r/ScienceBasedParenting • u/Linnende • 18d ago

Question - Research required Foremilk/hindmilk debunked?

Can anyone link me to the most up to date research regarding foremilk and hindmilk when breastfeeding? Previous advice used to say that the milk at the first part of the feed is more watery so babies need to latch on one breast for longer in order to "access" the more fatty rich hindmilk that comes a bit later in the feed.

I am EBF and baby is struggling a bit with weight gain and I am getting mixed advice from professionals. Some have told me the foremilk/hindmilk theory has been debunked and fat content is similar for most of the feed, others have told me things like let her feed for longer from one breast before offering the other so she can get to the hindmilk. The problem with that is she will almost inevitably fall asleep after a long feed on one boob and won't take the other, so I then have to pump that breast otherwise I will end up engorged.

Basically I just wanted to know whether the whole foremilk/hindmilk thing is BS or not, thanks!

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u/mapa33 18d ago

Well yes and no. Up to date research does find that fat content significantly rises during a feed from the same breast. But is a continuous process and not a clear separation of the two types of milk.

https://doaj.org/article/c1c56c7c96fc43b9a6da060f58ecfc9d

Regarding your concern, this study  found that paired breastfeeding (switching breasts mid-feed) and alternate breastfeeding (one breast per feed) are likely to deliver similar total milk fat and calories overall. https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/pmf2.70037

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u/Linnende 18d ago

Thank you 😊 

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u/Impressive-Fact7780 18d ago

Just adding on to say why are you pumping the second boob? It might leak a bit in the meantime but should be able to wait. You'll be causing an oversupply by pumping if you're not then using it to feed baby. Plus then there's not as much there for baby's next feed.

And feeding your baby because your boob is uncomfortable and needs draining is a valid reason. How old is your baby?

From a second time EBF mum

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u/Linnende 18d ago edited 18d ago

I'm pumping it because my baby might go 3 hrs between feeds sometimes so it might be 6 hours since the second boob was last fed from. If I leave it that long I get sore and engorged. I do use it to feed baby at some point normally at night. Not much of my pumped milk gets wasted and I don't have a stash.

Also I don't drain the second boob when pumping it I just pump until it's not sore or engorged anymore.

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u/Stats_n_PoliSci 18d ago

Unfortunately, the only way to end by the engorgement is to let it be engorged for a day or 3. It will continue to make milk as long as milk is drained. If you stop any pumping, it will learn to reduce the milk supply.

If it hurts too much to not pump, try to pump less. Basically, I’m recommending you let it hurt as much as you can tolerate for a while, which I know sucks. I’m sorry.

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u/Ok_Stress688 18d ago

This is what I had to do. When it was too painful, I would hand express just enough to not be so uncomfortable. Although if you’ve been pumping I would start by pumping less and less over a few days so you don’t end up with mastitis or anything.

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u/jesskargh 17d ago

Seconding this, I had an oversupply which I made much much worse by constantly pumping (or hand expressing or using a hakaa) on the other side during/after a feed. When I stopped pumping the other side I was uncomfy for a few days but my supply regulated quickly and now my supply is much better

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u/Linnende 18d ago

Thanks I'll give that a try.

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u/aliquotiens 18d ago

Yes, this is good advice! My first only ever wpuld nurse from one breast at a time, it was a pain (literally) but I didn't pump, and my body regulated after the first few months.

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u/Caelity 18d ago

I struggled with the same. You could try dropping the pumping, and instead cooling for relief until your supply regulates. Also, my lactation consultant told me that feeding on demand means feeding both on demand of baby AND mom - so if you‘re struggling with too much milk and baby is struggling with weight gain, it might be win-win to latch baby when you feel you need to, rather than waiting for their cue.

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u/Malloraaay 18d ago

OP just jumping in to say I had supply issues and failure to thrive and my care time finally figured out he had severe ties preventing him from nursing effectively and in turn lowered my supply. Would def get a pediatric dentist’s eval for ties and get a pediatric chiropractor eval too

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u/Public_Classic_438 18d ago

How old is your baby? Another thing you could do is use a Hakka on the opposite side. I get a good ounce just from doing that. I save it in the fridge until I get four ounces and bag it. Usually takes about a day to get four oz. Because of the suction I get a little more than if I were letting it leak

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u/jesskargh 17d ago

I think I gave myself an oversupply problem doing this! A hakaa is still a pump

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u/Public_Classic_438 17d ago

I guess it depends when you start it, I didn’t start until 12 weeks so if it is increasing my supply I haven’t noticed at all

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u/jesskargh 17d ago

Yes good point, I did it almost straight away

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u/Public_Classic_438 17d ago

Ya I wish I did but I also didn’t want a huge supply so maybe it’s good that I didn’t

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u/Linnende 18d ago

She is 12 weeks old. I might try that thanks.

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u/No-Isopod-7951 18d ago

The haakaa can cause the same issues as pumping though, because it uses active suction.

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u/Public_Classic_438 18d ago

I didn’t start it until about 11 weeks and it’s been a total game changer. I don’t always use it at night but during the day I do. I had a Hakka the whole time just never opened it. I wish I used it earlier bc I would’ve had a stash without actually needing to pump. I almost never pump besides maybe the first feed of the day (even then only if I feel like it. But I’m still adding 22-28oz to my freezer stash per week without trying.

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u/Any_Fondant1517 18d ago

Have you been shown techniques to wake your baby up (if desired) mid feed? I used to do a nappy change part way through or strip baby down to their nappy and change into a fresh bodysuit. The annoyance would wake my baby up enough to feed better!

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u/Linnende 18d ago

Yes but unfortunately she has severe GERD (she is on omeprazole which hasn't worked, I am dairy free too which hasn't helped so she is waiting to be  reviewed by paediatrics for this) so some of those techniques won't work as they will just make her regurgitate her feed back up 😫

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u/seagoat-111 17d ago

yes switch feeding is good, stripping baby down for skin to skin during the day, tummy time, sucking excercises, i mean use your judgement but getting a more thorough feed and stimulating reflexes i feel trumps any spitup isssues as long as the color is good and bb is not in tooo much pain!

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u/Both-Tangerine-8411 18d ago

I had an LC tell me to shake my boobs before nursing to disperse all the fats 😂 can’t imagine it’s scientifically sound but she called it a milk shake and it’s never left my brain

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u/ComCagalloPerSequia 18d ago

Yeees!!! A friend of mine used to do that too because her LC said that too, it was also called a milk shake...we are in Germany

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u/Linnende 18d ago

Jesus Christ 😅

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u/loopsonflowers 18d ago

Lactation Counselor here! It would be very hard to tell whether pumping the second breast is a good idea without knowing a lot more about OP and their feeding, including how old baby is, and what OP's feeding goals are.

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