“You have to wait and let your breasts fill up for three hours before you feed again. If you feed them too quickly then your milk won’t be fatty enough.”
“Your milk is too watery. That’s why your baby isn’t gaining enough weight.”
“Your baby isn’t getting enough of the hindmilk.”
“Your baby is too fat, your milk must be too fatty or you’re feeding him too much.”
One of the most common questions I receive during a consultation from a mother is whether or not their baby is “getting enough hindmilk”, and if that could be a problem. It’s something some of us are told from health care professionals too. “Your baby is getting too much watery foremilk” …and so on.
First, an important note to start with: IF YOUR BABY ISN’T GAINING ENOUGH IT’S NOT BECAUSE THEY ARE GETTING “WATERY MILK”. IT IS BECAUSE THEY ARE NOT GETTING ENOUGH (AS IN VOLUME) OF MILK. So it’s about quantity. NOT quality. Here is my article on breastmilk quality.
We are left feeling very confused and don’t quite know what to do. So here’s the deal in a nutshell:
Well OK, I’ll give some more details here 🙂
There are a few reasons that you don’t have to worry about it…
- Unless you are limiting your baby’s time at the breast, for example 5 minutes on each side (as in you are taking them off after a period of time even if they haven’t finished), they will be getting as much foremilk/hindmilk as needed since they are in charge of finishing the feed. If your baby’s in charge…don’t worry about it! And look, the reality is that even if you did do this your baby would probably be fine anyway.
- Everyone has different storage capacities (Hartman et al 1996). Everyone has different rates at which their milk changes from more watery to less water as the feed goes on. If you’re feeding on demand and allowing your baby to finish the feed, then don’t even think about foremilk/hindmilk. Studies also show that “fat content tends to increase as the day progresses” (Hurgoiu V, 1985).
- Your milk doesn’t just change from foremilk to hindmilk at a certain in the feed. This change from more “watery” to more “creamy” milk happens gradually as the feed goes on. This could happen very quickly or very slowing during the feed. It depends on how long your milk has stayed in the breast for (the length between feeds) and how much your child removes during the feed. Again, all of this actually doesn’t matter as long as your feeding your baby on demand and not trying to stick to scheduled feeds or limit the time they are on the breast. If you put your baby in charge then they will make sure they receive as much foremilk or hindmilk that they need.
- I mentioned this previously within the blog post but I’m going to say it again because it’s so important. If your baby is not getting enough breastmilk or is not gaining well…it has NOTHING to do with foremilk or hindmilk. It has to do with the volume (the AMOUNT) the baby is getting. They are either having trouble removing the milk, they have a medical condition going on that is preventing them from growing well or absorbing the nutrients, or you (the mother) has something going on that is affecting your ability to make enough milk. If this is happening for you and your baby, please seek help from an IBCLC as soon as you can to get to the bottom of what’s going on.
“But what about green, explosive frothy poop? “I was told that’s too much foremilk…” (or lactose overload or over active let down or over supply).” So here’s where it can get confusing. Ironically, when I started to write this blog post up yesterday, I was speaking with my sister who is right now as I type this sentence, dealing with this EXACT PROBLEM! Her baby has explosive, watery, green poop and lots of them. Her baby is also extremely gassy and spends much of the night farting and appears uncomfortable trying to get his poop and farts out. Now, after speaking with her about it over the next day and gathering as much information as I could, my suggestion to her was to stay on the one breast for a bit longer (until she feels it’s really well drained) before switching to the other side.
I AM NOT TALKING ABOUT BLOCK FEEDING. Block feeding is where a mother stays on one breast for a long time before switching to the other. While this can work for some women, for other women it can lead to a delayed onset of low milk supply where they all of a sudden have problems making enough milk. Rather than block feeding (and staying on the one boob for hours at a time) just try to drain the one side really well before switching to the other. You might have to feed off of the one breast a few times before switching if they are cluster feeding. If you have any questions about over-supply PLEASE SEEK HELP FROM AN IBCLC or volunteer breastfeeding counsellor as soon as you can. This will help establish whether or not it actually is oversupply and what to do about it. Sometimes it’s not oversupply at all but rather a baby who is not able to effectively and efficiently manage your flow. That’s a whole different issue and one that must be thoroughly investigated.