I agree that we are in uncharted territory with moms with bariatric 
surgery! It would be very interesting to have these moms breastfeed, 
pump until no more milk comes, manually express till they can't get 
anything more, and then do a creamatocrit on those last drops.

I suspect that there might be different outcomes for different women 
based on time elapsed from surgery, type of surgery (I'd expect the 
gastric band to cause less problems than the older and more destructive 
surgeries). You are right Pamela, we do need research here!

I was just saying that there could be some confounders that we need to 
consider, since the physiology of milk production (as we now understand 
it) does not support fat free milk. That doesn't mean that this 
mechanism can't be altered if mom has an inborn error of metabolism or 
surgery, we just don't understand how.

Catherine Watson Genna, BS, IBCLC  NYC

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