Foremilk Hindmilk Imbalance

Foremilk hindmilk imbalance is one of the most common breastfeeding problems and usually occurs due to wrong information and misconceptions of how breastfeeding works.

Colostrum is produced only a few days before and after giving birth. It is the clear liquid that is very rich in nutrients and antibodies…read more about colostrum and its benefits.

What is foremilk? Foremilk is the milk that is lying in the front of your breast's milk producing cells (alveoli); this is the first milk that baby drinks with a breastfeeding session and this milk is watery compared to hind milk and is usually bluish in color. Foremilk is also abundant in carbohydrates, protein and vitamins.

What is hindmilk? Hind milk is the milk further at the back of your breast's milk producing cells (alveoli), that is calorie loaded and much higher in fat percentage; it also looks thicker and darker in color.

So why this difference in milk?

When the milk is produced it passes the alveoli (milk producing cells). Most of the fat in the milk then sticks on the back side of these, resulting in hind milk and the rest of the milk collects in the front of the alveoli. (less fatty foremilk)

So the fat actually just becomes stuck further back in the breast's alveoli, and this is what causes the large difference between the milk in the beginning of a feed and the milk at the end. The fat content in the milk increases gradually during a feed as the fat globules are released from the alveoli.

The longer Mom waits between feedings, the more foremilk is allowed to collect and the longer it will take before baby receives the hind milk.

The high lactose level found in the foremilk is important for energy and brain development and also quenches baby’s thirst. The hind milk is important for growth and helps baby feel full.

What is a Foremilk Hindmilk Imbalance ?

This happens when Mom allows baby to breastfeed only for a few minutes on each side; it will result in baby becoming full on only foremilk which again results in an oversupply of lactose, causing gassiness and foamy green explosive stools.

For this reason it is so important that Mom allows baby to drink from one breast until it seems empty (breasts are never fully empty because they are constantly producing milk) before offering the other breast. This will ensure that baby receives the foremilk and hind milk. The hind milk will fill baby more and decrease colic symptoms and explosive stools.

Sometimes Mom might have an oversupply of foremilk which will also result in a foremilk imbalance problem. What causes this? Breastfeeding too often, and not allowing baby to finish one breast at a time.

How can you fix this? Do not allow baby to comfort feed if you already have an oversupply of milk (flutter sucking usually indicates comfort sucking)

Foremilk Hindmilk Imbalance Symptoms

* Green frothy explosive stools.

* Baby spits up a lot.

* Colic symptoms.

* Baby wanting to breastfeed all the time; not becoming satisfied.

* Gassiness.

* Blood in stools.

* Slow weight gain.

* Diaper rash due to acidic stools.

* Baby has a bowel movement immediately after feedings.

The Causes of a Hindmilk Foremilk Imbalance

* Oversupply (read more on how to handle oversupply).

* Nursing for short frequent feedings.

How to Prevent or Stop a Fore milk Hind milk Imbalance

* To prevent this, Moms should breastfeed only from one breast with each breastfeeding session. If the other breast becomes a bit engorged (overfull), Mom can just express some of the milk until her breast feels less full and tight.

* If Mom has an oversupply of breast milk, she can pump out some of the breastmilk before breastfeeding to ensure that baby receives the hind milk as well as foremilk.

* To remedy the imbalance, Mom can breastfeed from each side for a separate 12 to 24 hours. (To prevent engorgement you can express some milk).

* How to reduce breast milk supply: If Mom has an oversupply, she can try reducing milk supply by drinking Sage tea or using cabbage leaves.

* Usually the oversupply is accompanied by a forceful letdown. (Read more on overactive and under active milk let down here).

 NB – Information update

Whether foremilk/hindmilk is the reason for problems is a matter of debate at the moment.

The existence of foremilk or hindmilk is questioned.

Updates will be published as soon as this issue has been cleared.

Other pages on “breastfeeding problems” in connection with foremilk hindmilk imbalance

- Lactose intolerance in the breastfed baby

- Breastfeeding on demand

- Breast engorgement

- Overabundant milk supply

- Breastfeeding overfeeding