To Kathy Dettwyler and Linda Smith re:  where does colostrum go and other
thoughts on the immed. post-partum. Dr. D. You'd probably know more about
this than I, but I've read there are cultures where colostrum is a taboo
substance and babies are fed teas and gruels until lactogenesis when "real"
milk appears. The mechanism of lactogenesis has more to do with delivery of
the placenta and removal of prolactin inhibitory factor.  The pp hormonal
changes are what initially drives lactation.  After the onset of copious
production somewhere around day 2-6, the mechanism which drives lactation
from then on is frequency and thoroughness of milk removal.  So it isn't
physical closeness with mom or even efficient removal of colostrum which
brings in milk (altho I bet good early contact may speed it up.). That's why
I see red flags when lactogenesis is delayed.

I was interested when I read some of the info speculating on why bfg might
have protective benefits against breast cancer.  One theory is that lactation
flushes the gland of impurities.  We know that colostrum is rich in immune
factors, but could it be that colostrum as 'start up' milk is flushing out
the pipes and that the perception of it as 'dirty milk' that exists diff
places is not necessarily as whacky as it might seem?  Not that I'm
suggesting we withhold colostrum, but I have to wonder whether anyone has
ever looked at the level of contaminents being released in colost. as being
differ. than in mature milk.  This is one of those hypothetical musings which
I would never want to be misunderstood.  Its just a curiosity I'm indulging
in.

I was interested in the idea that Peter Hartmann says babies of diabetic mom
with delayed lactogen. get colostrum the whole time.  In the cases I
mentioned, babies were gen. beset with the typical prob. of babes born to
diabetic moms:  macrosomia (they were big!) often jaundiced, and got pretty
dry and lost more than 10% of body weight waiting on that milk to show up.
 Colost. is low vol. (at least that's my understanding) and I guess I thought
it was produced in a finite amt. and once gone you were just waiting for milk
to show up.   I realize its usually kind of grad. with a transitional stage
where you see a yellower milk indicating some mix of colostral subst. with
milk. Anyway, I couldn't see any evidence the moms had more than a few drops
after sev. days of nursing or pumping.  The mom whose milk came in on Day 13
was dry as a bone until then.  Then it was a prob.  getting her up to full
prod.  Prob. a month of feeding tube use with augmented stim from double pump
AND lots of baby at breast.  Granted she was older 38-39.  Was this also 'old
breasts?'  These colostrum questions you ask Dr. D.  Verrrry intersting.
Barbara Wilson-Clay, BSE, IBCLC  priv. pract. Austin, Tx