Hello, All.
       I find this an interesting thread, especially since I don't work in a
hospital setting, so I don't get to see these situations "up close and
personal."  Someone (I've fogotten who) hypothesized that perhaps the larger amount
of colostrum that can be pumped in the first hour might be an accumulation of
the colostrum that formed in the breast during the final weeks of pregnancy,
and that hadn't yet been removed.  Originally, this made sense to me since I had
my babies a million years ago, in the dark ages when we were still instructed
to "prepare" our nipples.  One of the more humane preparation techniques
espoused at the time was to massage the breasts during the last weeks of
pregnancy.  I would often get a couple drops of colostrum as I did this.  So, since we
often don't tell moms to "prepare" their nipples anymore (it isn't necessary),
I could see how the colostrum might accumulate because the mother wouldn't be
expressing it in those last weeks.
       But as I thought more about this, I realized that if this were true,
then that bolus of colostrum should still be there at 6-8 hours after the
birth, if that were the first time mom had ever tried to express and baby hadn't
nursed.  But it *isn't* there, or at least it won't come out(!), so where would
it have gone?  And then I thought about those mothers of very premature
babies, who didn't have those "final weeks" of normal pregnancy, yet still seem to
be able to produce significant amounts of colostrum if they hand express in the
hour after birth.
       Something else must be at work here.  It will be very interesting to
someday know just what the mechanism is.
       Dee

Dee Kassing, BS, MLS, IBCLC
Collinsville, Illinois, in central USA

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