My understanding is that lactose is constant in breastmilk, it is the fat
that is variable.
Fat concentration increases as the breast is drained and is variable
depending on time of day, length of time between feeds and so on. So a high
intake of low fat 'foremilk' goes go through the gut faster resulting in the
symptoms of 'lactose overload'. If you increase the fat intake you slow gut
transit time, allowing time for the lactase to breakdown the lactose.
For a good reference see (although it was written in 1998 it is still a good
explanation):
http://www.health-e-learning.com/breasted_web_articles/Lactose.pdf

Cheers
Karen Clements
IBCLC
Melb Aust

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