When her baby consistently rejected feeding, one mother discovered a high lipase content in her breast milk. Here’s an expert insight into what it means to your baby to drink milk with a high lipase content and the steps that can be taken to manage it.
My maternity leave expired when my baby was a few months old, and I returned to the Army Reserve weekend battle assembly. Although I was still breastfeeding, I diligently pumped for weeks previous to my return date and stored dozens of ounces of breast milk for my husband to give her while I was away.
Two hours into my first day back at drill, I received a text message stating, “She refuses the bottle.”
My heart sank, and I panicked immediately: What if she doesn’t eat while I’m gone?
Bottle refusal can be an immensely unpleasant and discouraging experience for parents who are separated from their infants for any length of time, regardless of the reason. We all want to feel confident that our children will be cared for in our absence, but when a breastfeeding infant refuses to take a bottle, it can cause considerable anxiety. No matter what we did, my kid refused to drink the warmed milk, and this gradually escalated into exasperation. She would take a sip, recoil in revulsion, and turn her head away.
I was at a loss after trying six different nipples and bottles. In a desperate attempt to solve the situation, I sampled the milk and quickly spat it out since it tasted like soap. I searched the internet, confused and honestly repulsed, and discovered the culprit: excessive lipase.
My initial thought was, what on earth is a high lipase level? Why do I own it?
What Is Milk with High Lipase?
“Lipase is a naturally occurring enzyme in human milk. It makes fat globules tiny and more digestible”, according to a neonatologist at the Johns Hopkins All Children’s Maternal, Fetal & Neonatal Institute, Lilly Lan Chang, M.D., MS, FAAP. By breaking down the milk fat, the infant has more access to fat-soluble vitamins.
Dr. Chang adds that when someone has excessive lipase, the milk fat begins to break down sooner after expressing it.
Although the lipase process is typical, at excessive concentrations it might leave the milk with a metallic or soapy aftertaste, similar to what I had experienced, and make the milk unattractive. The alteration of flavor might occur between hours to days.
Is Milk High in Lipase Hazardous for Your Baby?
Dr. Chang notes that while excess lipase can alter the flavor of breast milk, it is not detrimental to the infant.
It may even be advantageous for your milk. “It is actually protective against pathogens and prevents the milk from degrading,” says Stephanie Nelson, BSN, R.N., IBCLC, CCRN-NICU, co-owner of Success Lactation Specialists, LLC in Wisconsin.
What Causes Excessive Lipase?
Some medical specialists believe that high lipase is not discussed enough, but it is unclear how many people encounter it and why some do, and others do not. Dr. Chang explains that “after the lipase has impacted the milk, there is no way to treat it.”
Nelson says she routinely sees clients with elevated lipase levels, and levels can fluctuate greatly between individuals and even between pregnancies, as was the case with me.
According to my knowledge, I did not have excess lipase with my first child (or he was unaffected by it), but I did with my second. After some experimentation, I also observed that my milk began to taste soapy after chilling alone. As Nelson suggests, some individuals only have this problem when they freeze milk. “We do receive calls from customers refusing only previously frozen milk, and this is typically the cause,” she explains. Others, including myself, need help even to store it in the refrigerator.
AAP Alters Breastfeeding Recommendations, Urges More Support.
What to Do If Milk Is High in Lipase
Nelson asserts, “There is little a family can do if the infant does not object to the milk.” In other words, your infant can safely consume it despite its soapy flavor and odor.
But what if your infant is one of the fussy ones who refuse the milk outright? You can cover the flavor by adding a few drops of alcohol-free vanilla essence or combining the thawed milk with freshly-pumped milk. Before mixing freshly expressed milk, the Centers for Disease Control and Prevention recommends cooling it.
Nelson argues that if that doesn’t work, there are other ways to help. “First, you can deep freeze your milk immediately after it has been expressed or pumped, which reduces the lipase activity,” she explains. “The disadvantage is that you would have to immediately freeze it as cold as your deep freezer can go, and not all home deep freezers have this capability.”
Because lipase is inactivated at high temperatures, another possibility is heating the milk. Nelson says that you can stop the lipase activity in milk by scalding it in a saucepan before freezing. This can be accomplished by heating the milk to around 144.5 degrees Fahrenheit for about one minute or 163 degrees Fahrenheit for about 15 seconds (a thermostat is preferred), then immediately cooling and freezing.
Dr. Chang concurs that scalding is a viable treatment, although it may reduce the milk’s nutritious content and antimicrobial qualities. She adds, however, that this should not be a concern unless all of the baby’s milk has been heated.
Scalding my milk (although time-consuming and inconvenient) turned out to be a godsend for me and the only way my daughter would drink from a bottle.
In the end, I was relieved to have an explanation and learn that neither I nor my milk was ill. And as I began discussing it with my mom’s friends, I was surprised by how many of them had had the same problem.
If you’re a nursing mom who’s having trouble getting their infant to take a bottle, high lipase is not necessarily the problem, but it’s worth investigating or talking with a professional lactation consultant. Yet even if it turns out to be the cause, family-friendly remedies are available.
Meaningful articles you might like: 4 Factors That Can Reduce Your Milk Supply, How to Properly Store Breast Milk, 7 Facts Parents Need to Know About Non-Dairy Milks