BREASTFEEDING + PUMPING

Hindmilk + Foremilk: What These Mean + What You May Be Misunderstanding

July 2, 2021

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Ok friend, never heard of this or not worried about it? Good. You probably don’t need to! But if you have, you may have learned the wrong things. Foremilk and hindmilk are terms that circulate often in the breastfeeding or pumping world. They refer to the milk that empties out of a woman’s breast during these processes. Hindmilk gets a lot of “praise” for being the rich fatty milk that baby needs, while foremilk is often less attractive or desirable because it is waterier, less fatty, and less nutritive. While some of this is true, much of it is not and it is vastly misunderstood.

Keep reading friend. Once you understand these two terms better, I think you’ll feel a lot better about the whole discussion. Let’s dig into some common misunderstanding or misconceptions.

WHAT ARE FOREMILK + HINDMILK?

Foremilk and hindmilk are NOT different types of milk. Our body produces milk – that’s it. But depending on when the milk is being “released” from the body, the fat content can be different. Foremilk is the milk that is released at the beginning of a feed or pumping session. It is usually higher in volume and lower in fat. Hindmilk is the milk released at the end of a feeding or pumping session, lower in volume and higher in fat. In one particular feeding/pumping session, the hindmilk (the milk at the end) will have a higher fat content than the milk initially released (the foremilk).

WHAT IS GOING ON PHYSIOLOGICALLY?

More or less, all of our breastmilk is a fatty substance. But as milk is produced in our breasts, the fattier components of it (sometimes called globules) stick to the walls of the breast alveoli and stick to each other. As a baby starts to eat or a pump starts to express, the fat is essentially ‘stuck’ farther back in the ducts. The first milk that comes out is often less fatty, as much of the fat is still ‘stuck’ behind. As the session continues, the fat makes its way down and out of the ducts.

HOW MUCH TIME BEFORE IT SWITCHES FROM FOREMILK TO HINDMILK?

This system is NOT a switch. There is no specific time where the fat content changes over. This is a gradual system that is continuously occurring throughout a feed. Kelly.mom urges you to consider a hot water faucet. When you initially turn on the tap, the water moves from cold, to cool, to warmer, to warm, to hot – the fat in the breasts does the same thing. For those more visual, consider the different types of cow’s milk we can purchase – we can move from skim, to 1%, to 2%, to whole, to heavy cream. Again, this is a gradual change with no clear delineation between non-fatty milk and fatty milk. Because of this system, it is important to allow your child to full empty one breast before moving them to the next and to allow them to dictate when they are finished as opposed to having them on a clock. This ensures that they DO get to that “heavy cream” (or the hot water) hindmilk.

IS FOREMILK EVER FATTY TOO?

YES! And this is what I believe is one of the biggest misconceptions or misunderstandings floating around. The fat content of the milk being released IS ABOUT THE TIME BETWEEN FEEDS OR PUMPING SESSIONS, OR THE EMPTINESS OF THE BREAST. When our breasts our really full (the time between the feeds or pumping sessions has been long), you will see that waterier, low fat milk as the foremilk and progressively move to that fattier hindmilk. However, when our breasts are more empty (the time between the feeds or pumping sessions has been short), you will see a fattier, richer milk released right away. In this scenario, the foremilk is rich and fatty!

Foremilk gets a bad rap for being the watery non nutritive milk, while hindmilk gets all the glory for being the fatty “good” milk. Let go of this misconception. It isn’t always true. In one particular feeding/pumping session, the hindmilk at the end will be fattier than the foremilk from beginning, BUT if the time between feeds/sessions has been short, that foremilk will be rich and fatty and creamy too.

OK, NOW I’M CONFUSED

Let’s go back to the water faucet example from Kelly.mom. If it has been awhile since we’ve turned on the hot water tap, it takes some time for the water to heat up. However, if you just used the hot water tap, it will warm up a lot quicker AND be warmer right from the start. The fat content of our milk is the same. When our breasts are REALLY full (or its been a long time since the ‘tap’ has been used) it takes some time to get to the rich fatty milk (the hot water). But when our breasts are emptier (the ‘tap’ was more recently used), the fatty milk (warm water) is right there from the start and quickly gets fattier (hot water).

Here’s 2 quick real life examples from my own experiences:

1. Normally, baby wakes up at 2 am and 6 am to feed. For whatever reason, baby skips both of these wake-ups and sleeps until 7am. I have to pump at 6am because I’m so full and uncomfortable. That foremilk is super watery (sometimes more bluish in color) because my breasts are so full and that fat has been pushed way back in the milk ducts (a much longer time between feeds).

2. I feed my baby around 7 am every day. I then pump around 8 or 830. This pumped milk is VERY fatty right away (the foremilk is). This is because my breasts are emptier (and much shorter time between feeds).

WHY DOES EVERYONE TALK ABOUT A FOREMILK/HINDMILK IMBALANCE?

Many women hear about (and worry about) a foremilk/hindmilk imbalance as well. And while this can occur, it is not nearly as common as it may seem. It is most commonly associated with women who have an oversupply of milk, babies who switch frequently back and forth between breasts, or mother’s who cut feeding shorts based on the clock. In these situations, baby may get too much watery foremilk (too much lactose). While both foremilk and hindmilk have nutritive value and purpose, baby does need the richer milk from the end of the feed too. You may know you have an imbalance if you are seeing frequent, green, mucousy stools in your little’s diaper.

A foremilk/hindmilk imbalance can usually be corrected. Amanda from Exclusive Pumping discusses some of the ways you can try to correct any issues at the bottom of her article here. If you have any concerns about your supply and the subsequent effect on baby, please reach out to your provider.

SO SHOULD I BE WORRIED?

Probably not. Like I mentioned at the beginning, this is talked about a lot but I’m not so sure we really need to hear so much about it. While things can change from feed to feed, research indicates that if a mother doesn’t cut feedings short, over the course of the full day babies receive the amount of fat they need. For the vast majority of mothers, this topic can truly be one we can more or less forget about.

Cheering for you!

Lo

There’s a full discussion about all of this on our Instagram community as well. Join us there.

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