Margaret,
I know it's been a while since you posted this request to LactNet but I've been working on a response for you.
>> The prevailing wisdom on lipase in breastmilk seems to be that there
really isn't anything mothers can do to reduce levels. For moms who
express their milk to feed to their babies, excess lipase can be a
pain in the neck, requiring them to scald freshly-expressed milk to
prevent rancid, soapy, metallic, spoiled, or 'off' odors and taste.
Some mothers apparently experience excess-lipase problems during one
lactation but not another. Also, I have heard that for some mothers
the problem comes and goes during a single lactation. This seems to
indicate that lipase levels are not fixed for a given mother, but are
subject to some variability. <<
This is a situation that I've been trying to figure out, too. I work in a corporate lactation program and have had to deal with the distress of a woman who has returned to work only to find out that some if not all of the milk she has been saving for her baby is rancid.
One specific woman found that some pumpings were fine and some weren't from the same day. Currently the solution seems to scald the milk but that doesn't solve the problem of why it occurs. This woman is now expecting her second child and wanted to know if she was going to have the same problem this time around. The first time the problem didn't seem to pop up until about 4 months after her child's birth.
I've been in communication with a researcher who is working on related issues and he is also stumped. This is some of what he had to say:
>>By deactivating the lipases like we did
last time we may have just stopped the effect without treating the
cause. I've done some more reading on rancidity in milk and found a
couple of areas that it might be a good idea to follow up. Frankly
I'm a bit embarrassed I didn't think of them before. The first is
the use of antioxidants. These should improve the over all oxidative
stability of the milk and mean less oxidation of the lipid. Whether
maternal intake of these has an effect on their levels in milk I'm
not sure. Might be something to research in the literature.
The second was one from a dairy journal article (which I have now
lost)
[HFS: I found the article he mentioned to be by Baker, Linda D., VMD, "Investigating the Cause of Chronic Milk Rancidity in a Dairy Herd," Veterinary Medicine, August 1990, pp. 901-5]
that spoke about chronic rancidity in milk from one herd. They
found that the diet of the cows was deficient in phosphate and
hypothesised that this lead to the decreased integrity of the fat
globule lipid membrane (a phospholipid membrane) which meant the
lipases were afforded an easier route to the fats and thus increased
rancidity.
For a variety of reasons (I am not a physician and I don't know this
mother's dietary history and we are speculating on causes and
effects) I am very reluctant to recommend supplementation of the
maternal diet with antioxidants and phosphate. However, this might
be something to follow up in the literature and for you and the
mother to discuss with her physician.
It is often difficult to pull together various bits of seemingly
unrelated information and then to be confident that it is going to
work as hypothesised. If you do delve into the literature please let
me know what you find and what your conclusions are. It would be
nice to know if these leads are worthwhile or if I'm way off track.<<
I have done some literature searches but have not been able to come up with anything that proves or disproves these possible reasons and causes. I'm probably not using the right parameters but I'm continuing my search.
Twenty to thirty seconds is the scalding time we determined using a microwave instead of a stove. Most women who are pumping at work are without access to a stove much less have the time to add that step to their routine. They are also working with ounces rather than cups or pints of expressed milk, hence 20-30 seconds seems to be enough time to do the job and for their schedules.
> Harriet F. Smiley, IBCLC, RLC
> Senior Lactation Consultant
> LifeCare Inc.
400 Nyala Farm Road, Box 2783
Westport, CT 06880
Ph: (203) 291-3425 Fax: (203) 291-3575#3425
E-mail: [log in to unmask]
www address: http://www.lifecare.com
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