Therese, I'm not surprised you found nothing when checking out the
anecdotal report recommending setting milk aside after pumping. Perhaps you
could tactfully ask your informant to think about how mothers managed back
in the days when direct, at-breastfeeding was the usual mode, and
expressing or pumping was uncommon? Sometimes with a third-person report or
advice received, I wonder how accurately it has been remembered.

So often mothers and some of their advisers start worrying about foremilk
and hindmilk - often unnecessarily. Most of the time the varying milk
composition through the day will balance itself out, provided that mothers
breastfeed without restricting the duration of the feed (or, if separated
from the baby, express efficiently by hand or machine). I'm sure when
you assess the individual mother-baby duo, you will provide guidance and
reassurance, based on what you observe and your clinical judgment.

While a few individual children may have temporary lactose overload or
other situations, so often a focus on 'hindmilk' versus 'foremilk' results
in unnecessary worry and attempts at manipulation.
From time to time I see a mother who has become stressed about whether her
baby is getting enough hindmilk - or she might even call it the 'good
milk'.  That's when I do some education about how babies need both, they
are both good, how the composition fluctuates. Then I explain the role of
lactose in infant nutrition, brain development and the complex
anti-infective process. That infants need lactose. They not adults.

Women's milk is such an amazing fluid. We keep learning so much more about
it.

Virginia Thorley, OAM, PhD, IBCLC, FILCA
Ipswich, Queensland, Australia

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