Dear Anne-

I wanted to answer your query about discussion of hindmilk and foremilk at
mother's bedside.
I have the benefit of being able to talk to most of our new breastfeeding
moms in the hospital the day of their baby's birth or the next day.

I usually begin by asking the mother if she has any specific questions or
concerns about breastfeeding.  Quite often I am asked how long to nurse the
baby on each side.  My recommendation to them is that they let the baby
nurse on one side until the baby has either fallen off the breast or is
still at the breast looking very content and no longer sucking.  I tell them
that the next step is to try and burp the baby or change the baby's diaper
and then offer the other breast.   If the baby wants to nurse let him but if
not just start with that breast at the next feeding.  Mainly- watch the
baby's cues.

Usually at this point I am able to talk about how their milk will change
from the beginning of a feeding from more skim-like milk (but still chock
full of anti-bodies and other great stuff) to a higher fat milk that helps
baby to feel very satisfied.  I have to gage how much information the mother
seems to want or can handle at that time.  Sometimes they don't want to know
why they just want to know how.

I like to let them know how important it is for the baby to have the fat in
the later milk.  Most moms seem to understand and appreciate knowing.  I
know that we have had some discussion about "cluster feeds" on Lactnet. I am
sometimes able to help a mom after she is home to understand the value of
the extra fat gained by these "cluster feeds".   I basically go over the
same information  with her again.

Sometimes it is helpful to let a mom know it is really ok to nurse the baby
a long time.  If they have a "scientific" reason- somehow it is alright for
them to do what they feel like doing anyway but feel guilty for whatever
reason.

I have found talking about foremilk/ hindmilk very helpful when moms call
with a fussy baby.  Sometimes just letting the baby get that extra fat will
settle him down so much.    Anyway-  These are some of the times that I go
into the foremilk/ hindmilk  explanation.  I guess I just try to gage the
interest / needs of the mom.

Hope this is helpful to you.

Trying to nurse a 23 month old and type, :O)

Lori McCulloch
WIC Breastfeeding Coordinator and still Peer Counselor
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