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Subject:
From:
Joy Anderson <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 19 May 1999 14:42:04 +0800
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Nikki Lee wrote:
>        Wonderful  Dr. Peter Hartmann's work is changing the fore/hind milk
>notion some. He has discovered ladies who have a higher fat content in the
>first milk that comes because it is left over from the feed before.

I totally agree with what Nikki wrote about keeping it simple for mothers.
Just thought it might help here to re-post a message I sent to Lactnet in
Dec 1997 about this topic. It was in response to another post that appears
below with the > marks alongside.

>   It is my understanding that as the baby nurses, the foremilk comes first,
>and then becomes a mix of fore and hind, and then becomes just the hind
>milk.  That is why we want a baby to finish one side before going to the
>other, and why we encourage moms with oversupply to feed just on one
>side at a feeding (as well as to help reduce the supply over time).
>
>So if a baby is stopping and starting, over the period of an hour, say, on
>just one side, doesn't he keep getting just foremilk?  Or does he keep
>getting a blend? Does it depend on the length of the breaks he takes? Like
>with every three to four minutes, he might be getting the continuum over an
>hour;  but with every 20 minutes, he keeps getting new supplies of skim or
>skim and  whole without ever getting to the cream?

*****The fat content of the milk available at any one point in time is
dependent on the degree of emptiness of the breast, regardless of *when* in
the feed it is.*****

So when a baby stops feeding, the breast keeps on making milk (at a rate
according to the degree of breast emptiness - the emptier it is, the faster
it synthesises new stuff), so the fat concentration begins to fall
gradually as the breast fills up again. Babies never totally 'empty'
breasts, they stop when they have had enough milk and/or sucking. So the
residual milk (and hence the fat content) left after a baby comes off will
vary greatly from time to time and mother to mother. Also contributing to
this variation is the differing storage capacities in different mothers and
individual breasts on each mother.

There are heaps of posts in the archives about all this. Or even better,
get hold of Peter Hartmann's papers for an explanation of the control of
milk synthesis. He has shown that it is possible in the one mother (one
breast actually) to have the 'foremilk' of one feed (late in the day) with
a higher fat content than the 'hindmilk' of another feed (early morning
after a long sleep). He believes we should stop talking about 'foremilk'
and 'hindmilk' altogether as it is often meaningless.

Nature is so clever - the system is fantastically designed. Problems only
arise when *we* muck up the system in some way.

(N.B. Peter Hartmann and his PhD students at the University of Western
Australia have published in several journals, including JHL (Daly SEJ &
Hartmann PE, 1995, Infant Demand and Milk Supply. Part 1: Infant Demand and
Milk Production in Lactating Women,  J Hum Lact 11(1): 21-26 and Daly SEJ &
Hartmann PE, 1995, Infant Demand and Milk Supply. Part 2: The Short-Term
Control of Milk Synthesis in Lactating Women,  J Hum Lact 11(1): 27-37) and
in Experimental Physiology.)


******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia.   mailto:[log in to unmask]
******************************************************************

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