Excess Lipase in Breastmilk

"Why does my milk taste bad?" 
               "Why won't my baby drink expressed milk?"

Feeding M at Maymont.

These two questions usually have one answer. Albeit a rare condition, excess lipase in breast milk does  happen. And it's happening to me. 

We had struggled to get my 3 month old to take a bottle for weeks. And finally found one that she would drink from, not choke and take more than half an ounce. So with a sigh of relief I returned to work, breast pump at the ready. 

Then 2 days back, it happened. I returned home from work one day, my husband very upset. "She won't drink any of this milk, and I tasted it, it's awful!" No it's not. I tasted it too, it's sweet tasting. What do you mean awful? So I gave it a try. 

I. Thought. I. Would. Vomit! It was awful, worse than awful. What was wrong with me? With my milk? So the research began. I googled everything and finally found what the problem may be, but solutions were much harder to come by. And that is why I'm sharing what I've found with you.

Lipase is an enzyme, that in breast milk  helps to digest the fats. One of the reasons breast milk is so perfect, it even helps to digest itself. In rare occasions, excess lipase causes a quick breakdown of fats causing the taste of the milk to change. It's not harmful, and if your little one will drink it, there's no issue. The issue lies when, like Madison, your little one refuses the milk.

If you're exclusively breastfeeding without bottles or pumping, you would never even know there was an issue. For most people the milk doesn't begin to turn until 24 hours or more after it's expressed, and a couple days if it's frozen. [For us, it's almost exactly 24 hours]. 

I've found the only solution is to scald your milk prior to freezing it. We do this on the stove with a thermometer. [My husband has assumed this role. Only fair, I pump, he "cooks" it. And has gotten so good he can do it by looks and no longer uses the thermometer.] Scalding can also be done in the microwave [but not recommended, see below] or with a bottle warmer. The bottle warmer is the best option if you need to do it at work. To scald, the milk must be at 160 degrees or greater for 15 seconds. Immediately cool it and bring to room temperature before freezing it. 

Won't this make the milk less nutritious you ask. Yes, sorta. It does changes the bacterial content of the milk and may breakdown some of the nutrients. They recommend this only if it is not the main source of the baby's milk. [So if you're exclusively pumping, give mainly fresh milk and keep the scalded stuff for backup.] 

To help slow the processes, be sure to rinse all your pumping parts and bottles with distilled water to remove any metals or water impurities. Metals and other impurities act as catalysts spreading the work of the lipase along. 

I remember being told that pineapple can help emulsify the fats, also slowing the processes. But I can't find any evidence of this and it made no change for me. In fact, many people have said that no diet changes had any effect. 

Our experience in a nut shell.

We've had great results with scalding. She only gets it 3 days a week while I'm at work. I pump and put it into a cooler bag and then [my husband] scald it all when I get home, cool it, and into the freezer. My 10 month old baby girl is a plump 24 pounds, walking, babbling and very active. She's had [knock on wood] one cold in her life. So it's working for us. Don't be discouraged, it can work for you to!

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*Microwaving milk has been said to kill the anti-infective properties of the milk, scalding or even pasteurizing keeps the anti-infective properties intact. Also, please remember that microwaved breast milk MUST be treated like formula when considering storage. 

References on microwaving human milk, sorry I don't have the links.

§  Sigman M, Burke KI, Swarner OW, Shavlik GW. Effects of microwaving human milk: changes in IgA content and bacterial count. J Am Diet Assoc. 1989 May;89(5):690-2. 

§  Quan R, Yang C, Rubinstein S, Lewiston NJ, Sunshine P, Stevenson DK, Kerner JA Jr. Effects of microwave radiation on anti-infective factors in human milk. Pediatrics. 1992 Apr;89(4 Pt 1):667-9. 

Oma giving me a bottle while Mommy's at work.