Dear Friends:
    As I understand it, the notions of foremilk ( a  sample of milk taken 
before the feed) and hindmilk ( a sample of milk taken  after the feed) came from 
the dairy industry. Babies actually never get either,  according to this 
definition.
    Fat content in milk varies with the feeding  frequency; someone posted 
somewhere about the analogy of hot water in an older  house. One has to open the 
hot water faucet and let the water run for  a long time to get hot water up 
to the shower on the second floor for  the first person taking a shower in the 
morning. The second person taking a  shower right after the first doesn't have 
to run the water as long to get  the warmth. 
    Fat in milk is similar the hot water in that  analogy; if baby fed 
minutes ago, there is a relatively high level of fat  in the milk. If baby fed hours 
and hours ago, it will take some time at breast  (and multiple MERs) to bring 
up the fat content.
    As there is no representative sample of human milk,  which is so variant, 
how can we know what nutrients are available?
        I wish that all texts with  the descriptions of foremilk ("like skim 
milk") and hind-milk ("the dessert")  would vanish. All these notions seem to 
do is worry mothers; the basic idea is  to put baby to breast. Whatever is in 
the breast at that moment is perfect. In  this framework, when during a feed, 
does the milk switch over to being  hindmilk?
    I never understood the bit about bio-engineering,  where the milk stands, 
the cream is taken off and given to baby to increase rate  of weight gain. 
Wouldn't a fatty meal make a baby take less volume? Wouldn't  the calories of a 
high-fat, low volume feed or a lower fat, high volume  feed be roughly 
equivalent? Can someone help me understand this  better?
    warmly, 
 
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct  Faculty Union Institute and University
Film Reviews Editor, Journal of Human  Lactation
Support the WHO Code and the Mother-Friendly Childbirth  Initiative

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