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Thread: Hindmilk Foremilk Imbalance

  1. #1

    Default Hindmilk Foremilk Imbalance

    How can you tell if you have a hindmilk foremilk imbalance? I’m currently pumping exclusively because my 5 weeks old baby was in NICU and would not latch to me. My baby is always crying, very gassy, having stomach pains and never seems to be satisfied. I may have an over abundance because I pump every three hours and is producing around 8 to 12 ounces each session.
    I would like to give him breast milk exclusively but hate to see him in so much pain. Can you provide me with and suggestions or feedback?

  2. #2
    Join Date
    Jun 2009
    Posts
    5,289

    Default Re: Hindmilk Foremilk Imbalance

    lisha, first off, it is amazing you are pumping for your baby and providing your breastmilk for your baby. Please know that even if there IS a foremilk/hindmilk issue, your milk is still the very very best thing for your baby.

    I think it does sound as if you have over production. If you are pumping every three hours (9 times a day) and getting an average of 10 ounces each time, that is 90 ounces of milk a day, -literally, enough for triplets. Very hungry triplets. So I think it might be time to talk to someone (a lactation consultant) about this and consider if steps to reduce production are warranted and safe at this point-for your own comfort, if nothing else.

    But, in general, if I understand it correctly, any foremilk/hindmilk "imbalance" (really, the issue is "too much foremik") would only be occuring when a baby nurses at the breast. What happens in this case is, Mom has SO much milk in her breast at a time, baby only gets the high lactose foremilk, because typically, after getting 2 or 3 ounces, (at this age, less for a younger baby) baby is full and stops nursing. and it is the "too much" foremilk that (possibly, not always) MAY cause some gastrointestinal distress. Again, there is nothing wrong with moms milk and it is still the best thing for baby.

    But how would this be happening if baby is getting bottles? I have some thoughts but first some questions:

    Why was baby in the NICU nad how long was baby there?

    When you pump, do you pump until no more milk is coming, or the flow slows way down? or are you still getting major flow when you stop pumping?

    Do your breasts feel much softer after pumping?

    How long (how many minutes) do you pump for each time? (on average)

    How is your expressed milk stored and in what amounts?

    How often is baby being fed, and how much each time?

    How is babies weight gain? Output? (poops)

    is baby getting (or has baby ever gotten) any other substance besides your milk-any infant milk fortifier, etc?

    When baby gets a bottle, is the technique 'paced bottle feeding" or "baby upright" feeding being followed? Such as described here? http://www.llli.org/docs/00000000000...astfedbaby.pdf

    Are you trying to get baby nursing at the breast? or interested in doing so?
    Last edited by @llli*lllmeg; July 23rd, 2013 at 08:06 PM.

  3. #3

    Default Re: Hindmilk Foremilk Imbalance

    Why was baby in the NICU nad how long was baby there?
    Baby wasn’t breathing when he was born and need assistance with his breathing. He also had an viral infection.

    When you pump, do you pump until no more milk is coming, or the flow slows way down? or are you still getting major flow when you stop pumping?
    I’m pumping until no more milk is coming.

    Do your breasts feel much softer after pumping?
    My breast is really soft after I pump, but is very hard if I’m late or miss a pumping sessions.

    How long (how many minutes) do you pump for each time? (on average)
    I pump every 3 hours for 20 minutes.

    How is your expressed milk stored and in what amounts?
    I’m storing the excess milk in a 12 ounce Tommie Tippie storage bag and putting it in my deep freezer. My deep freezer and now full and I’ve only been pumping for 5 weeks.

    How often is baby being fed, and how much each time?
    Baby eats every 2 to three hours around 3 to 4 ounces.

    How is babies weight gain? Output? (poops)
    Baby was born 6 pounds 9 ounces and now weight at 5 weeks 9 pounds 2 ounces.
    He’s pooping after every feeding and is getting a diaper rash.

    is baby getting (or has baby ever gotten) any other substance besides your milk-any infant milk fortifier, etc?
    Baby has only gotten my breast milk and no other substitutes.

    When baby gets a bottle, is the technique 'paced bottle feeding" or "baby upright" feeding being followed? Such as described here? http://www.llli.org/docs/00000000000...astfedbaby.pdf
    I feed the baby upright.

    Are you trying to get baby nursing at the breast? or interested in doing so?
    Yes, I try everyday but he gets frustrated and starts screaming.
    ]

  4. #4
    Join Date
    Apr 2013
    Location
    Salt Lake City
    Posts
    86

    Default Re: Hindmilk Foremilk Imbalance

    This definitely sounds like oversupply. If you're still having trouble getting baby to feed at the breast and still have a lot of engorgement, check out this article: http://kellymom.com/bf/got-milk/supp.../fast-letdown/
    I had to use sage to decrease my supply. This can dramatically reduce supply and inadvertently lead to weaning if you're not careful, so consider other methods first. But here is the article on sage: http://kellymom.com/bf/can-i-breastf...bs-oversupply/

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