Thank you so much for both your very logical argument (which I think that
this pedi would actually listen to) and your fantastic metaphors!
All the best,
Chayn

On Thu, Feb 23, 2017 at 12:36 AM, Jarold Johnston <[log in to unmask]>
wrote:

> Date: Wed, 22 Feb 2017 18:32:47 +0200
> From: "Fogelmans ." <[log in to unmask]>
> Subject: most of the milk in the first 5 minutes - study please
> Dear Friends,
> Today one of our pediatricians told the mother that according to research,
> after the first week, babies take the majority of their feed in the first 5
> minutes.
> I wanted to ask her for the research but there was already too much tension
> between us and I decided not to. Does anyone know of such research or
> something showing the opposite.
> Thank you so much,
> Chayn Fogelman IBCLC RN Israel
>
> Chayn,
>
> I think the pediatrician is both right and wrong at the same time.  Geddes
> et al. did some really elegant work with the "show milk" measuring system.
> They had women pump while also ultrasounding the breast.  What they found
> was much more than the pediatrician is talking about.
>
> They confirmed what we always seemed to have known (there was an article
> back in the 50's talking about it), that most of the volume comes out in
> the first and most powerful let down (MER) and that each let down after
> that has less volume.  Yes, 75% comes out in the first, another 20% or so
> in the second let down, so yes, something like 90-95% of the volume comes
> out right away.  But that is all fore milk.  Then the following let downs
> are much smaller but have more fat (the hind milk).  It is simple fluid
> dynamics.  The liquid will flow before the solids will flow.  I tell my
> patients that the first MER is skim milk, the second is whole milk, the
> third is a milk shake and the fourth is ice cream.  Each one has a place
> and each one is needed.
>
> They also found out that very little or nothing comes out between MER,
> which helps to explain why babies appear to sleep at the breast for minutes
> at a time.  They are not sleeping, they are waiting for the next MER.  I
> don't hurry the baby, I don't wake the baby, I just wait with the baby.  It
> does no good to get the baby sucking again if nothing is coming out.  I
> also remind the mom that only college students chug their drinks, everyone
> else takes a sip, then rests, then sips again.  No one hurries me when I'm
> enjoying my coffee and it doesn't matter if I drink it fast or slow, I
> still drink the same cup of coffee.
>
> Hope that helps.  They do get most of the volume, but they don't get the
> calories and fat until 10-20 minutes into the feeding.
>
> Tom
>
>
>
> Tom Johnston CNM, IBCLC
> Assistant Professor of Nursing
> Methodist University
> 910-480-8423
>
>
>
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