A forceful letdown and oversupply of milk can also result in foremilk/hindmilk imbalance and its sequelae, mimicking reflux.
Too much foremilk is also believed to cause stomach and gastrointestinal (GI) issues in babies. The extra sugar from all that foremilk can cause symptoms such as gas, abdominal pain, irritability, crying, and loose, green bowel movements. 2 You may even think that your baby has colic.
Too much foremilk can cause gassiness and spit up because of too much lactose being emptied into their bowels. This can also cause a baby to eat more frequently because the foremilk does not actually fill their little tummy up – and you know everyone wants to nurse constantly.
Babies with lactose overload can appear like they're suffering from a digestive disorder. They may have a lot of flatulence/gassiness (wind), green, foamy or frothy, explosive stools and pain which will usually be noticeable with lots of screaming, not just grumbling or occasional complaining.
This out-of-balance amount of foremilk causes a lactose overload for your baby. The undigested lactose has nowhere to go but the large intestine, where it gets fermented and creates a lot of gas. This gas is the root of your baby's foremilk/hindmilk imbalance symptoms.
By offering the other breast when the first is finished, and repeating breast compressions if needed, your baby will get the correct balance of foremilk and hindmilk automatically. Using both breasts when needed (and sometimes three or four!) will drive up and maintain your supply.
How long should a baby nurse to get hindmilk? After about 10 to 15 minutes of breastfeeding, the milk flow slows and transitions to the sweet and creamy hindmilk, which contains vitamins A and E, and has more fat and calories than foremilk.
Light green: Consistent green stools in a breastfed baby can indicate an imbalance of foremilk/hindmilk. Foremilk is the low-calorie milk that comes first in a feeding.
If you see bright green and frothy poop in your baby's diaper that almost looks like algae, they're probably getting too much foremilk – the low-calorie milk that comes first in a feeding – and not enough hindmilk, the higher-fat, super-nutritious stuff that comes near the end.
The Haakaa breast pump helps you collect both foremilk and rich hindmilk. Because it's only a piece of silicone, there's no electricity nor any cords required, making it so easy to integrate into your daily routine!
If your breasts are really heavy and full before your baby breastfeeds, hand express or pump for 1-2 minutes and discard your foremilk. Foremilk flows at the beginning of the feed and if your breasts are really full…. this milk can flow fast and furiously!
To collect hindmilk for your premature baby, you should use a breast pump and separate the foremilk from the hindmilk as you pump. When you begin pumping your breast milk, it will be thin and watery. Pump for about 2 minutes, then remove the collection container from the pump.
Offer more frequent feedings.
Nursing more often prevents milk with a higher water and lactose content from building up in your breasts, so your baby takes in less lactose while she drinks. A gentle breast massage before a feed may also maximize the fat content of the milk if you're dealing with an oversupply issue.
However, if there is an overabundance of foremilk, the baby can consume it before receiving enough hindmilk. This is known as a foremilk-hindmilk imbalance, and it can result in gas, loose green bowel movements, and colic symptoms.
The first explanation is that you're not pumping long enough to get to the "hindmilk." Balanced Breastfeeding noted that since hindmilk sits further back in the duct, it's harder to draw out.
If on the fifth day, baby's stools turn green instead of yellow, as in the case of oversupply, this may be a sign that baby can't drain the breast well enough to get past the low-fat/high sugar foremilk. In this case, though, a health or anatomy issue (like tongue tie) may be the cause.
Milk expressed at the beginning of feeding is known as foremilk and that at the end of feeding is known as hindmilk. As hindmilk contains higher fat, vitamins A and E, and higher calories than foremilk, feeding only hindmilk initially and reserving foremilk for later are practiced in some neonatal intensive care units.
If your breast milk fed baby is waking up constantly hungry during the night, make sure that they are actively feeding at the breast for enough time for them to get foremilk and hindmilk. Hind milk tends to contain more fat, which will keep babies satisfied, and asleep, for longer.
Breastfed infants have a growth pattern different from formula fed infants. They grow more rapidly during the first 1–2 months (mo) and then more slowly—both weight gain and linear growth—in the first years [1,2,3].
Usually blueish or clear, watery breast milk is indicative of “foremilk.” Foremilk is the first milk that flows at the start of a pumping (or nursing) session and is thinner and lower in fat than the creamier, whiter milk you see at the end of a session.
Your baby getting too much foremilk and not enough hindmilk may result in the following symptoms: Becoming more fussy than normal. Having symptoms of colic. Becoming gassy.
Foremilk and Hindmilk
Foremilk is the milk that is released during the beginning of nursing, immediately following let down. It will immediately quench your baby's thirst as it has a higher water content. Hindmilk is the milk that comes at the end of the nursing session, during expression.
Some moms notice the morning milk has more volume and lower fat content, while the evening milk may have more fat but be lower in volume. By pooling your breast milk, you ensure baby receives nourishment that is more uniform and consistent.