Breastfeeding mothers give out standard breast milk that can be divided into two types - foremilk and hindmilk. Foremilk is the milk that your baby consumes at the beginning of a feeding, and hindmilk comes after.
Generally, foremilk is mostly water combined with other nutrients and hindmilk is highly fatty. Both contain lactose that your baby needs to develop and grow properly. Isn't it amazing that your breast milk changes throughout a feeding to give your baby exactly what they need?
Lactose helps the growth of good bacteria in the digestive system to help your baby fight off bacteria, parasites, and viruses. It also contributes to brain and nerve development, supports your baby's growth, and gives them the energy to develop new skills. However, the imbalance of foremilk and hindmilk could prevent your baby from getting the lactose they need to grow.
Foremilk/Hindmilk imbalance
A foremilk and hindmilk imbalance, also known as lactose overload occurs when the breasts make too much of one type of milk and not enough of the other. It can happen due to overfeeding, feeding that is low in fat or feeding in large volumes.
When your baby drinks a large quantity of breast milk, the foremilk that comes first can make them full even before they are able to drink much of the hindmilk, making them consume low-fat milk more and less of the high-fat milk.
If your baby drinks more foremilk than hindmilk, the fat content of their feeding will be imbalanced. Fatty substances are slow to break down. Since foremilk usually is lower in fat, it moves quickly through your baby's digestive system that all of the lactose in the foremilk does not get enough time to break down and be digested.
The imbalance 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, which causes digestive discomfort and changes to your baby's stool.
Symptoms of lactose overload
If your baby is experiencing foremilk/hindmilk imbalance, they may have shown any combination of the following symptoms:
- green, foamy or watery stool
- has more gas than usual
- stomach pain accompanied by crying, screaming, and general fussiness
- bloating
- trouble sleeping
- more appetite than usual
Fixing lactose overload
If your baby seems happy and comfortable with normal-looking stool and does not show any symptoms of lactose overload, it means the amount of foremilk and hindmilk that they are getting is fine and your breast milk is giving them exactly what they need.
However, if you suspect your baby is experiencing lactose overload, you might want them to get checked by your doctor and try the following to improve the situation!
- Feed your baby more often. Nursing more often prevents milk with a higher water and lactose content from building up in your breasts, so your baby takes in less lactose while they drink. A gentle breast massage before nursing may also help to maximise the fat content of milk if you are dealing with an oversupply issue.
- Ensure one breast is drained before offering the other. Breaking off one breast before it is totally drained means your baby will get less high-fat milk towards the end.
- Change your breastfeeding position. If oversupply is causing your baby to consume too much milk at once, nursing from a laid-back position can help slow your flow.
- Don't limit your baby's feeding time. The longer they feed and the more hindmilk they take, the better their digestion will be.
