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!
First things first: Unless your baby is showing symptoms of lactose overload, the amount of foremilk versus hindmilk that he's getting is probably fine. If your baby seems content and comfortable and his poops are normal, your breast milk is delivering exactly what he needs.
Lactose overload, or foremilk and hindmilk imbalance, is a rare condition causing green, frothy poops, stomach pain, and insufficient weight gain in babies. To fix an imbalance, try laid-back feeding, nursing on one side until the baby stops, ensuring a good latch, and hand expressing a little milk before nursing.
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.
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 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.
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.
The Haakaa breast pump helps you collect both foremilk and rich hindmilk.
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.
When a mother produces more milk than their baby needs, it is an oversupply. With an oversupply, you may notice a foremilk and hindmilk imbalance, also known as lactose overload. At the beginning of a breastfeeding session, a baby starts by receiving foremilk.
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.
It works by mixing the milkfat back into milk, much like shaking a bottle redistributes the fat that clinged to the edges and floated to the top. Breast massage and jiggle before latching is called "The Milkshake Technique" and it works wonders at instantly resolving foremilk/hindmilk imbalances.
The theory behind foremilk-hindmilk imbalance is that if your baby drinks mostly foremilk without enough of the fat-rich hindmilk, it may lead to green poop.
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.
Here's what the color might be trying to tell you: Black: Black is normal! This is typical in the first few days after birth. Light green: Consistent green stools in a breastfed baby can indicate an imbalance of foremilk/hindmilk.
Foremilk is low in fat (skim) so it passes through the stomach quickly and dumps into the intestine. It's also high in lactose (milk sugar) which makes it hard to digest. Too much lactose may cause gassiness, fussiness and mucus-like and/or explosive green, watery stools.
A forceful letdown and oversupply of milk can also result in foremilk/hindmilk imbalance and its sequelae, mimicking reflux.
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.
Some babies are snackers – they nurse for a minute or two, take a break, and then go back. Other babies can drain the breast in two minutes and be satisfied for a few hours. It depends on how much milk you're making and your let down, too.
This is because the hormone prolactin (the milk making hormone) peaks in your body during nighttime. Most moms are able to pump out the most breast milk first thing in the morning. Milk expressed in the early am has higher volume, lower fat content, and higher levels of lactose.