Robin, from Reno, Nevada, asks about factors that affect the *quality* of
the mother's breast milk.  Diet and general nutritional status of the mother
seem to have very little effect on milk, as the composition of milk from
malnourished mothers in the Gambia (West Africa) and Thailand is essentially
the same as the composition of milk from healthy, well-nourished Western
women.  What *can* affect the fat content of the milk is frequency of
feeding, and relative emptying of the breast.  I will try to summarize
succinctly the work of Dr. Michael Woolridge and colleagues on this topic,
without being able to do his work justice, I'm sure.

Basically, Woolridge and coleagues have found that milk fat content is
highly dependent on frequency of feeding and emptying of the breast.  The
more often the baby nurses, the higher the fat content of the milk
(collected over a 24 hour period).  Also, the fat globules apparently adhere
tightly to the internal breast tissue, and only dislodge and come out when
the breast is almost empty.  So, when the baby first latches on it gets lots
of low-fat milk.  When it has drained the breast (emptied? collapsed?) of
this milk and continues to suck, then the fat globules dislodge, and the
baby gets less milk, but with a much higher fat content.  If the baby only
nurses for a few minutes, it will take the low-fat milk but not the high-fat
hind milk, and then if it doesn't nurse again for 4 hours, there will be
lots of low-fat milk that must be removed in order to get to the high-fat
milk again.  So you can have a mom with an abundant supply, whose baby
nurses infrequently, and is switched off one breast too soon to the other,
so it gets lots of low-fat milk, and never any high-fat milk.  Woolridge has
some excellent articles about "managing" oversupply in mothers like this,
involving mainly letting the baby nurse often, but only from one breast at
each feed, so that it is sure to drain the breast of all the low-fat milk,
and then gets the high-fat hind milk as well.

Uh, lets see, what was the point here.  The point was that if the mother's
milk appears to be "too low in fat"  -- she needs to adjust the way she is
breastfeeding her baby, rather than changing her diet or going to
supplemental bottles.
Kathy Dettwyler
e-mail to [log in to unmask]
Cockroach queen