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Wed, 25 Feb 2009 00:54:32 -0500 |
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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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