One breast or two? How many sides is a feed?
The typical arrangement of human mammary glands is two breasts aligned on the chest, roughly level with the armpits. While babies can be fully breastfed with just one breast, here we will discuss the most common scenario.
Decades ago there was a wealth of misinformation given to new mothers about breastfeeding. One of the most unhelpful was the timing of the baby being permitted to be attached. It went something like this:
Day one: feed baby on first breast no longer than one minute. Swap to second breast for one minute. Repeat every four hours. Top up with sugar water (!) from a bottle if needed!
Day two: feed baby on the first breast for three minutes. Swap to second breast for three minutes.
Day three: feed baby from first breast for five minutes. Swap to second breast and feed for five minutes.
Day four and onwards: feed from first breast for ten minutes before swapping to second breast for ten minutes.
The thinking behind this was flawed: it was supposed to stop nipples becoming sore. It didn't.
Foremilk and Hindmilk
By the late 1980s, mothers were no longer advised to limit feeds by the clock. The descriptors Foremilk and Hindmilk were developed to describe how the milk glands released milk higher in fat during the let-down and breastmilk becomes increasingly richer as a feed progresses. Advice to mothers changed from offering both breasts equally at each feed to allowing babies to “finish the first breast first” so they could get this richer hind-milk.
However, mothers were increasingly being advised to keep their baby on the first breast for particular lengths of time in case they “missed out” on the hind-milk. Now babies were being restricted from accessing the second breast and being repeatedly put to the one side throughout the feed! Effectively, they were practicing block feeding, a technique used to reduce over-supply. Inevitably, they would seek advice on increasing their supply and the simple solution was to feed baby both breasts per feed.
It is common for babies to be fully satisfied by one breast in the early days but usually by around 12 weeks, they will need both most feeds. Babies can regulate how long to stay on the first breast and get all the fat-rich milk they need. The milk in the second breast will also have an increased fat content due to the let-down reflex.
The composition of breastmilk is different at every feed and the foremilk at one feed might be higher in fat than the hind-milk in another! The closer together the feeds, the higher the fat level remains.
Humans are the only mammal on earth who ever see their own breastmilk
And whatever we express is just a snapshot of that moment in lactation
Switching it up
Switch feeding is a technique used to increase baby's intake and imstimulate production. The baby feeds on the first breast until they stop regularly swallowing and are then offered the second side. After they stop actively feeding on that side they are brought back to the first breast again and then the second once more. This stimulates supply by limiting the release of the Feedback Inhibitor of Lactation (FIL) and is functionally the opposite of block feeding. The baby is effectively being “topped up” by the breast and receiving additional fat-rich milk.
When a baby is feeding efficiently and effectively removing milk from the breast, there is no need for their mother to monitor or regulate their access. Sometimes one side will be enough, sometimes two or three are needed.
