Updated: April 2021
Have you wondered what all the fuss is about regarding fully emptying your breasts while feeding or pumping for your baby? Interested in learning why sometimes your breast milk looks more transparent and at other times has a creamy appearance?
Some of these answers can be found by understanding the difference between foremilk and hindmilk.
Hindmilk versus Foremilk
What’s the difference?
Foremilk is the milk present in the breast at the beginning of a feed and may be relatively lower in fat than Hindmilk, the milk in the breast toward the end of the feed, which is often (but not always) dramatically higher in fat.
While the concept of “fore” and “hind” milk is complicated to explain because they can have equal amounts of fat at times, there is still much benefit to ensuring you fully empty your breasts during feed and pump sessions.
Emptying your breasts fully has several amazing benefits, one being more hindmilk that your baby will consume.
So, how can you tell whether you are expressing more hindmilk by fully emptying your breasts? You should be able to tell by the color of your breastmilk! When pumping, you may notice your milk appears creamier (think whole milk) the more you fully empty, whereas the initial foremilk expressed appears lighter (think skim milk). This means the more you empty, the more hindmilk you express, the creamier looking your milk will be. Seeing this difference allows you to visually determine whether the milk you express does have more fat from one pump session to another!
Fascinating, isn’t it?
How Much More Fat Does Hindmilk Contain?
But HOW much more fat is in your milk by fully emptying? You now understand that the creamier looking milk has more hindmilk and more fat, but have you ever noticed that sometimes your milk separates with a layer of fat on top? How thick or thin the fat layer is can indicate whether there’s more foremilk or hindmilk in the bottle.
Don’t fret too much over it, though!
In most cases, you won’t need to take any great measures to track which bottle you reach for to feed your baby. Fat content in milk changes throughout the day. For example, evening foremilk can be much higher in fat than morning foremilk (because of a shorter stretch between nursing sessions, with less time for a large volume of milk to collect). The best thing you can do is make sure to fully empty as often as you can!
Getting Enough Hindmilk
Should you make sure your baby is getting enough hindmilk during each feed?
This is a very common question! As interesting as it is to learn about foremilk and hindmilk, the focus should be more on fully emptying as often as you can, rather than stressing about the foremilk and hindmilk your baby is consuming during each feed.
When feeding at the breast, pumping before and after feeds is a great way to ensure you are fully emptying, regardless of how long your baby spends at the breast, especially if they prefer feeding at one breast over the other. This way, you can also feed expressed milk, which may have more hindmilk, the next time your baby is ready to eat.
Overall, while understanding hindmilk is important, as long as you are focused on fully emptying, you can be sure that your baby will get the appropriate fat they need throughout the day.
Is there a way to express the Hindmilk, faster?
We love this question! The composition of breast milk is also changed by the way and rate it is taken from the breast. If you are pumping for your baby, massaging your breasts while you pump will enable your breasts to empty more completely, and faster, which increases fat content as well.
Massaging while feeding at the breast is also a great way to achieve a letdown, empty faster, and helps ensure your baby keeps actively feeding – just make sure your baby is comfortable with the increased flow of milk!
Massage has many more benefits, which we will dig into another day, but for now, let’s stay focused on talking about getting to that fatty hindmilk
Can an oversupply keep my baby from getting enough Hindmilk?
If you prefer feeding at the breast, an overabundant milk supply is a common issue that can prevent your baby from getting enough hindmilk, because they may first fill up on foremilk – but don’t worry, there is a way around it!
Try pumping the foremilk before you begin feeding at the breast, to help ensure your baby fills up on hindmilk while nursing. You can also finish with pumping if your baby fills up without fully emptying.
Hindmilk, Your Milk Supply and Preemies
Hindmilk for Babies Who Are Not Gaining Weight Well
You should always talk to your baby’s doctor if you have any concerns about your baby’s weight. They will keep track of your baby’s growth and let you know if you need to take any special measures to help your baby gain more weight. If your breast milk supply is sufficient, you can ask your pediatrician about feeding your baby more hindmilk. Similar to the oversupply solution mentioned above, you can do this by pumping for a minute or two before you begin to breastfeed. By pumping before you nurse, you will remove some of the foremilk and your baby will get more of the high-calorie, high-fat hindmilk.
However, if your breast milk supply is low, you should not pump before a feeding. Instead, you want your baby to get as much breast milk as possible, so nurse your baby on both sides until both breasts are empty. Massaging while you nurse is a great addition here as well. Another tip to try is “triple feeding”. This involves nursing the baby until sated, pumping to make sure your breasts are completely empty, and then feeding that milk you expressed to the baby.
If you pump (or hand express) after you breastfeed your baby, it provides extra stimulation and removes the last little bit of breast milk from your breasts. This provides a signal to your body that it needs to produce more milk and can help to increase your milk supply (think supply and demand). The breast milk that is collected when you pump immediately after nursing is that high-fat, high-calorie hindmilk we have been talking about and makes an excellent supplement, should your baby need it.
Preterm Babies or Babies With Health Issues
Babies who are born prematurely or with certain health issues can definitely benefit from the advice mentioned to help support the added nutrition they typically require.
When in the NICU, discussing the variety of ways to manually express and pump, and the benefits of incorporating hand massage will help ensure you have the right tools in place to fully empty and express the most nutritionally dense milk you can – and begin building an adequate milk supply.
As always, it is important to consult with your physician to determine a feeding plan that suits your babies individual needs.
Whether you have a preemie in the NICU, are trying to help your baby gain weight, or just want to understand more about breast milk, the tips and tricks above are great tools to ensure you fully empty your breasts during each feeding or pumping session. We hope it will be useful for you on your breastfeeding journey!
How to Collect & Separate Hindmilk
To collect hindmilk for your preterm baby in the NICU, you should use a breast pump and separate the foremilk from the hindmilk as you pump.
- Begin pumping
When you begin pumping your breast milk, it will be thin and watery. Pump for about 2 minutes.
- Remove foremilk
Remove the collection container from the pump. This collection will contain foremilk. You can save this milk in a separate container or milk storage bag.
- Continue pumping
Place a new collection container on your breast pump and continue pumping until your breast is empty. This thicker, creamier breast milk that you get at the end of your pumping session is your hindmilk.
- Label collections
Mark you storage containers appropriately for foremilk and hindmilk.
- Hand-off the separated hindmilk to NICU staff
Give the container of your hindmilk to the hospital staff to use for your baby now, and store your foremilk in the freezer for the future.
Whether you have a preemie in the NICU, are trying to help your baby gain weight, or just want to give your little one the most nutritious milk, use the tips and tricks above to fully empty your breasts during each feeding or pumping session can help you get the most hindmilk possible.