse of Scripture is Mr. Ezzo's
justification for allowing children to "cry it out" (a common
parenting practice of the last generation that is now being
questioned by the medical community). Throughout PFP, Mr. Ezzo
advocates teaching children to sleep, to wait for their next
scheduled feeding, or to accept forced separation from the parents
by allowing them to cry for what he believes are short periods of
time. The short period of time is "5-45 minutes" (page 125), "15-20
or even 30 minutes" (page 133), "5 minutes or off and on as long as
1 hour" (page 134). He includes a footnote comment (endnote 9, page
216) stating that "a normal baby may cry as much as 3 hours total per
day, with 5-45 minutes of on again and off again crying." While this
is an accurate assessment, it results from studies of infant care
methods similar to those outlined in PFP. Dr. Sears, a noted Christian
pediatrician, believes this much crying is not necessary for a normal
baby*2. Other studies show that prolonged crying raises a baby's
heart rate, often to dangerous levels, and blood pressure while
decreasing the oxygen content of his blood*3 and even crying for a
few minutes can cause a baby to become disorganized creating feeding
difficulties.*4.
Again, Mr. Ezzo turns to Scripture to support this medically refuted
parenting practice. On page 142, he sites Matthew 27:46 saying,
"Praise God that the Father did not intervene when His Son cried out
on the cross." He uses the Father's nonintervention at this pivotal
moment in history as an example for us to follow in parenting infants!
I understand that Mr. Ezzo is taking a stance against parents who
jump, often without thinking, at their children's every whim, and
certainly we should all strive to mirror God's sacrificial love, but
**This unique and spectacular event in human history is not normative
and to apply it to the crying of infants is just unacceptable!!!** At
the crucifixion, Jesus took all the sins of the world upon Himself.
He literally became sin. God, being perfect and holy cannot look upon
sin, therefore *He was forced to turn away and not look upon His only
Son.* Grey Gunn, representing Focus on the Family writes
href="http://www.mailing-list.net/redrhino/Ezzo/FOTF.txt, "We see no
way to make such an application of this verse without completely
disregarding its original context and purpose." I agree completely.
The crucifixion portrays a Sacrifice, not normal interaction between
parent and child. There are numerous other Bible verses illustrating
God's response to crying to which Mr. Ezzo could have turned for
guidance. Let's consider some:
--And it came to pass in process of time, that the king of Egypt died:
and the children of Israel sighed by reason of the bondage, and they
cried, and their cry came up unto God by reason of the bondage. And
God heard their groaning, and God remembered his covenant with Abraham,
with Isaac, and with Jacob. And God looked upon the children of Israel,
and God had respect unto them. Exodus 2:23-25
Here, God hears and responds to the cries of his people
--And Moses and Aaron went out from Pharaoh: and Moses cried unto the
LORD because of the frogs which he had brought against Pharaoh. And
the LORD did according to the word of Moses; and the frogs died out
of the houses, out of the villages, and out of the fields. Exodus
8:12-13
--And the people murmured against Moses, saying, What shall we drink?
And he cried unto the LORD; and the LORD shewed him a tree, which
when he had cast into the waters, the waters were made sweet Exodus
15:24-25
I find this verse particularly interesting. Mr. Ezzo contends that
if a baby is hungry (or thirsty) at times other than designated
by his routine, the parent must insist the baby wait until
the next scheduled feeding. This is apparently to teach the
infant to take a full feeding each time (the incorrect
assumption that the last feeding was a snack and snacks are
wrong) and to guide his hunger patterns into the routine.
Offering the breast to quench baby's thirst is wrong, yet
God provides water for his people when they cry to Him.
--And when the children of Israel cried unto the LORD, the LORD raised
up a deliverer to the children of Israel, who delivered them, even
Othniel the son of Kenaz, Caleb’s younger brother. Judges 3:9
--I cried unto the LORD with my voice, and he heard me out of his
holy hill. Selah. I laid me down and slept; I awaked; for the LORD
sustained me. Psalm 3:4-5
--In my distress I called upon the LORD, and cried unto my God: he
heard my voice out of his temple, and my cry came before him, even
into his ears. Psalm 18:5-6
--Thou hast also given me the necks of mine enemies; that I might
destroy them that hate me. They cried, but there was none to save
them: even unto the LORD, but he answered them not. Psalm 18:40-41
Here, God does not answer cries, but whose? David's enemies,
not God's own children.
--LORD, by thy favour thou hast made my mountain to stand strong:
thou didst hide thy face, and I was troubled. I cried to thee, O
LORD; and unto the LORD I made supplication. Hear, O LORD, and
have mercyupon me: LORD, be thou my helper. Thou hast turned for
me mymourning into dancing: thou hast put off my sackcloth, and
girded me with gladness; To the end that my glory may sing praise
to thee, and not be silent. O LORD my God, I will give thanks unto
thee for ever. Psalm 30:7-8, 10-12
This Psalm is interesting. David is troubled when God hides
his face. His response? To cry out to the Lord. Should we not
expect an infant to cry out when his parents hide their faces?
And what then should be the response of the parents? God
turns David's mourning into dancing. Should we not at least
try to do the same for our children, assisting them with
whatever it is they're struggling, whether it's falling
asleep or separation for their parents? And if it's not possible,
be their to support them with our love? Mr. Ezzo advocates
non-intervention, allowing a child, an *infant* to remain
alone to work through his troubles himself. God intervenes!
--This poor man cried, and the LORD heard him, and saved him out of all
his troubles. Psalm 34:6
--I cried unto him with my mouth, and he was extolled with my tongue.
If I regard iniquity in my heart, the Lord will not hear me: But
verily God hath heard me; he hath attended to the voice of my prayer.
Blessed be God, which hath not turned away my prayer, nor his mercy
from me. Psalm 66:17-20
Here, David puts a condition on God's hearing him, whether or
not his heart it right. While this is an acceptable condition
to place on older children (we do not want to give in to the
selfish desires of our children), a newborn is not able to
distinguish between needs, reasonable desires, and selfish
desires. A parent must take time to train the child's
understanding before he can refuse the child's plea for help.
Many parents do not recognize how early a child begins to
understand this, but Mr. Ezzo incorrectly applies this
principle to newborns, turning away their pleas and not
displaying the mercy which God shows to David.
--I cried unto God with my voice, even unto God with my voice; and he
gave ear unto me. In the day of my trouble I sought the Lord: my
sore ran in the night, and ceased not: my soul refused to be
comforted. Psalm 77:1-2
David cries to God but is not comforted. Although David feels
abandoned by the Lord, He knows that God is there offering
comfort. It is David's own lack, the refusal of his own soul,
that turns away the comfort. No where in the Psalm does
David imply that God chooses cast him out of His presence
because of this refusal. Contrast this with Mr. Ezzo, "if the
child is not comforted by the baby swing, an infant seat,
siblings, or Grandma, consider the crib." (page 150) Infants
in the newborn stage do not know someone they cannot see
exists, so putting an infant who cannot be comforted into
his crib is essentially putting him out of your presence.
This is not a godly response to an infant in a particularly
fussy time.
Here are some other verses you can look up:
--Psalm 107:6, 13; 119:145-151; 120:1; 138:3; 142
--Matthew 20:34
Certainly, there are times when God's answers to our prayers is, "No,"
and for our own good. There are times when our troubles are so great
that we feel abandoned by God, but we must keep in mind that God has
promised, "I will never leave thee, nor forsake thee." (Hebrews 13:5)
As adults, we can understand that God is present despite our feelings.
A newborn infant, left on his own to cry cannot find comfort in that
sort of rational thought. There will be times when we must tell our
children, "No." When deciding the course of our actions, we must keep
in mind the developmental limitations of a newborn. Using the events
of Christ's crucifixion to justify non-responsiveness to the cries
of a newborn is a blatant misuse of Scripture. It appears that Mr.
Ezzo has looked to Scripture to justify his own beliefs about
parenting rather than honestly assessing how God truly responds
to our cries.
The misuse of the crucifixion is the most offensive misuse of Scripture
in PFP, but there is one that is much more prevalent. The entire
program presented in PFP is based on Mr. Ezzo's interpretation of
1 Corinthians 14:33, "For God is not the author of confusion, but of
peace, as in all churches of the saints." Many versions translate
"peace" as "order." While Paul is speaking about proper order in
church meetings, Mr. Ezzo tenuously applies this verse to parenting.
He believes, correctly, that this verse implies that peacefullness/order
is one of God's characteristics. From there, he extrapolates an
entire infant management program designed to bring "God's order to
your baby's day."
The Greek Word for "peace" or "order" in 1 Corinthians 14:33 is eirene.
Enhanced Strong’s Lexicon says it is "probably from a primary verb
eiro (to join)" and defines it as:
1. a state of national tranquillity
1a. exemption from the rage and havoc of war
2. peace between individuals, i.e. harmony, concord
3. security, safety, prosperity, felicity, (because peace and harmony
make and keep things safe and prosperous)
4. of the Messiah’s peace
4a. the way that leads to peace (salvation)
5. of Christianity, the tranquil state of a soul assured of its
salvation through Christ, and so fearing nothing from God and
content with its earthly lot, of whatsoever sort that is
6. the blessed state of devout and upright men after death
Gary Ezzo writes, "Order speaks of routine and scheduling" (page 54)
yet there is no support in the original language that the "order" or
"peace" to which Paul refers has anything to do with a routine or
schedule. The context of the verse also does not imply so much a
specific routine for church meetings, but a way to keep the peace
and harmony God's character requires. Mr. Ezzo apparently has a
propensity for order, and that's fine. Order does remain a godly
quality, but his application of this verse as the entire basis for
an infant management program is Scripturally unsound.
Gary Ezzo, himself, points out one problem with this approach. On
page 141 he writes, "When someone isolates or elevates any of God's
attributes above the others, they distort the real meaning of that
attribute." Yet this is precisely the mistake Mr. Ezzo makes.
Throughout the manual, he elevates God's orderliness to a position
of primary importance in parenting. Mentions of mercy and compassion
in his program are limited to insignificant comments, while order
is emphasized through the routine he develops. He also implies,
rather strongly, that no other parenting method can create order
in the home.
After thinking about this for a while, I decided to count the number
of time order and it's various synonyms (routine, schedule, and
structure) are used in PFP and compare it to the number of times
other attributes of God are used (love, patience, care, compassion,
mercy, concern). In doing so, I stuck with only the text. I did
not include the titles of the book or chapters or the subheading,
nor did I count the "questions for review" found at the end of each
chapter, the sample schedule worksheet found in chapter 7 or the
various growth charts at the end of the manual. I was careful to
include references that referred to the feeding routines and daily
order and skip over comments that used these terms in other contexts.
I also did not include the section entitled "Defining the Terms"
in chapter 2. This is a discussion of the historical feeding methods
and, in fairness to Mr. Ezzo, I did not want to count references to
the strict clock feeding schedules in my tally. I also skipped
chapter 10 "Multiples: The Endless Party" as it was actually authored
by someone other than the Ezzo's and I did not want to be unfair in
my count. This was probably unnecessary, as the chapter is included
by Mr. Ezzo as accurately depicting his theories, but again, I chose
to err on the side of fairness to Mr. Ezzo. This is only my count,
tallied from one straight reading of the text, not a computer tally.
I more than likely missed incidents of the various terms I looked for,
but the count is reasonably close, and as such, serves to illustrate
my point. Here are the results:
ORDER: 39
ROUTINE: 124
SCHEDULE: 24
STRUCTURE: 9
***Grand Total: 193
LOVE: 34
PATIENCE: 2
CARE: 6
COMPASSION: 2
MERCY: 1
CONCERN: 1
***Grand Total: 46
note: when I use ORDER I am including all forms of the word such
as orderly, orderliness, ordered, etc. This is true of the
other words, as well.
To be fair, I believe I missed a couple references to "mercy" and
"compassion." On the other hand, only some of the mentions of "love"
were actually in reference to how Mr. Ezzo would apply love in his
PDF program. Several of the mentions are referring to the "love"
demonstrated by demand feeding, which Mr. Ezzo defines as "selfish,"
"permissive," and "indulgent." These mentions, although I counted
them, do not actually support Mr. Ezzo's claim that his program is
"firmly based on God's many attributes" (page 13). I also neglected
to count the term "cycle" as I did not notice how many times Mr. Ezzo
used it synonymously with "order" and "routine" until I was a fair
way into the book and did not want to take the time to return to the
beginning of the text to count this term. Overall, I believe I erred
significantly in Mr. Ezzo's favor, yet my count still shows that
Mr. Ezzo elevates order (and it's relatively synonymous concepts)
at a ratio of **more than 4 to 1** over several other important
aspects of God's characters and their application to our parenting.
The following are just a few examples of his overemphasis of order in
infant management.
--Order and routine are two powerful contributors to a happy, contented
baby. Because of the lack of order associated with the
attachment-parenting methodology, the one statement attachment mothers
do not hear is: "My, what a good natured baby you have." (page 49)
1. What ever happened to love and security being powerful
contributors to a happy, contented baby? Order and routine
are secondary to a loving relationship. Several years ago,
a study was done to see what language a group of infants
would learn to speak if they were not spoken to. These
infants were well-cared for in that they had their physical
needs met. They were changed, fed, kept warm and dry, etc.
They experienced order and routine, yet the study failed to
determine what language they would learn because *all of
these children died before their 2nd birthday*. These
children could not even survive without love. What good is
it to talk of the order and routine in their lives?
Note: I realize Mr. Ezzo would not go this far in his
recommendations, and to be fair, he does mention the
cuddling and nurturing that take place in the normal
activities of caring for baby, but he makes several
comments in his book that diminish the importance of
parental interaction in baby's life while elevating
the importance of his routine.
2. Attachment parenting does not lack order. This is a
personal bias expressed by Mr. Ezzo, not a factual statement.
3. Attachment parenting mothers *frequently* hear how good
natured their babies are. I have heard it. For a time
I participated on an e-mail list with other mothers who
practiced attachment parenting with their infants, and
they've heard it too. Dr. Sears, in his books, documents
such accounts as well.
--"You can have structure and still meet all the developing needs of
your baby with PDF" (page 50)
PDF is Parent Directed Feeding, a specific routine and pattern
of sleep time/feed/wake time developed by Mr. Ezzo
--Considering that God is orderly in His workings, how is it that we who
were created in His image think we can succeed with the absence of
order? Routine and order are part of the communicable attributes
of God, transferred with His image. Orderliness is a Biblical
virtue (1 Corinthians 14:40). We see God's order in His handiwork.
The planets travel the universe on a course set by God. The ocean
tides move in and out in a pattern that is charted to the minute by
almanacs. The four seasons are all part of the earth's sleep/wake
cycle. The laws of universal order hold the smallest atomic particles
in place.
"The order in nature bears silent witness to the value of order in other
areas, such as a baby's routine. Please note that routine does not
equal rigidity. If God's universal order were rigid, then winter's
cold temperatures would stop at midnight on the first day of spring.
Fall's colorful pageant would suddenly appear one morning, and then in
unison the leaves would fall to the ground at the same time. Universal
order gives us routine without rigidity. PDF does the same. As God
has ordained order in the material universe, so also has He placed
it in the immaterial universe by way of His principles and precepts.
Order complements God's character; confusion does not." (pages 55-57)
These 2 paragraphs are Mr. Ezzo's concluding remarks from a 3
page section entitled "The Need for Order" and "Universal
Order." No where does Mr. Ezzo dedicate 3 paragraphs, much
less 3 pages, to any of the other attributes of God. The
closest he comes is a section entitled "Teaching Your Baby
to Love?" (question mark is in the original). It is
approximately 1½ pages in length and rather than emphasizing
the importance of love in parenting, it emphasizes
non-responsiveness using love as an excuse. This is
clearly elevating order to a position of prime importance.
The very mistake he criticizes in others.
Notice also, how Mr. Ezzo prepares the reader to accept the
program he is about to spell out. First he begins insisting
order is needed. The paragraphs which precede this passage
include a fictional comparison between a child who is not fed
on a routine with a child who is. The unsubstantiated
assessment that a lack of routine "negatively impacts
[the demand fed infant's] metabolism" is enough to scare
anyone into accepting Mr. Ezzo's claims. After establishing
the supposed need, he associates "routine" with godly
characteristic of order, then he brings in the concept of
sleep/wake cycles in nature. By the time he associates PDF
with universal order, the reader is generally ready to accept
his claims.
By associating PDF with the universal order created by God,
Mr. Ezzo creates the impression that PDF belongs to God's
order as well. The implication is that other parenting
methods do not. Indeed, Mr. Ezzo writes, "Working from a
Biblical mindset and practicing demand-feeding can never be
harmonized since the two are incompatible philosophies."
Also, when "Asked in a telephone interview if Christian mothers
could, in good conscience, practice attachment parenting,
Anne Marie Ezzo would only concede that such mothers could
probably be excused for their ignorance."*5
Although the Ezzos deny that their program is the exclusive Biblical
feeding method, comments such as these, and the general tone of their
materials leaves one believing otherwise.
In order to accept Mr. Ezzo's assertion that PDF is consistent with
Scripture while demand feeding is not, we must assume that God defines
order as Mr. Ezzo does. So let's examine the specifics around which
Parent-Directed Feeding hinges to see if it is consistent with God's
order. Mr. Ezzo correctly states that the Bible is silent in matters
of infant feeding, so that leaves much of this open to interpretation.
As I mentioned earlier, many of the medical sounding claims of the
program are unsubstantiated. I will point out some of them in this
section as they prove a good way to evaluate whether or not PDF is
consistent with God's design.
Before outlining the actual routine, Mr. Ezzo wants to assure us that PDF
is flexible. By this, he means that it is not based on a minute by
minute clock-timed schedule (ie, baby is fed every 3 hours, not a
minute sooner, not a minute later), but that it allows for some variation
in feeding times. In chapter 7, it is clear that flexibility, according
to Mr. Ezzo, allows for variations of up to ½ hour in the routine. Also,
this routine is not to be flexed into shorter increments than what
Mr. Ezzo allows. "During the first ten days to two weeks, the daily
routine for most new mothers will be a continual repeat of a 2½ to 3
hour cycle from the end of one feeding to the beginning of the next."
(page 113) Note how he times feedings, from the *end* of one feeding
to the *beginning* of the next. Doctors and lactation consultants time
them from start to start. Unless otherwise noted, I will translate
Mr. Ezzo's timing into the universally accepted start to start timing
to avoid confusion. The smallest increment allowed in the general
routine of PDF is 3 hours, thus limiting a baby to 8 feeds per day.
Mr. Ezzo does admits that there are situations, which may necessitate
feedings closer than 3 hours apart, but insists that the parent must
not establish a routine outside of his specified limits. "it's OK to
deviate from the 2½ to 3 hour feeding norm {this is Mr. Ezzo's timing,
end to start}. But do not deviate so often that you establish a new
norm" (page 117) It is my understanding that in edition 6 of PFP,
Mr. Ezzo allows for feedings at slightly closer intervals, *up to* 10
feeds per day. While the American Academy of Pediatrics (AAP) and
La Leche League International (LLL) state that 8-12 feedings per day
is *average,* Mr. Ezzo does not allow for 11 or 12 feedings per day,
never mind more than 12 which is implied when 12 is considered average.
Where, in Scripture, does Mr. Ezzo come upon these limits to feeding
increments? How does this compliment God's order when the medical
evidence, is that more frequent feedings are normal, sometimes even
necessary? At least one anthropologist believes the spaced feeding
method is completely outside of God's design. Kathy Dettwyler writes
http://www.prairienet.org/laleche/detsleepthrough.html:
Human children are designed (whether you believe by millions of
years of evolution, or by God, it doesn't matter) -- to nurse
*very* frequently, based on the composition of the milk of the
species, the fact that all higher primates (Primates are the
zoological Order to which humans belong, higher primates include
monkeys and apes) keep their offspring in the mother's arms or
on her back for several years, the size of the young child's
stomach, the rapidity with which breast milk is digested, the
need for an almost constant source of nutrients to grow that
huge brain (in humans, especially), and so on. By very
frequently, I mean 3-4 times per hour, for a few minutes each
time. The way in which some young infants are fed in our culture
-- trying to get them to shift to a 3-4 hour schedule, with
feedings of 15-20 minutes at a time, goes against our basic
physiology.
While I'm not claiming that all mothers should switch to nursing their
infants "3-4 times per hour, for a few minutes each time," I do
acknowledge that her assessment of the composition of milk and it's
rapidity in digesting is consistent with other research. Research
further indicates the composition and rapidity of digestion varies
from mother to mother, and even with the same mother at different times
of the day. Also, milk storage capacity varies from mother to mother,
as much as 300%, and frequent, unrestricted feeds enhances the quality
of breastmilk.*6 As we are unable to measure the quantity and
composition of breastmilk at any given feed, we are unable to assess
the status of our milk outside of the infant's hunger cues. Our
infant's hunger cues also give clues as to our breastmilk storage
capacity. It would therefore seem more consistent with God's design
to feed infants according to these cues. Research supports this.
Again in Examining the Evidence for Cue Feeding of Breastfed Infants:
The evidence is very strong that arbitrary (defined as set by
external influences, such as averages) scheduling of breastfed
infant feedings is inadvisable for any mother who desires
to breastfeed successfully, most especially for the recommended
longer periods of up to a year or more. Individual storage
capacities of mother's breast is one major factor in the
determination of which babies can be fed at long versus
shorter intervals, and the proper development of adequate
prolactin receptors is another major factor that favors more
frequent feedings. Coupled with the evidence that suggests
that frequency of feeds --unrestricted-- may influence the
fat content of milk in a positive correlation, it appears as
overwhelmingly good sense to allow baby to feed whenever he
signals the need to, ala "on demand" or "on cue."
Moreover, it would appear that this is nature's design, and
for those who acknowledge a Creator, really God's design, for
breastfed infants and their mothers.
With all the evidence stacking up in favor of demand or cue feeding of
infants as being consistent with the design and physiology of our
bodies, it makes one question why Mr. Ezzo would insist godly order
calls for feedings spaced according to the clock. If it is outside
of God's design, it must be outside of God's definition of order.
It is also interesting to note that Ms. Dettwyler considers frequent
feedings to be essential to optimal brain development. Research
indicates that breastfed children show higher IQs and academic
achievements than those fed formula. Perhaps this is due in part to
the fact that breastfed infants are typically fed on demand at more
frequent intervals than formula fed infants, thus promoting better
brain growth.
The basic characteristic of PDF is the repetition of "three basic
activities that repeat themselves during the day: feeding time,
waketime, and naptime. Feeding must be first, waketime second, and
naptime third. Do not change that order, with the exception of the
late-night and the middle of the night feedings when a waketime is not
necessary." (page 111) Not only is there no Biblical evidence that
this order is preferred over another, I know of no scientific or
medical evidence to support it. I believe the insistence on this
order comes from Mr. Ezzo's aversion to nursing an infant to sleep
which he believes, "makes the baby unnecessarily dependent on mom for
sleep and keeps him from learning to sleep on his own." Again, there
is no evidence to support this claim. Babies learn to sleep just fine,
even when nursed to sleep, if the mother remains discerning in her
parenting, does not continue this practice beyond what the infant
actually needs, and guides the child through the learning process when
his own system is ready for it.
In keeping with this concern about infant sleep, Mr. Ezzo believes
that "usually, within their first eight weeks of life, healthy
fullterm babies have the ability to sleep continuously for 7-8 hours
through the night" (page 65). This is not consistent with medical
research which shows the average time for babies to sleep through the
night is 3-6 months. It is not consistent with the physiology of
breastfeeding from the infant's standpoint, as noted above. It is also
not consistent with the physiology of breastfeeding from the mother's
standpoint, where the frequency of feeding helps to establish and
maintain a proper milk supply. "Much of your success," Ezzo concludes
the paragraph, "will depend on your parenting philosophy and feeding
practices." Yes, I'm sure it does. The question is how do we define
success? Mr. Ezzo apparently equates it with a baby conforming to the
standards of his program. There is no Biblical evidence that this
constitutes successful parenting. As I mentioned above, the evidence
continues to stack up against Mr. Ezzo's program, and successful
parenting and feeding would more accurately be defined by responding
to and cue feeding infants.
Mr. Ezzo also concerns himself with the details of how an infant
spends his waketime. He discourages the parents from giving excessive
attention to the infant. He writes, "One thing is certain: Your baby
doesn't need to be carried or entertained by you all day long"
(page 130) Throughout the day, baby will need to be fed, changed and
bathed. Mr. Ezzo encourages parents to make this a time of interaction
with the infant. I agree, but I am concerned with his attitude
about interacting with baby at other times. "In addition to feeding,
changing, and bathing your baby, you might have at least one playtime
a day when the baby has your full attention for 15 minutes or so."
(page 132) *Might?!?!* Consider the alternative: the only
interaction baby has with his parents is while they are caring for
his immediate needs and baby is left alone at all other times. As
a matter of fact, Mr. Ezzo gives several suggestions for things baby
can do alone, including pictures, mobiles and crib/floor gyms to
entertain himself; swings (be sure not to allow baby to be lulled
to sleep) and infant seats from which he can watch the world go by
as a spectator; and of course, the playpen which Mr. Ezzo contends
is an important part of baby's routine beginning at 4 weeks of age.
I would never deny the usefulness of the playpen when used with
discretion. It allows mom to complete certain activities, such as
a shower, while the baby is safe. Mr. Ezzo, however, presents it as
a necessary part of establishing godly order in the home. This is
most certainly an extraneous detail which conforms to Mr. Ezzo's
personal view of family life and infant management, not a Biblical
view of order or parenting.
I also take issue with Mr. Ezzo's emphasis on the importance of baby
alone time. Sure, baby will spend some time alone, but PFP
deliberately encourages it in an overzealous attempt to discourage
child-centered parenting. What about the Biblical admonition,
"And these words, which I command thee this day, shall be in thine
heart: And thou shalt teach them diligently unto thy children, and
shalt talk of them when thou sittest in thine house, and when thou
walkest by the way, and when thou liest down, and when thou risest
up." (Deuteronomy 6:6-7). While I accept that we do not need to
entertain our children all day, we are admonished to teach our
children as we go through our daily activities. How are we to do
that if they are not involved in our daily activities. Sure, infants
can watch activities from a swing or infant seat, but they can become
a part of them, learning from them, when mom opts to carry her infant
in a sling or other carrier at least part of the time. This practice,
though it brings baby into the family (instead of treating baby as
spectator), and allows parents the opportunity to follow God's
instructions for teaching baby is rejected by Mr. Ezzo. "slinging
your baby at your side all day long is an artificial way to parent.
You are not a marsupial, and should not treat your baby like a
kangaroo joey!" There is nothing artificial about including baby
in daily activities. I believe it is more consistent with Scripture
than Mr. Ezzo's playpens, crib mobiles and other impersonal parenting
gadgets.
Mr. Ezzo's program does not advocate Biblical training of children
in the areas of sleep and independence, but abandons them to figure
it out by themselves. It fails to take into account developmental
stages of infants (these developmental stages, are themselves, part
of God's design and order). It creates a false dichotomy between
adults and children which is not present in the Bible. It does
not allow for an infants individual personality, but assumes all
babies will respond "properly" to the program. When a baby does not,
blame is place on the parents or other outside influence. In order
to fit all babies into this same, small box, Mr. Ezzo produces a
program based on a parenting philosophy that is "far too rigid"
according to Focus on the Family
http://www.mailing-list.net/redrhino/Ezzo/FOTF.txt.
Other prominent believers have expressed concerns about GFI and
their materials http://www.mailing-list.net/redrhino/Ezzo/prom.html.
Concerned with Mr. Ezzo's emphasis on non-Biblical matters and the
divisive tendency associated with GFI, Grace Community Church, which
supported Mr. Ezzo as he launched his parenting ministry has
disassociated themselves from GFI
http://www.fix.net/~rprewett/grace-ezzo-final.html. Eric & Julie Abel,
the couple who originally appeared in GFI videos, has asked to be
removed from their materials. Their letter of explanation
http://home.earthlink.net/~ericabel/GFI.htm reads, in part, "As God
would further have it, we parted company with this organization in
1994. At that time, we were mainly concerned about the integrity &
direction of the company. Since then, we have been exposed to
additional concerns regarding the curriculum which we can no longer
support."
Mr. Ezzo states that there is no one right way to parent, yet
throughout PFP he criticizes other styles of parenting. These
negative comments give the impression that Mr. Ezzo believes PDF
is the only way to bring godly order into your home. Opposing
viewpoints are not allowed to be discussed in their parenting classes
or on their website forum. Parents are discouraged from allowing
their children to play with children from families who do not follow
the GFI principles. The implication is clear: GFI is right; all
others are wrong.
This has created a rift among Christians that has even divided some
churches. I know one woman whose church revoked her membership in
1993 when she expressed concerns with the Prep program and talked
openly about it to other church members."
http://www.bhip.com/features/ezzo.htm While this type of action
is unusual, the underlying attitude is common with GFI supporters.
The Christian Research Institute, a noted authority on cults, looked
into GFI. They ran a cover story, "More than a Parenting Ministry?
An Evaluation of Growing Families International"
http://www.fix.net/~rprewett/CRI.html in their April-June 1998 Journal.
They determined that, "although it is not a cult, [GFI] has
consistently exhibited a pattern of cultic behavior, including
Scripture twisting, authoritarianism, exclusivism, isolationism,
and physical and emotional endangerment."
Rather than seeing Preparation for Parenting and Parent Directed
Feeding as a Biblically sound way to parent, I see the opposite.
Mr. Ezzo has misused, twisted and stretched Scripture to support
his own ideas of parenting and has ignored Scripture that contradicts
it. I've noted a couple of the medical discrepancies this causes.
Others have commented more thoroughly on them. Rather than
summarize or repeat them, I refer you to the following links.
A couple of these are statements by doctors and others are articles.
There are some very serious concerns levied against Mr. Ezzo and
GFI and I urge you to read them with discretion.
--http://www.mailing-list.net/redrhino/AAP/aneyaap.html ~
Babywise advice linked to dehydration, failure to thrive by Matthew
Aney, M.D.
--http://www.mailing-list.net/redrhino/AAP/Unsub.html ~
According to Dr. Matt Aney, there are at least thirty five
unsubstantiated and/or false medical statements in Babywise
--href="http://www.mailing-list.net/redrhino/AAP/mediaalert.html ~
AAP ADDRESSES SCHEDULED FEEDINGS VS. DEMAND FEEDINGS
This statement is apparently in response to the media attention
being given to the demand vs. schedule feeding issue generated
by GFI materials
The media has also carried stories about _Preparation for Parenting_
and _Babywise_
--http://www.mailing-list.net/redrhino/Ezzo/brave.html ~
The Brave New Baby by Thomas S. Giles; reprinted from Christianity Today
--http://www.washingtonpost.com/wp-srv/WPcap/1999-02/27/051r-022799-idx.html
A Tough Plan For Raising Children Draws Fire, 'Babywise' Books
Worry Pediatricians and Others; Washington Post
--http://www.salonmagazine.com/mwt/feature/1998/08/cov_06feature.html ~
Getting Wise to "Babywise"; Salon Magazine
--http://www.bhip.com/features/ezzo.htm ~
In God's hands?: Religious-based parenting program may endanger
some infants by KELLY GRIFFITH; Bradenton Herald Internet Plus
As I have mentioned, _Preparation for Parenting_ is not supported in
the medical literature. As a matter of fact, the endnotes in the
manual are sorely lacking. Of the 29 notes included:
--18 are from the appendix, "The Secular Mystics." This section is a
discourse on secular parenting philosophies,and although and
interesting lesson on the history of secular view of human nature
(ie the innate goodness of mankind), does not lend support to
Mr. Ezzo's routine.
--4 more are not actually references, but Ezzo's interjected comments:
#4 is personal opinion on extended breastfeeding
#7 is an brief discussion on the development of infant immune
systems. It could be accurate, but there is no actual study
referenced.
#8 is personal opinion on the nonexistence of nipple
confusion. Again, Mr. Ezzo's statement contradicts most
other's. LLL and most pediatricians believe nipple confusion
can be an actual problem.
#9 Is a refuted discussion of "normal" crying periods. Although
it is based on studies, Mr. Ezzo provides no actual
reference. See my footnote 2.
--Of the remaining 7 references, 4 are vaguely related to PDF:
#1 is related to feeding history, specifically "hyperscheduling"
and does not support to PDF. This endnote also contains
Mr. Ezzo's analysis of what the reference means.
#2 is an extremist definition of demand-feeding. It does not
illustrate the typical practice of demand feeding, yet Mr.
Ezzo has chosen to use it as the basis for his rejection
of this feeding practice. Rejecting this extremist view does
not necessarily mean one must accept PDF.
#3 is another reference to feeding history. It is a commentary
on child-centered parenting and lends no support to PDF.
#11 is a comment on the bonding theory and maternal behavior.
I believe this study to have been refuted by more recent
studies, but either way, it is a comment on bonding and
not PDF.
--And the other 3 attempt to lend direct support to PDF:
#5 is another historical reference, this time, trying to
establish that infant feeding routines were the norm in
Hebrew society. "According to the definitive work on the
subject, a Hebrew mother did not carry her baby in a sling;
instead, she swaddled her young infant and left him in his
cradle when attending to her daily chores." This work is
difficult to find, apparently not a major work, and is
refuted by other sources. According to Lisa Marasco, IBCLC,
Mr. Ezzo "misapplied it in neglect of statements on the
next page."
http://www.mailing-list.net/redrhino/Ezzo/node3.html#concern3.
In Infant Feeding in Ancient Israel: A Commentary on the Ezzos
http://www.prairienet.org/community/health/laleche/detisrael.html,
Katherine Dettwyler, Ph.D., an anthropologist at Texas
A and M University writes,
The concept of scheduling infant feeding began early
in this century with "scientific" approaches to
mothering and the desire to raise children who
could cope with factory work (I kid you not). . .
Anthropological studies of breastfeeding frequency
in "traditional cultures" shows that mothers may
feed children earlier than they are indicating a
want/need, because mom has something else to do, or
they may try to placate the baby by tying them on their
backs when they have something they have to finish (in
other words, not everyone drops what they are doing to
nurse the baby truly "on demand" in every culture),
but that no one outside of industrialized/Western
cultures nurses children on a schedule. People simply
have no access to clocks, pay no attention to how long
it has been since the child last nursed, etc. Kids
are carried with the mother as she does her work, and
her nursed very very frequently. My own research in
Mali (West Africa) shows that women nurse their
children while doing their work, and children are
thought to have the absolute right to be nursed
whenever they need/want. It is certainly true that
Mary, and other women of ancient Israel, and around
the world today, work very very hard and have lots of
physical labor that they must accomplish each day.
NONE OF THEM nurse according to a schedule, however,
nor do they do much of anything else according to a
schedule except perhaps prepare meals. They
incorporate frequent and irregular nursing into their
lives without missing a beat. Short of having a time
machine to go back and watch, I think we can safely
assume that Jesus was nursed several times an hour,
around the clock, slept with his mother, was carried
on her back, and nursed until he as 3 to 4 years of
age, or older.
Again, Mr. Ezzo has sought out the one piece that appears
to justify his position while ignoring that the bulk of
the evidence contradicts it.
#7 is a La Leche League study pointing out the demand-fed
babies wake "as often as every 2 hours on a recurring
basis" and that they "may do that routinely for 2 years"
(page 66). Mr. Ezzo's point is that his feeding plan will
condition a child for continuous night time sleep, while
demand-feeding interferes with it. Although demand fed
babies do not sleep through the night as early as PDF
babies, Mr. Ezzo fails to prove that this is harmful or
ungodly, and as Katherine Dettwyler asserts in her
article Sleeping through the Night
http://www.prairienet.org/community/health/laleche/detsleepthrough.html,
it may actually be good for a child to *not* sleep through
the night.
#10 is a reference to support his statement that "colic is very
rare PDF babies but is intensified indemand-fed babies."
(page 150). The actual endnote reads, "Pediatrician Leila
Denmar believes that 'one of the most common reasons
for crying and fussing is when a baby is fed too often and
his stomach doesn't have time to rest, thus causing
discomfort.'" Notice this doctor "believes." The true
cause of colic is unknown. Studies have failed to prove
a correlation between frequent feedings and the current
stance of the AAP is that "The definite cause [of colic]
is unknown. Demand-feeding is not cited as a cause nor is
any relationship established between colic and demand
breastfeeding."
http://www.mailing-list.net/redrhino/Ezzo/graf.html
These references do *not* support Mr. Ezzo's points in the way he
intends. Giving Mr. Ezzo the benefit of the doubt, perhaps he
misunderstood the references when he read them. However, several of
his errors, such as equating demand feeding with colic, have been
pointed out to him. I do not understand why continues to promote
his own ideas against the medical evidence.
Mr. Ezzo insists there is medical support for his position, yet he
refuses to produce it stating, "Yes, the research is available. But
you will need to take the time to pull it together, if you are
really interested." I have not looked in the medical journals
personally, but know some who have looked and could not find it.
Mr. Ezzo further insists he's had peer review of his materials.
When asked who these peers are, he responds, "Can you have our list?
No, these people are too important to be bothered with the trivia
served up by the critics." (Both quote taken from the Bradenton
Herald Internet Plus, Q & A with Gary Ezzo KELLY GRIFFITH
http://www.bhip.com/features/eqa.htm .) I have 2 problems with
these answers. First, if I had uncovered some new medical evidence,
I would be anxious to show them to the world. Mr. Ezzo has created
an entire infant management program around these supposed new and
better claims, yet refuses to produce them. I have to wonder "why?"
and until Mr. Ezzo chooses to cooperate, I can only assume the
answer is, "Because they don't exist." Second, I find these
responses to be quite rude toward those who are looking for honest
answers. Many of the questions have come from respected
professionals attempting to resolve a controversy and get to the
bottom of the issue in the best interest of infants around the world.
Yet, Mr. Ezzo refuses to answer and puts them off with insults. I
would think, for a man whose ministry goal is to instill godly
character in Christian children, Mr. Ezzo could display more of the
godly characteristics of cooperation and brotherly love.
In summary _Preparation for Parenting_ begins on the right note and
with the correct goals. However, in actual practice, this material
is Biblically tenuous, medically inaccurate, and dangerous. I
believe Mr. Ezzo has acted in a less than gracious manner towards
brothers and sisters in Christ and that GFI has discredited themselves
with multiple medical inaccuracies. I am deeply grieved that the
secular world is beginning to see this program as a model for
Christian parenting. I would not spend one penny on materials from
a ministry that has acted in a manner which endangers infants and refuses
to acknowledge their errors and I urge my readers to avoid GFI
materials as well. But please, don't take my word for it. Examine
the evidence yourself. Follow the links I've included in the article
and check this page for more:
http://www.mailing-list.net/redrhino/Ezzo/Files.html ~
Files on the WWW about Gary Ezzo and GFI
It contains links to the articles I've sited above as well as many
others. You will also find the link to the GFI website where you
can read their side of the story. Also, Dr. Aney, a pediatrician
in California, has prepared a packet of information about the
Ezzos' programs and GFI. If you would like to receive this packet,
send him an email at ANEYBODY@aol.com. Include your snail mail address.
------------------------ENDNOTES------------------------
1. Unless otherwise noted, all quotes are from Preparation for
Parenting, 5th edition, 4th printing, spring 1996.
2. "Many studies state that infants cry 'an average of two or
three hours each day.' I urge parents to beware of drawing
any conclusions from these studies of crying. These studies,
which are widely quoted, often conclude that it is normal for
babies to cry two to three hours a day. I do not personally
believe this. In my own practice and personal experience I
would certainly not consider it normal for babies to cry
two to three hours a day. The reason I caution parents about
putting much faith in these studies is that I don't want
parents to conclude that it is all right to let their baby
cry two to three hours a day. The mothers in these studies
were not given any counseling about what to do when their
babies cry and were not specifically advised to use all
possible mothering skills to keep their babies from crying.
In cultures in which an immediate nurturing response is the
normal response to an infant cry, the amount of crying is
reported in terms of minutes, not hours." William Sears, M.D.,
_The Fussy Baby, How to Bring out the Best in Your High Need
Child"_ (La Leche League International, 1985) pp 49-50.
3. Gill, Nancy E., Marjorie A. White, Gene Cranston Anderson;
(1984) Transitional Newborn Infants in a Hospital Nursery:
From First Oral Cue to First Sustained Cry.
Nursing Research Vol. 33, No. 4; 213-217.
4. Marasco, Lisa, Jan Barger; (1997) Examining the Evidence for
Cue feeding of Breastfed Infants."
http://www.fix.net/~rprewett/evidence.html
5. Aquilina, Mike; (1998) Crib Notes: Do the Ezzos Know Best?
Our Sunday Visitor Vol. 86, No. 49; 6-7.
5. Marasco, Lisa, Jan Barger; (1997) Examining the Evidence
for Cue feeding of Breastfed Infants."
http://www.fix.net/~rprewett/evidence.html
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