The Myth of Foremilk / Hindmilk Imbalance

By Danelle Day © 2018

"If we had the power to eliminate just one misunderstood notion about breastfeeding, it would be the concept of foremilk and hindmilk!" write Cindy and Jana, Registered Nurses and International Board Certified Lactation Consultants (IBCLCs) who have assisted over 20,000 breastfeeding mothers.

Research clearly demonstrates that nursing mammals (human babies, too) receive milk near the end of most natural nursing sessions that is higher in fat content than milk at the beginning of that feeding. One biological reason for this is that early milk is the thirst quencher - baby can cue to nurse for just a few minutes to satisfy thirst, or comfort needs. Early milk is also power-packed in immunobodies and glyconutrients (the healthy sugars that kill cancer cells and feed the developing immune system) - super charging baby's immunity even when nursing briefly on-the-go. As breastfeeding continues, milk gradually becomes more and more dense in (healthy) fat content with each swallow baby takes. This beneficial fat feeds the cells of the rapidly developing brain and body. When baby is able to choose his/her time to breastfeed, because of this perfect set-up, s/he can get a quick snack for thirst and comfort and immunity, or s/he can get a full hearty meal that fills the tummy and feeds the brain.

This being said, there is no magic set amount of time from one mother to the next, one baby to the next, one nursing session to the next, or even one breast to the other, at which milk suddenly changes from 'foremilk' to 'hindmilk.' It is all just milk! Very gradually fat content increases. With each swallow baby takes, milk content shifts to meet baby's needs. When s/he is in control (and able to nurse effectively) baby is able to determine just the right amount of time to breastfeed to get just what s/he needs. This is why it is so vital to watch your baby, not the clock.

For one mother this may mean baby nurses on one breast for 30 minutes. For another mother baby may nurse each side for 20 minutes, or 15, or 10. Baby may nurse for 5 minutes, and come back 10 minutes later to nurse again. And again. Baby may nurse for longer periods of time at night than in the morning. One baby may nurse differently than his/her sibling did. Baby may nurse differently today than s/he did yesterday, and change week to week, due to his/her needs and also mom's hormone fluctuations. Milk content changes from one swallow to the next, from one baby to the next in the same mother, from one day to the next, and certainly from one mother to the next. In the midst of this beautiful dance of lactation and normal baby feeding, there is no 'foremilk / hindmilk imbalance' that occurs within any one individual mother's breasts.

When well meaning friends or ill-informed medical professionals tell nursing moms to "make sure your baby nurses long enough to get hindmilk" or "if your baby's poop is green, you have a foremilk/hindmilk imbalance" they are not dispersing information based in science, and this leads to mothers being troubled and thinking something is wrong. Many U.S. hospital postnatal rooms reinforce this myth by having mom record "how long baby breastfeeds on each side" on a chart that is reviewed by nursing staff. Breastfeeding moms wonder, "How long is 'long enough' for baby to get hindmilk?" "Should I only feed from one breast to try and help my baby gain?" Women want to do what they are being told by hospital staff, and begin to watch the clock instead of their baby -- the precise thing we should not be doing.

"A little knowledge can be a dangerous thing." writes Nancy Mohrbacher, author of the fantastic books, Breastfeeding Made Simple, and Working and Breastfeeding Made Simple, among others. "This has never been so true as in the ongoing debate about foremilk and hindmilk and their impact on breastfeeding. The misunderstandings around these concepts have caused anxiety, upset, and even led to breastfeeding problems and premature weaning."

Where did the foremilk / hindmilk imbalance myth arise from?

The foremilk / hindmilk imbalance idea was coined in a 1988 journal article * that reported the qualitative observations of a few mothers who breastfed by the clock, switching baby from one breast to the other after 10 minutes, even if baby was not finished nursing on that side. This is not something that is ever good to do as it does not allow baby to gradually control the amount of milk s/he takes in. The results from this one report have never been duplicated, and newer research calls its methods and conclusions into question. Many well versed in lactation science doubt there is even such a thing as a foremilk / hindmilk imbalance.

Myth-busting Lactation Facts: 

There are not two distinct kinds of milk. That's right - 'foremilk' and 'hindmilk' (as commonly as the terms are used) do not actually exist. There is no magic moment when foremilk becomes hindmilk. As noted above, the increase in fat content is gradual, with the milk becoming fattier and fattier over time as the breast drains more fully.

It is the total milk consumed daily by baby—not 'hindmilk' alone—that determines baby’s weight gain. Whether babies breastfeed often for shorter periods, or go for hours between feedings and nurse for longer times, the total daily fat consumption does not vary significantly.

Early milk is not always low-fat. The reason for this is that at the fat content of 'foremilk' varies greatly depending on the daily breastfeeding pattern. If baby breastfeeds again soon after the last nursing, the early-consumed milk at that feeding may be higher in fat than the late-consumed milk at other feeding. The longer a baby goes between feedings, the more varied milk will be from beginning to end when baby breastfeeds next. If baby is nursing more often than every 2-3 hours (frequent breastfeeding is normal and healthy for many babies at many points of development) than baby will be consuming fattier milk from the start.

If your baby is nursing more often, s/he is consuming more 'foremilk' that is higher in fat than babies who breastfeed less often. In the end, whether baby nurses for loooong stretches and goes 2-3 hours between, or breastfeeds more frequently, for less time, it all evens out at the end of the day, and watching baby and his/her cues is crucial (Kent 2007). Breastfeed on cue, around the clock, and safely sleep by your baby so that cue nursing and dream-feeding at night is easy too. See also: Your Baby's Signs of Hunger

Mohrbacher re-emphasizes: "What’s most important to a baby’s weight gain and growth is the total volume of milk consumed every 24 hours. On average, babies consume about 750 mL of milk per day (Kent et al., 2006). As far as growth is concerned, it doesn’t matter if a baby takes 30 mL every hour or 95 mL every three hours, as long as he receives enough milk overall (Mohrbacher, 2010). In fact, researchers have found that whether babies practice the frequent feedings of traditional cultures or the longer intervals common in the West, they take about the same amount of milk each day (Hartmann, 2007) and get about the same amount of milk fat. Let’s simplify breastfeeding for the mothers we help and once and for all cross foremilk and hindmilk off our 'worry lists.'"

Pumped breastmilk does not look like other forms of processed milk (cow, goat, etc.) that we are accustomed to seeing in the store. Cow milk is made perfectly for baby cows, not humans, as it is different in composition for the mammal it is designed to feed, and it also does not appear this way directly from a mother cow to her calf. Instead, natural human milk has a thin and watery appearance, with a creamy fat layer that may or may not develop when milk sits in the fridge. This is normal, and it will vary from one pumping to the next, and from one breast to the other.

If you are breastfeeding on cue, around the clock, babywearing in the day and safely cosleeping at night to keep baby close, and still find yourself concerned about baby's consumption, take note of how your baby nurses rather than watching any clock. Is your baby swallowing? Is s/he relaxed and content after nursing? Do her little hands open up into a tiny 5-point starfish when she is full? Is he gaining weight over the course of weeks passing? Baby's behavior matters far more than timing, and when we watch our babies and tune into their cues, we allow them to lead the way. In situations where baby is not gaining weight, an IBCLC can do a weighted nursing session (before/after breastfeeding), check for latch and suckle techniques by baby, and also note if a tongue or lip tie is preventing effective milk consumption. Reach out to an experienced lactation consultant in your area, and join local La Leche League and mom's milk cafe groups near you.

What about Green Poop?

Baby’s first bowel movements are the black and tarry meconium that was in the gut at birth. As breastfeeding commences, around Day 3 of life on the outside, baby’s poop changes to 'transitional stools,' which have a dark greenish color. Around Day 5, baby's poop color shifts again to yellow. Its consistency while exclusively breastfed (that is, while nothing but human milk is consumed) may look like mustard or split pea soup - liquid with seedy bits in it. Even when baby’s poop is all liquid with no seeds, and any variation of yellow-orange-green-brown, this is also normal.

In general lots of milk consumption in the early months, means lots of poops, no matter their color or how liquid or seedy they are. After 2 months of age, it is normal for many babies to poop only once every 3-4 days. There is very little waste in human milk, and this does not mean that baby is not receiving enough. Before 6-8 weeks of age, if baby is not pooping daily, a weight check is justified to ensure baby is receiving adequate amounts of milk.

Baby's poop color is not reason to worry if baby seems well and is gaining weight. In her book, Baby Poop: What Your Pediatrician May Not Tell You, Dr. Linda Palmer reminds readers that green is the most common color of baby stools seen, and should not cause alarm. "Beyond the newborn stage, the first matter of order when seeing green is to determine whether baby has eaten some especially green food, including kiwi, spirulina, or green veggies. It's said that grape-flavored Pedialyte [and other grape or chocolate or dark flavored/dyed items] can turn baby poop a bright green. If a child is being given iron supplements, these can turn his stools a dark evergreen." Palmer continues, "[I]f it's not a food pigment, is the digestive juice bile; the same stuff that, when properly digested, imparts the normal yellow to brown colorations of poop. When bile comes out green, it is because the stool has been rushed through baby's digestive system, and not hung around long enough to break down. The question to ask is why."

Causes of Green Poop: 

1) Food dye, natural coloring, or flavoring in mom or baby's diet. This is the most common reason for green colorations of baby poop. In the majority of cases, something minor has shifted poop coloration for a few days.

2) A virus. When baby is ill, the body produces excess mucus that is swallowed by baby. This rushes poop through the digestive tract faster, and poop color may change for several weeks. Keep breastfeeding! It’s the best way to support baby's immune system in fighting the virus.

3) Antibiotics, which also cause stool to rush through baby's system.

4) Teething. When baby is teething large amounts of saliva are swallowed, entering and irritating the digestive tract, causing matter to rush through more quickly. Give baby plenty of teething options to make the process as painless as possible. See: Teething Solutions.

5) Abundant milk supply. If mom produces so much milk that baby receives mostly high-sugar/low-fat milk, it may overwhelm baby’s gut in the early weeks and cause watery or green stools. One way to change this is to simply pump for a few minutes before nursing, and use the pumped milk for your later freezer stash when milk supply regulates, and/or baby grows to be more effective at nursing, with a larger mouth and bigger stomach. We've also used this high-immunity pumped milk to turn into breastmilk popsicles for teething or toddler days. Doing this gets baby fattier milk from the start, and gradually decreases milk production when baby does not fully empty the breasts. Another form of reducing milk supply is block nursing (or block feeding).

6) Inability to breastfeed effectively. A health or anatomy issue (tongue tie, lip tie) may prevent baby from getting the milk s/he needs. See an IBCLC in person to determine if this is the case.

7) Sensitivity to a food or drug in mom's diet. There are certain foods (cow's milk, nuts, soy) that contain proteins that cannot be digested by newborn human babies, but pass easily through mom's milk when they are in her daily diet. This impacts all babies in their early life, but some much more than others. If you notice that your baby is agitated, "colicky," has gas or tummy pain, reflux, sometimes combined with frothy/green stools, it is very likely that your baby is responding more intensely to these items in your diet. Eliminating nuts and soy in the early months, and switching to vanilla rice milk (for example) instead of cow's milk, will help baby's digestion, discomfort, and pain in virtually all cases. For an easy-to-understand synthesis of the research on this, see Palmer's excellent book, Baby Matters: What Your Doctor May Not Tell You About Caring For Your Baby.

In conclusion, the foremilk/hindmilk myth is a misconception that is popular, but not based in lactation science. Breastfeed your baby on cue, around the clock, in a pattern that is baby-led (not clock-led). Find comfortable ways to babywear and sleep by your baby to make life easier for you, and to provide baby with round-the-clock access to the milk s/he needs. Provided s/he is gaining weight, wetting, and occasionally pooping (yellow, green, orange - lots of variations of normal), and is a happy and alert baby, all is well.


Aksit, Sadik, Nese Ozkayin, and Suat Caglayan. "Effect of Sucking Characteristics on Breast Milk Creamatocrit.Paediatr Perinat Epidemiol Paediatric and Perinatal Epidemiology, 16.4 (2002): 355-60.

Hartmann, P.E. (2007). "Mammary gland: Past, present, and future." in eds. Hale, T.W. & Hartmann, P.E. Hale and Hartmann's Textbook of Human Lactation. Amarillo, TX: Hale Publishing, pp. 3-16.

Kent, J. C. (2007). "How breastfeeding works." Journal of Midwifery & Women's Health, 52(6), 564-570.

Kent, J. C., Mitoulas, L. R., Cregan, M. D., Ramsay, D. T., Doherty, D. A., & Hartmann, P. E. (2006). "Volume and frequency of breastfeedings and fat content of breast milk throughout the day." Pediatrics, 117(3), e387-395.

Mohrbacher, N. Breastfeeding Answers Made Simple: A Guide for Helping Mothers. Amarillo, TX: Hale Publishing, 2010.

Mohrbacher, N. Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers.
New Harbinger Publications, 2nd Edition, 2010.

Palmer, L. Baby Poop: What Your Pediatrician May Not Tell You. Sunny Lane Press, 2015.

Palmer, L. Baby Matters: What Your Doctor May Not Tell You About Caring for Your Baby. Baby Reference, 3rd Edition, 2015.

* Woolridge MW and Fisher C. "Colic, 'overfeeding,' and symptoms of lactose malabsorption in the breast-fed baby: a possible artifact of feed management?" Lancet. 1988 Aug 13;2(8607):382-4.

Breastfeeding mothers are welcome to join the Breastfeeding Group on Facebook:

About the Author

Danelle Day focused on human labor and lactation sciences as part of her graduate work in human development. After ten years teaching at the university level, Day left full time academia to raise babies of her own, and joined Peaceful Parenting in 2006 as a clinical advisory board member where she has served thousands of breastfeeding families since that time.

Castor Oil Induction

By Anu Morgan and Danelle Day © 2018

Those last few weeks of pregnancy can be tough at times, especially with round ligament pain, difficulty breathing, pressure from family, friends and pushy practitioners, and so much more. At this time many women are tempted to get labor started on their own, as fast as we can, and look to any method that may allow us to meet our little ones sooner. Looking into 'natural induction methods,' castor oil is among one of the most commonly mentioned. However, this does not mean that it is safe, or without risk for both mom and baby.

Castor oil is a vegetable oil that comes from the castor plant and is best known as a laxative. As it enters the body, castor oil increases small intestinal secretions that stimulate the bowels, often causing intense diarrhea. Diarrhea results from the increase in prostaglandins from castor oil intake, that forces the small intestines to contract unnaturally. Extreme diarrhea is notorious for leading to dehydration, and in the case of a pregnant mother, dehydration can cause labor to occur when baby is not yet ready for the outside world -- leading to a host of other complications with baby's lungs, immune system, and increasing NICU stay needs.

Not only does excess diarrhea and intestinal contractions lead to dehydration for expecting mothers, but castor oil itself also decreases the body’s glucose absorption. This means that when a pregnant mother needs nourishment more than ever, her body is not able to absorb all the nutrients that she takes in, further complicating dehydration and electrolyte imbalance.

The second side effect of castor oil that many are not informed of is that just as it causes contractions of the small intestines to be irregular and unnatural, castor oil similarly impacts the uterus -- causing contractions of the uterus to be more intense, irregular, and unnatural for both mom and her baby. Coupled with dehydration, this leaves a birthing mother drained of energy when she needs it most - to birth her baby, and does not give her a normally functioning uterus in top capacity spurred only by natural birth hormones.

A third risk factor of castor oil is that just as it causes intestinal contractions for mom, so it can with baby. This means that there is a much greater chance baby will pass meconium while inside the uterus, which can lead to fetal distress, or even death. A study published in the Journal of Biology, Agriculture and Healthcare in 2014 stated that 18% of the women who took castor oil had meconium stained waters, verses only 6% of women who did not ingest castor oil. APGAR scores of all newborn babies induced through castor oil were also impacted negatively and significantly.

While it can be hard to wait for our little one to get here, take heart in knowing that baby has a lot to gain from growing inside those last few weeks and days. Normal human gestation periods range from 38 to 43 weeks, with 42 being the most common for first time mothers, and some women birthing naturally into their 43rd and 44th weeks. At 40+ weeks a mother is not overdue. Lung development is critical during these final weeks. Just as we see in animal husbandry and veterinary science, each extra day that a mammal grows on the inside results in a stronger, smarter, more healthy baby, and so it is true for humans. In fact, research suggests that it is a lung protein that is released by baby that tells mom's body baby is ready for the outside world, and labor begins. In the absence of other health complications (including dehydration, malnourishment, drug use, extreme stress, abuse, etc.) mothers birth their babies when they are truly ready to arrive earthside, and this is a good thing!

Veteran midwife and contributing editor of Midwifery Today, Gloria LeMay, writes:
On the subject of all the women in a hurry to get their babies born: I was 3 weeks ‘overdue’ with my oldest daughter. What really helped me was when I had lunch with a friend at about 8 months pregnancy. Her son had been born 6 months before. When she saw me walk into the restaurant, all hugely pregnant, she said, "Oh, Gloria, when I see you I miss my pregnancy so much." I knew that one day I’d be saying that too, so I made up my mind to enjoy it as long as possible, and I’m so glad I did! Six months from now you’ll be wondering what the rush was.

One final note begs attention here and that is the myth of the "aging placenta." This misconception is pushed upon mothers who reach 41+ weeks gestation, and it is completely bogus: your placenta will not all of a sudden stop working.  This myth is not based in science, and is used to coerce and push artificial labor induction and c-sections upon women in a broken birth world that does not trust birth, or the woman and baby whose bodies know just what to do when left alone. In a fantastic review of research on the "Aging of the Placenta" published in the British Medical Journal, authors conclude:
A review of the available evidence indicates that the placenta does not undergo a true aging change during pregnancy. There is, in fact, no logical reason for believing that the placenta, which is a fetal organ, should age while the other fetal organs do not: the situation in which an individual organ ages within an organism that is not aged is one which does not occur in any biological system. The persisting belief in placental aging has been based on a confusion between morphological maturation and differentiation and aging, a failure to appreciate the functional resources of the organ, and an uncritical acceptance of the overly facile concept of “placental insufficiency” as a cause of increased perinatal mortality.
Relish in your little one's movements on the inside. Savor these last weeks talking, singing, walking, dancing with your baby snuggled safe within. Take photos. Take videos. Take long, soothing baths. And know that your baby will be born in his or her own perfect time. ♥

Related Reading

Fetal Lungs Protein Release Triggers Labor to Begin:

Castor Oil Safety and Effectiveness on Labor Induction and Neonatal Outcome:

Castor Oil Inductions - Gloria LeMay:

The Thinking Woman's Guide to a Better Birth:

Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First (Dr. Marsden Wagner):

Birth Reborn: What Childbirth Should Be (Dr. Michel Odent):

Birth and Breastfeeding: Rediscovering the Needs of Women During Pregnancy and Childbirth (Dr. Michel Odent):

Length of human pregnancy and contributors to its natural variation:

Length of human pregnancies can vary naturally by as much as five weeks:

Pregnant Pause: My Baby's Not 'Overdue':

Fox H Aging of the placenta Archives of Disease in Childhood - Fetal and Neonatal Edition 1997;77:F171-F175.

Why Pregnancy Due Dates are Inaccurate:

The Lie of the Estimated Due Date (EDD):

No Induction is 'Normal':

Trusting Birth: 43 Weeks of Faith:

Pregnant Moms Due [this year] Group: (more mainstream)

Birthing Group: (more holistic)

Should I Circumcise My Son? The Pros and Cons of Infant Circumcision

New to the subject of infant circumcision and the benefits of the prepuce (foreskin)? The following are resources many families have found useful when looking at the subject for the first time. They are meant to be a starting point into deeper investigation and further research that is widely available today. If you only have a short period of time to spend on this topic, a blue star marks films with physicians' statements who are in practice today, as well as medical professionals' materials.

★ Functions of the Foreskin:

★ Foreskin and its 16+ Functions (not 'just skin'):

★ Intact vs. Circumcised: A Significant Difference in the Adult Penis:

Why did circumcision start as we now know it in the U.S.? Hear from some original doctors on the matter:
A Brief History in Physicians' Own Words
Circumcision to Reduce Men's Pleasure

★ Are there medical benefits to circumcision? Read national medical statements from around the world:

Physicians' thoughts within the medical field
• Notably, Dr. Morton Frisch: Time for U.S. Parents to Reconsider the Acceptability of Infant Male Circumcision
• Peer reviewed research (studies published in medical journals):

Well researched BOOKS written on the subject:
Marked in Your Flesh
Circumcision: A History
What Your Doctor May Not Tell You About Circumcision
Doctors Re-examine Circumcision
Circumcision, The Hidden Trauma
Circumcision Exposed
The Foreskin and Why You Should Keep It
Circumcision: A Jewish Perspective
Celebrating Brit Shalom

 VIDEO: Dr. Ryan McAllister Georgetown University video lecture, Elephant in the Hospital (also included on DVD in the Saving Our Sons Info Pack):

 VIDEO: Dr. Christopher Guest, Circumcision: The Whole Story:

VIDEO: Whose Body, Whose Rights? Award-winning circumcision documentary:

VIDEO: The Real Reason You're Circumcised from College Humor:

VIDEO: Penn & Teller: Bullsh*t Circumcision Episode:

★ Intact Care:
Circumcision Care:

The two most common forms of circumcision in North American today: 
• Gomco:
• Plastibell: [Note that Plastibell is the type of circumcision most often mistakenly referred to as a 'no-cutting' or 'no-blood' method.]

Outcome Statistics (Circumcised vs. Intact):

Men speak |
• Facebook conversations by men:

Over 250,000 men are restoring some of what was lost to circumcision. It improves sexual pleasure in a wide variety of ways. Google Foreskin Restoration and check out any of these resources:

Psychology Today article collection:

For those with older sons who were circumcised: 
Keeping Future Sons Intact Public Page: 
Discussion Group:
Articles written by those with circumcised sons: 

What does this have to do with WOMEN? 
• Sex As Nature Intended It:
  Book by same title:
• How Male Circumcision Impacts Your Love Life:
• Women's Health and Male Circumcision Resource List:

Faith Considerations on Circumcision
• Resources by/for Jews, Christians, and Muslims:
• For Jews - Intact Jewish Network
• For Muslims - Intact Muslim Network 

HIV/AIDS and the African Trials:

50 Reasons to Leave it Alone: 

If you'd like to join a community of parents (many with both circumcised and intact sons) to ask questions while making your decision, you are welcome to the Intact: Healthy, Happy, Whole group. Everyone is welcome to this safe-space, non-venting community group. The Saving Our Sons Community Group is for those who are already pro-intact advocates, and families raising intact sons.

For Sharing

★ The Info Pack (includes a DVD with several videos and full length articles); the smaller Expecting Pack; Postcards for a Friend; or have a professional exchange online correspondence via email or Facebook message by writing to SavingSons(at)

Informational items (cards, stickers, bracelets, etc.):

Please feel free to email ContactDrMomma(at) any time. Several clinicians volunteer time to field questions, and if we're not able to answer, we'll seek out a place to go for further information.

If you find these resources to be of use, please support Saving Our Sons and work we collectively do. Peaceful Parenting and SOS continue solely by volunteers' time and generosity. See current needs at: or give directly:

The Penis: Sex Education 101 with Marilyn Milos



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