BY SR TERESA HAYWARD (RN, RM, LACTATION CONSULTANT, INFANT & PAEDIATRIC NUTRITIONIST, BABY SLEEP CONSULTANT)
Breastfeeding moms all produce a unique breastmilk that is totally suited to the baby they are feeding, and this milk is divided into two courses – foremilk and hindmilk. Foremilk is the milk that baby drinks at the beginning of the feed, and in an average feed, it will be the first seven to ten minutes of the feed. The hindmilk then follows it.
Foremilk is typically mostly water combined with other nutrients, whereas hindmilk is highly fatty and contains the majority of the nutrients and sustenance. Both contain lactose that your baby needs to develop properly. Lactose also helps good bacteria grow in the digestive system, which helps your baby fight of bad bacteria, viruses, and parasites.
Lactose contributes to brain and nerve tissue development, as well as supporting your baby’s growth and gives them the energy to develop new skills. A foremilk/hindmilk imbalance will prevent your baby from getting the lactose they need to grow, so a rule unless we are sure baby has a lactose intolerance, we don’t want to eliminate Lactose from moms and baby’s diet.
FOREMILK/HINDMILK IMBALANCE
Foremilk/hindmilk imbalance is also known as lactose overload, can happen when your baby has trouble digesting the lactose in your milk. It often happens due to overfeeding, feeding that is low in fat (where mom is timing feeds and baby ends up getting more foremilk than hindmilk) or feeding in large volumes.
When your baby drinks a large quantity of breastmilk, the foremilk can fill them up, and they get full before they’re able to drink much hindmilk. So, they don’t consume enough high fat milk and end up taking in a lot of low fat milk. If your baby drinks more foremilk than hindmilk, the fat content of their feeding will be out of balance. Fatty substances are slow to digest, and because foremilk is low in fat, it moves through the baby’s digestive system quickly. It passes so fast that all the lactose in foremilk doesn’t get a chance to breakdown and be digested.
This out of balance amount of foremilk causes a lactose overload for your baby as the undigested lactose has nowhere to go but the large intestine, where it gets fermented and creates a lot of gas. This gas is the root of your baby’s foremilk/hindmilk imbalance symptoms
Your baby’s symptoms
If your baby has foremilk/hindmilk imbalance, they will often have very similar symptoms to babies with lactose intolerance:
· More gas than usual
· Green foamy or watery poo
· Stomach pain accompanied by crying, screaming and general fussiness
· Bloating
· Trouble sleeping
· More appetite than usual
· Can have poor weight gain or rapid weight gain
Treatment
Many people will tell you to take dairy products out of your diet, but don’t take this advice. The breastmilk your body creates is custom made for your baby, independent of what you eat.
You can do different things to help your baby by managing their feeding but contacting a Lactation consultant or infant feeding specialist will definitely help you.
· Having baby’s latch assessed and ensuring a better latch as they’ll have more control over the flow of milk with a deeper latch
· Don’t limit your baby’s feeding time. The longer they feed and the more hind milk they get, the better digestion will be
· Always feed on one breast per feed for as long as baby wants to feed
· Feeding more often can help ease their pain, but it often worsens the problem
If your baby shows signs of lactose overload, contact your Lactation consultant for assistance
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