Despite my ups and downs with supply, I've managed to build a nice little freezer stash by pumping prior to returning to work. Like so many others, I had planned to use the frozen milk on days where I didn't have enough milk from the previous day's pumping sessions, or for visits to grandma's, Mondays (so that I wouldn't have to pump on the weekend) and all the other times I might need a little extra. I ended up having over 400 oz in a freezer (a freezer we bought especially for breast milk storage). I'm committed and determined to breast feed my child. My body on the other hand, seems to have other plans. I finally needed to pull out some of the milk from the freezer last week. Low and behold, every bag I pulled out wreaked of soured milk. Some of them smelled like spit up, some smelled like metal, some just smelled so bad I couldn't even describe it.
Bag after bag of frozen breast milk turned rancid smelling and the taste was so bad I wanted to puke just testing it from my finger tip... I finally began to understand why my daughter wasn't eating during the day. I have excess lipase in my breast milk. Meaning, that as soon as I pump, the clock starts running on how long I have before the taste of my breast milk starts to turn. Some sites describe the taste as soapy, or metallic. Mine was metallic and spit up taste combined. For me, I typically pump at work, and then use the milk from today for her to drink tomorrow. Unfortunately, by the time she's ready to drink it, my milk has already started to turn (an hour by hour taste test helped me to pin point that my milk starts to turn by hour 22. Not enough for her to make it a full day.)
I want to make it clear, that breast milk with excess lipase is perfectly fine and safe for babies to drink. It only tastes bad, which is why some babies won't drink it. Some don't mind the taste and will drink it. My daughter will not.
I began to panic. I cried, I sobbed, and I had a total melt down. All those hours of pumping, all the lost sleep, all the work that went into making that stash. All that milk. I now understand why my daughter has been stuck on a
reverse cycle for over two months!!
Then I got online and started researching. I was clearly not alone. Tons of nursing mothers have had this same problem. A friend of mine from my mommy group also had excess lipase, so I had a starting point for what to look for. I found out that it could be more than excess lipase, that it could possibly be chemical oxidation. If you're nursing and you've never heard of either of these (like me) then I'll give you the nutshell version. They both make your milk taste bad. But they do it because of different reasons.
Excess lipase is an over abundance of the enzyme (lipase) in your breast milk that helps break down the fats for digestion. It basically has so much, that it breaks it down too fast and starts to turn the milk before your baby can drink it when it's been expressed. The time frame varies from woman to woman, and I was unable to find information on why it happens. It may not happen each time a woman has a baby either. So if you've had it once, you might not have it next time. Chemical oxidation on the other hand, makes your milk taste bad due to the process of pumping/storing and what you put into your body. If your refrigerator isn't cold enough (32-39 degrees F) then your milk might be turning faster, and can make you think you have excess lipase when that really isn't the case. If you have city water with a lot of chemicals in it, these might also affect your milk because of how you wash and sterilize your bottles and pumping equipment. If you eat an excessive amount of polyunsaturated fat then you can also have chemical oxidation from this as well (from what limited information I was able to find).
To be honest, it frustrated the hell out of me knowing that it could be multiple reasons. The first thing I did was review my
storage process. I started with the fridge. I bought a fridge thermometer and found out my fridge was at 42 degrees. Not cold enough to keep breast milk. I was also keeping my milk on the top shelf toward the front. We now keep it on a lower shelf in the back, since the thermometer revealed that as the coldest place in the fridge. I had been washing all my gear in regular tap water. I bought distilled water for rinsing and sanitizing and boiled them each night for a week. Turned down the temp. Moved the milk. Sterilized everything. Nothing changed. I was pretty sure it was excess lipase at this point, but wanted to be sure, as it would make a big commitment on my part to keep pumping milk. I then did the last test I could figure out... I scalded the milk. I read that scalding the milk will make milk that has chemical oxidation taste even worse because it further breaks down the milk and it will turn even faster. However, if you have excess lipase, your milk will taste fine after scalding and will last longer than it does without scalding.
My fridge and kitchen looked like a laboratory. I used 3 tubes of 2.5 oz containers of breast milk. The first (control) contained milk that was pumped and put straight into the fridge. The second, contained milk that was pumped, put in the fridge at work, brought home, scalded to 180 degrees, then put back into the fridge. The third contained milk that was pumped, scalded immediately, and then put in the fridge. The fist container turned before 24 hours was up. The second, didn't have that taste to it, and lasted 4 days before I tossed it, The third came out the same as the second and lasted 4 days before I tossed it. Both may have lasted longer, but I just needed to know if I could salvage milk pumped on Fridays to be used on Mondays. It just proved that I could scald either immediately, or wait till I got home from work. I had read mixed reviews about this though, that the additional cooling and heating could break down the milk further, and to try to do it right away if possible.
But I work... full time.... so how the heck was I going to make that happen? I already take so much time away from my desk a day to pump. Then I ran across a
blog that gave the
best advice ever. I couldn't believe how easy this was going to be, and why I didn't think of it myself!
So you have excess lipase?
You don't have to stop breast feeding/pumping. It is still possible to do it, and to still have enough to freeze. It will just require an extra step on your part. If you work full time like I do, this means you'll need even more equipment at work, and I'd suggest letting HR know what's going on. Mine was super accommodating and said to do whatever I needed to do and to not stress about it. They know I'm aiming for one year, and that I'm the kind of employee that will make up the work. Only 7 more months to go right?
What to do about it:
Buy an
instant read digital thermometer,
bottle warmer without an auto shut off feature, and a
stainless steel bottle. When you pump at work, pour the milk into the stainless steel bottle immediately, and then scald the milk in a bottle warmer, and pull it off as soon as it hits 180 degrees. I then cool the milk under running cold water until it's cold enough to put into glass bottles (I found that for me personally the glass absorbs smell and bacteria less than the plastic ones, and Dr. Browns glass bottles are the same fit as my Medela pump). Then I put them in the fridge at work until I go home. It does add on time, and I get everything ready to go while pumping. (Double check with your HR department to make sure your work's fire alarm system won't be activated by the hot steam just in case). As soon as I'm done, I pour the milk into the stainless steel bottle, and then start the bottle warmer. I clean up while it's heating up. Then I only have a couple more min before it reaches the right temp. I unplug the bottle warmer and dump the rest of the hot water from it. Bring a towel, since 180 degrees is very hot. You will need to cool the milk as soon as you heat it. Don't let it sit to get cool. This information was super helpful:
Cooling down heat-treated milk: Cooked foods have a ‘danger zone,’ a temperature range from 60ºC/140ºF to 4ºC/39ºF where bacteria like to grow. It is therefore important to cool milk down quickly after it has been heated. Cooling the container in ice water is the quickest way to cool milk. Depending on the amount of milk, cooling it in the refrigerator is generally not recommended as the milk will cool unevenly, leaving some milk too warm for too long. Please know that not all glass is suited for heating and rapid cooling. (see source number 3 below)
This great note from Kelly Mom was very helpful for me:
What can I do if my storage problem is due to excess lipase? Once the milk becomes sour or rancid smelling/tasting, there is no known way to salvage it. However, newly expressed milk can be stored by heating the milk to a scald to inactivate the lipase and stop the process of fat digestion. Scald the milk as soon after expression as possible.
To scald milk:
Heat milk to about 180 F (82 C), or until you see little bubbles around the edge of the pan (notto a full, rolling boil).
Quickly cool and store the milk.
Scalding the milk will destroy some of the antiinfective properties of the milk and may lower some nutrient levels, but this is not likely to be an issue unless all of the milk that baby is receiving has been heat-treated.
Per Lawrence & Lawrence, bile salt-stimulated lipase can also be destroyed by heating the milk at 144.5 F (62.5 C) for one minute (p. 205), or at 163 F (72 C) for up to 15 seconds (p. 771).
I find that I'm able to let pumped milk from Friday at work, sit without issue, and without being frozen, in the fridge until Mondays when she drinks it. After being scalded and cooled immediately, the milk is able to survive the weekend.
If you have chemical oxidation, here is what you can do about it:
Cut out all polyunsaturated fat and rinse all pump parts/bottles with distilled water. Make sure you sanitize your bottles and pump equipment every time you use them in distilled water. Also use a soap that is phosphate free (medela breastmilk soap is what I used). Some sites also recommend that beta carotene and vitamin E need to be increased in your diet (be careful as I've read that these can be toxic in the wrong doses).
What do I do with all that frozen milk with excess lipase?
If you found out late in the game, and have a big freezer stash like me? Consider donating to a
legitimate milk bank... be careful, as most hospitals can only accept through one of these places since they do a blood screen (their cost, not yours) and the milk is pasteurized so that they can still use it. NICU babies often are tube fed, so they won't have to taste the bad flavor, but can still receive the benefits. Some places are "milk banks" that charge the recipients. You can read more about this
here. Don't trust these places, as they don't go to the families in need. There are only 14 legitimate milk banks in the US that hospitals receive this milk from. You can find them
here.
Amazing resources:
