Susie,

I can't help you with research on negative outcomes due to rigid 
scheduling.  But if the outcome is very slow weight gain, or failure 
to thrive, perhaps you could focus on that and the likely 
consequences of malnutrition/marasmus/kwashiokor for the baby.  These 
most definitely should be of concern to the mother and if they are 
not then perhaps a referral needs to be made to child protection services?

I enjoy working with low gain and failure to thrive situations.  The 
causes can be many, and often the parents simply don't see that it's 
happening so that it takes someone else - a friend or a grandparent - 
to alert the parents to the fact that there really is a 
problem.  Some of these cases also begin because the mother seems not 
to perceive how very vulnerable her young baby is to inadequate 
intake in the early weeks.  One thing leads to another, and then even 
the most dedicated mother may be powerless to stop the baby's slide 
down the weight chart because the baby becomes unable to breastfeed 
effectively due to lack of energy.  She may need concrete care plans 
to increase the baby's intake and boost her flagging milk 
supply.  Advice to feed more often may not work past a certain 
stage.  I recently worked tangentially with a case where a baby 
younger than 6 months, who was currently being exclusively breastfed, 
was diagnosed with marasmus and I have to say that from the reports 
etc that I saw the baby's healthcare providers were not without blame 
because they provided reassurance to the mother that low gain was 
fine when it clearly was not.

If you have access to the baby's weights from birth, and if you 
compile a careful chart, and make an assessment of the average daily 
rate of gain, you should be able to make a fairly good assessment of 
what's going on. As a rule of thumb a baby should gain 30g/day from 
0-3 months, 20g/day from 3-6 months and 15g/day from 6-12 months.  If 
you plot the chart and see the baby falling down the percentiles, or 
if you make the assessment and see that the baby should weigh xxxx 
and he weighs an appreciable percentage less than that, then there's 
a duty to discuss the numbers with the mother.   When a baby is 
failing to thrive, it doesn't really matter when it started or the 
reason for it (though that is of interest to prevent it happening 
again in the future, and it's helpful to go through the chart with 
the mother so she can SEE what has happened).  You can then focus 
less on the rigid scheduling and more on the baby's current poor 
physical condition and the fact that the baby is not developing 
normally for his age.  What is of the utmost importance is to 
identify for the mother that this baby has a problem NOW.  Then you 
can let her know what changes need to be made in order to remedy the 
inadequate weight gain - starting immediately, and including a 
referral to a paediatrician -  so that the baby's current nutrition 
and future growth and cognitive development are not permanently 
compromised.  Eventually, once the mother starts feeding the baby 
more milk, and more often, she will see for herself that the rigid 
scheduling was perhaps the cause, or at least one of the causes, of 
his failure to thrive.

Some refs you might like to check out are:
Krugman, SD, and Dubowitz, H. Failure to Thrive. Am Fam Physician. 
2003 Sep 1;68(5):879-884. available at 
<http://www.aafp.org/afp/2003/0901/p879.html>http://www.aafp.org/afp/2003/0901/p879.html 

Wright CM, Garcia A. 2012. Child under-nutrition in affluent 
societies: what are we talking about? Proc Nutr Soc. 2012 
Nov;71(4):545-55. doi: 10.1017/S0029665112000687. Epub 2012 Sep 7.
 From ENN 
<http://www.actionagainsthunger.org/sites/default/files/publications/Summary_Report-_Management_of_Acute_Malnutrition_in_Infants_MAMI_Project_10.2009.pdf>http://www.actionagainsthunger.org/sites/default/files/publications/Summary_Report-_Management_of_Acute_Malnutrition_in_Infants_MAMI_Project_10.2009.pdf 

Shields B, Wacogne I, Wright CM, Weight faltering and failure to 
thrive in infancy and early childhood.  BMJ 2012;345:e5931
Desmarais L and Browne S, Inadequate weight gain in breastfeeding 
infants;  assessments and resolutions.  Lactation Consultant Series 
Unit 8, La Leche League International.
Riordan J & Wambach K,  Breastfeeding and Human Lactation, Fourth 
Edition, 2010, Jones & Bartlett Pubs
Walker M, Breastfeeding management for the clinician;  using the 
evidence;  published by Jones & Bartlett 2006.

Hope this helps.

Pamela Morrison IBCLC
Rustington, England
-------------------------------

At 19:35 04/12/2013, you wrote:
>Date:    Wed, 4 Dec 2013 19:35:38 +0000
>From:    Susie McCulloch <[log in to unmask]>
>Subject: Research on negative psychological/physical effects of 
>rigidly scheduling and limiting breastfeeding?
>
>Hi Everyone,
>Does anyone know of any research on the negative outcomes for baby 
>when breastfeeding is rigidly scheduled/limited due to parenting 
>beliefs? I don't have permission to post so I won't go into 
>details,  but I think giving specific research to a mom that I am 
>working with might help her if she can see  the long term 
>consequences of what she is doing, because the very slow weight gain 
>is not that concerning to her.
>
>Warmly,
>Susie McCulloch, IBCLC   retired LLLL

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome