Getting clear on foremilk/hindmilk

Q. I read about foremilk/hindmilk imbalance on the Internet and I’m worried that I have it. What should I do?

A. Oh, the Internet. What a great resource it can be for quick answers and support on so many topics. Yet, sometimes it’s misleading.

Inevitably when a breastfeeding mom is concerned about this issue, I know she has been self-diagnosing online. Information on the Internet about foremilk/hindmilk imbalance tends to trick a mother into thinking she has the condition when, in fact, it’s a very rare condition, says Cindi Freeman, International Board Certified Lactation Consultant and owner of Freeman Lactation Services in Cary, North Carolina.

“Not only is it a very, very rare condition, but it presents itself with other symptoms like failure to thrive and green, frothy bowel movements,” says Freeman.

The best way to rule out an imbalance is to seek the help of a professional. A lactation consultant can help you find out if you do have it as well as address your breastfeeding concerns even if you don’t.

It’s important, too, to understand that a lactating mother does not make two kinds of milk. Instead, the ratio of fats in her milk increases throughout the duration of a feeding. The milk starts thinner, higher in volume and more thirst quenching. Then, as the feeding progresses, the volume decreases and the fat content increases. 

“There isn’t a specific time when the milk changes from foremilk to hindmilk,” says Freeman. “Research shows that each new swallow the baby takes has more fat in it than the previous swallow.”

While we celebrate the “hindmilk” for the weight gain it provides, the earlier “foremilk” hydrates and provides important water-soluble vitamins our babies need. In other words, it’s important, too! 

So how can we help our babies get enough fat in their milk? La Leche League International says to finish the first breast first. That means, feed your baby on the first breast until it softens, or feels like Jell-O, as Freeman likes to say. Then, burp and offer the second breast if baby is still hungry.