>My question:  Is there such a thing as low cal breastmilk?  or no hind milk?

It angers me to hear that moms are still told that their milk is "too
weak," "too lean," "not rich enough."  I usually ask a mom if her health
care provider ("HCP") did any testing to diagnose this problem.  No one has
ever said yes.  Re: the situation in your post, this sounds like an "easy
out" of a delicate (and time consuming) situation on the part of all the
HCPs involved.

There is a quick way to test for milk fat percentage, by the "crematocrit"
method discussed in Lawrence.  Any lab should be able to do this.
Basically, use hematocrit methods with a small mixed sample from pre-feed,
mid-feed, and after feed (ideally small samples from several feeds, well
mixed).  Blend well, draw up in a capillary tube and spin in a centrifuge
for 5 minutes. I don't have my copy of Lawrence here at home--can't
remember what the overall fat percentage should be.  (I think it's
somewhere in the area of 3%?  Please look it up, I don't trust my numerical
recall at all.)  I have not seen a low crematocrit from a well-mixed
sample.

Having an old WIC centrifuge on hand, I have occasionally done this test
for a mom and sent the results to her HCP together with my report of what
recommendations I have made to increase milk supply.  A few HCPs have
responded, "Oh, I didn't know you could test milk."

As far as fat content goes, to my knowledge, there is some variation in the
percentage of fat in mother's milk.  A malnourished mom may have lower fat
milk than a well-nourished mom.  However, I think it is a small difference.
Certainly not like the difference between whole and skim bovine milk!

This is not to say that there are not cases of lactation insufficiency.
Certainly they exist.  IMHO, they are overdiagnosed, at least in my neck of
the woods!!

Cindy Turner-Maffei, MA, IBCLC