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Thread: Not producing Hindmilk

  1. #1
    Join Date
    Dec 2010
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    11

    Unhappy Not producing Hindmilk

    I have oversupply of foremilk, am pumping out 5 oz and baby is 1 month old. Have been with my lacatation consultant every week and baby is now 1 month old. He is eating all of the time but has still not regained his birth weight. We looked at my milk and for some reason the hindmilk is not coming in even during a full pumping session. I have done block nursing for over a week and that is not helping. My Mom had the same problem and had to stop BF. I have to supplement now. I am taking Omega 3's and have MTHFR. Any suggestions?

  2. #2

    Default Re: Not producing Hindmilk

    Did your LC do weigh, feed, weighs to see how much milk your LO was transferring in an average feed?

    How do you know there's no hindmilk? Did a lab analyze your milk? I'm curious to know because my LO is HUGE. She's 27 pounds at almost 8 months. I wonder if I have too much hindmilk. I know I have a huge supply of milk overall. I pump ten to fifteen ounces three hours after a feed.

    I read that new research points to weight gain in breastfed babies having more to do with the over all volume of milk consumed by baby and not with hindmilk like many professionals once theorized. Plus, I read that hindmilk is produced several times during a feed and not just at the very end. There's no magical moment when the milk turns from fore to hindmilk.

    Oh, and what's MTHFR? I'm not familiar with than acronym.

    Sorry you're having a hard time!

  3. #3

    Default Re: Not producing Hindmilk

    Here's a link to the article I read that explains away some of the confusion out there about fore and hindmilk...

    http://www.nancymohrbacher.com/blog/...-hindmilk.html

  4. #4
    Join Date
    Nov 2008
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    68

    Default Re: Not producing Hindmilk

    That's a good article -- definitely read it!

    When people talk about foremilk and hindmilk it sounds like there are two different kinds of milk. There aren't. It's all just milk.

    What happens is that when milk is produced during letdown, it's high in fat. Some of that milk is stored in the breasts between feedings. Over the course of a few hours the fat in the stored milk is reabsorbed.

    So when your baby starts nursing, the first milk he gets is the milk that has been stored since the last feeding, and which now has less fat than when it was first produced. During letdown, the higher fat milk starts to flow. After he's been nursing for a while, he uses up the stored milk and gets more and more of the newer, higher fat milk.

    When a mom has a large storage capacity there's a lot of stored milk in between feedings that the fat is being reabsorbed from. If a mom has a large storage capacity and oversupply, then baby is getting a whole lot of the lower fat milk before he gets to the newer, higher fat milk and he might be too full by then to keep going! That's where a foremilk/hindmilk imbalance can happen.

    Okay, this was all a long-winded way to say-- It's not possible to not have hindmilk. That would basically mean you're producing milk with no fat in it at all. Not possible.

    If the milk you're getting from pumping is really watery, it could be that you're only pumping out the milk that has been stored since the last feeding and not getting a letdown while pumping. That's entirely possible. I personally was never able to get a letdown with a pump.

    You mentioned you tried block feeding and it didn't help... How often were you nursing? The longer you go between feedings, the less fat the stored milk is going to have. So it may help to nurse more frequently. Maybe every 1.5 to 2 hours?

    Are you feeding the baby at the breast or are you pumping exclusively? Or doing both? If you're pumping in addition to nursing at the breast it might be increasing your oversupply, in which case you'd have more of the lower fat milk stored between feedings. Trying to pump it out would actually make the problem worse.

    My suggestion would be to stick to nursing only (unless there's a reason why you have to pump, in which case if you pump after feedings instead of before the milk is going to be higher in fat) and continue the block feeding with very frequent nursing sessions.

    I know I wrote a textbook , if you can get through it I hope something here helps. Good luck!
    Karen

    ~~~~
    My brilliant "babies":
    Butterfly - 13 yo - environmentalist
    NinjaBoy - 10 yo - stuntman

  5. #5
    Join Date
    Dec 2010
    Posts
    11

    Unhappy Re: Not producing Hindmilk

    Thank you all. Let me try and answer all of the questions:

    1. Milk transfer - LC did weigh before and after and am transferring about 2 oz to baby.

    2. Not enough hindmilk or fat in milk - When the milk separates I only have a thin layer of fat on top. That is after a full pump out with multiple let downs and letting pump for 2 minutes after nothing comes out per LC. I guess according to the article I should change the title to not enough fat in my milk. I had breast augmentation behind the muscle but the LC said that wouldn't affect it.

    3. Block feeding - Been doing for over a week without pumping. Will do one breast for 3 feeding sessions and then the next breast. I could go up to 12 hours or so on one breast.

    4. Length of feeding - Baby is sucking and swallowing for 45-60 minutes with a burp half way through. I have a quick let down so he chokes sometimes and I have to pull him off. The next feed is usually and hour and a half to two hours from the start of the first. So sometimes I am only having 15 minutes between when he finished eating and when he's starting to eat.

    5. MTHFR - It's a genetic defect that makes you prone to miscarriages and birth defects. Baby is great but I didn't know if the defect would affect the production of the fat in my milk.

    I really appreciate any and all help. I had to give my little one some formula today after he was actively on my breast for 1 1/2 and was still starving. He ate another 2 oz of the formula after refusing it for awhile. I was soo upset and really don't want him to have formula. 30 minutes later he got diarrhea. There has to be a way to increase the fat in my milk.

  6. #6
    Join Date
    Nov 2010
    Location
    Sunny Florida
    Posts
    112

    Default Re: Not producing Hindmilk

    Does he have consistant green poops? If he is having some normal color poops, then is is probably getting an ok amount of hindmilk. If every single poop is really green, then he isnt getting enough hindmilk.

    My pumped milk separates in the fridge and a thin layer of fat lays on top and the rest looks pretty watery. I think this is normal and my LO doesnt have green poops.

    Maybe try and do breast compressions when you are pumping and nursing to get some of that hindmilk down from your ducts.

    I'm really surprised the feedings are lasting almost an hour if you have an OS with a forceful let down - this normally makes feedings faster.

    Also, if he is on your breast for 1.5 hours and still acting hungry - that may mean he isnt getting a lot of milk or he is working to get your supply up- even if he was just getting all foremilk, his belly would get full and he would not act hungry still

    Dont give up on it - it will all balance out if you continue to nurse on demand - just try not to supplement. And try not to pump more than 1-2 times a day for more than 10 minutes to balance out your supply. I know its gets really frustrating - it should get easier

    Hopefully some of this will help
    I'm a proud first time mommy , born 10/19/2010 and a wife to an amazing husband

    Birth 10/19/2010: 7lbs 3oz
    3 days old 10/22: 6lbs 6oz
    2 1/2 weeks old 11/05: 6lbs 14oz
    4 weeks old 11/17: 7lbs 15oz
    8 weeks old 12/15: 10lbs
    4 months old 2/28: 14lbs

  7. #7

    Default Re: Not producing Hindmilk

    Quote Originally Posted by @llli*tiggerx40 View Post
    When the milk separates I only have a thin layer of fat on top.
    A thin layer of fat on top is normal. That's how it's supposed to look.

    I agree with jenblueeyes81. It seems strange that it takes so long for your LO to nurse if you have OS.

    Also, at one month, my LO was regularly drinking 3-4 ounces from my breast every three hours or so. I know because I had the scale for two months out of paranoia from trouble with my first baby and low supply.

    If I were you, I wouldn't block feed. Block feeding is very dangerous because it will quickly lower your supply, and if you don't truly have a supply problem, then you're stuck trying to correct low supply.

    As the article I posted earlier says, weight gain is about the amount of milk consumed on average daily.

    If my LO were having trouble gaining, I'd rent a scale like the one your LC used. If she won't rent one to you, you can find one to rent in your area by doing a search on the Medela web site. The average cost to rent one is only five dollars per day. If you rent it for a few days, you can get a good average of how much your LO is consuming daily.

    After all the trouble I had nursing my first, I rented one for several months (overkill I know, but I have OCD) with my second and third babies. It helped ease my mind so much in those scary first few months.

    Again, I have oversupply with my current baby, and she is HUGE! LLL says most moms with oversupply have babies that gain more rapidly than average. I'd think it's rare for a baby to have trouble gaining if the mom does have OS.

    Rent the scale. It will help a ton. I promise.

  8. #8
    Join Date
    Nov 2010
    Location
    Sunny Florida
    Posts
    112

    Default Re: Not producing Hindmilk

    Yeah - I with Chickennoodlemom - I'm thinking you do not have an OS. When you pump the 5oz, is that in the morning? If so, thats sorta normal. I actually pump about 6-7oz in the morning. Most people with an oversupply can pump like 10oz in one sitting any time of the day. And your supply will be higher in the morning so you'll always pump more then.

    If your LO is eating as often and as long as you are saying and not gaining weight, then you might actually have an undersupply - especially after block feeding. Try feeding her regularly and often without block feeding for several days and see if it starts to get better.

    I'm wondering why your LC hasnt talked to you about some of this. Maybe you should seek a 2nd opinion
    I'm a proud first time mommy , born 10/19/2010 and a wife to an amazing husband

    Birth 10/19/2010: 7lbs 3oz
    3 days old 10/22: 6lbs 6oz
    2 1/2 weeks old 11/05: 6lbs 14oz
    4 weeks old 11/17: 7lbs 15oz
    8 weeks old 12/15: 10lbs
    4 months old 2/28: 14lbs

  9. #9
    Join Date
    Dec 2010
    Posts
    11

    Default Re: Not producing Hindmilk

    Thanks to all. It is soo frusturating. He had 2 green poops and was getting a really bad rash on his face after he ate. Now his poos are yellow but not cottage cheese like. They have just a little mucus. I am not sure if this is normal. We started to give him Mylacon. Can you have undersupply with a forceful let down? He chokes and I have to pull him off and it sprays everywhere. He will eat and be done in 10-30 minutes sometimes and then starving in 5 minutes. I found a scale on craigslist, going to buy it tomorrow.

  10. #10
    Join Date
    Dec 2010
    Posts
    11

    Default Re: Not producing Hindmilk

    Forgot to mention, the 5oz is pretty consistent throughout the day. Lately i have only been pumping in the am though when he doesn't wake. He will sleep for 6hrs or so at night. As for the fat on top. my LO said it should be 50/50. I am glad u said yours was only a thin layer. sorry for spelling, am typing with 1 hand and bf with the other.
    @chickennoodlemom- does your baby have a prb with the lactose? My lc said with os they can not gain weight too becuz they aren't getting the fat they need. Ugh, I wish I knew. All i know is my poor LO is crying all the time. I hear him suck and swallow when he's eating.

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