Hear hear.  Just reading this on Monday.  So true.  Since I have had a creamatocrit machine - let me tell you what I have found.  Creamatocrits of HIGHER levels at the first hand-expression, LOWER after the baby nursed.  Creamatocrits as high as 37% for a composite milk sample.  Never lower than 23% on any of the moms I've tested so far.  Couples sent to me by pediatrician for "hind-milk/foremilk imbalance" but the real problem was a "no milk imbalance."  Woolrich's original article talked about colic and this, he later repudiated the "interventions" employed.  The formula companies LEAPED on this to create lactose-free formulas!  Don't think that there are plenty of entrepeneurs, designers, etc. that will leap on any "variance" in breast milk to build a better formula - witness the new high protein infant formulae being fed to our preemies!  It's all about marketing.  That's why we have to keep on being the standard-bearers for NORMAL> 

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Susan Burger
Sent: Friday, August 21, 2009 11:49 AM
Subject: Re: NOT TWO KINDS OF MILK

Dear all:

I am quite frustrated with the link to the article on foremilk/hindmilk.  It starts out with a complete and total falsehood.  There are NOT two kinds of milk.  There is a gradual shift in the fat content during a feeding and there is no one moment that it can be labeled foremilk and one moment that it can be labeled hindmilk.  There is simply no criteria whatsoever.  Furthermore, even if there were an established criteria for the fat content that would enable you to declare it "foremilk" or "hindmilk" you can't give a mother any simple criteria for determining when that "hindmilk" might be attained. The variation in how long it takes to shift from a certain level of fat content to a higher level of fat content from woman to woman, breast to breast, feed to feed is far greater than the variation in total volume from woman to woman and feed to feed.  

What I see more frequently with busy second time mothers is that the baby simply doesn't have enough time on the breast, period.  

As as for draining the breast -- they aren't ever drained.  So why do we talk about "draining" when the latest research suggests that a fair bit of milk is left in the breast even by an efficiently feeding three month old?  It seems to me that the sonogram studies showed that the physiologic norm is to still have a fair bit of milk in the breast (the number I remember was 50% but I could be wrong on that one).  The studies on the pump actually showed that the particular pump that was studied drained the breast even more than the baby and so therefore, that is NOT the physiologic norm.  If a baby is no longer swallowing on the breast, they are NOT getting milk out of that breast. So, keeping them on that breast longer is not achieving the goal of removing more milk or feeding the infant.  It would permit bonding.  If the baby is still hungry and can no longer remove milk out of a breast, then that baby is not going to be able to get more milk out merely by keeping the baby on that breast for a longer time. 

Time and time again, I keep reading about the leap to one sided feeding without sufficient information to really judge whether or not it is warranted.  Sometimes it IS warranted, but I think you need to gather a lot more information before concluding the appropriate approach is one sided feedings than is usually provided in a typical Lactnet post.

I'm sorry, but I couldn't read further when an article starts off with a false statement.

Best, Susan Burger

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