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To make fermented coconut water, the sweet water is mixed with a culture (milk kefir grains, water kefir grains, whey from yogurt or a powdered starter) and left to ferment for 18 to 48 hours in a warm place.
Long answer: Coconut milk is made by grating coconut and running very hot water through it to extract oils and flavor, then straining out the coconut pieces. It is a mix of water soluble parts and fats, and can emulsify just like normal milk or thicken sauces similarly to milk cream.