I posted this in January on the Private Practice list:

I have always wondered why some women have elevated serum-stimulated

lipase, while no one tends to have elevated levels of bile-salt

stimulated lipase. Bile-salt stimulated lipase has no ability to

activate outside of the infant's gut, as it requires the presence of

bile salts. But, serum-stimulated lipase will digest the milk while it

sits in a container--causing rancidity.



The thing is that serum-stimulated lipase seems to have no benefit to

the infant and is not activated in his gut, and elevated levels are

believed to be the cause of breastmilk jaundice. Also interestingly,

the activity of serum-stimulated lipase seems to differ in women based

upon their diets.



So, my concern is that while we can just tell women to scald their

milk, there is a cause for this elevation in serum-stimulated lipase

that we are ignoring. My thought is that we are more likely to see

higher levels in women who have a lower nutritional profile and

probably have inflammation.



In one study that compared Ethiopian women with compromised nutrition,

Ethiopian women of privilege and Swedish women, it was observed that

the Ethiopian women with compromised nutrition had the highest levels

of Levels of bile-salt stimulated lipase did not differ between

groups, but activity levels were highest among the privileged

Ethiopian women and the Swedish women had the lowest activity. The

highest values of serum-stimulated lipase were in the Ethiopian women

with compromised nutrition and the lowest in the Swedish mothers. Milk

volume had no correlation.



Among the general population, elevated lipase levels in the blood are

related to either gall bladder or pancreatic dysfunction, both

conditions of poor nutrition--often including over-consumption of poor

quality foods (including high triglycerides), obesity and inflammation.



So, I guess while I was treating the milk, I'd also be interested in

treating the mother.




Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network LLC

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