The fuller the breast, the lower the fat content of the milk. Therefore, milk that is expressed at the beginning of a nursing or pumping session tends to be more watery than milk expressed at the end. (However, if sessions occur close together – and the breast doesn't have time to refill – this may not always be true.)
The longer the time between feeds, the more diluted the leftover milk becomes. This 'watery' milk has a higher lactose content and less fat than the milk stored in the milk-making cells higher up in your breast. You can't tell how much fat your baby has received from the length of a feed.
By pumping before you breastfeed, 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 you breastfeed to try to give your baby more hindmilk.
In babies that nurse, this can happen if the mother has an oversupply or if the baby is frequently switching breasts during a nursing session. When this happens, baby becomes full from the foremilk and stops eating, so she doesn't get hindmilk from either breast.
Is watery breast milk good for your baby? In a word, yes. Both fatty milk and watery/less fatty milk are good for your baby, and it's important that your baby gets both. (Think about when you're eating a meal – most of the time, you want both substance to fill you up and a drink to stay hydrated.
Signs and Symptoms of Foremilk and Hindmilk Imbalance
Fussiness with feedings. Gassiness. Frequent stools. Stools that are green, frothy, and “explosive”
You may have read or been told that you must nurse for at least 15 minutes for the baby to get the “good milk” a.k.a. “the hindmilk.” Not true. Some babies get it immediately, for some babies it takes 45 minutes. This depends on your milk supply, the time of day, and the last time you expressed milk.
Some breastfeeding mothers may have attempted to add thickener to their expressed breastmilk (EBM). This doesn't work since the live enzymes in the EBM breaks down the starches that make up many thickeners.
Breastmilk at night
For most mothers, breastmilk will gradually increase in fat content throughout the day. During the evening, young babies often cluster feed, taking in frequent feeds of this fattier milk, which tends to satisfy them enough to have their longest stretch of sleep.
In these situations the baby can find it difficult to digest all the abundant lactose in the plentiful foremilk causing temporary lactose intolerance or lactose overload. They may be fussy and uncomfortable with copious green, frothy and foamy nappies.
The Haakaa breast pump helps you collect both foremilk and rich hindmilk.
"There is a wide range of normal when it comes to color for breast milk," says Hali Shields, a certified birth and postpartum doula, national board-certified health and wellness coach, and certified lactation education counselor. "Blueish, yellow, cream, orange are all normal and safe for baby."
The overall amount of fat in breast milk is highest in the evening and at night, compared with milk produced during the day. However, multiple factors contribute to the amount of fat in breast milk, especially the frequency of feeding. More frequent emptying of the breast increases the fat content in breast milk.
Lactose overload, or foremilk and hindmilk imbalance, is a rare condition causing green, frothy poops, stomach pain, and insufficient weight gain in babies. To fix an imbalance, try laid-back feeding, nursing on one side until the baby stops, ensuring a good latch, and hand expressing a little milk before nursing.
The theory behind foremilk-hindmilk imbalance is that if your baby drinks mostly foremilk without enough of the fat-rich hindmilk, it may lead to green poop.
Not only will your baby receive a good flow of milk as your milk lets down but this reflex will be squeezing the higher fat milk that adheres to the sides of the alveoli down to your baby too. This higher fat milk is often called 'hind milk,' while the first milk your baby drinks is referred to as foremilk.
After about 10 to 15 minutes of breastfeeding, the milk flow slows and transitions to the sweet and creamy hindmilk, which contains vitamins A and E, and has more fat and calories than foremilk.
You can and should save/store any excess milk you collect or pump off. If you're using the Haaka during feedings, or pumping a few ounces off an engorged breast and notice the liquid is thinner and more clear, this is likely foremilk. Foremilk is totally fine to feed to your baby.
When is breast milk replenished? All the time, even while you're pumping or nursing. Your breasts are constantly making milk, so it's never possible to completely empty them.
Breast milk tends to be extra watery first thing in the morning because milk has been sitting in your breasts for awhile as you and your baby sleep at night.