Foremilk vs hindmilk

The breast only makes one type of milk. But how milk is released from the breast can change the fat content throughout the feeding. Foremilk is the higher water milk that gets to baby first to rehydrate the baby. Hindmilk is the creamier, higher fat milk near the end of a feeding/pumping session that helps baby grow and feel satiated. Babies need both for healthy growth and development.

There is no switch that gets flipped during the feeding, it’s a gradual change throughout the feeding. Like turning turning up the heat on the thermostat. The room will gradually feel warmer as time passes.

Depending on your nursing pattern, it’s possible for fat content to be higher at the beginning of a particular feeding than it is at the end of other feedings. The longer the time between feedings, the lower the fat content at the beginning of the next feeding. If feedings are closer together, you’re starting off with a higher fat content.

Having a true foremilk/hindmilk imbalance is rare but can happen. It usually happens when:
🤱🏽A robust oversupply
🤱🏼An overactive let down
👼🏼Baby is being limited in their time at the breast
👼🏼Switching breasts too quickly in the feeding 📝 Combination of all of these

Signs of an imbalance include
💩 Really watery, foamy, green poops
👼🏼Baby nurses often and transfers high volumes of milk but doesn’t gain weight as expected

How to help:
🥛Regulate the over supply (bring it down to just what baby needs). This may include reducing pumping.
🥛Shake your breasts and do some massage before feeding. Milk is a liquid. By shaking prior to feeding you can activate the fat to flow faster
🥛Feed baby one side until they are finished on that side. You may need to block feed, or offer one breast for a set amount of time, to help increase fat content from that side
🥛 Work with a qualified IBCLC to figure out the root of the imbalance and get feeding back on track

Full vs empty breasts

While it seems counterintuitive, the emptier your breasts are, the faster they make milk. A full bread has no place to store or hold the milk, so milk production slows to prevent plugged ducts and breast discomfort. Cluster feeding on an emptier breast actually tells the body to make more milk at a faster rate!! Some incorrectly assume you have to wait for the breast to “fill up” before feeding your baby or for pumping while at work. This will eventually lead to less milk, as a fuller breast tells your body baby isn’t eating very often and to slow milk production. The more frequent you empty the breast, the higher the fat content in that milk and the faster milk is made. The longer often you wait and the fuller the breast, the higher the water content in that milk and the slower your body will make milk overall.

Watch the baby, not the clock. Breasts may feel really full between feedings in the first few weeks after birth, but they’re also not supposed to stay engorged. There will come a time when they stay soft and don’t feel full between feedings or pumping, so waiting for that as a cue to feed will also sabotage your supply. Don’t be alarmed when your breasts no longer feel full between feeding. You’re entering a new stage where you’ll still make plenty of milk for your baby as long as you’re routinely emptying that milk. Trust your body. Trust your baby.

The witching hour

The dreaded witching hour. Have you heard of it? The time typically in the evening when baby is inconsolable. On and off the boob. Doesn’t want to settle. Cries and nothing works. Can last for two hours or more. You may think you’re doing something wrong or you don’t have milk. You check your breasts and milk is still there. You become panicked when baby will take a bottle but refuses the breasts. Babies have been doing this as long as babies have been around. You are not alone. It usually starts around 2-3 weeks and can last 6 or more weeks. We suspect it happens when baby has been over stimulated throughout the day and now doesn’t know how to self soothe. Most likely they wanted to sleep but missed the magic window and now their still developing brain goes haywire.
Unfortunately it also coincides with a natural dip in supply at the end of the day which gets baby ready for sleep at night. However most mamas blame their breasts and a perceived low supply as the cause of the crying and often reach for a bottle. If this happens every night for multiple nights, moms body thinks baby doesn’t need that milk and what was a perceived low supply turns into a real one. What can you do instead?
Know what’s actually going on! If your baby normally takes the breast through the rest of the day and over night, DON’T BLAME THE BREAST. If you know around the time the baby becomes fussy each night, try to jump the gun and get baby down for a nap before the fussiness begins. If the baby is already in a meltdown, offer the breast. If baby won’t take it, don’t push it. Rock, cuddle, snuggle, bounce and soothe. It may take you a few days or even weeks to figure out how your baby likes to be soothed, but this too shall pass. If baby is making lots of wet and poopy diapers and latching well the rest of the day, don’t blame the breast as the culprit for your baby’s melt down.
My little peach went through this for over a month until I figured out it always happened around dinner time when I was trying to make food for my older daughter and had the baby in the kitchen with me. I changed my routine to put her in her sleep sack in her bed twenty minutes before dinner prep and it changed the whole mood of the night. She outgrew it around 9 weeks.
Are you in the witching hour phase? You’re not alone.

How do I know baby is getting enough breast milk? Do I have a low breast milk supply?

Milk supply and sleep are the biggest concerns of new parents. One of the top reasons to wean before one year is perceived low milk supply, whether or not there actually is a true low supply. Our expectations of how much milk we should make may not actually be true of how much baby really needs. When baby wants to feed more often, fusses at the breast, or tugs/pulls on the breast, this gets misinterpreted that milk is not adequate, either in quality or quantity.
Signs of plenty of milk:
💩 6+ wet and 1-2 daily poops
💕Pain free latch
⚖️Consistent weight gain over time

🤱🏽Baby nursing frequently does not equal low milk supply
🤱🏾Baby not settling after a feeding does not mean you have low supply
🤱🏿Occasional long, frequent, endless feeding, especially during growth spurts, are not a sign of low supply
🤱🏼Waking frequently at night and changes in sleep or nap routines are normal
🤱🏻Babies don’t like being put down
🤱🏻 Breasts no longer feeling full between feedings is normal. Your body gets more efficient as time goes on. They go back to pre pregnancy size and still make plenty of milk 🤱🏾Not every one leaks. Some never leak. Leaking stops over time while still maintaining a full supply
🤱🏼 Some never feel their let down. Many stop feeling let down as baby ages
🤱🏽Baby fussing at the breast, pulling away, but still wanting to nurse does not mean you have low supply
🤱🏾 Babies want to nurse for more than just nutrition. It is comforting, pain relieving, soothing, and bonding. Being on you is safety.
🤱🏿Pumping is NEVER a good indication of your true supply as baby is way more efficient at accessing you milk (unless there is a tongue tie or oral motor weakness)
🤦🏽‍♀️It is possible for a baby to refuse the breast and still take a bottle. You can’t force a baby to latch the the breast but you can make a baby latch to a bottle.
💕If breastfeeding has been going well for several weeks/months, don’t blame the boob as the root of your baby’s behavior unless there is a justifiable cause (like taking medications or birth control, starting your period, reducing your number of feedings/pumps)

Why does my breast milk look like that?

Sisters, not twins. This milk is from the same pump session. Each breast made different colored milk!!! Did you know your breasts work together and independently? Here’s some fun facts about your girls:
⭐️70% of us make more milk on the right side, often significantly more (up to double for some!!)
⭐️Each breast can have its own flow rate. Some babies prefer the flow from one side over the other
⭐️ Breasts and nipples are not symmetrical. The left is usually slightly larger than the right. Nipples can be different sizes and lengths. For a significant size difference, you may need to pump with different sized flanges
⭐️Milk during the same feeding can taste and be a different color from side to side. The fat content can also be different based on which side baby fed from last. I once had a toddler tell their mom that they preferred milk from one side because it tasted like oatmeal, and the other tasted like tea!!
⭐️When you have a milk let down, your milk will let downs on both sides, which is why many will leak from the opposite breast while feeding. It’s also why we usually recommend pumping both breasts at the same time to take advantage of those let downs.
⭐️ You can successfully breastfeed from only one breast. One side can make enough milk to feed you cold.
⭐️ If you tandem feed and we’re to keep the other child on one side and the younger always on the other, your breasts would make different milk for them based on how often each child feeds.

Complementary Foods

Breast milk or formula should be the primary source of nutrition for babies under 1 year old. The first foods we introduce to our babies are often called “complementary foods” because the idea is to introduce foods that complement breast milk/formula, not to simply replace milk.

Introducing solid/table/first foods should start when babys mouth and gut are ready to tolerate digesting them. Baby’s tongue thrust reflex should have disappeared, baby should be able to sit unsupported for at least the length of a meal, and baby should be using a pincher grasp to be able to bring their own food to their own mouth. This usually happens around 6 months, although for some it’s a little younger and others a little older. Food choices should be about exposing baby to a full palate of flavors and a wide variety of textures that add to baby’s feeding experience without taking away the nutrients and energy found in milk. The goal of complementary feeding is NOT to try to fill baby up with as much food as possible to cut back on giving breast milk or formula. It’s about baby gradually increasing the amount of foods eaten from your family’s unique diet across multiple months.

Cooked sweet potatoes, mashed avocado or banana, purée canned pears or peaches, and cooked carrots are wonderful first foods and simple to make. Next offer foods from your family table first (in the appropriate purée or cooked and cut form). Your baby has already been exposed to what you eat on a daily basis through your milk and they’ll have a higher likelihood of preferring those foods. Many foods marketed for babies, like rice cereal or oats, don’t actually add any nutritional value to baby’s diet. Read jarred food labels carefully for preservatives and sugar. There’s also a risk of filling your baby up with low calorie jarred foods which then decreases the amount of nutrient dense milk they will want to drink.

Remember: just as every family eats different foods and has their own unique way of doing meals, so does every tiny human. If you’re concerned about your littles eating habits, request feeding therapy with an occupational therapist at your next pediatrician appointment.

⭐️ The World Health Organization recommends breastfeeding until 2 years of age
⭐️ Breast milk never loses its nutritional value and is good for children at any age
⭐️ From 7-9 months babies need about 250 calories from food a day
⭐️ From 10-12 months babies need around 450 calories from food a day

Should I wake up to pump if baby sleeps longer at night?

💤 Prolactin, the major milk making hormone, is rises when we sleep, so it is naturally higher at night. Prolactin rises about 90 minutes after sleep begins and peaks around 4-5 hours later and stays high for about 2 hours after waking up. This helps you make more milk throughout the rest of the day

🛌 For most, milk removal in the middle of the night is essential for maintaining milk supply. If your exclusively breastfed baby under 12 months is waking at night, most likely they want to feed. If your baby is naturally sleeping longer on their own (with no sleep training or sleep devices to help baby sleep longer), they are telling you they are getting enough milk from you at other times to not need milk at night for growth.

Breast storage capacity has a LOT to do with whether or not you need to wake up to pump. If you have a large breast storage capacity you may be able to go longer between pump or feedings without dropping supply or feeling uncomfortable. You may be able to get a 4, 5, or even 6 hour stretch of sleep and not see your supply drop. Baby also has more milk available at other feedings and may take very large, less often feedings.

Those with low supply, small breast storage capacity, or baby struggling to feed efficiently may need to take advantage of higher night time prolactin levels made during REM. Even if you feel like you have a healthy supply in the first 4-6 weeks, a sudden drop in supply can happen if insufficient milk removals start too early into your breastfeeding journey when supply regulates around 3 months.

If you’re not sure what your storage capacity is, if baby is sleeping longer and you’re waking up engorged, or you’re waking up and pumping and then baby wants to feed and you have now pumped that milk, there are Lots of options:

✏️ Dream feed. If you’re waking up engorged and baby is still sleeping, some times you can sneak in a dream feed to relieve the breast and help baby sleep even longer. Bring sleeping baby to the breast to root and usually they will latch and feed while still sleeping. Lay them back down when you’re done. Don’t burp or change diapers as this will wake them up.
✏️ Pump 30-45 minutes after your last breastfeeding ends when you anticipate baby to take a longer sleep stretch. This will help you go a little longer before the next feeding without getting as engorged, seeing as drastic a supply dio, or pumping too close to the next feeding.
✏️ Pump when you feel uncomfortable but only pump enough to feel comfortable and not to empty the breast. If baby wakes up, you can always offer the breast and top off with what you pumped if they’re still hungry
✏️ Do nothing. If your baby is naturally sleeping longer at night on their own with no sleep training, your body will naturally regulate your supply.
✏️ If you are sleep training baby or using something like the Snoo to help baby sleep longer, you may need to still get up every few hours over night to maintain your milk supply.