----- Original Message ----- 
From: "Pamela Morrison" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, July 31, 2009 11:24 AM
Subject: [LACTNET] Fat content of breastmilk and weight gain (was bariatric 
surgery)

**Hi Pamela,

> Catherine, (and everyone)
>
> What you say - that the babies who gain weight the best are those whose 
> mothers have the lowest creamatocrit at the end of the feeding - is 
> fascinating!

**I don't think I fully grasp your reasoning, but could it be that if you 
would also check the crematocrit at the *beginning* of the feeding, you 
would get a clearer picture...?
If moms feed very regularly (which would likely lead to good growth), the 
difference between fore- and hindmilk will be lower, thus maybe causing 
*lower* crematocrit at the end, *but *higher* crematocrit at the 
beginning...?!

> Could we take this one step further and hypothesize that mothers with 
> higher fat content in their milk are those who under-produce, as the 
> reports you cite, Catherine, seem to suggest?  In other words, that 
> fat-content in the milk is a marker not only for inadequate drainage, but 
> also for low production?

**Doesn't sound bad. I recently heard (where was it...? oh yes, at GOLD, I 
think) that produced volume will go down under bad nutritional 
circumstances, in order to let the maternal reserves last longer. So 
concentration of certain constituents related to the quantity will remain 
fairly stable or go up a bit, but overall quantity will reduce. (Please, 
correct me if I remember incorrectly!)
Difficult material... Every time you think you got it, something pops up and 
you have to reframe your thinking. The more we know, the unclearer it seems 
to become! ;o))

Bye,

Marianne Vanderveen IBCLC, Netherlands

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