I don't really know why I don't like it.  Sounds too scientific to me, I
guess, because we don't really know what an "imbalance" really means here.
Talking like this has mothers coming in and asking "when do I get to the
hindmilk", so it gives the wrong idea, that there is a moment when the
foremilk becomes hindmilk, and this is not true.  The increase in fat is
gradual, not abrupt.  It also makes it sound that if we could get the baby
getting, say 40% foremilk and 60% hindmilk, instead of 60% foremilk and 40%
hindmilk it would be just fine (again, because the increase in fat is
gradual, this makes no sense anyway).  This pushes many people to suggest,
as the *first* approach, expressing off some milk before putting the baby to
the breast.  And this is not the best approach, because it makes
breastfeeding complicated when it doesn't have to be.

Maybe I'm just being ornery.

Jack Newman, MD, FRCPC

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