Tuesday, January 17, 2012

Breastmilk Imbalance

We have all heard it before. The ol' cliche of breastmilk. How it is the perfect mixture of nutrition. Now........ as true as that is...... sometimes, just sometimes, your liquid gold may not be so perfectly "mixed." Shocker right?! I know I was thrown through a (breastmilk) loop when I found this out. You see, when Pooker (my oldest, former Nummie Lover) was 5 months old I noticed some (errrrr) "odd" poop in her diaper. Now she was a pretty sick little Nummie Lover. She had pretty bad Silent Reflux and breath apnea, weighed only 12 lbs at 5 months (which put her below 3% for her weight and she was labeled "poor weight gain." To be honest she was not even on the whole weight chart...... even the breastfeeding chart.) So when I noticed this "new" poopy development..... I was confused. Let me explain..... Pooker's poops began to remind me of a bright green foamy latte! (NO JOKE!) I even used that description to her G.I doctor and he was at a loss as well. Her poops were nothing but a bright green foam... no really! 

Think...... latte foam art
Yeah... see the white foam....now imagine a diaper full of bright green foam........ yupp that is what Pooker's poopy diapers looked like.

So I decided to do some investigating of my own. Since her G.I. doctor said he was clueless....after he giggled over the phone... he thought I was kidding, bless his heart! I came to a term called "Foremilk/Hindmilk Imbalance."

Foremilk is the thinner milk the baby gets first, which has a lower fat content and hindmilk is the high-fat, creamier milk that follows. When there is an imbalance the Nummie Lover gets more of the foremilk and less of the hindmilk. Think of it as having the desert before the meal. The foremilk is the sugary desert and the hindmilk is the calorie bursting cheeseburger.

When Pooker was nursing she was getting TOO much foremilk and not enough hindmilk.... which caused her poop to be green and foamy. This also was the reason for her "poor weight gain."

BUT what the heck causes this imbalance?

For us, I didn't offer her the last side she nursed from when it came time to her next feeding. This action did not agree with my nummie makers and made them so out of whack. Doing this for 5 months took a toll on my breastmilk and caused an imbalance. 

How can you tell if you have an imbalance? Well you don't have to search the poopy diapers. If you pump, take a look at the fatty layer on the top. (Let the expressed milk sit in the refrigerator for a while. This way the milk will "relax" and you will see the foremilk/hindmilk separate.)  You should notice a layer on top (that is the hindmilk.... the fatty part) if that layer is small (as in VERY thin) then you most likely have an imbalance. 
Here are some other signs you can look out for:

Green frothy explosive stools (check!)
 Baby spits up a lot
 Colic symptoms (fussiness)
 Baby wanting to breastfeed all the time…not becoming satisfied
 Gassiness (check!!)
 Blood in stools
 Slow weight gain (triple check!!!)
 Diaper rash due to acidic stools
Baby has a bowel movement immediately after feedings (Oh yeah!!! This one too!)

Oh but not to worry, Mummies..... there is nothing wrong with you. I have some great news! There are ways to correct it! WAHOOOO!

For us, I changed the way she nursed. She would still take both sides, but I made one small change. She would begin on the side she finished! (AHHHHH light bulb went off in my head!) I HAD heard of that before... bit sill me thought "why would it matter?" DUH! First time Mummie... it DOES matter! hehe. Now it took a month or two to correct my imbalance.... but Pooker's poops did go back to normal and my latte cravings ended! (KIDDING about the cravings! EWWW After seeing latte looking green poop.. a latte never looked the same again!)

Here are some other ways you can help fix the imbalance:

*To prevent this, try to breastfeed only from one breast with each breastfeeding session. If the other breast becomes a bit engorged, mom can just express some of the milk until her breast feels less full and tight. This is also known as "Block Feeding."
*If you have an oversupply of breast milk she can pump some of the breastmilk before breastfeeding to ensure that baby receives the hindmilk as well as foremilk.
*To remedy the imbalance breastfeed from each side for a separate 12 to 24 hours. (To prevent engorgement you can express some milk)

Hope this helps!!! 



  1. This happened to us too and is great info to share with other mummies!

  2. Thanks for an excellent article.

    May I ask, did you get any trouble from health visitors about your child's poor weight gain? Did they help to identify the problem or did they urge you to top up with formula?

  3. @alpha Parent. That is a great question and I do not mind answering at all! Pooker's original Pediatrician did not seemed concerned about the no weight gain, but her G.I Specialist and we were. LUCKILY her G.I. Specialist accepted and agreed, with me, that breastfeeding was super important to us. His only question was if I minded the breastmilk be right from the breast or if pumped breastmilk was okay too. I told him, in my opinion, breastmilk is breastmilk! No doctor suggested supplementing with formula (in order to help her weight gain.) But her G.I doc suggested I give her 1.5-2 ounces of pumped breastmilk following all of her nursing sessions. Which I was fine with. So after doing this for one month (and correcting my imbalance... as this all happened at the same time) she was gaining weight again and never lost or stayed the same after that.

    The main reason she was not labeled "Failure to Thrive" is because she was meeting all of her milestones and was actually 3-4 months ahead on them. She looked very healthy (despite her silent reflux and breath apnea .... she was just small.... very very small.

    The doctors did not help identify the problem, The LLL did. Both her G.I doc and Pedi thought it was all based around her reflux. Which it was.... but not solely that reason.


  4. Thank you for sharing. It must have been a very stressful time for you.

    Who referred you to the Pediatrician?

  5. Pooker spent 4 days in the children's hospital at 3 days old due to her reflux and breath apnea. We asked her Pedi to sent us to a GI Specialist and we are so thankful we did!

  6. Thanks so much for sharing! Were dealing with this now & I thought it was my diet! Thanks again!


Thanks for commenting!