High Lipase Milk
High lipase can be a tricky subject. Some women may immediately jump to the “high lipase” conclusion if their baby refuses even one bottle; where, another mom may not know what high lipase is! In this blog I'm going to discuss what high lipase breast milk is, how to know if you have it, and what to do about it.
WHAT DOES IT MEAN TO HAVE high lipase milk?
Lipase is wanted in breast milk! Lipase is an enzyme found in breastmilk. Its job is to break down fats in breast milk so it’s easier for our baby to digest! However, “extra” or “high lipase” can speed up this process and cause your breast milk to smell/taste “soapy” or “sour” or “metallic” the longer it sits. (The consensus is usually “soapy”.) This typically isn’t an issue in fresh breastmilk (direct nursing or freshly pumped and fed to baby) because there isn’t time for the extra lipase to act and start initiating this fast fat breakdown. If you’re letting milk sit for a while, that enzyme has more time to break down the fats, causing the soapy/sour taste and smell, which leaves some babies less likely to want it. Not all babies refuse high lipase milk and it is perfectly okay for them to drink it! The milk is still good and it still has all those good nutrients baby needs! There is no reason to throw it out if your baby is willing to take it. However, many babies do refuse to take high lipase milk— and that’s where we start running into issues.
HOW DO I KNOW IF I have IT?
If baby takes fresh breast milk or nurses without issue, but refuses milk that’s been refrigerated for a while or previously frozen, you may want to test it out. You can taste/smell a bit of your freshly expressed breast milk compared with previously refrigerated/frozen breast milk to see if a different taste/smell is noted. Remember we’re looking for a “soapy”, “sour”, or “metallic” taste or smell. Since you can’t tell if you have high lipase milk until the milk has had time to sit and begin that fat breakdown, many mamas don’t find out about this issue until they’re dipping into their frozen milk stash or attempting to feed baby a bottle that’s been in the fridge for a day or two. Don’t worry, I have some tips and tricks for what you can do about high lipase milk!
WHAT CAN I do about it?
First thing’s first, having high lipase milk does not mean your milk is “bad”! Some babies take high lipase milk without thought. Yes, it is perfectly safe for babies to drink high lipase milk. If they have no issue with it, that’s amazing! Others may refuse high lipase milk due to the taste— but there are some things we can try!
If you think high lipase is the culprit, now what? You tasted/smelled your breast milk and decided it was a little soapy, the most common solution is scalding your freshly pumped milk. Unfortunately, you cannot just pump and immediately freeze the milk when it’s high lipase. With the process of “scalding”, you have to heat the milk to 180 degrees to inactivate the lipase, then immediately place it in an ice bath before freezing. You can do this on the stovetop or in a bottle warmer (without the auto shut off). It’s also important to have a thermometer, so that you can monitor how hot the milk is getting and make sure it's getting up to 180 degrees. Then, you will put the milk straight into ice cold water. Afterwards, you can decide if you want to put the milk in the fridge for feeding in the next day or two, or go ahead and freeze the milk for future use. Like I said before, if the milk is already refrigerated or frozen, without scalding prior, thawing and scalding is not going to fix it and get rid of the high lipase. This needs to be done with freshly pumped milk.
STEP BY STEP HOW TO SCALD BREAST MILK:
Scalding milk means heating your breastmilk to about 180°F using the stovetop or a bottle warmer before storing. The sooner the better! Here’s how:
1. Prepare an ice bath (ice in a basin) and place an open stainless steel bottle inside
2. Pour fresh breast milk into a saucepan on the stove or stainless steel bottle in bottle warmer
3. Heat the milk to 180°F (use an instant read thermometer to monitor)— keep a close eye! You want bubbles forming on the rim, but not a rolling boil. **if you’re at work, this is where a bottle warmer may be a better option**
4. Pour into your stainless steel bottle in the ice bath once reaches 180°F ** tip, use pump flange as a funnel**
5. Once cooled, pour into a storage bottle or bag for the fridge/freezer to store for later.
WHAT ABOUT MY freezer stash?
The big question we’re left with is “What if I don’t notice until I start dipping into my freezer stash?…Is it too late?… Is there anything I can do to salvage it?” Let’s talk about that! It truly depends on the baby and their sensitivity to the smell or taste of the high lipase milk. There are a few things you can absolutely try, though they don’t work for everyone and I’d always bring up to your care team first:
MIXING MILK - in this instance, you can try mixing your high lipase milk from the freezer (which has already “turned”) with some freshly pumped milk to dilute the “soapy/sour” smell or taste and see if baby will take it. This has worked for some, and not for others, but it is worth a shot! One thing to remember is that if baby still refuses the mixed milk, we’ve now ‘wasted’ our precious freshly pumped milk! TIP: I think it’s best to do this in smaller amounts to start and see if/how much of the added in high lipase milk your baby is willing to tolerate. Some moms start by adding a “splash” of high lipase milk to the fresh milk for the first feeding. If baby takes it well, they may try a little more at the next feeding, etc, until they get half high lipase milk and half freshly pumped (if possible!).
ADDING A DROP OF NON-ALCOHOLIC VANILLA EXTRACT - This is something that needs to be discussed with your pediatrician before attempting, but has been an “easy fix” for many mamas! They just add a drop to the bottle of high lipase milk, and many babies will take it like a dream!
TRY DIFFERENT TEMPS - sometimes babies can be picky with their bottle temps (I had one baby like this!). It may be as simple of a fix as trying the bottle at room temp, or warming up a tad more to see if they’ll take it.
TRY FROZEN HIGH LIPASE MILK FROM A DIFFERENT DATE - don’t give up after trying a few bottles from the same day or week of previously frozen high lipase milk. If you have milk you froze over a period of weeks or months, try different time periods.
OFFER WHEN BABY IS VERY HUNGRY - Try offering high lipase (or slightly mixed) milk in the morning when baby wakes up very hungry— try for a few minutes, and if it isn’t working, don’t fret! Many of us are willing to eat something we aren’t pumped about when we are extremely hungry, so it’s worth a shot, but not worth frustration!
DONATE TO A MILK BANK - Milk banks are incredible, and donating milk is a beautiful gift! When I floated to the NICU at my old hospital, the milk tech (who fortified and mixed breastmilk based on doctors’ orders) told me that a lot of the donated milk was high lipase milk. Many of the babies in NICU are on feeding tubes, so aren’t able to notice the taste, just get full and satisfied! I think this is truly such a gift, so this is always another option available too. Of course, check with the milk bank you would like to donate to for their rules and regulations! Get help finding a milk bank here!
So mama, have you dealt with high lipase milk? How did you handle it? If not, did you know about this? I hope this is helpful! Please refer to my Instagram “high lipase” highlight + reel for more information on how to scald the milk properly using a stovetop or bottle warmer!
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