I first heard of Gary Ezzo’s book Babywise when I was reading a chapter on sleep in Baby 411 by Denise Fields and Ari Brown. The two authors graded a handful of books on sleep, giving Babywise an “F.” Months later, when I received Babywise along with some other baby items for my daughter, it reminded me of that harsh rating and I looked back on what was said. From their short summary, Ezzo’s book sounded more harmful than helpful. So instead of putting it in the pile to take to the used bookstore to sell, I put it in our recycle bin so that I wouldn’t contribute to other moms possibly harming their babies. A few days later, I found out that an expecting friend of mine had read Babywise and loved it. I immediately went to the internet to find reviews on the book to share with her, and was easily able to find 55 one-star reviews on amazon.com (most were very much against it and gave specific reasons why). But instead of just telling my friend to ignore this book based on hearsay, I thought I might pull it out of the recycle bin and read it myself.

I went into it with as much of an open mind as I could, but I didn’t get very far before red flags started coming up. I decided it would be beneficial to take notes along the way of the specific problems I was seeing, rather than try to remember it all at the end and only be able to make general statements about what I disagree with. I kept making more and more notes, until I realized that I had major problems with a lot of what was being said, and felt called to put it all in writing and share it with as many people, especially new moms, as I could. If I just sat on my shock and complete disagreement with this man’s philosophies, then I’d be helping no one.

After doing more internet research, I discovered what a controversial book (and man) this really is. In April of 1998, the American Academy of Pediatrics (AAP) issued a media alert against using the practices in this book, saying that it can lead to dehydration and failure to thrive in some babies. The website www.ezzo.info gives a detailed look into Ezzo’s background (which includes nothing in the medical field or child development), the history of the controversy, the problems with the Babywise book itself, and a lot more. It also gives a long list of stories from parents who formerly used the system and are now against it. I went looking for a good example to highlight, but reading these stories made me sad, so I stopped. You can go look for yourself.


Ezzo’s Character

An eye-opening section of ezzo.info is under “Character Counts.” As I looked through some of the many articles written about this man, I started to see who is really behind this controversial method of parenting. Just looking at the surface, this is a man who has been excommunicated from his church (said to be “unfit for public ministry”), is very critical of anyone who questions the materials in his books, has been cut off from his own children, and has been known to be dishonest.

Frank York, a former employee, says in his article Adventures in Ezzoland, that after working for Ezzo for only two weeks, he “quickly learned Ezzo’s public persona was a façade that covered a personality that might best be described as deceitful and vengeful…When [he] expressed [his] concerns about Ezzo’s lying, [his coworker] confirmed [his] worst fears by telling [him]: ‘Oh, it’s generally understood by the upper management that Gary is a liar.’”

One of the articles linked on ezzo.info is a Q&A with Gary Ezzo and the Bradenton Herald. Ezzo was given two weeks to respond in writing to the questions, only to side step some of them and deny that he even has any critics. In Ezzo’s answers, there is a certain tone of annoyance and negativity coming from him. The third page of the article gives a comparison chart between what Ezzo teaches and what the AAP doctors teach on specific baby issues. This is definitely worth taking a look.


Non-supporters of Babywise

1) Baby 411:

“When parents followed this method to the letter, some babies became dehydrated and did not gain weight appropriately. Setting up a routine for your four month old is healthy. Setting up a routine for your newborn is not. Memo to the authors of the Babywise book: Newborns need to eat frequently (yes, sometimes even more than every three hours) because their body metabolism functions that way. Grade: F”

2) Excerpt from an article by Dr. Matthew Aney of the AAP:

“On Becoming Babywise has raised concern among pediatricians because it outlines an infant feeding program that has been associated with failure to thrive, poor weight gain, dehydration, breast milk supply failure, and involuntary early weaning. A Forsyth Medical Hospital Review Committee, in Winston-Salem N.C., has listed 11 areas in which the program is inadequately supported by conventional medical practice. The Child Abuse Prevention Council of Orange County, Calif., stated its concern after physicians called them with reports of dehydration, slow growth and development, and failure to thrive associated with the program.

Many parents are unaware of problems because the book is marketed as medically supported. Efforts should be made to inform parents of the AAP recommended policies for breastfeeding and the potentially harmful consequences of not following them.”

3) Review from amazon.com:

“Please, PLEASE before you follow Ezzo's babywise method, google ‘babywise ezzo’ and read objective criticism, as well as horror stories about this method from people who followed it. Ezzo, though utterly lacking in credentials or expertise, presents the info with an air of authority. Many sleep-deprived new parents are understandably just looking for an easier solution, and scheduled feedings (among other schedulings) sound promising. I don't fault these parents or question their love for their children, I simply criticize Ezzo as a charlatan espousing unsound methods.

Some friends of ours had a baby two and a half months after we did. They raved about how much they loved Babywise, and how much more sleep they were getting once they started following it one week after her birth. Their daughter weighed almost 9 pounds at birth. On Babywise, by age 4 months, this baby girl barely weighed 12 pounds. Her skin was wrinkled from dehydration - absolutely horrifying! She saw my daughter having a bottle and began to whimper and tried to reach for it. I suggested to her mother that she was hungry, and her mother and father LOOKED AT THEIR WATCHES and said IN UNISON, ‘it isn't time yet.’”

4) Excerpt from another review on amazon.com:

“I have personally seen one of my friend's children become unhealthy and emotionally damaged from using this program. Not only that, but my friend was anything but peaceful and relaxed as a result of this parenting style. She was consumed by the constant schedule and worry to stay on schedule and go ‘by the book’. I watched as her child cried and was ignored due to the child not following the schedule. I was also very sad to see her mother discourage everyone, even her grandparents, from holding her. She was visibly irritated when people wanted to hold the baby and the child was constantly in a carrier on the floor. By the age of one, her daughter already appeared to be lonely and have little bond with her mother. I've never seen such a young child look at her mother with clear disdain and anger. It was frightening. She rejected her mother's breast at an early age which her mother was very sad about. I was quite shocked and confused at how my friend was raising her child. I knew her to be a loving, bright, and highly capable person before having children. I knew this bizarre behavior was all stemming from this book. A few years later when I had my own children and was looking at parenting styles and books I did a little research on Babywise and was astounded at what I found. I was up all night in surprise and horror at the depth of harm this book has caused, and surprised at how many people have fallen under Ezzo's ‘spell.’”

Overview of Babywise

Ezzo’s promise is that if parents follow his system, their newborn will be a very happy, alert baby, who sleeps through the night - without feeding - somewhere between 8 and 12 weeks (sleeping 10 hours a night by 12 weeks). The way this is accomplished is by setting up a routine of feed/wake/sleep that is regulated by the mother. His plan, starting from one week, has “three basic activities. Baby is fed. Baby is awake. Baby sleeps. With the exception of the late-night and the middle-of-the-night feedings when waketime is not necessary, this order should not be altered.”

Throughout the book, he continually puts down demand-feeding (feeding your child when hunger cues are given, not by looking at the clock or going by any sort of schedule), which is highly recommended by the AAP. He starts out by saying that each family needs to find what works for them, but then continues to have an underlying tone that suggests that if you don’t use his methods, you will have a cranky, uncontrollable baby who will have difficulty sleeping through the night, and who won’t learn to regulate his own sleeping and eating routines. Ezzo is not presenting his system as one option of parenting, he’s suggesting that it’s the only way to have success.

On the surface, it sounds wonderful to have your two or three month old sleeping through the night without waking to eat. The parents get more solid, continuous sleep, as well as the baby. Everyone is happy, and who wouldn’t want that? The gigantic problem is that 12 weeks or younger is far too soon for an infant to go 10 hours without eating each night (not to mention the danger to the mother’s milk supply). Also, from my own experience, I know how difficult it would be to regulate a newborn’s schedule. Getting them to cycle between feeding, being awake and sleeping, would be a lot of fighting against what the child really needs to do at that time. And a newborn doesn’t need that kind of opposition from his mother, regardless of her good intentions.

Ezzo repeatedly talks about the 2 ½ to 3 hour intervals between feedings. He admits that “while 2 ½ to 3 hour feedings are a healthy norm, there may be occasions when you might feed sooner. But take heed. Consistently feeding exclusively at 1 ½ to 2 hour intervals may wear a mother down.” He allows for exceptions to his timeframe a) if the baby is hungry sooner (but not to make a habit of it), b) if the baby is premature or has medical problems, or c) if there is a growth spurt. He never admits that some babies just need to eat more often. In those cases, the parents of a healthy full term baby that cries all the time (like ours who had indistinguishable cries), might stick to a rigid timetable instead of feeding their child. He makes you afraid to feed too often, which he says might fatigue the mother and lead the child to “snack” throughout the day and not get full feedings. This would be true if the mother were feeding every hour or so, 15 times a day. But simply feeding regularly at 2 hour intervals, instead of 2 ½, is no big deal. I had to feed our daughter about every two hours (during the day only) for her first 6 or 7 months. Yes, it’s time consuming, but it did not wear me down. She needed the food, and I was the only place she could get it.

In addition to discussing the intervals between feedings, he also talks about one of the dangers to long-term night feedings. He claims that they too will cause the mother to be fatigued and completely worn out. In my experience, the fatigue of having a newborn only lasted the first several weeks. In the beginning, babies don’t know the difference between night and day, so they are sleeping on and off throughout the night. Also, you have to feed them about every four hours during the night, so yes, this is very disruptive of the mother’s sleep. After you get past that beginning stage, you get down to one, maybe two feedings per night. So if the mother is getting her 8 hours of sleep, but having to get up for a 20 or 30 minute feeding, I don’t think that will send her into a state of fatigue. At least it didn’t for me.

Ezzo is creating a mold that not every baby (or breastfeeding mother) can fit into. The danger is when a mother forces this method when it is not right for her or her baby. She might not even realize it until the baby is not thriving. Ezzo admits that this will not work for 100% of all babies, but he’s not leaving much wiggle room if you want to follow his methods and have your baby sleep through the night by 12 weeks. As I said earlier, some babies just need to eat more often. Period. Some women have finicky milk production and need to nurse more often for stimulation. Our child was colicky, and I don’t believe I would have had a prayer of getting her into the feed/wake/sleep routine he talks about. And if I had tried and not been able to make it work, then I might have felt like a failure as a parent.

There are many people out there that fully support Ezzo’s philosophy and have successfully used his technique. I don’t doubt that this can work for a lot of parents, but even though the ultimate goal of their young infant sleeping through the night might be achieved, they could be unaware of nutritional harm they are doing along the way (maybe the harm is not extreme, therefore goes unnoticed). And even if no harm is done, is a good night’s sleep worth even the risk of putting your child’s health in danger? As far as I’m concerned, when you have a child, you are pretty much giving up your right to a good night’s sleep for quite a while. It’s just the (mother) nature of the job.

I suspect that a lot of the people who are pro-Ezzo are only taking pieces of his advice and not the whole thing. Not everything he says is bad or wrong, a lot of it is perfectly good advice. And if you use a softened version of his methods, it can probably work just fine with no consequences. And by that, I mean using a very loose routine in the beginning that the parent may modify to meet the baby’s immediate needs instead of “sticking to the schedule.” This softened version of his methods would also allow night feedings. It’s good for a baby to get 10 hours of sleep, but not without waking briefly to eat.


Other Sources on Scheduling

Here are what some other sources say about schedules and sleeping through the night:

from www.babycenter.com -

“While your baby's a newborn, he should call the shots when it comes to his eating and sleeping schedule. This may mean that days and nights are interchangeable and that there's no clear pattern, but that's okay for now…At 6 to 8 weeks of age, most babies begin to sleep for shorter periods during the day and longer periods at night, though most continue to wake up to feed during the night. Somewhere between 3 and 6 months, experts say, most babies are capable of sleeping through the night. They're not talking about eight hours, though — they generally mean a stretch of five or six hours.”

From What to Expect the First Year -

“Very young infants (under the age of two or three months) shouldn’t be put on a schedule – they should eat and sleep on demand. Even later on, denying your hungry baby the breast or bottle because the clock says he shouldn’t be hungry yet is never a good idea (and if baby’s breastfed, can lead to a diminished milk supply and even failure to thrive).”

Getting Specific

The following are some quotes or paraphrases from the book, along with my objections (the book I am reading from is the 2nd edition from 2001; there is a 3rd edition which may or may not have been revised significantly).

Discussed on pages 36 & 37:

Child-led feeding: feeding ONLY when hunger cues are given, even if that means waiting 6 hours to see any cues. The times between feedings can range from 20 minutes to 4 hours, very inconsistent.
Clock feeding: going by the clock ONLY. Feeding every, say, 3 hours even if the baby is hungry after 2 hours.
Parent-directed feeding: both hunger cues and the clock are watched to find the middle ground.

By these definitions, I have no problem with parent-directed feeding being the best choice. Taking either extreme with “child-led” or “clock feeding” would be potentially harmful for a parent to do. Either way you are risking dehydration. There has to be middle ground where you respond to your child if he is hungry, but limit the time frame to something like a minimum of an hour to no more than 3. So initially, this seems okay, but it’s not the whole story.

Page 44: (throughout the book, “Chelsea’s” mother is using the Babywise method of parent-directed feeding, and “Marisa’s” mother is feeding anytime her baby gives the hunger cue)

“Chelsea will establish healthy and continuous nighttime sleep sometime between the seventh and ninth week. She will probably be sleeping ten hours a night by week twelve. Marisa, on the other hand, will still be waking two or three times a night to snack. To her mother’s dismay, this pattern is apt to continue for two very long years.”

There are a few big problems with this. First of all, a 12 week old should not be weaned from night feedings. That is far too young. The earliest you should cut out night feedings is 4 to 6 months. The nutrients they need throughout the day and night are far more important than sleeping 10 hours straight. And notice how he downplays Marisa’s night feedings to a “snack,” like it’s not important. Reliable sources on this:

babycenter.com: “Somewhere between the ages of 4 and 6 months, most babies are getting enough calories during the day to sustain them for five or six hours at night.”
Baby 411: “Four month olds can sleep six hours without needing to eat. Five month olds can sleep nine hours without needing to eat.”
What to expect the first year: “Most two- or three-month old babies, particularly breastfed ones, still need to eat once or twice during the night.”

Second, feeding your 3 month old once or twice during the night will not put you on course for having night feedings last until he is two years old. In our experience, we very easily and successfully weaned our daughter from night feedings at 5 months.

Third, going 10 hours without breastfeeding when your child is 12 weeks is very dangerous for your milk supply. You shouldn’t go more than 6 hours straight without feeding (or pumping) for at least the first 6 months.

Page 46:

"Establish your infant in a parent-guided feed/wake/sleep routine…After the first week following the baby’s birth, mother’s job is to establish this sequence…Allowing an infant to regulate his own life leads to the formation of nighttime sleep disturbances and poor sleep habits…Is it the parent’s job simply to respond to an infant’s demands? When, then, would this concept switch over to allow the parents to direct the child? Toddler years? Preteen or teen years? Hardly. By then you’ve missed the boat, and your child sails full speed ahead oblivious to fundamental skills like falling asleep alone."

What drama! We are talking about a newborn baby!! Just because you don’t control your newborn’s every action (as if you can!) when he is 2/4/8 weeks old, that doesn’t mean you can’t take more control over his schedule as he gets older. I disagree with his suggestion that a routine has to be established from one week old or you have missed the boat. Newborns don’t need to be on a feeding or sleeping schedule; they eat and sleep when they need to and mom shouldn’t interfere with this.

Page 50:

"From the start, Marisa has been put to the breast ten to fifteen times a day and allowed to suckle for forty-five minutes to an hour. With that type of feeding pattern, there isn’t much time left for the RSP (relaxed sleep pattern) cycle to repeat itself."

It is recommended that a newborn be fed 8 to 12 times during a 24 hour period, feeding 20 to 30 minutes total at each session. His exaggerated example of Marisa’s feeding is misrepresenting the opposing argument of “feeding on demand,” which he uses to his benefit to make “parental-direct feeding” look like the superior method. If you feed your baby as much as Marisa is being fed, then of course he won’t have much time left to sleep! I don’t feel that his example is comparable to Chelsea’s “perfect” cyclical feeding/sleeping routine. And because these are fictional situations, he was able to manipulate them any way he wanted.

Page 100:

"Unfortunately, as a result of their training, the members of the lactation industry are heavily biased in favor of the attachment parenting theories…Do not be surprised if the concept of putting a nursing infant on a “flexible routine” is questioned."

For me, that sends up a big red flag. If his methods and theories on nursing infants are raising questions from lactation consultants, whose entire job revolves around breastfeeding, then that should say that something is wrong with what he is teaching. If his ways are the right way of doing things, then wouldn’t it easily be accepted by the medical field? His statement here could lead parents to ignore advice given to them by their pediatrician or lactation consultant.

Page 103:

"If you question your milk supply in the first two months: for a baby between three and eight weeks old, consider feeding on a strict 2 ½ hour routine for five to seven days. If your milk production increases, work your way back to the three hour minimum. If no improvement comes, work back up to three hours with the aid of a formula complement for the benefit of your baby and your own peace of mind."

I don’t agree with this advice at all. If you are having problems with your milk production, the main thing that is going to increase it is to feed more often. Why limit it to every 2 ½ hours? That might not be often enough – and probably won’t be. It is extremely important to have a sufficient milk supply, and if he’s worried about putting stress on the mother by her feeding too often, it will be much more stressful when her baby is not getting enough to eat and not thriving. There are other considerations when it comes to increasing milk production that he doesn’t mention here, like drinking more water, eating more (good) calories, getting more sleep, etc.

And his solution if it doesn’t improve over 5 to 7 days? Increase the time between feedings and supplement with formula. This is a shortsighted solution to give to someone who has to continue feeding their baby for the next 12 months. Giving formula will only make the problem worse because the baby will be sucking on a bottle instead of stimulating the breast (and giving a bottle too young can cause nipple confusion if breastfeeding is not already well established). If the baby’s intake truly becomes an issue, then the mother should immediately contact her pediatrician or a lactation consultant. He doesn’t even mention that here.

Page 109: How he defines a “flexible schedule”

"When you think of a flexible item, you think of something with a particular shape that can bend and then return to its original shape. Returning is perhaps the most crucial element of flexing. During the critical first weeks of stabilization, you are giving your baby’s routine its shape. Too much “flexibility” in these weeks is viewed by a baby as inconsistency. Routine must first be established. After that, when necessary deviations are made, baby will bounce back to the original routine. Doing so, however, may require your firm guidance."

From what he is saying, you must be firm with your one or two week old to establish a routine. This might mean keeping him awake when he wants to sleep, feeding him at the right intervals and not sooner, and making him nap when it’s time to nap. But if Ezzo allows you to deviate as much as needed to attend to the baby’s demands (and he does, a few pages later: “If your baby shows signs of hunger before 2 ½ hours – feed her”), then how does that become any different than demand feeding, or basically having no schedule at all? Of course, you can’t meet the baby’s every demand and have a rigid schedule both at the same time. And despite what he says about flexibility, it’s clear that he believes you should enforce a schedule with rigidity.

Page 114:

"The stabilization phase is usually completed by the eight week. By this time, most babies are sleeping through the night or very close to achieving that skill…Most PDF (parent-directed feeding) moms are comfortable alternating between a 2 ½- and 3 ½- hour routine, getting in six good nursing periods."

Ezzo: 2 months – six feedings a day and sleeping through the night

Baby 411: “2 to 4 months…Hopefully, you will be down to one or two night feedings…4 to 6 months: You can look forward to five or six breast feedings a day. You should be able to get an evening stretch of six hours without nursing.

babycenter.com: By 6 months, she'll most likely be down to around five or six feedings every 24 hours.


Protecting the Small Ones

The overall message of getting your one week old on a routine (even a flexible one), and ending the night feedings by 12 weeks just doesn’t sound healthy to me. Not to mention the 2 ½ to 3 hour feeding schedule that not every healthy baby can handle. All other sources I found do not advocate these things.

“A discerning reader should be able to identify good points vs. troubling ones. But a large part of Ezzo's readership are attracted to this book for the very reason that it offers specific directions to guide them in an area where they feel inexperienced and unconfident. Also the materials are presented in such a way as to intentionally bias the reader against other ideas and approaches that parents might otherwise incorporate to balance Ezzos' ideas.

“For example, the authors' own ideas are often presented after a lengthy—and often inaccurate—negative portrayal of other ideas. This predisposes the reader to be alarmed about other philosophies, and to accept that of Babywise uncritically…The Ezzos make it pretty clear that their method is to be taken as a whole and that straying from their method produces serious problems.

“As to simply choosing the good parts, the key recommendations of Babywise spring from faulty premises. And if you're avoiding the key recommendations, why bother with the book at all? The good advice in Babywise can be found elsewhere; the unique aspects are not good--for either parents or babies.” (http://www.ezzo.info/faq.htm)

Ezzo portrays his method as a guarantee for success, but what about all the stories from parents whose babies are getting dehydrated or not thriving? Maybe they misread the book or followed too strict a schedule...but did all of them? Maybe. But as for me, I vote to protect the small ones and go nowhere near Ezzo and Babywise.