Breastfeeding and Baby Fussiness

Foremilk/hindmilk imbalance

Parents often worry about their babies’ green, watery, frothy stools. Most pediatricians will test the baby’s stool for traces of blood, and if blood is found, they might diagnose it as food allergy and suggest dairy elimination from your diet. Before you change your diet, you might want to discuss FOREMILK/HINDMILK IMBALANCE with a lactation consultant and your doctor.

Mothers produce two different kinds of milk: foremilk and hindmilk. Foremilk is produced at the beginning of the feeding and is more watery, has less fat and has more lactose than the hindmilk. Hindmilk is produced at the end of the feeding and has more fat content and is creamier than the foremilk. It is important for babies to intake both foremilk and hindmilk as the foremilk has lactose for energy and the hindmilk has fat for growth.  Hindmilk will help the baby digest breastmilk more easily and the fat content will help the baby feel more satisfied.  Women with oversupply of milk that switches the baby to the other side before the baby has completely emptied the breast might only be feeding the baby the foremilk with less fat content and more lactose.  This could result in a fussy baby that will cry right after feedings with gas, cramps, and will usually have explosive bowl movements.  Over time, the lactose in the baby’s system could irritate the intestines and cause small bleeding in the stools.

So what is the solution to foremilk/hindmilk imbalance?  Allow your baby to nurse in one breast until it feels “empty,” “drained.”  If the other breast feels very full and uncomfortable, pump it for a couple of minutes until you feel comfortable again.  It is important that your breast is not completely drained.  Remember, the more you pump, the more milk you will produce, and it will be even more difficult for your baby to get to the hindmilk. Also, do not wait too long between feedings, the longer the time between feedings, the lower the fat content at the beginning of the next feeding.  Be patient, it may take a while for your body and your baby to get used to this new feeding routine.  It may take a few days for your baby to fully adjust and pass normal grainy mustardy stools. After your breast milk regulates, and if your baby’s stools and fussiness have not changed, you may want to pay closer attention to what you are eating and start eliminating certain foods from your diet that could be irritating your baby’s digestive system.  The usual suspects are cow’s milk products, soy, wheat, corn, eggs, peanuts and any food that a family member is allergic to. It is helpful to keep a food journal.

This article was written by Fernanda Haido, the founder of FefisBaby. It is based on her personal experience with foremilk/hindmilk imbalance and it should not be a substitute for medical/professional consultation.  References: What is the difference between foremilk and hindmilk? Is my baby’s fussiness caused by the lactose in my milk? By Diane West, BA, IBCLC and Incorrect Breastfeeding Advice Results in Fussy, Uncomfortable Babies by Dr. Melanie Beingessner. 



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