Date: Wed, 22 Feb 2017 18:32:47 +0200
From: "Fogelmans ." <[log in to unmask]>
Subject: most of the milk in the first 5 minutes - study please
Dear Friends,
Today one of our pediatricians told the mother that according to research,
after the first week, babies take the majority of their feed in the first 5
minutes.
I wanted to ask her for the research but there was already too much tension
between us and I decided not to. Does anyone know of such research or
something showing the opposite.
Thank you so much,
Chayn Fogelman IBCLC RN Israel
 
Chayn,
 
I think the pediatrician is both right and wrong at the same time.  Geddes et al. did some really elegant work with the "show milk" measuring system.  They had women pump while also ultrasounding the breast.  What they found was much more than the pediatrician is talking about.
 
They confirmed what we always seemed to have known (there was an article back in the 50's talking about it), that most of the volume comes out in the first and most powerful let down (MER) and that each let down after that has less volume.  Yes, 75% comes out in the first, another 20% or so in the second let down, so yes, something like 90-95% of the volume comes out right away.  But that is all fore milk.  Then the following let downs are much smaller but have more fat (the hind milk).  It is simple fluid dynamics.  The liquid will flow before the solids will flow.  I tell my patients that the first MER is skim milk, the second is whole milk, the third is a milk shake and the fourth is ice cream.  Each one has a place and each one is needed.  
 
They also found out that very little or nothing comes out between MER, which helps to explain why babies appear to sleep at the breast for minutes at a time.  They are not sleeping, they are waiting for the next MER.  I don't hurry the baby, I don't wake the baby, I just wait with the baby.  It does no good to get the baby sucking again if nothing is coming out.  I also remind the mom that only college students chug their drinks, everyone else takes a sip, then rests, then sips again.  No one hurries me when I'm enjoying my coffee and it doesn't matter if I drink it fast or slow, I still drink the same cup of coffee.
 
Hope that helps.  They do get most of the volume, but they don't get the calories and fat until 10-20 minutes into the feeding.  
 
Tom 
 
 
 
Tom Johnston CNM, IBCLC
Assistant Professor of Nursing
Methodist University
910-480-8423
 
 

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