Hi all:

I'm working on a hypothesis for which I'd like either validation from y'all
:>) or a gentle "You've lost it here, Nancy."

Once upon a time, Failure to Thrive (AKA Reactive Attachment Disorder of
Infancy) was a Dx that primarily referred to a child who was underweight, had
poor hygiene, etc. as an (assumed) result of parental neglect or inadequacy.

With the advent of the field of lactation, FTT took on a more restricted
meaning, being used commonly to describe babies who don't gain weight,
generally due to feeding or metabolic problems.

Many of us have been concerned about trends moving back towards scheduled
feeds (i.e. pdf) and those babies we've seen in practice who are FTT--not
gaining and all that goes with it.  I am wondering if we are missing the boat
by only looking to inadequate feeds, diminished milk supply, etc. *in these
particular instances*.

If we have a mother who is attempting to rigidly adhere to a schedule and,
for instance, a "high need" baby, is she shutting him off in a room so as not
to hear his cries until "feeding time"?  Could the possible result be a baby
who begins to shut down psychologically (and we do know that infants can
experience clinically demonstrable depression)?  Could this then add to
already existent problems by creating a baby who, when offered the breast is
withdrawing from his environment sufficiently to impact his behavior at
breast?

One clinical implication may be that we would need to actually prescribe
cuddling time and maybe model some "en face" interacting for these moms as
part of our counsel.

Thoughts, anyone?    --Nancy Williams