By Louisa van den Bergh, Founder of Lulubaby antenatal classes & their breastfeeding consultant
Chances are if you breastfed your baby you are aware of these 2 terms: foremilk and hindmilk.
For some mothers knowing about this and understanding how their milk changes is crucial to successful breastfeeding… For others “ignorance is bliss” and it makes no difference to how they feed their baby.
So what exactly are foremilk and hindmilk?
Foremilk is typically described as the milk which is released at the beginning of a feed, whilst hindmilk comes towards the end of a feed. There is, however, no sudden switch or two different types of milk (which is why I am not crazy about using these terms) It is rather a gradual transition, similar to the way in which a hot water tap starts off running cold but gradually warms up to hot.
Mums can often see that their milk is a different colour and consistency depending on the stage they are at in the feed. Foremilk is runnier and often more grey in hue, whilst the hindmilk is creamier in colour and consistency. I often tell my mums that it is a bit like your baby having a whole meal, starting off with a drink, light starter, main course and followed up by the creamy fat rich pudding which is less plentiful but highest in calories.
Why they may matter
There is some debate in breastfeeding circles as to whether mums should learn about these two terms and surely we are just worrying and confusing mothers more?
For many mothers whose babies are thriving and content, there is no reason to complicate matters – see my piece “Is my baby getting enough milk?” However, I think there are two important reasons why most mums should be aware of at least a change in their milk even if they can’t remember the precise terminology.
The first reason is that foremilk is generally lower in fat content whilst the hindmilk is higher in fat content. The consequence of this transition is that if a mother does not “do” one breast well, but instead offers both for a short time, her baby may be hungry soon after feeding again as they have not had the benefit of the fat rich, more satisfying hindmilk.
This transition is explained by the fact that as milk is produced in the breast, fat globules tend to stick together and to the walls of the milk-making alveoli. When baby is not feeding (i.e. in between feeds) the milk amasses in the breasts and moves out towards the nipple (making them feel fuller), whilst basically the fat gets “stuck” further back in the milk ducts. As you progress through a feed, the fat globules are drawn down and the fat content of the milk increases.
The second reason is that foremilk is higher in lactose than the hindmilk. Lactose is an essential part of your baby’s diet and (in very basic terms) most babies are born with a suitable amount of lactase which breaks down the lactose. The problems begin if a baby is receiving too much foremilk: she will receive higher quantities of lactose which she may struggle to cope with. A baby that is receiving too much foremilk may be uncomfortable, in pain and windy with explosive green stools.
Not understanding that your baby needs to drain one breast fully in a feed can therefore sometimes lead to uncomfortable, unhappy babies which require extremely regular feeding. At this stage, mums often ask me “well how long should I feed on one side to make sure that my baby gets the right balance?” It is a good question, and one which only mum can really answer as it depends on several factors including the speed of her let down, the efficacy of her baby’s sucking and how long since the last feed.
This last point is important and it is worth noting that if it has not been very long since the last feed, then the hindmilk is more readily accessed – a bit like that hot water tap. If you go back to it soon after you have turned it off, the water will run warm and reach hot quicker than if you have left it a long time.
You are the expert
Very quickly mums to get to know their babies and how they feed and one way of checking is to see the colour of the milk and softness of the breast. For many mums, a quick squeeze of the breast will indicate how full it is and how well their baby has fed from it – something which is hard to imagine whilst you are pregnant, but once you are in the thick of feeding, you understand where I am coming from!
One final point which I like to make is that you can never “empty” a breast – there is always something there, even if it is not very plentiful.
Whilst there is no need for many mums to be aware of this, the key takeaway is that there is a gradual change in milk during the feed (assuming there has been a break since the last feed) therefore mum should make sure that her baby has a good feed from one side, before offering the second side. That way she can ensure that her baby has a full “meal” – after all, no meal is complete without pudding in my book!
Click here to read Louisa’s other article on ‘Is My Baby Getting Enough Milk?’
Lulubaby run antenatal classes in several locations in SW London. With a team of professionals, they prepare new mums for birth and life with a baby.