The Breastfeeding Problem I'd Never Heard of (Until It Happened to Me)
My baby was refusing the bottle, and with only one month to go before I had to go back to work, I was in a bit of a panic.
Before I had my daughter Mabel, I knew I wanted to breastfeed. (I do work at Health after all, and am pretty well versed in all the myths and facts of breastfeeding.) Before she was born, I took a breastfeeding class, stocked up on gear, and was ready to go when the time came. Luckily, I didn't experience any major problems and didn't seem to have any of those issuesÂ that can happenÂ early on; for example, someÂ breastfeeding infants will refuse to drink from aÂ bottle.
In fact, from the day she was born, MabelÂ switched effortlessly back and forth from bottle to breast, which I knew would make it easier for me to return to work. Then at three months of age, she started refusing the bottle. She would suck eagerly a couple of times, then jerk her head away, letting milk spill out of the side of her mouth. Then, sheâd cry. With only one month to go before I had to go back to work, I was in a bit of a panic. Finally, I just tried a sip ofÂ the milk myself and found that it tasted--well--soapy.
I did someÂ searching and found that Â lipase, an enzyme that breaks down the fat in milk, could be the problem.Â It seems thatÂ breastfeeding mothers have varying degrees of lipase in their milk, and some have higher concentrations of lipase than others. This is not a problem while breastfeeding, but when high lipase breast milk is stored in the refrigerator or freezer, the enzyme starts breaking down the fat in milk over time, causing the milk to taste soapy. Some babies donât mind the flavor, but many will refuse it.
After doing a taste test, I discovered that my milk starts tasting soapy after two days. Iâm one of the lucky ones, because some people with high lipase report that their milk turns after only 3 or 4 hours. The solution? You can deactivate the lipase by scalding the milk, then rapidly cooling it.Â This means bringing the milk to an extremely high temperature, then immediately plunging it into an ice bath to bring the temperature back down. After that, I can refrigerate or freeze it for long-term storage.
Because I have a two-day grace period, I can still express milk at work and give it to my baby the next day without having to treat it. But to store my milk for any longer than two days, I have to scald it to deactivate the lipase.
It's a bit tricky, becauseÂ milk loses someÂ nutritional value as it reaches higher temperatures, so it's important to get it right. The process can reduce levels of protective antibodies and some nutrients in the stored milk, but this shouldn't be a problem if you are breastfeeding at least some of the time.
"Any time you heat, cool, or store milk, the components are altered in some way," saysÂ Danielle Tropea, a board certified lactation consultant in Maplewood, N.J. "The results of scalded human milk to remove lipase is generally considered to be appropriate and safe."
Being a busy mom, I created a process that allows me to scald my breast milk easily, and within minutes. First, I purchased the following: a 9 oz Kid Kanteen Baby Bottle ($17, amazon.com), a Weber 6492 Original Instant-Read Thermometer ($10, amazon.com), a Munchkin High Speed Bottle Warmer ($20, amazon.com), and Dr. Brown's Breastmilk Storage Bags ($6.36, amazon.com).
Photo: Min-Ja Lee
To start, I prepare an ice bath, and set it aside. Then, I pour breast milk into the 9 oz Kid Kanteen baby bottle. I love this bottle for many reasons. First, itâs big enough to comfortably hold all of the breast milk I can express in one sitting, which can range anywhere from 2 to 7 oz. When I screw the nipple onto the bottle, the Weber grill thermometer slides easily into one of the two vent holes on the nipple. This holds the thermometer in place so that the tip of the probe enters the milk without touching the sides of the bottle. This allows for a more accurate temperature reading.
Because the bottle is made of stainless steel, I can heat it up and cool it down very quickly and safely, unlike plastic or glass, which can crack or break. When I use the Munchkin bottle warmer to heat up the bottle, I need to keep a close eye on the thermometer because the milk can reach extremely high temperatures within two minutes. Sometimes, Iâll cover the bottle warmer with a clean towel so as to keep the heat in, helping the bottle warm up even faster. As soon as the thermometer hits 180 degrees Fahrenheit, I remove the bottle to plunge it quickly into the ice bath. (Tropea says you can heat milk to 144.5 F for one minute or 163 F for up to 15 seconds.)
Then, I can start gently swirling the bottle within the cold water to cool it down faster. When the bottle is cool to the touch, Iâll pour the freshly scalded milk into a milk storage bag for storage and freezing.
Iâve been scalding my milk for two months now. The process takes only a few extra minutes out of my day, and itâs practically effortless. Iâm happy to report that Mabel is eating well. Once again, sheâs switching easily from bottle to breast, and she couldnât care less if the milk has been freshly expressed, refrigerated, or frozen.
Happy baby, happy mom!
Photo: Min-Ja Lee