Foremilk vs. Hindmilk: The Unnecessary Controversy

Foremilk vs. hindmilk seems to be quite a popular topic among breastfeeding mothers.  If I switch the baby too soon to the other breast, will he get the hindmilk?  How do I ensure that my baby is getting all of the fatty milk that he needs?  Sometimes I feel like too much breastfeeding information can add stress to a new mom.  And this is why….

All breastmilk, whether it is 1 minute into the feeding session or 25 minutes into the feeding session, has both foremilk and hindmilk.  As your baby drinks from the breast, she/he gets both the low-fat milk (foremilk) and the cream (hindmilk.)  The better your baby drains your breast per feeding, the more hindmilk she/he has access to, as this creamier milk hangs out back further in the milk ducts, so it has further to travel.

Here are some ways to know that your baby is getting enough breastmilk in the first few months:

  • Your baby is feeding 8 or more times in a 24 hour period
  • Your baby is gaining 4-7 oz. per week
  • Your baby is having several wet a day
  • Your baby is having several yellow-poop diapers a day
  • Your breasts feel softer and more pliable after your baby feeds

If your baby is meeting the above criteria, then there is really no need to look at the clock or worry about if she/he is getting enough of the creamy hindmilk.  Follow your baby’s cues….she/he will let you know when she/he is full or ready to feed from the other breast.

 

Now, what if your baby has green, frothy poops, lots of gas, and chokes while breastfeeding?

Looking at these symptoms, the first question I would ask is, “Do you have enough breastmilk to feed an entire village?”  If the answer is yes, then what we are probably working with is an oversupply.   If the answer is no, then it is probably time to look into your diet to see if your baby is intolerant to something you are eating. (We will discuss this next week in a different article)

If you have a tremendous supply, your baby is probably drinking a lot of breastmilk.  Since the cream (fat) hangs out further away from the nipple, your baby has to take in more milk to bring down that cream.   When this happens, lactase (an enzyme in your baby’s tummy) is overwhelmed by the sheer quantity of breastmilk lactose it has to digest, so that lactose starts to ferment, causing gas.  By gently slowing down your milk supply, your baby won’t feel so full before she/he gets to all of the milk fat she/he needs, thereby allowing the lactase to breakdown a manageable amount of lactose.

 

How do you gently slow down your milk supply?

Lean back

If your baby is choking and sputtering while breastfeeding, it is possible that your flow is overwhelming her/him.  It’s like the garden hose has been turned on and there is no reprieve!  So, lean back.  Picture yourself in a lazyboy chair, with your feet up, all relaxed.  When you lean back, gravity naturally slows down your fast flow, thereby helping your baby tolerate your flow and control how much she/he is taking in at a time.  For more information on laid back breastfeeding, see our article Laid-back Breastfeeding: Physically and Mentally and the Biological Nurturing Web site.

Place your baby in an upright position

When your baby is in a more upright position (head higher than bottom) your baby can tolerate a fast flow more easily.  You can do this in many ways:

  • Have your baby straddle your leg, almost sitting up, and leaning into your breast
  • If your baby likes to feed in more of a cradle position, lower her/his bottom into your lap so that she/he is more diagonal (head above bottom)
  • If you are using a breastfeeding pillow, place a blanket under your baby’s head so that it elevates it above her/his bottom

Breastfeed one side per feeding

Feed your baby from one breast per feeding.  This will help to gently slow down your milk supply, as your milk supply is based on how much milk is emptied at each feeding.  Now your baby will pull all of that fatty milk down through your milk ducts, thereby helping him/her to feel more full and satisfied before he/she takes in too much milk. 

Please note: When breastfeeding from one side per feeding, it is important to pay attention to your breasts.  If they begin to feel overly full and uncomfortable, you will want to offer that side to reduce the pressure.  Think of that side as dessertJ  If your baby is not hungry anymore, you may need to hand express or pump the skipped side for a minute or two, just to relieve the pressure.  Once you have been doing this for a while, your milk supply should regulate. 

Another note: Always pay attention to your baby’s feeding cues.  Around 2-3 months of age, many babies end up needing to feed from both sides again.  This means it is time to start offering both breasts during a feed again.

Herbs

Sage tea is a great way to gently reduce your supply.  Since each mother reacts to herbs differently, it is important to try this slowly.  One mom I worked with noticed that her supply decreased by 50% every time she drank sage tea, so she only drank it when her supply had drastically increased over time.  Another mom I worked with drank a cup once a week and noticed that it kept her supply in balance.  Again, pay attention to your body and work with a Lactation Consultant if necessary.