>>Today we discussed FTT.  I mentioned that FTT is sometimes found in infants
that are placed on strict feeding schedules, ie less than 8-10 times a day
with very short feedings.  My instructor told me that FTT is not at all
linked to that kind of feeding schedule. <<

Megan,
It is true that there are no direct studies showing that scheduled feeding
leads to FTT. I wish it were so clear cut!  One must know the literature to
understand all the connections. One reference I can point you to is in
Riordan & Auerbach, p. 87-8. The topic is the prolactin receptor theory and
how it relates to the autocrine theory. They cite a couple of studies, one of
surveyed moms at 2 mos.  Those who were still breastfeeding fed an average of
9+ times a day, those who had weaned fed an average of <8 times a day. Most
notable was the fact that the mothers who had weaned (and reason/cause to
wean was not defined) had also perceived that they had been nursing *too
often*.  This last comment parallels the mentality that often accompanies
scheduled feeds--- the fear of feeding too often and creating bad habits.
 Also, most scheduled feeders do so on 3 hour or longer intervals, falling in
the 8 and below category.

It was explained in this section of R&A that prolactin receptors seem to need
to be stimulated in order to proliferate, and that the frequency of suckling
appears to be the stimulus.  If not properly laid down in the first 3 mos,
milk production may decline when the switch to autocrine control occurs--- at
which time prolactin levels are much decreased from pp levels, possibly
making the number of receptors a more significant factor.

This seems to explain why milk supplies may become inadequate after a time,
and for those mothers who are not in tune with their babies' hunger cues,
most especially when things had previously *seemed* to go well, why some
babies have become FTT on a schedule.

Another explanation for the cause of schedule-induced FTT may lie in Peter
Hartmann's work on breast milk production and storage.  Peter has shown that
one woman can have triple the capacity of another, and that larger storage
capacities were associated with less frequent feedings while mothers with
smaller capacities nursed more often.  If the mother's physiology doesn't fit
in with the schedule, problems are almost guaranteed.

And, of course, we must always take into account that every mother/baby dyad
will present with their own unique mix, and the one-size-fits-all approach of
scheduling is bound to fall short in such a context.

Don't give up--- you have the right idea. It just needs to be reworded to
sound less dogmatic; dogmatism can only come after published research, and
even then is sometimes risky.  :-)  Use phrases like "according to latest
discussions",  "recent anecdotal evidence suggests", "recent published
stories warn of a possible correlation", etc., and the point can be made
without putting you on the spot. Good luck!

-Lisa Marasco, BA, IBCLC