Almost daily I get asked how long baby must nurse to get the hind milk.
This issue is one that most mothers seem to "know" - usually from baby
magazines and 'those' books.  It causes great distress and confusion.

By definition, foremilk is the milk that can be expressed from a breast
prior to a feed; hindmilk is the milk that can be expressed from that same
breast immediately following the end of a feed.

My understanding is that the breasts only produce one kind of milk - "full
cream milk" or the milk we typically think of as hindmilk.  As milk is
produced, the fat globules tend to stick to each other and to the walls of
the alveoli.  Between feeds, milk collects in the breasts and gradually
moves out towards the nipple.  The fat globules remain stuck to the milk
ducts further back.  Once the MER is triggered the milk moves down the
ducts, the fat globules are slowly dislodged and become more available as
the feed progresses.

The variability in fat content is due primarily to the degree of fullness of
the breast and the time since the last feed.  If feeds are frequent, the fat
has less time to move back in the breast and to stick to the duct walls.

See Kent JC, Mitoulas LR, Ramsay DT, Doherty DA, Hartmann PE. 2006  Volume
and frequency of breastfeeding and fat content of breast milk throughout the
day.  Pediatrics 117, e387-395.

Research by Mizuno in Tokyo shows that each milk duct delivers a different
composition of milk in terms of fat and protein content.  (still unpublished
data as far as I know).

Jean Ridler  RN  RM  IBCLC
South Africa   [log in to unmask]

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