Is watery breast milk good for your baby? In a word, yes. Both fatty milk and watery/less fatty milk are good for your baby, and it's important that your baby gets both. (Think about when you're eating a meal – most of the time, you want both substance to fill you up and a drink to stay hydrated.
The longer the time between feeds, the more diluted the leftover milk becomes. This 'watery' milk has a higher lactose content and less fat than the milk stored in the milk-making cells higher up in your breast. You can't tell how much fat your baby has received from the length of a feed.
Foremilk is thinner and may fill your baby up but not satisfy them for very long. Babies who drink only foremilk tend to nurse more often, and they can end up overeating. Too much foremilk is also believed to cause stomach and gastrointestinal (GI) issues in babies.
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!
ABOUT FOREMILK
At the beginning of a nursing/pumping session, the breast milk that flows out first (the foremilk) tends to be more watery. Foremilk has less fat and higher levels of lactose (milk sugars). Sometimes it's thinner, tinged blue or seems more clear.
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.
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.
To ensure your breast milk has adequate fat, be sure to always empty one breast before moving to the other one. This enables your child to get the “hindmilk”, which is the fatty part of the milk. You can also try pumping more, massaging your breasts, and eating a well-balanced diet.
By pumping before you breastfeed, you will remove some of the foremilk and your baby will get more of the high-calorie, high-fat hindmilk. However, if your breast milk supply is low, you should not pump before you breastfeed to try to give your baby more 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.
The sheer volume of milk and high sugar content often means babies gain weight very well with foremilk hindmilk imbalance—even though they aren't getting their “pudding”. However occasionally some babies may not gain enough weight in this situation.
The total milk consumed daily—not the hindmilk—determines baby's weight gain. Whether babies breastfeed often for shorter periods or go for hours between feedings and feed longer, the total daily fat consumption does not actually vary. Foremilk is not always low-fat.
The other explanation for not seeing the hindmilk is that you actually have an oversupply of breastmilk. Although an oversupply is rare, it can happen from pumping too often, or simply because your body produces milk on overdrive.
You may have read or been told that you must nurse for at least 15 minutes for the baby to get the “good milk” a.k.a. “the hindmilk.” Not true. Some babies get it immediately, for some babies it takes 45 minutes. This depends on your milk supply, the time of day, and the last time you expressed milk.
Aim to spend 15 to 20 minutes hooked up to the pump to net a good amount of breast milk (some women will need 30 minutes or more with the pump, especially in the early days). Pump until the milk starts slowing down and your breasts feel well-drained. Be sure to clean the breast flanges after every use.
The Haakaa breast pump helps you collect both foremilk and rich hindmilk.
A forceful letdown and oversupply of milk can also result in foremilk/hindmilk imbalance and its sequelae, mimicking reflux.
You may notice your milk seems thicker and creamier towards the end of a feed. This is because, as the feed progresses, the fat composition gradually increases due to the mechanics of milk moving through the breast. It's often referred to as hindmilk, while the first more 'watery' milk is known as foremilk.
"There is a wide range of normal when it comes to color for breast milk," says Hali Shields, a certified birth and postpartum doula, national board-certified health and wellness coach, and certified lactation education counselor. "Blueish, yellow, cream, orange are all normal and safe for baby."
It's important not to give a baby thickened feeds unless advised by a doctor. Since gastro-oesophageal reflux disease can be associated with medical problems, exclusive breastfeeding (i.e. without any thickeners, etc) is advisable whenever medically possible.