Heather, you wrote:
<My understanding is that the foremilk is milk that trickles down from
the
storage cells, leaving the fattier milk behind because it is stickier -
being fattier. Of course you're right in that the milk as it's produced
is
all the same.>
<When the baby finishes his session at the breast there is hindmilk in
the
reservoirs and ducts, and that gets joined by foremilk that's trickled
down
in the time between the baby's sessions. So the longer the gap between
feeds, the higher the proportion of foremilk. The shorter the gap, the
more
hindmilk.>
I seem to remember we have had this discussion before, including Kathy
D's analogy of colored balloons. While that was somewhat helpful to me, I
still find Winnie's understanding 100% right on from what I understood
from Dr. Hartmann's articles, I believe.
If I remember correctly, it is the lactose itself, which given enough
time, draws extra fluid from the tissues into the ducts to create a
better osmotic balance. When this "watering down" occurs, the classic
physical phenomenon begins to take place. Fat (cream) simply rises, given
time.
I simply call to mind the glass bottles of non-homogenized milk delivered
on the doorstep in my own childhood. The cream had risen to the top, the
adults poured it off to save for their coffee, and I got stuck with "blue
milk" for my cereal. Living in a family where one HAD to clean one's
plate, I remember very clearly my four year old "cereal strikes" over
this very factor. (When I explain it to parents, of course, I have to
depend on them having heard their grandparents reminisce.)
I too find this fascinating to think about this, especially in relation
to the mother's own position in space. While I'm sure the "stickiness" of
fat keeps whatever fat which is in contact with the duct walls clinging
to ducts more readily than the fluid portion, I think the rising of fat
is in relation to the greater gravitational pull on water and it's
solutes. (i.e. differences in specific gravity). Just tip the measuring
cup of separated juices from the roast to see what I mean.
I think your own analogy with the sponge (which is not like a breast,
though may illustrate what you tell parents about the stickiness factor),
also illustrates what I explained above. The "trickle down" there is in
fact due to specific gravity, natural separation, and greater
gravitational pull on the water and it's solutes.
Therefore, when a mother is lying down for any length of time, say for
instance on her right side, I wonder if her milk is transferred in a more
"homogeneous" manner at the MER and suckling, despite any "stickiness"
factor. Theoretically, the cream content per cc. would still be about
the same near the front of the breast as it is further back, having risen
to the left side of all the ducts and not more toward the chest wall,
which would be a sideways, not upward direction.
There has been a previous discussion, brought up by Rob and his closely
observed sample of one (wife), I believe, that this might enter into
mastitis, from pressure of bras at night time. Perhaps breast compression
during feedings at night, especially of the upper, outer portion of the
superior breast, might be needed to move cream more efficiently in a
pendulous breast with longer tubings.
Or consider a mother with an A cup (shorter ducts, less "foldover" of
breast tissue) sleeping on her back for 2 hours between feedings. Besides
less total tubing for regulation of osmosis by lactose, might the cream
not collect in the sinuses, or at least the ducts closer to the nipple,
and exit first?
When we make an absolute statement about what is fore and what is hind, I
believe we are thinking of this most commonly in a mother with a Bcup or
beyond, who has been standing or sitting in an upright position for
several hours. I also definitely note a more marked separation in mothers
with larger cup sizes because of longer tubings, and I think I heard that
Dr. Hartmann also addressed this recently.
Sorry to be so long, but you struck a chord, and with 7+" of snow
on the ground, it's a good day for musing, and lactnet.
Jean
**************************************************************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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