Breastfeeding Basics, pt. 1: One Breast or Two? Low or high fat milk?

A common question mothers ask is whether they should give both breasts at each feeding or if they should give just one. The answer is ‘neither.’ Ideally your baby will make this decision. When a baby is healthy and breastfeeding normally, he is fully capable of determining when it’s time to switch breasts. After all, he’s the only one who knows how much milk he’s had and if he’s ready to go to the other side.

Finish the First Breast First: Not too long ago, the common advice given to breastfeeding mothers was to breastfeed for 10-15 minutes on the first breast, take the baby off, and then keep her on the other breast for as long as she liked. This strategy worked well for many mothers and babies, but there were some for whom it didn’t work.

Disadvantages of Breastfeeding by the Clock: For the lactation professionals trying to help these mothers, the problem was mysterious. The moms obviously produced a lot of milk, but their babies were not gaining weight well. The babies were also colicky, gassy, and had green, frothy stools…Eventually when the cause of their problem was discovered, we gained a new insight into an aspect of breastfeeding that had not been widely understood.

The issue was that these mothers had been following the standard advice to switch their babies to the second breast after 10-15 minutes. In 1988 researchers Michael Woolridge, PhD and Chloe Fisher, a British midwife solved this mystery. In 1988 they described to the world in the medical journal Lancet how this way of managing breastfeeding had caused the problem.

Fat, they explained, sticks to the milk ducts in the breast. This means that when the breasts are full, the first milk that is released is low fat!

As the breast is drained and more milk is pushed toward the nipple, fat is dislodged from the ducts into the milk, increasing its fat content. By switching breasts too soon, these babies had gotten mostly low-fat milk on the first breast. They they were switched to the other breast where they also received mostly low-fat milk, having filled their bellies before reaching the higher fat milk. This overload of low-fat milk rushed through their digestive systems, causing the gas, the colic, and the low weight gain.

Look for pt. 2 in coming days.

From Breastfeeding Made Simple, Mohrbacher and Kendall Tackett 2010.