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Babywise: “assessment of real need”

Look at this manipulative bastard.

I’m still not past Chapter 2.  I’ve noticed a really disturbing underlying assumption.  First, let me provide the actual quotes (emphasis added).

“[In attachment parenting] the baby is offered the breast simply and immediately without regard to assessment of real need.”

“the single most critical element for all aspects of infant care . . . an acquired confidence to think, evaluate and respond to real need,”

“using parental assessment to decide when to feed based on actual need.”

“Feeding based on fixed times ignores legitimate hunger cues

Lest you think I’m combing the book and cherry picking, those quotes all appear on pages 33-38.  The chapter is dense with this concept.

If parents need to constantly assess whether a baby has “real need,” and whether his cries are “legitimate hunger cues,” that assumes that babies also express “fake needs” and “counterfeit hunger cues.”  It’s clear from his use of this language that Ezzo is worried that babies are just shamming when they cry for a parent’s attention, and unless parents are careful that the baby has a genuine need, they’re just suckers for the baby’s sly emotional manipulation.

That interpretation is borne out by additional language in the first two chapters:

“If she believes she is central to the family universe, her self-centered feeling will carry over into every relationship in her ever-expanding world.”

“[The baby should learn] from the start that giving is equally important as receiving.”

“The virtues [of kindness, goodness, gentleness, charity, honesty, honor, and respect for others] are not inherent in her or any new life.  Therefore, Chelsea’s parents must govern and monitor her . . .”

There you go.  Babies are sociopaths, and only constant vigilance by the parents will train the evil, conniving ways out of a newborn.  Attachment parenting is a huge mistake because those gullible parents are duped by their babies into thinking every cry is genuine, and not merely a bid for domination of the household.  Sure, sometimes babies have “actual needs,” but a lot of the time they’re just trying to assert their power over the family, and you have to learn how to tell the difference.  If you don’t start in the first two months, it’s all over – your baby will be a selfish, manipulative jerk for the rest of her life, and never have a fulfilling relationship.  She’ll probably go to hell, too.

I suspect that they actually believe that bit about hell, and that’s what’s driving all this suspicion of neonates’ byzantine motivations.  A while ago, a friend suggested that I look into the original Ezzo parenting program, Preparation for Parenting, an explicitly Christian guide on children and parenting.  Babywise began as a mere copy of PfP materials, with the overt Christian references expunged.  With this in mind, all this blather about assessing whether a cry indicates a legitimate need makes more sense.  In their own words, the Ezzos proclaim that they “clearly teach the doctrine of the depravity of man and original sin.”  More to the point, PfP materials maintain that “children enter the world in a depraved state.”  I definitely need to get my hands on the PfP materials and compare, as my friend mentioned.  I think it will be very illuminating.

In the meantime, there’s plenty of evidence here that Babywise is based on the idea that newborn babies aren’t just subject to original sin in a vague, eventual way, such that they will require forgiveness when they reach the age of reason.  Babywise assumes that babies are actively sinful from the moment of birth, and indeed, that their sin nature imbues them with a precocious capacity for subterfuge, manipulation, and possibly even mustache-twirling accompanied by maniacal laughter.

This is not just silly, it’s dangerous when they are pressuring parents to adopt this approach for infants who can only communicate their needs by crying, and who have “legitimate needs” far beyond that for caloric input.  In the rush to squelch the legacy of Eve, Ezzo ignores the growing research that babies actually require human touch and interaction, help organizing their mental functions, and sensory stimulation including sucking, rocking, and hearing human voices.  Remember, this guide is for babies less than six months old, and this advice is meant to apply from the moment of birth.  Ezzo isn’t talking about beginning to socialize a toddler, whose needs and wants have diverged to some extent.  The bottom line is that all of a baby’s needs are legitimate, and all of their cries are disingenuous, and Babywise recklessly ignores these facts to service its hidden religious agenda.

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Ezzo and “Neoprimitivism”

Chapter 2 of Babywise is really dense.  Ezzo does a lot of work to confuse the issue, set up straw men, and create a fantasy scenario in which his method is a sane middle ground.  Unpacking all this may take some time.

First, he sets up two extremes of baby care philosophy – behaviorism and “the neoprimitivistic school of child care.”  Here’s how he helpfully “cites” the proponents of the latter: “That belief inspired the neoprimitivistic school of child care, supported by Ribble (1944); Aldrich (1945); Trainham, Pilafian, and Kraft (1945); and Frank (1945).”  Trying to unearth the actual writings he’s talking about is near impossible.  Google any permutation of “neoprimitivistic” and you get lots of interesting information about a school of painting that influenced Marc Chagall.  What you don’t get is anything about child care philosophy or psychology.  Search for “neoprimitivistic” and any of those names, and you get . . . Ezzo, and no other hits.

Now of course Wikipedia and Google are not the be-all and end-all of information.  I have little doubt that there’s at least one instance of at least one of those listed names being involved in a psychology movement labeled neoprimitivism.  But clearly this was not a highly influential group, at least under that name.  And given Ezzo’s previous disingenuousness, one wonders if he searched out and cherry-picked that term because it sounds pejorative.  Like he wanted to be able to say, “Do you want to follow a science-based, modern, enlightened philosophy, or a primitive way of life?”  To be fair, he says “The title “neoprimitivistic” is not name-calling, but a specific school of thought.” But he’s a tricksy one – I suspect by lampshading his word choice he’s really just trying to compound the impact of using an inflammatory word and thus leave a stronger impression with readers.  He’s all about constructing the appearance of sane moderation, while engineering all the information he delivers to paint any deviation from his edicts as a descent into laughable irrationality.

Anyway, believe it or not, I found some writings to which he might be referring.  And it’s interesting reading.  It’s true that these writings indicate an element of Freudian (or maybe Rankian) psychology.  The one paper I found by Frank et. al. includes some brief discussion of how an infant’s experience might influence the development of later problems such as thumb-sucking, elimination difficulties, and even “negativism and hostility.”  However, the main thrust of the discussion is refreshingly in tune with modern, mainstream medical understanding about the physiological needs of infants:

As a young mammal, the newborn has the same organic needs as other young mammals. He needs close tactual contact, cuddling, licking, nuzzling, mothering and needs the opportunity to suckle and use his lips and he needs frequent, if not almost continuous, nourishment. These needs arise from the lack of homeostatic capacity in the newborn so that he gets cold easily, and cannot keep warm; his skin is exquisitely sensitive and needs contact for relaxation. He gets hungry quickly since his blood sugar may go down rapidly and he is unable to endure prolonged hunger without discomfort and distress.

I was personally blown away that medical professionals were writing stuff like this 12 years before the founding of La Leche League, and decades before Sears coined the term “attachment parenting.”  I find it delightful to read about men and women in the 40s and 50s who were advocating for an understanding of infant needs that is only now becoming mainstream.  We tend to think of anything before the 60s or 70s as a wasteland of Victorian-inspired “detachment parenting,” but clearly the field of child-care philosophy was much more nuanced, and more advanced in some quarters, than I ever knew.

According to Ezzo, these proto-AP proponents claimed that

the separation at birth momentarily interrupts the mother-child in utero harmony. Therefore, the goal of early parenting is to reestablish that harmony. How is this supposed to be achieved? Only by the constant day-and-night presence and availability of the mother to the child. New mothers are instructed to do whatever it takes to neutralize the supposed trauma of birth and offset its effect. By 1949, the birth-trauma theory, lacking objective verifiable data, was dismissed as a nonsensical theory.

However, I’m not seeing any talk about birth trauma.  Rather, the hypothesis seems to be that when you deny the most basic physiological needs of newborn babies, starving them and failing to offer the touch that helps regulate their temperature and neurological processes, babies get pissed off.  And perhaps leaving babies to starve and shiver and fend largely for themselves might be bad for their psychological development, as well as their immediate bodily health.  They also thought maybe routinely withholding food from infants whose blood sugar was severely low might be a cause for later feeding problems.

The frequent pattern of newborn care, especially in hospitals, is that he is taken away from his mother, deprived of cuddling and soothing and of opportunity for sucking and the comfort of breast feeding. He is also prematurely subjected to prolonged fasting after having been continuously nourished during gestation and is subject to strong emotional provocation, allowed to cry uncomforted and to undergo prolonged fits of rage or of fear and anxiety. In consequence, eating, which should be a simple, pleasurable experience, may become an occasion for tension and emo-tional disturbances which may be the beginning of frequent feeding problems observed among pre-school children.

Given that the infants they’re talking about might be fed as few as 4 times a day, their concerns are hardly the whacky, discredited psychobabble Ezzo wants to paint them as.  In this article, we’re seeing the origins of modern pediatric understanding about the biological needs of infants, which is most definitely informed by the knowledge that we are mammals, and have needs closely tied to those of other mammal neonates.  Come to think of it, perhaps this is part of Ezzo’s problem with mainstream, evidence-based pediatric thinking: it’s based on acceptance of evolution.  I haven’t found any reference to Ezzo’s beliefs about evolution/creationism, but it would not surprise me to find that he rejects evolution, given that his whole parenting philosophy grows out of Biblical interpretation.

In any case, Ezzo is once again misrepresenting his opposition.  He of course does it in a convoluted way that makes it almost impossible for parents to check on his assertions.  First, he manufactures a semi-mythological school of thought, neoprimitivism, then he assigns silly-sounding, discredited beliefs to it that may or may not have influenced its members, then he assumes without proof that modern attachment parenting is really a resurgence of this school.  All this without proper citations of course.  Ezzo fervently wants to believe that anything but his approach is extreme, loopy, and contrary to evidence, and he’s very clever at creating that illusion, as long as the reader has little context to check his assertions against.

Babywise: Feeding Philosophies

Miss Scarlet: Why?!
Wadsworth: To create confusion!
Mrs. Peacock: It worked.

- Clue

Earlier we saw that Babywise attempts to reduce the large array of real parenting options to two polar opposites: Babywise, or anything-goes. As Ezzo embarks on a discussion of feeding babies, he switches to the opposite approach. He flails around wildly in an attempt to make feeding babies seem ridiculously complex and confusing. He works hard to manufacture bewilderment among readers, so the author can then offer a seemingly sensible, clear solution.

“Demand-feeding. Hyperscheduling. Cry feeding. Breastfeeding and bottle. . . . why all the confusion? One reason might be the overabundance of parenting theories. With so many options it is no wonder parents get confused.”

It goes on like that, with Ezzo reaching for odd, academic-sounding terms and italicizing them to emphasize their strangeness: demand-feed, demand schedule, self-regulating schedule, natural feeding, hyperscheduling, rigid feeding, cry feeding, responsive feeding, bottle-feeding. Seriously, he italicizes “bottle-feeding” like it’s an exotic foreign term. He wraps up the obfuscation triumphantly: “Who can decipher all the terms and techniques?” No one, when you describe them Gary.

I Googled these supposed terms of art. The results were not surprising. “Demand feeding” and “Cue feeding” are treated as synonyms – they are two ways to refer to the same practice. A search for “rigid feeding” turned up some articles about whether to demand feed or feed by a schedule, but the term “rigid feeding” as a separate philosophical approach did not appear. All the other terms failed to return any references to them as feeding philosophies, except in articles quoting Ezzo himself.

Here’s the bottom line: the first choice in infant feeding is whether you will nurse exclusively or use formula. The second choice is whether you will feed on demand (looking for baby’s hunger cues and responding), or feed the baby on an imposed schedule. And that’s pretty much it for choosing between feeding philosophies. Everything else is a lot of sound and fury, signifying nothing. And I trust you remember who tells a tale like that.

So why the huge effort to create confusion? It’s simple – the smoke and mirrors are meant to create the illusion that Ezzo’s approach is a sane middle ground. In reality, Babywise is well known as the most rigid, schedule-driven advice around. To dodge this criticism, Ezzo must create a fantasy landscape of crazy, diverse feeding philosophies in which to situate his approach as a sensible compromise.

It seems I’ve written at least a post’s worth on the very first page of this chapter. I think I’ll save the rest for another post. There’s an awful lot of trickery to unpack in this chapter!

Gary Ezzo wants the ta-tas all to himself

I wish I could put a still from the Mitchell and Webb Look sketch, "Bitty." Go look it up, it's hilarious.

OK, having dealt with the obvious flawed premises, logical fallacies, and internal contradictions, I promised to unpack the subtext of Chapter 1 as well. Let me start by simply laying out relevant quotes, and see if you follow these to the same conclusion I did.

“The husband-wife union is not just a good first step toward child-rearing. It is a necessary one. Too often, parents lose sight of this fact, getting lost in a parenting wonderland of photos, footsteps, and first words.”

“Marriage is unique – totally without parallel. It transcends all other relationships.”

“Where the marriage is intact, keeping this relationship a priority is your starting point for successful parenting.”

“Too often when a child enters a family, parents leave their first love: each other. The spotlight shifts to illuminate the children, and the marriage gets lost in space.”

“Date your spouse. . . . Continue those loving gestures you enjoyed before the baby came along.”

See where I’m going with this? And don’t for a minute think that Ezzo is concerned equally with each spouse’s happiness. It seems very clear to me that these are exhortations to a new mother not to focus too much attention on her new baby, but to make sure she keeps her husband satisfied. See: (emphasis added in all quotes below)

“With child-centered or mother-centered parenting, parents intensely pursue the child’s happiness.” Seriously, he just throws “mother-centered” parenting in as an equivalent of child-centered parenting, without comment.

“When you become a mother, you do not stop being a daughter, a sister, a friend, or a wife. Those relationships, which were important before the baby, still must be maintained.”

“Date your spouse . . . The baby will not suffer separation anxiety from one night without mom.”

“If you buy a special something for baby, select a little gift for your mate as well.” Who generally buys items for the baby? Yeah, Mom. Or maybe I should call her Wife.

Oh, and I almost forgot this bizarre statement: “Since infants are entirely dependent on parental care, their dependency creates for new parents a heightened gratification.” What the hell? I can only guess, but this seems to be another jab at mothers being “overly involved” with baby care (i.e., taking appropriate care of a newborn), as though properly responding to an infant indicates some pathological need on the part of the mother. If someone can explain this non sequitur, please enlighten me.

I’ll just quote here the marginal notes I made when I twigged to all this: “OMG! This is written by a man who feared/resented having his boobies/mother figure taken away. What a weak, fearful, grasping man.”

Really. This book seems to have been written by a man so insecure, immature, and petty that he is jealous when his wife buys a present for their baby. So sad. And sadder still that he has conned thousands of people into following his, “NO, I want to be the baby!!!” philosophy, under the guise of responsible parenting.

Babywise, dissected

It’s generally a bad idea to judge things based on hearsay.  And yet, I really hate the Ezzos and their stupid book Babywise just on reputation.  I’ve read enough excerpts and seen enough stories from healthcare providers about babies having Failure to Thrive on this program to make me very concerned about anyone using their advice.

But, in the interest of fully informed vituperation, I obtained a second-hand copy of Babywise.  I started reading it and picking it apart years ago, but then I needed a break.  Well, I’m back in fighting form and ready to proceed.  Obviously I admit that I have a strong prejudice against this going in, but if they make a decent argument I’m willing to change my mind.  And I have no doubt there’s some good ideas in there – even a blind squirrel finds a nut sometimes.  But the whole philosophical basis is of concern, and the arguments they’ve made so far are laughably weak and fallacious.

Reading the Preface, I’m seeing two themes. First, the focus is on results, results, results. And for them “results” means the baby sleeping all night long without any parental intervention, and the mother being well rested. No mention so far of meeting baby’s needs, fostering empathy and closeness, or listening to one’s mothering instincts. The other focus is on how they are right and everyone else is wrong. La Leche League gets called out specifically, and the tone seems to be, “Go ahead, look at what those other methods get you” – any mother who is stressed or tired, and any child that has any behavioral hiccup must be the result of inferior baby training methods.

For me, the biggest problem will probably be differences in basic assumptions. They assume that babies should sleep all night without any intervention, and that tired parents are the greatest problem to be avoided. I assume that babies are primates who are wired to need parental intervention quite often when young, and that this intervention brings benefits. It also becomes less frequent, on average, as the baby matures, and the key at the beginning is finding strategies to deal with the need for intervention, rather than trying to extinguish the baby’s calls for help.

Chapter 1 – Your Baby Needs a Family

First, let me note that Ezzo uses two “examples” of children raised in different ways. I put examples in quotes because they are not real children, just made up characters crafted to support Ezzo’s views. Chelsea has the perfect parents according to Ezzo – married, committed, and bound and determined to be her authority figures, not her friends. Marisa, meanwhile, is apparently the daughter of unmarried lesbian democrats who crave her constant approval and dare not thwart her. Got it? Let’s proceed.

Ezzo starts by painting all other parenting approaches as ineffectual, naive, and downright stupid: “You think [these parents] are too sweet. Too kind. They all have the best of intentions. If wishes and dreams were bright lights and lollipops, every day would be bliss. But there’s much more to parenting than just high hopes.”

He then goes on to lay down the prerequisite to parenthood: good old Judeo-Christian marriage. “The husband-wife union is not just a good first step towards child-rearing. It is a necessary one.” OK, pretty clear – traditional marriage is absolutely indispensable to good parenting. Except two sentences later, when he tells single parents they can use his method too. OK – marriage is completely vital, except it’s not really. I didn’t expect things to go off the rails this quickly.

(Credit where credit is due, I can see a lot of wisdom in promoting a solid pair-bond in parents to make kids feel secure and prevent excessive anxiety. A stable home is important to kids – not the most profound revelation, but I’d say they’re right as far as that goes.  Of course, they’re wrong about it having to be one man and one woman united by holy matrimony, though.)

Assuming you’re starting with a solid heterosexual marriage, Ezzo remarks, “To be a good mom or dad, all you need is to continue as before.” Seems like he is echoing a sentiment that seems prevalent in our culture – having a baby shouldn’t cause even a ripple in your life. Anything a baby does to disrupt your sleep, your schedule, or your leisure time is a problem to be fixed. This is confirmed when he trots out “Marisa” as a bad example. He describes her parents making room for her needs in their lives (not going out for a few months because she doesn’t do well with sitters, and not force-feeding her a food she rejects) summing up with, “Welcome to the circus.” Yes, these parents have done two things to accommodate their baby – mass chaos will surely ensue!

I’m coming to see that Gary Ezzo is extremely fond of the False Dilemma fallacy. In fact, it appears to be the foundation of all his parenting advice. Follow Babywise, and your child will be secure, cooperative, kind, good, charitable, honest, honorable and respectful. She will be “a joy to have around.” Fail to follow Babywise, and instead follow your instincts or “the La Leche League attachment-parenting style” and your parenting will be “disabling . . . emotionally crippling . . . devastating.” You will be catering to your child’s every whim, making her totally self-centered and selfish for the rest of her life.

Clearly Ezzo is unfamiliar with the actual tenets of attachment parenting, which emphasizes loving guidance, which can include using authority and behavior modification techniques. Surely there are parents out there who ascribe to a passive, lazy approach, or who consider their little darling a creative genius not to be squelched with the slightest redirection. But these are by no means essential to attachment parenting. More to the point, wherever attachment parenting falls on the continuum, it is patently true that there is a continuum of parenting choices ranging from the very permissive to the very authoritarian. There are a lot of points on the continuum between Ezzo and utter permissiveness, but he refuses to acknowledge them.

All in all, this first chapter paints a picture of an author terrified of losing control. The implication is that one must keep utter mastery of children, from the moment of their birth, or all will be lost and the child will be unruly, selfish, and miserable forever. To him, placing an infant at the center of attention and care in a family, even for a few weeks or months, is a recipe for disaster, never mind how utterly dependent newborns are.

There is another subtext to this chapter, but I’ll leave it for a separate post, as this is quite long enough already.

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