There comes a time in many breastfeeding mother's lives where they wonder if their baby is getting enough milk. Even if you think you've established a good feeding routine, breastfeeding a baby can still be a big guessing game. Your breasts aren't like coffee pots with convenient labels that let you know how much liquid gold is available. But it's not just the amount that matters — the right mix of milk is equally important for your growing baby. If you suspect a composition issue, you may wonder how to deal with a foremilk-hindmilk imbalance. The good news is there are several simple options to help resolve it you just need time and patience.
A foremilk-hindmilk imbalance is when a baby fills up on foremilk — which has a lower fat content — first, and then has a hard time digesting the lactose in the hindmilk — which has more fat — because it's not properly mixing in the breast, according to La Leche League International (LLLI). The breast automatically mixes these milks up to deliver a digestible and full meal to a baby. But an imbalance can sometimes occur when the breasts aren't being properly drained. "Babies who aren't ingesting enough of the higher fat component may see produce green, foamy stools, as opposed to occasional, which is normal," Deena Blumenfeld, a Lamaze Certified Childbirth Educator (LCCE) and Fellow of American College of Childbirth Educators (FACCE) of Shining Light Prenatal Education tells Romper.
If you suspect and foremilk-hindmilk imbalance know that it's pretty common and it can be easily resolved. Here are seven things to try if you suspect an imbalance in your breast milk.
1. Don't Switch Breasts Quickly
Switching from one breast to the other after only five minutes can exacerbate a foremilk-hindmilk imbalance, according to Healthline. The general rule of thumb is to finish the first breast before you move on to the second breast, as explained on LLLI. There's not really a set time for emptying a breast, but it's recommended that the baby come off the first breast by themselves, the mother burps the baby, then the second breast is offered.
2. Increase The Length Of Feedings
Increasing the full length of a feeding is suggested if you're dealing with an imbalance because you'll need enough time to get out the fatty milk. According to LLLI, each feeding for a baby is complete with an appetizer, meal, and "dessert" so you'll want to make sure they're getting all of it. If they're just get the appetizer each time, they won't be full. As a result, the baby will likely want to feed more and more because they're only getting the snack portion of the milk.
3. Feed Baby At First Cues
According to the aforementioned Healthline article, feeding a baby that's super hungry will result in an aggressive sucking pattern. If this sucking pattern becomes the norm, it could alter how a mother's milk is let down during a feeding, impact foremilk-hindmilk mixing in the ducts, and result in oversupply.
4. Switch Up Your Feeding Positions
There are some positions to help with imbalance, including placing baby in a more upright position, that way the baby's head is higher up on the breast during the feeding offering more control, as suggested by LLLI. You could also try positioning yourself leaning backwards with the baby being almost on top of you as they latch. Finally, you could try a side-lying down position which helps you and your baby relax and maybe even drift off for a little nap thereby increasing feeding time (without you even realizing it).
5. Give Baby A Little Break
If you're emptying the first breast and extending the length of time for a whole feeding, you may want to take a break in between breasts. During the brief break you could try burping the baby or changing their diaper. By giving them a break you're helping them nurse for longer and get that hindmilk they need to really fill them up.
6. Express A Little Milk Before Feeding
"It may be necessary to pump a little off the top before a feeding to ensure baby gets the fattier milk," Blumenfeld suggests. You can do this with a breast pump or you could do a little hand expression before a feeding. Doing so can help get some of that watery foremilk out of the way before your baby gets to the breast.
7. Be Patient With Yourself
Breastfeeding is a commitment and sometimes very challenging. Both mom and baby are learning, and just when you think you've got it down, the breastfeeding patterns or routines change. The key is to be patient with yourself (and your baby) and know that everyone's breastfeeding experience is different.
And if you need a little help, ask for it. If you're sensing something isn't quite right with your feedings, like a foremilk-hindmilk imbalance, this is something a lactation consultant can help you with. Most breastfeeding issues can be resolved with time, practice, and patience.