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Thread: Foremilk/Hindmilk imbalance while EP'ing?

  1. #1

    Default Foremilk/Hindmilk imbalance while EP'ing?

    Hi ladies--is it possible my baby is suffering from foremilk/hindmilk imbalance? My LO just turned 4 months old, and I have been EP'ing since we got home from the hospital. I'm a single mom and only have time to pump 4-5 times a day (20-30 mins at a time), but I produce about 45oz of milk. By the time I am done with one pump session, the milk at the bottom of the bottle already looks a little clear. After spending time in the fridge, there is the tiiiniest line of fat at the top of the bottle, and the bottom third looks clear.

    My LO has horrific gas and poop problems. His poops are explosive, watery, mucousy, and flecked with blood. We saw a pediatric GI who suspected allergies and I have been on a strict elimination diet for two months: no dairy, soy, egg, wheat, peanuts, tree nuts, fish or shellfish. The only difference is that my LO's poops have gone from green back to yellow, but everything else remains the same.

    My LO eats a LOT and has put on heaps of weight--he already hit 18lbs at 16 weeks. I hate seeing the awful pain he's in...and neither of us get any sleep as it seems to be worse at night.

    My pediatrician and GI both rolled their eyes when I mentioned foremilk/hindmilk imbalance. What do you ladies think??

  2. #2
    Join Date
    May 2006

    Default Re: Foremilk/Hindmilk imbalance while EP'ing?

    Foremilk/hindmilk "imbalance" is the biggest non-issue in breastfeeding. The "imbalance" is simply another word for oversupply, which does sound like a problem for you. On average, exclusively breastfed babies eat around 20-30 oz per day and you're producing close to double that amount.

    Here is what I would do, if I were you:
    1. Start adding foods back into your diet. It's time to test whether or not the elimination diet is actually making a difference. If it's not, it's worse that useless, because a nursing mom needs her strength and elimination diets are extremely tiring and often quite depressing.
    2. Try to pump a little more often but take less milk each time. That should signal your body to make less milk, and when your breasts are less full you should have an easier time " reaching" the creamier milk that comes out when the breast is relatively empty.
    3. Try to adjust your baby's bottles so that there's more fat in them. You should be feeding your baby around 20-30 oz per day, leaving 25-15 oz of extra. Those extra oz can sit in the fridge until the creamy fraction floats to the top, and the creamier parts can then be poured into the bottles which you are going to feed to your baby.
    4. Work on getting your baby to the breast? I am not sure if that's something you want or which is possible- we'll help you if we can! But nursing straight from the tap and nursing frequently is usually the best way to deal with oversupply.

  3. #3
    Join Date
    Jun 2009

    Default Re: Foremilk/Hindmilk imbalance while EP'ing?

    I agree with mommal that you may have OS, but if I am understanding the situation, you feel fine even with infrequent milk removal, but baby is miserable. If you can really only pump 5 times a day, it is a good thing you have over supply and you probably do not want to reduce it too much, as it will probably reduce on its own over time. I agree with mommal about how to get more fat/less clear into the bottles (yOU still want some of both!) But by far the simplest solution would be to pump more often but not as long as she suggests. I think It is the length of time between pump sessions that is making this issue so pronounced.

    But also, How much, exactly, is baby being fed total each day and how? (How much at a time, how many bottles a day, is paced bottle feeding used, etc.) it is entirely possible baby is simply being overfed and that is the problem or part of the problem on babies end. Just because you pump 45 ounces does not mean this is what baby should be getting with bottles. Overfeeding happens with bottles unless focused steps are taken to prevent that.

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