Foremilk/Hindmilk Myth

flcl

I was asking a pumping question to my LC and she told me something quite interesting.  I asked if I could freeze milk that Ive pumped from when I was engorged. (LO is starting to sleep longer stretches (yay) but it's leaving me really engorged (boo))   I was afraid there would be too much fore milk in those batches, especially when I pump just to alleviate some pressure.  The LC said that there was a recent study debunking fore milk/hind milk and hind milk is released by stretching the nipple rather than time on the breast.  She said to definitely keep the milk pumped since pumping stretches the nipple, it extracts hind milk.

1) Do you keep milk pumped from when you're engorged?  Any issues with using this milk?

2) Anyone else heard of this hind milk theory?

inluv4life2

1. I've used that milk and had no issues

2. We just discussed this article in my lac group last week.

I think milk is milk and I never waste any! If you are really concerned, save the milk to add to homemade baby food when baby is ready.

ohsowell

That's really interesting, we have been dealing with a foremilk/hindmilk imbalance versus allergy/intolerance for a few weeks now. Does anyone have the link to that article?

TheBorg7of9

I keep and use all milk, even if I was engorged. And anyway, I mix milk from several days together so it would even out anyway

SomersIsles

I'd love to read this article too... Any details on it so I can find it online?

I pumped the other day to get some relief from engorgement. It came out like cloudy water! Definitely foremilk! lol Froze it anyway and just marked it as all foremilk... I kinda wish I mixed it with other milk before freezing. Oh well

SouthRNComfort

Interesting. I just noticed that when I nurse my daughter before work, she only needs one side since I'm so engorged. So when I use my double pump at work a few hours later, the side she didn't nurse on is all hind milk, very watery. The other pumped side is fatty and creamy. So I thought of mixing the two to give her a balanced bottle (she's really gassy and I heard too much lactose in fore milk can make gas worse) Is this right?

flcl

SouthRNComfort said:

Interesting. I just noticed that when I nurse my daughter before work, she only needs one side since I'm so engorged. So when I use my double pump at work a few hours later, the side she didn't nurse on is all hind milk, very watery. The other pumped side is fatty and creamy. So I thought of mixing the two to give her a balanced bottle (she's really gassy and I heard too much lactose in fore milk can make gas worse) Is this right?

When that's happened with me, like some PPs mentioned, I would mix the bottles.  I figured that those are balanced then.  In the beginning when I first started nursing, I was having engorgement issues on both sides, I would pump both and it seemed like the milk was more watery.  Those batches were the ones that I was questioning in my OP.  I haven't seen the article, I'll ask my LC for it. 

flcl

Below is the info that my LC gave me.  The study is by Cregan and Hartman... she's looking for that article for me (my LC is awesome.)

Nancy Mohrbacher is a great resource...

see how she explains this: 
 
The truth about foremilk and hindmilk.  Research has found this concept is not as simple as it sounds.  It is true that fat sticks to the milk ducts in the breast and the percentage of fat in the milk increases during a breastfeeding as the fat is released from the ducts during milk ejections.  But the reality of this seemingly simple dynamic is not always as it seems.  

• There are not “two kinds of milk.”  Despite this common belief, there is no “magic moment” when foremilk becomes hindmilk. As the baby breastfeeds, the increase in fat content is gradual, with the milk becoming fattier and fattier over time as the breast drains more fully. 
• The total milk consumed daily—not the hindmilk—determines baby’s weight gain.  Whether babies breastfeed often for shorter periods or go for hours between feedings and feed longer, the total daily fat consumption does not actually vary.
• Foremilk is not always low-fat.  The reason for this is that at the fat content of the foremilk varies greatly, depending on the daily breastfeeding pattern.  If the baby breastfeeds again soon after the last feeding, the foremilk at that feeding may be higher in fat than the hindmilk consumed at other feedings. 

How does this work?  Interestingly, foremilk and hindmilk are concepts that really only make sense when longer intervals such as two to three hours or more occur between feedings.  The longer the time gap between feedings and the fuller a mother’s breasts become, the greater the difference in fat content between her foremilk and hindmilk.  These differences in fat content can vary greatly over the course of a day even among individual mothers.  For example, when a long breastfeeding gap occurs during the night, at the next feeding a mother’s foremilk will be lower in fat than during the evening when her baby breastfeeds more often. 
What really matters.  Research indicates that there is no reason to worry about foremilk and hindmilk or to coax a baby to feed longer.  As long as a baby is breastfeeding effectively and the mother does not cut feedings short, baby will receive about the same amount of milk fat over the course of a day no matter what the breastfeeding pattern (Kent, 2007).  This is because the baby who breastfeeds more often consumes foremilk higher in fat than the baby who breastfeeds less often.  So in the end it all evens out.
What’s most important to a baby’s weight gain and growth is the total volume of milk consumed every 24 hours.  On average, babies consume about 750 mL of milk per day (Kent et al., 2006).  As far as growth is concerned, it doesn’t matter if a baby takes 30 mL every hour or 95 mL every three hours, as long as he receives enough milk overall (Mohrbacher, 2010).  In fact, researchers have found that whether babies practice the frequent feedings of traditional cultures or the longer intervals common in the West, they take about the same amount of milk each day (Hartmann, 2007) and get about the same amount of milk fat.  Let’s simplify breastfeeding for the mothers we help and once and for all cross foremilk and hindmilk off our “worry lists.”
References
Hartmann, P.E.  (2007). Mammary gland: Past, present, and future. in eds. Hale, T.W. & Hartmann, P.E. Hale & Hartmann's Textbook of Human Lactation. Amarillo, TX: Hale Publishing, pp. 3-16.

lilies&orchids

Very interesting and good timing of this article! My milk has been looking very "skim" these past few days and I was afraid that LO would be dissatisfied with the bottles yesterday, but he was just fine. Like PPs, I typically mix my skim and fatty milk to create a better balance when I can.