The act of breast-feeding and breast milk’s ability to nourish a baby is a wondrous thing.
Researchers know that milk changes composition throughout the course of a feeding. Some moms are concerned that their babies may not get enough of the hindmilk, which is the high-fat milk at the end of a feeding.
Here’s what you need to know about foremilk and hindmilk, and how to tell if your baby has an imbalance.
Breast milk changes consistency throughout a feeding. The first milk is known as the foremilk. This milk is often compared to that of skim milk. That’s because it’s low in fat and calories. But its consistency is satisfying to a hungry baby.
As a feeding progresses, the milk turns into hindmilk. If foremilk is like skim milk, then hindmilk is like whole milk. It tends to be thicker in texture and have a higher fat content. For babies, it can be like the dessert that finishes off a meal.
The fat content of a mother’s breast milk can vary greatly. Some moms may have very different fat contents in foremilk and hindmilk, while others may not.
One concern for some mothers is that a baby may not be getting enough hindmilk. This could affect a baby’s ability to feel satisfied with each feeding and gain weight. It might also result in additional gassiness and loose stools.
A baby may receive an abundance of foremilk at the beginning of a feeding and not eat the remaining hindmilk. This is known as oversupply, or a foremilk and hindmilk imbalance.
While the amount of lactose is relatively consistent throughout a feeding, there is more lactose in foremilk than hindmilk. As a result, a baby may get extra lactose.
Signs your baby may be experiencing a foremilk-hindmilk imbalance include:
- crying, and being irritable and restless after a feeding
- changes in stool consistency like green-colored, watery, or foamy stools
- fussiness after feedings
- short feedings that last only five to 10 minutes
Sometimes a foremilk and hindmilk imbalance is misdiagnosed as an allergy to lactose, which is a rare condition. Other conditions that cause similar symptoms are colic, acid reflux, and a milk protein allergy.
Moms may also experience symptoms. These include having breasts that feel overly full often, and having frequent, plugged ducts. A mom may also notice a very forceful letdown or milk ejection reflex.
If you suspect that your baby is experiencing a foremilk and hindmilk imbalance, there are steps you can take to correct it. Examples include:
- Refraining from switching from one breast to another quickly (less than 5 to 10 minutes each) when feeding your baby. Increasing the length of feeding on each breast can help.
- Feeding your baby before he or she becomes excessively hungry to prevent aggressive sucking that could lead to oversupply.
- Switching up your feeding positions frequently, such as side-lying position or having a mom lean very far when feeding.
- Giving your baby a small break when they sputter off the breast. You can let your excess milk drain into a cloth or towel.
- Try expressing a small amount of milk before beginning a feeding to reduce the forceful milk ejection reflex.
If your baby doesn’t seem to be gaining weight well, experiences difficulty feeding, or has frequent diarrhea, talk to their pediatrician. These symptoms could be the result of an allergy.
Babies are usually very savvy when it comes to what they need for feeding. Allowing your baby to feed until they fall off the breast and watching their feeding cues carefully can usually help to correct a foremilk and hindmilk imbalance.
If your baby seems satisfied after their feedings, you likely do not need to be concerned about a foremilk and hindmilk imbalance.
This means that you don’t have to try to get your baby to stay on the breast longer. If you continue to have concerns about your baby’s feedings, talk to their pediatrician or a lactation consultant for tips.