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Thread: Scalding breastmilk due to excessive Lipase

  1. #231
    Join Date
    Nov 2006
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    6,959

    Default Re: Scalding breastmilk due to excessive Lipase

    Those are great links, thanks for the correction! Duly noted!

  2. #232
    Join Date
    Sep 2008
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    Default Re: Scalding breastmilk due to excessive Lipase

    My baby is 7 weeks old and I have been refrigerating and freezing milk since I came home from the hospital. My baby would sometimes drink heated milk from the frig, other times make a funny face and not drink the bottle. I can remember times when she would drink it though, but just not sure how old it was. I thought I was heating it to hot, causing it to spoil. I googled scalding breast milk and found out about lipase. So I went to the freezer and heated my oldest back of milk, and sure enough, it smelled like a tin can (metallicy). I heated another bag from mid August and it did not smell. But she would not drink it. So I concluded that I must have the lipase issue and thru out my frozen stash. I have a bottle warmer and a thermometer so I thougth scalding would not be so bad. But my baby will not drink the scalded milk! I am able to get her to drink maybe an ounce but that is it. Could the metal smell be from something else? And if she will not drink the scalded, what should I do? I get the milk to 145 degrees, then start my timer for 1 minute, then put in ice water. Then it goes to the frig. This has me really depressed as I am lost for what to do. I would like some milk for emergencies and for my husband when I go to the doctor.

  3. #233
    Join Date
    Nov 2006
    Location
    Durham, NC
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    723

    Default Re: Scalding breastmilk due to excessive Lipase

    Congrats on your baby!

    I am wondering if your babe is having a hard time adjusting to bottle feeding? It is an acquired skill for most babies and can take some time to get used to. If you have not seen it yet, here are some tips.

    http://www.kellymom.com/bf/pumping/bottle-feeding.html

    It could also be that your milk needs to be scalded because of lipase issues. Have you tasted the milk. I know it sounds odd but it would be good for you to know vs. smell alone. Try it, then work to confirm that scalding helps it keep from tasting like yuck over time. Keep in mind scalding won't fix all the milk in your freezer. It will only help to deactivate the enzyme if scalded soon after expressing. The time you have prior to scalding varies from mom to mom.

    You can get past this. You're already doing a great job by trying to figure out what you need to do to help your baby. Hope that helps.

  4. #234
    Join Date
    Sep 2008
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    Unhappy Re: Scalding breastmilk due to excessive Lipase

    THanks for your post. I just tasted some day old refrigerated milk and it tastes like medal. My husband smelled it and said it smells like it to him. So I have scalded some (yesterday) at 145 degrees for 1 minute, then chilled. It tastes okay to me. So earlier my husband tried to feed it to her and she only would drink about an ounce. Then she would push the nipple out or gag. If I pump and put that straight into the bottle, she will drink it right up. Can anyone tell me what I am doing wrong with the scalding thing??? Should I mix formula in with my breast milk? I have to leave her on the 19th and this has me very depressed as what to do.

  5. #235
    Join Date
    Aug 2008
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    10

    Default Re: Scalding breastmilk due to excessive Lipase

    After iugr, an induction, jaundice, and many breastfeeding issues (lo wont really breast feed -gets only an ounce in 45 min, despite my big supply) I thought I at least had a freezer filled with milk. Nope not even that. Its sour. Im going to see if the milk bank will take it. I have 4 huge zip bags filled with 4 oz bags. Crap.
    I couldnt figure out why lo would only drink an ounce or two dispite being hungry. And now I know why when I rented the scale I realized he wasnt gaining any weight over a weeks time. He didnt want bitter milk. I scalded my first batch last night-although in a pan-so hopefully its ok. Im greatfull to find this site, now my baby will eat!
    I read this whole posting and have learned a lot. I was wondering-if its bile salts that do this to the milk-would it have anything to do with my liver/bile? I had my gallbladder out-so my fat proccessing is all wacked. Anybody else with gallbladder issues? And this is such a sad-why doesnt the hospital mention it before a mother has a 3month supply frozen? ARG

  6. #236
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    Nov 2006
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    Durham, NC
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    Default Re: Scalding breastmilk due to excessive Lipase

    Welcome.

    Interesting about the gallbladder - I don't know if it's related or not, but fwiw I've had my gallbladder out also. Anyone else?

  7. #237
    Join Date
    Aug 2008
    Posts
    10

    Default Re: Scalding breastmilk due to excessive Lipase

    Thanks. I'll be interested to see if anyone else has gallbladder/liver issues. Sometimes it can go undiagnosed for years. It took me 5 years to figure out what those tummy aches were.
    I figure the only way through the discouraging news is to take positive action. I went and bought a bottle warmer and have just put my first 12 oz in the freezer. Tomorrow Im calling the milk bank in Cali-we live in Oregon-where there isnt one. And Im calling a chiroractor/sacrocranial specialist about my LO breastfeeding problem... it would be nice to get that resolved so he doesn't have to drink scalded milk.
    I noticed a few ladies are mail delivery folks. I run my breat pump off my cars 12v-got a converter kit at Fred Meyers. Couldnt a munchkin bottle warmer run off that too?

  8. #238
    Join Date
    Jan 2008
    Location
    NoVA
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    1,535

    Default Re: Scalding breastmilk due to excessive Lipase

    Here is some great info from another La Leche League Leader - is this about "can diet change a Lipase issue?"

    Hi Jessica,
    This is a question that has long been of interest to me, too. I do not know of any research specifically looking at lipase levels and diet in humans. However, I have been privy to a correspondence between breastfeeding/human milk researcher Leon Mitoulas and another LLLL [La Leche League Leader]. This was back in 2004 and Dr. Mitoulas may have developed other thoughts on the matter since then.

    What he postulated in 2004 was that higher levels of antioxidants in human milk would probably make the fats more resistant to lipase activity, because the lipid membrane would be more resistant to oxidation. It isn't totally clear whether simply eating more antioxidants in the diet will lead to more antioxidants in a mother's milk. It may be an interplay of consuming antioxidant-rich foods AND avoiding 'bad' foods that use up the antioxidants in the mother's system. Just speculating here.

    Another idea that Dr. Mitoulas raised was the possibility of nutrient deficiencies in the mother's diet, specifically phosphate. There is research on cow's milk where a whole herd had problems with chronic rancidity. It was found that giving the cows more phosphate corrected the problem. The theory was that the milk fat globule membranes, which are partly made of phosphates, were weak because the cows' diet lacked phosphate.

    There are lots of things to consider when it comes to lipase. When women have a 'lipase problem' with stored milk, is it because they have more lipase? Or is their milk more susceptible to its activity -- do they have certain features in their fats, amount of fats, type of fats, etc? Part of it may be as simple as the overall milk fat content of a given batch of milk. ie, a batch that is more foremilk-y may stay fresh longer than a batch that is more hindmilk-y. Another consideration is that lipase tends to be in the skim portion, so when milk has separated into a fat layer and skim layer, the lipase will have less direct contact with the fats than if the milk were mixed. So maybe leaving the milk separated as much as possible & not shaking or swirling it together will lessen the opportunity for lipase to act on the fats. Research on cow's milk indicates that if the fat and whey are separated while milk is still warm, the milk fat globules may be less subject to lipase breakdown.

    After one mom asked me if the nutritional value of her expressed milk was compromised by high lipase activity, I realized the need to explain that lipase is not a defect or fault but a wonderfully functional component of human milk.

    In _Breastfeeding: A Guide for the Medical Profession_ by Lawrence and Lawrence, 6th ed, 2005, p. 156:
    "Milk fat is almost completely digestible. The emulsion of fat in breast milk is greater than in cow's milk, resulting in smaller globules. Milk lipases play an active role in creating the emulsion, which yields a finer curd and facilitates the digestion of triacylglycerols (TGs). The newborn easily digests and completely uses the well-emulsified small fat globules of human milk. Free fatty acids are important sources of energy for the infant.

    " . . . The lipases in human milk make the free fatty acids available in a large proportion even before the digestive phase of the intestine. . . .

    [Note: this may be one of the reasons why formula-fed babies have been shown to require about 30% more calories for adequate growth compared to thriving breastfed babies. Digestive factors such as lipase ensure that almost all the calories are made available.]

    " . . . Additional lipases in the skim milk fraction are stimulated by bile salts. Bile salt-stimulated lipase (BSSL) has greater activity and splits all three ester bonds of the triglyceride. This lipase is also stable in the duodenum and contributes to the hydrolysis of the TGs in the presence of the bile salts. . . . BSSL activity is protective against infection by virtue of the production of free fatty acids and monoglycerides, products of fat digestion that have antiinfective properties.

    "The enzyme activity of BSSL is remarkably stable during prolonged storage up to 2 years at either -20C or -70C (-4F to -94F). It has also been noted to be stable at 15C, 25C, and 38C (59F, 70F, and 100F)."

    [Note that freezing the milk does NOT inactivate or even reduce the activity of BSSL.]

    And from _Breastfeeding and Human Lactation_ by Riordan and Auerbach, 3rd ed, 2005, p. 122:

    "In order for human infants to digest fat, adequate lipase activity and bile salt levels must be present. The bile salt-stimulated lipase and lipoprotein lipase present in human milk compensate for immature pancreatic function and for the absence of amylase [necessary for the digestion of starch] in neonates . . . When human milk is frozen or refrigerated, lipase is not affected; however, heating severely reduces lipase activity. Several protozoa - Giardia lamblia, Entamoeba histolytica, and Trichomonas vaginalis - have been shown in vitro to be killed rapidly by exposure to BSSL . . . "

    We can state with confidence that lipase is a GOOD thing to have in your milk. It can be inconvenient to deal with when the baby is getting expressed milk, but overall, it is a beneficial component.

    You are welcome to share this post in the forums.

    Margaret
    LLLL, 6-year veteran of the PL Department
    Longmont, CO
    Jessica
    LLL Leader

    Breastfeeding is an instinctual and natural act, but it is also an art that is learned day by day.

    Visit LLL of Ashburn PM's Blog!

  9. #239

    Default Re: Scalding breastmilk due to excessive Lipase

    This is an amazing thread, and after reading through the thread, I realised some of the questions I have have previously been asked, but not answered:-

    1) I would describe the awful taste as oily (like overdue oil that had been kept for months), instead of soupy/ metalic taste. Is this the same lipase issue?
    2) If my baby is not rejecting the foul taste EBM, is it ok to continue feeding my baby with the milk, instead of scalding it?
    3) Is the "foul" taste milk harmful to my baby in anyway?
    4) I also noted that some suggested that it's the storage issue - i.e: we should use double bag (which I don't), and never put the milk at the door of freezer (which I do). I am running out of space as I have >50bags of milk stored in the tiny freezer
    5) It usually takes me >12hours to defrost (from freezer to fridge), and sometimes, I leave it to another 20hours or so befoe using up. So all in all, the time the milk is in fridge is ~32hours from freezer. Is that too long? But it only thaw after 12 hours or so...

    I have heard of friends tale that they continue feeding the baby with the awful tasted milk and their baby is alright. I am hoping to do so if it's not harmful to my baby & my baby is not rejecting it. I don't like the idea of scalding.....

    Thanks in advance for any idea/ suggestions!

  10. #240
    Join Date
    Nov 2006
    Location
    Durham, NC
    Posts
    723

    Default Re: Scalding breastmilk due to excessive Lipase

    This is an amazing thread, and after reading through the thread, I realised some of the questions I have have previously been asked, but not answered:-

    1) I would describe the awful taste as oily (like overdue oil that had been kept for months), instead of soupy/ metalic taste. Is this the same lipase issue?

    Perhaps - the only way to find out more conclusively would be to try scalding and see if your milk doesn't change taste.


    2) If my baby is not rejecting the foul taste EBM, is it ok to continue feeding my baby with the milk, instead of scalding it?

    Yes. It is ok.

    3) Is the "foul" taste milk harmful to my baby in anyway?

    No. It just has some of the fats already broken down.

    4) I also noted that some suggested that it's the storage issue - i.e: we should use double bag (which I don't), and never put the milk at the door of freezer (which I do). I am running out of space as I have >50bags of milk stored in the tiny freezer

    The issue with the freezer door is that your milk is not kept as cold - and also that every time you open and shut the freezer it can start to thaw and then refreeze.... then also in a self defrosting freezer it thaws and refrezes several times. Not too good. If you can swing it, a dedicated deep freezer is a better option for storage. Double bagging helps prevent freezer burn and also helps keep your milk from absorbing smells of things that are also in the freezer - for example, fish, etc.

    5) It usually takes me >12hours to defrost (from freezer to fridge), and sometimes, I leave it to another 20hours or so befoe using up. So all in all, the time the milk is in fridge is ~32hours from freezer. Is that too long? But it only thaw after 12 hours or so...

    You can thaw frozen milk quickly by running it under warm water. Generally, I've read that frozen milk should be used within 24 hrs. of thawing.

    I have heard of friends tale that they continue feeding the baby with the awful tasted milk and their baby is alright. I am hoping to do so if it's not harmful to my baby & my baby is not rejecting it. I don't like the idea of scalding.....

    It is ok and won't harm your baby. (If it's not broke, don't fix it).

    Thanks in advance for any idea/ suggestions!

    Welcome - and hope that helps.

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