Kathy D and I have been discussing this case, but thought I'd share it with
the list.  I saw 36 wk gest. fraternal twins at 2.5 wk pp.  Neither back to
birthweight.  Pedi who referred them had put  "ftt" on the little boy's
paperwork, so he made a clinical diagnosis that is serious and very scary for
parents.  But guess what he told the parents?  "Feeding is social behavior"
and " there's no way the kids could be hungry nor should they be fed more
freq. than 3 - 4 hrs.."!!!!!!!!  Good Lord have mercy.  What is the story
with this Ezzo method?  I told the parents they could continue to follow that
advice and when the babies were worse by the next pedi weight check (sched.
for 3 days hence) they could totaly wean to  formula which by then would
surely be suggested.  Mom had not received any help pumping in the 2.5 weeks,
has severly depressed supply.  Babies have been cup and spoon fed (a few
scattered bottles)  of handexpressed hm and/or formula.  Because boy had so
seldom been at breast he wouldn't go.  I really think you have to get babies
to breast quicker than this.  I threaded a feeding tube under a nipple shield
and both babies went right to breast and sucked (formula)  the sns dry.  Mom
was thrilled to have babies at breast, Dad was thrilled to see them eat.  I
sent home a pump w/ instructions to stay in bed and do nothing but pump and
nurse as above all weekend -- and to nurse (w/ formula in sns) very freq.
 Every hour if they were all awake.  I suggested dad give bottle in the
middle of the night so mom could keep up her strength for the sprint.  I told
them if very freq feeds didn't result in more moms milks and fatter babies by
Mon they could fire me and do whatever the doctor told them.  Naturally they
were up 8-9 oz each (back above birth weight) more alert, and breasts fuller.
 Now we'll work on getting bottles out.  Then begin to taper off sns.  Then
we'll wean off shield.  This Ezzo method is not applicable to compromised
infants.  It appears to me that it is downright dangerous to apply that
belief system to babieswho are failing to thrive.
I faxed pedi lc summary of what management suggestions I made.  I hope he
paid attention to the results of freq and generous feeds.  This ritual
starvation makes me sick.
Barbara Wilson-Clay, BSE, IBCLC
priv. pract. Austin