Dear All:

A little digging in Lactnet in the last few weeks will locate the article, which I critiqued 
because they confused undependability with inaccuracy.  Despite my picky comments, it 
does not negate the very important finding that the amount of time it takes to get to 
some fat content that qualifies as HIND milk is so highly variable that no one could ever 
predict from one women to the next, one feed to the next, and even one breast against 
the other when it will get to that particular fat content.

In fact, the fat content that qualifies as HIND milk has never been defined.  Fat content is 
a continuum.  The number of minutes on a breast that it takes to get to fattier milk is 
highly UNDEPENDABLE, especially if you have NOT WATCHED that infant feed.  

Again, I will say that it is not appropriate to conclude that there is some unbalance in the 
fat content without thorough and complete investigation.  And I, quite frankly, find that 
this much touted condition has little solid evidence to back it up.  I find it only in the 
excessive overpumpers who are feeding their infant from the breast first and feeding the 
freezer after every feed.  If the baby is taking all of the milk, the fat content is going to 
equilibrate over the course of the feed. I have not really seen enough evidence to 
convince me that it is truly an imbalance in the fat content as opposed to many other 
conditions that are not being fully explored.

Too many times, I have seen babies who have been DIAGNOSED as having 
foremilk/hindmilk imbalance who were NOT taking enough from the breast. Then the one 
breast prescription caused the milk supply to drop and the poor baby was still being 
overwhelmed with a fast flow, remaining hungry after on breast because they couldn't get 
enough and then failing to thrive.

I've previously posted on the conditions that should be explored. Jennifer Tow posts 
frequently on gut health.  

Best, Susan Burger

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