Tag: milk stash

High Lipase: My breast milk tastes soapy

- Julie Matheney

Have you heard of high lipase in breast milk? Lipase is an enzyme that helps break down fat in breast milk. The breakdown of the fat in breastmilk by lipase is normal but not noticeable when the baby is feeding directly at the breast. When lipase occurs in excess, this process happens much more rapidly and can make the milk taste off or soapy after a period of time. Milk with excess lipase is safe to drink, but some babies dislike the taste and refuse it.

 

How do you know if you have high lipase?

  • Test prior to freezing – Before freezing large amounts of breast milk, you can test it for odor and taste changes due to lipase. Collect and freeze 1-2 bags or small containers of breast milk for at least 5 days and then evaluate the odor to see if your baby will drink it.

What can you do if you have high lipase?

  • Freeze milk as soon as you pump it whenever possible
  • Reduce intake of polyunsaturated fatty acids
  • Scald you’re milk prior to freezing 
  • To scald fresh milk: Heat it in a pot until tiny bubbles form around the edges of the pan (approximately 180° F) but don’t boil it. Remove the milk from the stove and allow it to cool before freezing.

Scalding fresh milk will stop the enzymes from breaking down the fat, preventing that soapy smell and taste. Scalding milk does reduce some of the beneficial components in breast milk, however, so give your infant fresh breast milk whenever possible.

To scald milk:

  • Heat milk to about 180 F (82 C), or until you see little bubbles around the edge of the pan (not to a full, rolling boil with bubbles in the middle of the milk).
  • Quickly cool and store the milk.

Scalding the milk will destroy some of the immune properties of the milk and may lower some nutrient levels, but this is not likely to be an issue unless all of the milk that baby is receiving has been heat-treated.

Per Lawrence & Lawrence, bile salt-stimulated lipase can also be destroyed by heating the milk at 144.5 F (62.5 C) for one minute (p. 205), or at 163 F (72 C) for up to 15 seconds (p. 771).

Lawrence R, Lawrence R. Breastfeeding: A Guide for the Medical Profession, 6th ed. Philadelphia, Pennsylvania: Mosby, 2005: 156-158, 203-205, 771, 781.

Lawrence RA. Storage of human milk and the influence of procedures on immunological components of human milk. Acta Paediatr Suppl. 1999 Aug;88(430):14-8.

Have a ton of freezer milk with high lipase? Some babies don’t mind the flavor and will drink it anyway. If you’re won’t, Before pitching it, consider trying the following:

  • Mix frozen milk with fresh milk to make it more appetizing to baby
  • Some moms find adding a few drops of alcohol free vanilla extract can mask the lipase flavor. 
  • Use it for a milk bath which can help with dry skin

Milk taste rancid or metallic? That's not lipase, the cause may be chemical oxidation (Mohrbacher, p. 461). Reducing intake of polyunsaturated fats may help. Certain minerals or metals in drinking water may also be to blame like copper or iron ions. When this happens, Mohrbacher has a few suggestions to try:

  • Avoid your usual drinking water (either drinking it or having milk come into contact with it) by using bottled or reverse osmosis filtered water instead
  • Avoid fish-oil and flaxseed supplements, and foods like anchovies that contain rancid fats
  • Increase antioxidant intake (including beta carotene and vitamin E like berries, spinach, beets, and beans).

Mohrbacher N. Breastfeeding Answers Made Simple. Amarillo, Texas: Hale Publishing, 2010: 460-461.

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If Goldilocks Needed a Breast Pump

- Julie Matheney

IF GOLDILOCKS PUMPED

What pump do you have? What size flange are you using? The answer can make a huge difference in pumping success.

Not all pumps are created equal. Prior to the ACA, there were few pump choices. Once laws said people needed to be provided with a breast pump, and insurance would fit the bill, lots of companies flooded the market with pumps. Not all of them are good, and some will even sabotage your supply. You want a pump with a good motor in it that has lots of variability in the cycle (how fast or slow it pumps) and suction (how strong it sucks).

You also need to be mindful of the flange you’re pumping on. Most companies will send a standard 24mm flange. Sometimes they’ll send a larger size as well. In reality nipples, and thus flanges, are not one size fits all. And in my practice I hardly EVER use the 24 or bigger flanges. For almost all of my families we’re sizing down. Some times significantly smaller.

Flanges are the horn shaped part that actually touch the breast. The fit of the flange can make or break your pumping experience. Too small and friction can cause pain and even damage (and pain makes it difficult for milk to let down). Too large and the breast may not be stimulated well, which inhibits your let down to have milk flow. When too much areola is pulled into the flange, the tissue swells around the nipple pores and can prevent milk from efficiently emptying from the breast, resulting in plugged ducts, pain, tissue breakdown, and eventually a reduced milk supply. Using too large of a flange from the beginning may even prevent you from bringing in a full milk supply. Do you ever pump for 20+ minutes and still feel like there’s milk in there? Most likely too large of a flange. The stimulation from the pump is triggering you to make more milk, but the size of the flange is preventing you from emptying that milk efficiently. Poor flange fit can also impact the suction of your pump and how well it functions with your body. If you have the suction all the way to the highest level and aren’t emptying well, you flange is too big.

Flange fit tips:

Some of the flanges I tried

🗝Flange fit isn’t based on your breast or areola size, it is JUST the size of the nipple and how it changes with suction. Some nipples are dense and don’t stretch much. Some are super elastic and swell a lot. How your nipple responds to suction can make a difference in which flange you select and if other products are needed to happy pump

🗝Proper fit isn’t as simple as measuring your nipple, but it’s a start. See a trained IBCLC to help if you haven’t found the right fit or are struggling with poor output, pain/damage, or plugged ducts

🗝A small amount of space around your nipple in the flange tunnel is good. There should be no space around the areola or in the larger bell part of the flange. If your breast tissue recoils back into the horn part of the flange with every cycle, the flange is too large. If the tissue is white where the tunnel meets the horn, the flange is too small

🗝Pain or blanching means it’s the wrong size

🗝Nipples rubbing against the sides of the flange tunnel mean fit needs to be improved and there is a risk of pain and damage

🗝There should only be a small amount of areola pulled in the flange tunnel space. The bell or horn part will have most of the areola held back so it doesn’t get pulled into the tunnel

🗝The nipple tip shouldn’t hit the back of the flange. This means you have an elastic nipple. Sizing up isn’t necessarily the right answer. Using a pump insert, cushion like @beaugenmom or @pumpinpalofficial may be a better solution

🗝Evaluate as you pump. You can changing flange size mid-pump to improve comfort if you’re between sizes. You may also need to change the flange size the longer you pump. Our nipples can become more elastic and larger or smaller with time.

🗝Every nipple is unique and each side may use a different size (or shape/brand!). There are all kinds of flange sizes, inserts, and cushions to improve the pump experience

How often should I breastfeed or pump?

- Julie Matheney

BREAST STORAGE CAPACITY

The size of your breast has nothing to do with the amount of milk you will make. The size of your breast is determined by the amount of fatty tissue in the breast. The amount of milk you will make is determined by the amount of glandular tissue in the breast that makes milk. This glandular tissue starts growing during puberty. It increases during pregnancy and is part of what accounts for the increase in breast size during pregnancy. Everyone’s storage capacity is different.. just like every breast size is different. However breast size does NOT equal breast storage.

Small capacity: Approx 2-3 ounces per feeding/pump. Baby may need frequent feedings: 10-12 per day. Baby usually takes both breasts and may want each breast twice. Parent feels uncomfortable quickly between feedings and sees a supply drop with more than 3-4 hours between feedings

Medium capacity: Approx 3-4 oz per feeding/pump. Baby may feed 8+ times per day. Baby may take one breast or both breasts each feeding. Parent feels uncomfortable and see a supply drop with more than 4-5 hours between feedings

Large capacity: Approx 4-6 oz per feeding/pump. Baby may feed 6+ times per day. Baby may only take one breast per feeding. Parent may go up to 6 hours without seeing a drop in supply

XLarge capacity: 8+ oz per feeding/pump. Baby may feed 6+ times per day. Baby may only take one breast and parent may still feel full in that breast. Some babies may be gassy from higher foremilk intake as they may not drain the breast fully. Parent may go 6+ hours without seeing a supply drop. Parent may still feel uncomfortable between feedings depending on how quickly the milk fills the breast

All capacities have the same ability to feed baby well as long as the breast is routinely being emptied.

Do I need a breast milk stash?

- Julie Matheney

NO STASH NEEDED

If breastfeeding is going well and you’re planning on being home with your baby or only gone for a few hours at a time there is no need to have a huge freezer stash. Having milk in the freezer is a nice security, especially is your have to work or will be away from your baby. But if you’re always with your baby or are only gone for a short while, there is no need to have a stash.

Having the right stash for your family means having enough stashed for when you’re away from your baby. If you’re gone for one feeding, you only need one feeding worth of milk. If you’re gone 2-3 feedings, you need 2-3 feedings worth of milk. If your baby is being bottle feeding while you’re away, you would pump while you’re gone to tell your body the milk is needed. That milk then becomes the stash for the next time that you’re gone.

If you want to have a big stash, great!!! You can absolutely have that as an option. Just don’t feel pressured from other people’s journeys on social media to have something you may not need or use. I’ve had several moms who spent countless hours pumping and stashing only to have to donate or throw out the milk stash because they never used it and it was going to expire. I’ve also had several moms who thought you had to have a stash and were relieved to know they didn’t! Do what is best for you and your baby and not based off of anyone else.

You’ve got this. Trust your body. Trust your baby.

How can I make more breast milk?

- Julie Matheney

The best way to lose weight is to be in a calorie deficit. Choosing the right foods, protein, fruits and vegetables with moderation of carbs, sugars and starches is guaranteed for most to lose extra pounds. Sure, exercise helps. It helps burn calories, again contributing to calorie deficit. But exercise alone won’t help you lose weight if you’re still eating a high calorie diet. Sure, going vegetarian or vegan or doing Weight Watchers or Atkins or any other “diet” helps. It helps you monitor intake to be in a calorie deficit. But even on any diet plan, if you’re not following it correctly and still eating high amounts of foods you won’t lose weight. Certain people do better on certain diets or with specific exercise programs because of how their specific body handles and processes food, vitamins, stress, movement, and all of the other factors like environment and genetics. Finding a nutritionist, weight loss coach, or personal trainer helps you look at your specific body and goals and helps you reach them. You can absolutely get there in your own, having someone counsel you through often gets you quicker results from their experience and wisdom. But the principle remains: calorie deficit is the number one way to lose weight.

The best way to make breast milk is to empty breast milk. Whether that’s your baby or a high quality breast pump, moving milk multiple times a day tells the body to make more milk. The more often milk is removed, the faster it is made. Sure, supplements help. They support your thyroid and blood with the extra nutrients and hormones needed to produce milk. But supplements alone is no replacement for moving milk. You can take the best lactation bars and drink all the tea you want, but without emptying the breast every few hours routinely I wouldn’t expect the majority of us to make enough milk to feed baby. Sure, hydration and nutrition are important. It takes calories to make calories and hydration help with that process. But even the research shows women who are malnourished in famine torn countries make plenty of milk for their babies when baby is allowed unrestricted access to the breast. Yes, adding in chia seed, flax seed, oats, nuts and nut butters, and coconut water helps make milk. Certain people do better on certain herbs and foods because of how their specific body handles and processes food, vitamins, stress, hormones, and all of the other factors like anatomy and genetics. Finding a lactation consultant, peer counselor, or trained doula helps you look at your specific body and goals and helps you reach them. You can absolutely get there in your own, having someone counsel you through often gets you quicker results from their experience and wisdom. But the principle remains: emptying milk from the breast is the number one way to make breast milk.

Pumping while away from baby helps maintain your supply

How to build a breast milk stash

- Julie Matheney

You don’t need to have a stash. If you want to exclusively breastfeed and are never away from your baby, you don’t need any milk in your freezer. You don’t need a huge stash if you’re going to be gone from baby. It’s nice to have stored up milk, but that milk is extra milk. Feed the baby, not the freezer. You only need enough milk for when you’re away from baby. If you’re only going to be gone for 2-3 hours, you may not need any milk at all. Feed your baby immediately before you leave. If baby becomes fussy before you get home, have your caregiver take baby on a walk, distract with toys or use a pacifier and feed them as soon as you walk in the door. If you’re going to be gone more than 3 hours, you only need to have enough milk for the time you’re gone. Optimally if baby is being fed by bottle, to maintain your milk supply, you should be pumping, thus replacing the milk from your stash that was used.

There are several ways to build your stash

🍼Passively collect with a milk catcher like a Lacticup or Milkies Milk Saver. No extra work needed, this works great in the early weeks if you leak

🍼Use manual silicone breast pump like the Haakaa. While these look passive, the vacuum created does stimulate the breast and can increase leaking and milk supply

🍼If you have a large to very large storage capacity and only feed from one breast at a time, pump the other breast during or after feeding baby

🍼Pump with a double electric pump, after breastfeeding, for 10-15 minutes. Only expect to get 1/4-1 ounce as this is “left over” milk that your baby doesn’t need.

🍼Pump with a double electric pump in between breastfeedings when you think baby may take a longer nap. Aim to pump half way between when you think baby will want to feed again. If you think baby will go 2 hours, pump after an hour, etc. try not to pump too close to the next feed as baby may get fussy at the slower flow of milk.

Remember:

🥛Decide how often and how much you want to pump/collect. Know that the more you empty, the more you will make as you’re telling your body baby needs that milk.

🥛Too much pumping or frequently changing your pump routine does increase your risk of plugged ducts and mastitis

🥛You can combine 24 hours of milk into one batch

🥛Breastfed babies usually only need 2-4 ounces every 2-4 hours. Aim to leave 1-1.5 ounces for every hour you’re gone