BREAST MILK TASTE BAD? - Simply Rebekah...Rebekah Hoffer has captured the drama, the sorrow, and the need for a solution eloquently in these pages. She details with great compassion

© 2014 REBEKAH HOFFER

why does myBREAST MILK TASTE BAD?

One Mom’s Journey to Overcoming Excess Lipase Activity

By: ReBekah hoffeR

Copyright 2014 by Simply Rebekah LLC. All rights reserved. Please do not reproduce or

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Edited by: Megan Tietz and Lisa Snyder

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TABLE OF CONTENTS(click a title to go ahead to that page)

Foreword by Dr. Ruth Lawrence ............................................................................................................................................5

Preface ..............................................................................................................................................................................................6

My Story ...........................................................................................................................................................................................7

Chapter 1: Excess Lipase Activity ..........................................................................................................................................9

What is Excess Lipase Activity? ................................................................................................................................9

What Causes Excess Lipase Activity? ....................................................................................................................9

How to Test Your Milk for Excess Lipase Activity .......................................................................................... 10

Becoming Your Own Advocate .............................................................................................................................. 12

FAQ About Excess Lipase Activity ........................................................................................................................ 13

Chapter 2: Scalding Your Breast Milk ............................................................................................................................... 15

3 Different Ways to Scald Breast Milk: Microwave, Stove, Bottle Warmer ........................................ 15

Picking a Bottle Warmer ........................................................................................................................................... 19

Picking a Digital Thermometer .............................................................................................................................. 20

Scalding in Glass or Plastic? .................................................................................................................................... 20

Is Scalded Breast Milk Safe For My Baby? ......................................................................................................... 21

FAQ About Scalding Breast Milk ........................................................................................................................... 21

Chapter 3: What to do with Bad Tasting Frozen Breast Milk .................................................................................. 25

8 Things to do with Bad Tasting Milk ................................................................................................................... 25

My Journey Becoming a Milk Bank Donor: A 6 Step Process ................................................................... 27

FAQ About Donating to a Milk Bank ................................................................................................................... 31

Conclusion.................................................................................................................................................................................... 34

What is Your Story? .................................................................................................................................................................. 36

About the Author ...................................................................................................................................................................... 37

Acknowledgments .................................................................................................................................................................... 38

References ................................................................................................................................................................................... 40

Resources ..................................................................................................................................................................................... 41

Additional Resources by Rebekah Hoffer ......................................................................................................... 41

Milk Banks that Accept Milk Affected by Excess Lipase Activity ............................................................ 41

Milk Testing Printable Charts ................................................................................................................................. 46


DISCLOSUREI am not a medical professional. I am simply a mom who has walked this journey. This book is meant to be a reference only. It is not meant to be a substitute for professional medical advice. Consult your doctor and/or lactation consultant to determine the best course of treatment and action for your baby. This book explains what worked for me, but it might not be what is best for you and your baby. Little research has been done on excess lipase activity. Any new research could change the information suggested in this book.


FOREWORDThere is nothing more heartbreaking for a breastfeeding mother than to find her freezer full of sour milk. Crying helps ease the pain, but it does not fix the milk. Back in 1979, when the first edition of Breastfeeding: A Guide for the Medical Profession was written, I speculated that it might be the lipase in the milk digesting the fat and proposed scalding. This was without the benefit of scientific study, but the concept took off. Rebekah Hoffer has captured the drama, the sorrow, and the need for a solution eloquently in these pages. She details with great compassion the process of preventing the souring of the milk by scalding. She also recommends donating the sour milk to milk banks that are part of the Human Milk Banks of North America Association. This is a thoughtful, comprehensive, heartwarming description for mothers with similar problems.

Scalding, that is increasing the milk temperature to 160°F (never over 180°F), does decrease some vitamins and inactivates the enzymes which are so valuable to the digestion of human milk. Scalded milk still is far better than formula which is derived from cow milk that has been heated, separated and cooled to a fare-thee-well. An exclusive diet of scalded milk is not recommended without vitamin supplementation.

Now that expertise in the laboratory has expanded, it is possible to measure lipase. Scalding does not work for everyone because there are other causes for the spoilage of milk, including bacteria, viruses and contaminants. Hopefully, there will be some answers soon. In the meantime, some milk banks do not accept spoiled milk because the reasons for spoiling have not been studied. Perhaps only milk that responds to scalding because of presumed excess lipase should be donated to milk banks until the scientists share more information from the laboratory about cause and effect.

This lovely epic for breastfeeding mothers can help many women who have fallen victim to this scourge.

RUTH A. LAWRENCE MD

Distinguished Alumna Professor Pediatrics and Obstetrics/Gynecology University of Rochester School of Medicine


PREFACEI am a breastfeeding mother who knows the pain of having excess lipase activity. I experienced the punch-in-the-gut feeling when I realized something was wrong with my milk. I went searching for answers, desperate to find another mom to connect with, but came up short. I wept for the frozen milk that I wouldn’t be able to use. It was frustrating and emotionally draining. It hurt, but that wasn’t the end of my journey. It was only the beginning. I overcame excess lipase activity. You can too.

7© 2014 REBEKAH HOFFER

MY STORYIn 2009, I gave birth to my firstborn. Grace was beautiful and very easy-going. We nursed well and slept even better. From day one, she only got up once or twice at night. She started sleeping through the night after a month and a half! We were extremely blessed in that department.

Since Grace always slept well, I would find myself with some “extra” milk after her first morning feeding. I started pumping once a day after her first feeding.

Quickly I got into a simple routine. We woke up. I fed Grace. I let her play while I pumped and then I ate breakfast. Some mornings I would tell Grace, “Now be good while Mommy pumps. I’m pumping milk for later. I pump because I love you!”

Since I was a stay-at-home mom, that milk truly was meant to be for “later.” My goal was to give Grace breast milk in a sippy cup after she had weaned. I also planned on using breast milk in her cereal or to help dilute her homemade baby food.

I didn’t need a large stash of frozen milk, but I felt comfort in having it. I hoped to nurse Grace for a full year, but I honestly didn’t know if that would be possible. My sister had milk supply issues with her children and wasn’t able to breastfeed for a full year. Would that happen to me? What if there was an accident or illness that prevented me from nursing? I loved my stash of frozen milk. It was my breastfeeding insurance plan.

Each morning I pumped an average of 4 ounces that I put into Grace’s personal milk bank for the future.

I delighted in staying home with Grace. I hated to leave her with a babysitter, even if it was family, but eventually mama has got to get out! We started leaving Grace with family from time to time.

At first things went great, but slowly we started noticing a change. Around 5 months of age Grace refused to eat when I wasn’t around. She refused the bottle and would hold out until I came back. It broke my heart to come home to a crying baby and a frustrated babysitter.

One night I went out with girlfriends and left Grace home with my husband, Nate. While I was gone, Grace refused to drink her bottle and was very fussy all night. Just before I got home, she calmed down enough to drink 2 ounces and fell asleep.

Nate and I were frustrated that the night hadn’t gone well. Why wouldn’t she take a bottle anymore? What were we doing wrong? Did we need to give her a bottle more often? Did we need to give up on bottles completely? Was I ever going to be able to leave her for more than an hour or two?


WHY DOES MY BREAST MILK TASTE BAD My SToRy

While we were talking, I reached over, picked up the bottle Nate had been trying to give Grace, smelled it, and then took a small taste. It tasted awful!! Something was definitely not right. I started freaking out. I had been storing milk in my freezer for months and now there was something wrong with it???

Immediately I turned to Google. That is when I discovered excess lipase activity.

Excess what???

I had so many questions and struggled to find the answers. I searched the internet, desperate to find someone who could help me. I left blog comments on posts and never heard back. I called lactation consultants who gave me bad advice. I cried to my breastfeeding friends. I cried to my husband. I cried to my mother. I cried a lot.

I was a stay-at-home mom who didn’t need to leave my baby with a bottle, so why was I so heartbroken? Grace was 5 months old and I had been pumping every single day. I had 575 ounces of breast milk in my freezer. Writing out that number still takes my breath away and makes my eyes sting, and that was over 4 years ago.

What was I going to do with my frozen milk?! After all that work that I did to collect milk for “later,” and now Grace wouldn’t drink it. My dreams of giving her milk in a cup or in her cereal were gone.

I tried to explain my emotional struggle to my husband. I told him, “Imagine that you have worked one extra hour of over time every day for the past five months. You saved every penny and planned to use that money to go on a dream vacation or buy something you have always wanted. Then one day, someone comes along and tells you that the money you have worked so hard to save isn’t real. Your dream for the vacation or special purchase is gone, and you have to throw all the money away.”

Thankfully my story didn’t end with me throwing away my milk. I was able to find healing through donating to a milk bank. I continued to pump every day until Grace was 13 months old. I was able to leave her with a babysitter. She drank from a bottle. She breastfed for a full year and well beyond.

I overcame my issues with excess lipase activity and you can too.


CHAPTER 1

Excess Lipase Activity

WHAT IS EXCESS LIPASE ACTIVITy?

Let’s dig into the nitty-gritty of what excess lipase activity actually is. It can get a bit technical, but please remember this: Your breast milk may taste bad, but there is nothing wrong with its nutrition. You can continue to nurse your baby! If your baby accepts the bad tasting milk in a bottle, you can continue to feed it to him. You do not need to stop nursing or pumping because of excess lipase activity.

Now what is excess lipase activity?

Lipase is an enzyme that is present in every woman’s breast milk. Lipase helps your baby digest the fat in your milk. This is called the lipid break down. Lipase is supposed to be in your milk.

The bad taste in your expressed breast milk comes from the lipase breaking down the fats before it actually gets to your baby’s stomach. Some people describe the bad taste as soapy, metallic, or like vomit.

A common misconception is that women with this issue have extra high levels of lipase or excess lipase. The reality is that the amount of lipase in your milk is fine. The problem comes from having a high amount of lipase activity. The lipase is breaking down the fats too quickly. The issue isn’t excess lipase. It is excess lipase activity.

This small clarification is important because it reinforces that there is nothing wrong with the quality or composition of your breast milk. Your milk isn’t bad, it just tastes bad.

Your milk doesn’t come out tasting bad. It happens over time as you store it in the refrigerator or freezer. Freezing breast milk slows down lipase activity, but it doesn’t stop it. To stop the effects of high lipase activity you will need to scald your milk, which I will explain how to do in Chapter 2.

Breast milk is wonderful. It is natural. However, when we pump and store our milk we are actually doing a very unnatural thing. Breast milk isn’t designed to be pumped, cooled, refrigerated, or frozen. It isn’t naturally intended to be stored for later. It shouldn’t be too shocking that we run into issues with storing breast milk.

WHAT CAUSES EXCESS LIPASE ACTIVITy?

Some nursing mothers have questioned if diabetes, gallbladder issues, diet, or water quality have anything to do with it. I don’t have any of those medical issues, but my breast milk was still affected.


WHY DOES MY BREAST MILK TASTE BAD? EXCESS LIPASE ACTIVITy

Personally, I doubt that diet or water quality is the culprit. If excess lipase activity was caused by the water supply then wouldn’t we see more women struggling with lipase issues in the same neighborhoods? If diet was the culprit, wouldn’t we see mothers from the same family backgrounds who share similar diets having lipase issues?

The bottom line is that I don’t know what causes excess lipase activity. Since I don’t know, I decided to ask someone who might – Dr. Ruth Lawrence.

Dr. Ruth Lawrence, a pioneer in the breastfeeding community, wrote the book Breastfeeding: A Guide for the Medical Profession. She has spoken all over the world about breastfeeding struggles and has overseen much-needed breastfeeding research. It was truly an honor and privilege to be able to speak to Dr. Lawrence.

Dr. Lawrence shared with me the story of her “discovering” excess lipase activity in breast milk. She clearly remembers the first mom who came to her with this troubling question. Dr. Lawrence began looking for answers, but at that time there wasn’t much research done on breast milk. However, there was a lot of research done on cow’s milk since that was a big money maker. Through Dr. Lawrence’s research, she came up with the idea of scalding breast milk affected by excess lipase activity in order to stop the milk from developing a bad taste.

If anyone would know what causes excess lipase activity it would be Dr. Lawrence. Her response? “I have no idea.” There hasn’t been enough research done to determine why some women experience high levels of lipase activity and others do not.

Not knowing the cause may seem discouraging, but I find it liberating. Stop worrying about the water! Stop fussing over the food you eat! Stop thinking that it is something that you did to cause this! Let go of the guilt, and take a deep breath. This isn’t your fault.

Would you like to be part of a research study being conducted on excess lipase activity? More information is in the “What Is Your Story?” section of this book explaining how you can help.

HoW To TEST yoUR MILK FoR EXCESS LIPASE ACTIVITy

The process to test your milk for excess lipase activity is quite simple. Normal breast milk will stay fresh in the refrigerator up to 8 days. However, milk with high lipase activity will develop a bad taste much sooner than that.

To test your milk for high lipase activity, pump or hand express some fresh milk.

Set aside a small amount of your expressed milk. Half an ounce or less is enough. Place it in a dated storage container. You can use the rest of your expressed milk for your baby that day or freeze it.



Smell and taste your milk immediately after pumping so you know what your fresh milk tastes like normally. I would describe my milk as having a very mild and faintly sweet taste.

Every few hours, give your milk a good sniff, and taste a small drop. As the hours pass you might start noticing some changes. I always noticed the “after taste” of my milk changing first. The taste will get more and more offensive as time passes. Some mothers describe the milk as tasting metallic or soapy. Honestly, those words never crossed my mind when I tasted my milk. It simply tasted awful.

Be sure to take note of when your milk starts to change flavor. Some mothers see a change in their milk after just 4 hours. My milk tasted bad after 24 hours.

If your milk tastes the same after 6-8 days in the refrigerator, then you most likely do not have an issue with high lipase activity.

If you do notice a change in your milk, you most likely have excess lipase activity. I am sorry to say, welcome to the club.

Do you often leave your milk at room temperature for awhile after pumping? Or do you use your frozen milk supply quickly and have a high turn over? Temperature effects lipase activity. Freezing slows it down, and leaving breast milk at room temperature might speed it up. Repeat the test with a small amount kept at room temperature and taste it every hour (except at night – a mama’s gotta sleep!). Repeat the test with a small amount in the freezer. Thaw your milk every 24 hours, taste it, and refreeze it. Then you’ll have a good idea of how well your milk stays fresh in all circumstances. My frozen milk started to taste bad around 2 weeks.

Please note that you should never thaw and refreeze breast milk that you intend to feed to your baby. Thawing and refreezing should only be done when testing your milk for excess lipase activity.

Included at the end of the book is a free printable chart you can use to track the changes you taste in your milk.

It is important to understand that there are many reasons why milk might taste different. It is normal for your milk to change its taste because of your diet, vitamins, or medications. These might be slight changes that you don’t even notice.

Another normal change in taste comes from simply storing your milk. Breast milk isn’t really made to be stored, but thanks to breast pumps we have that option. Milk that has been stored in the refrigerator or freezer will naturally have a different taste from fresh milk, but not an offensive taste.

The final level of taste change comes from the fats being broken down by the lipase enzyme. That is when the milk becomes offensive in taste.



BECoMING yoUR oWN ADVoCATE

If you feel like you are alone or that you are the only one with the problem of excess lipase activity, it is with good reason. There is actually a very small percentage of people across the world who ever realize that they have excess lipase activity in their milk. If every mother pumped breast milk and had a baby with a sensitive pallet, it might be a more common issue. That simply isn’t the case.

Truthfully, there hasn’t been enough research done to determine how common this problem is, and we may never know.

Since excess lipase activity isn’t a problem that doctors and lactation consultants see very often, it can be difficult to find one that knows exactly what you are battling.

I struggled to find a lactation consultant who could help me with my lipase issues. One consultant told me I need to pump, freeze, and then scald my milk. That didn’t work. I just ended up with a kitchen that smelled like warm, nasty milk. Scalding needs to happen before freezing, which I will talk about more in Chapter 2.

Another consultant didn’t know anything about lipase issues and I ended up explaining it to her. I also needed to explain it to my pediatrician. It was extremely frustrating.



If you find yourself in this situation, don’t give up. Keep calling lactation consultants until you find one that knows what they are talking about. Suggest this book to your doctor. Don’t let someone push you into ending your breastfeeding relationship because of excess lipase activity.

I struggled to find support which is why I’ve written this book. I don’t want moms to feel alone and confused like I did. I believe strongly that you should have the support of your lactation consultant and/or doctor if you choose to scald your breast milk, but I hope that they are well educated when they offer you their support and opinions.

Eventually, I did find an amazing lactation consultant who fully understood excess lipase activity. Martha Kautz is employed by my pediatrician and has provided priceless amounts of advice and support to me and my little ones. She wasn’t at the practice when my first baby was born, but perhaps that was all part of God’s plan. If Martha had been there, and I had received the crucial support that I needed, I might not have felt the need to write this book.

Please don’t be shy about talking about your issues with excess lipase activity. The more people that talk about this problem, the more people that will realize they aren’t alone, and there are answers to their problem.

FAQ ABoUT EXCESS LIPASE ACTIVITy

Is excess lipase activity something that happens over time, or have I had this problem all

along and just never noticed?

This is hard to answer because of a lack of formal research. I didn’t notice the problem until my daughter was 5 months old. However, I was a stay at home mom who didn’t use bottles very often. Plus when I did use a bottle, I often gave our babysitter fresh milk that I had pumped that morning. It is also possible that my daughter’s sensitivity to the taste increased as she got older. Honestly, I don’t know the answer to your question, but I suspect that I had excess lipase activity from the beginning and didn’t notice it because of the reasons I mentioned.

Once you have it, do you always have it?

There hasn’t been any formal research done on excess lipase activity. I have done “informal research” by talking to many moms with this issue. It seems the most common that if you experience excess lipase activity with one baby, then you will experience it will all future babies. That was my personal experience also. Grace was born in 2009, and in 2012, Noah was born. I “tested” my milk right away after I had Noah and it was very obvious that I still had high levels of excess lipase activity.



Was your baby gassy and had frequent runny diapers? My baby has excessive gas, and I’m

curious if there is a link to this.

Although I am not a medical professional, my guess is that the excessive gas isn’t related to the lipase issue. There really isn’t anything wrong with excess lipase milk except for the taste, so it shouldn’t cause digestive issues. In conversations I’ve had with other women with excess lipase activity, none of them have mentioned this side effect from the bad tasting milk.

What tips can you give on getting a baby to take the bottle that he/she has learned to hate? I

tried a fresh pumped bottle and a scalded and reheated bottle and he/she still refused both.

I had similar problems with Grace. I’m not sure if it was related to her bad experience with the bottle, if the scalded milk tasted different from the fresh milk, or if she just truly preferred her milk straight from the breast.

You might find the best scenario is to leave the house completely while another caregiver offers a bottle. Sometimes babies will drink just enough to satisfy their thirst, but then will fill up when mom comes home. You could also try using a syringe or sippy cup.


CHAPTER 2

Scalding Your Breast Milk

HoW To SCALD yoUR BREAST MILK

The bad news about milk affected by excess lipase activity is that once the bad taste forms, there is nothing you can do to fix it. I had a lactation consultant suggest that I scald my bad tasting milk. That only resulted in a kitchen that smelled like hot, disgusting milk, which clearly was not very helpful.

The good news is that you can stop your milk from developing the bad taste by scalding it before the milk starts to change its taste. Heating the milk deactivates the lipase enzyme.

In my initial research, I found several suggestions for the proper scalding temperature. I read 145°F (63°C) for one minute or 163°F (72°C) for 15 seconds. I also heard that hitting 180°F (82°C) was the key temperature. After talking to my lactation consultant, I decided that the exact temperature doesn’t matter as much. It just matters that the milk gets hot. I liked my milk to hit 163°F (72°C), but always removed my milk from the heat once it hit 180°F (82°C).

3 Different Ways you Can Scald your Breast Milk

1. MICROWAVE

Microwaving breast milk is never recommended because it heats the milk unevenly and can kill important nutrients. It is difficult to make sure the entire bottle of milk has reached the proper scalding temperature if you use a microwave. Some mothers have tried this method, but I have always avoided it and do not suggest it.

2. STOVE

This is the most common way to scald milk and it is the first method that I tried. Pour your pumped milk into a pan on the stove and slowly heat the milk. Once small bubbles form on the outside edge of the pan, your milk is done and you should remove it from the heat. Do not boil the milk. Quickly cool the milk by transferring it to a sealed container and placing it in an ice water bath.

The stovetop method requires your full attention because the milk can quickly go from having tiny bubbles along the edge to a full boil. You can use a candy thermometer to monitor the temperature. Milk boils at approximately 212°F (100°C) at sea level. Remove the milk from the heat once you see bubbles or if the thermometer reads 180°F (82°C).


WHY DOES MY BREAST MILK TASTE BAD? SCALDING yoUR BREAST MILK

3. BOTTLE WARMER

For me, this is the easiest method. Once you figure out how much water to use with your bottle warmer, you can dump in the water and then go about your business without needing to babysit the milk. I am extremely thankful that I figured out how to do it with a bottle warmer. Otherwise, I can’t imagine standing at the stove every day trying to get my milk to the proper temperature.

Detailed Instructions on Using the Bottle Warmer Method:

ITEMS NEEDED:

• Bottle warmer

• Digital Thermometer

• Glass or Plastic Jar/Bottle

• Ice Water Bath

• Plastic Milk Storage Bottles

Later in this chapter I will cover each of these items in more detail.

METHOD:

Bottle warmers are normally used to safety and gently warm bottles before giving them to a baby to drink. Bottle warmers work by rapidly heating water to a boil. The steam and boiling water heats the milk. Once all the water is gone, the bottle warmer shuts off. However, when you use a bottle warmer to scald milk, you want the milk to get much hotter than you would if you were going to feed it to a baby. You “trick” the bottle warmer into scalding the milk by adding more water than you normally would for a bottle you are feeding to a baby.

The key to using a bottle warmer to scald your milk is figuring out how much water you need. A bottle warmer will continue to boil and steam the water until it is gone. For a normal bottle, you only need a little bit of water to get the bottle to the correct temperature. However, when you are trying to scald your milk you need more water to get the milk to that higher temperature.

THE AMOUNT OF WATER YOU NEED WILL DEPEND ON:

• How many ounces of milk you are scalding – more milk will require more water

• The container you are using to hold the milk – plastic requires more water than glass, tall and skinny containers require more water than short and wide containers

• The starting temperature of the milk – cold milk will require more water

• How hot you actually want your milk to get – the hotter you want it the more water you will need



STEP 1:

To scald your breast milk, add the appropriate amount of water to the bottom of your bottle warmer, place the bottle or jar of breast milk in the warmer, and turn the warmer on. Typically, I scalded 4 ounces of cold milk (from the fridge). I used an empty relish jar for a long time. Then I used a plastic bottle that came with my breast pump. You can read more about how to pick a jar and scalding in plastic or glass later in this chapter.

When I used a glass jar I filled up the blue “measuring cup” that came with my bottle warmer and dumped that in. When I used a plastic bottle I needed more water and used ¼ of a cup of water. (To clarify, that was ¼ of a regular, kitchen measuring cup and not ¼ of the measuring tool that came with the bottle warmer.)



STEP 2:

Pop in a digital thermometer to track the temperature of the milk. I found various recommendations for proper scalding temperatures and times. Instead of over analyzing which was the correct recommendation, I tried to find a nice middle ground. I heated my breast milk to 165°F. Then I left my milk in the warmer until it turned off or once the milk reached 180°F.

Use the thermometer to stir your milk gently a couple of times while it is heating. This helps the milk heat evenly and it prevents a film/skin from forming on top of the milk.



STEP 3:

After the milk is done heating up, put it in an ice water bath to quickly cool it down. If you are using a glass jar to scald your milk, you will have to transfer the milk to a plastic bottle so the hot glass doesn’t crack in the cold water. Once the milk is cool, you can freeze it immediately or put it in the refrigerator until you are ready to freeze it. Since I was only pumping once a day after the morning feeding, I usually collected 2 days worth of milk to freeze in one bag.

Scalding all my pumped milk wasn’t fun, but it became my new normal. Once Grace was eating solids, it actually came in handy. I liked to use warm breast milk for her oatmeal. Since you aren’t supposed to microwave breast milk, I started timing my scalding session to fit when I want to feed her oatmeal. After the milk was done scalding I poured some into her bowl and it worked out perfect.

PICKING A BoTTLE WARMER

When you pick a bottle warmer, you don’t want one with a lot of bells and whistles. A basic warmer will do. Many warmers advertise that they have a safety shut off. Typically that means that they automatically turn off after the water is gone. Just make sure that you don’t buy a super snazzy one that says it turns off once the milk reaches a certain temperature since you will be heating the milk much higher than anyone would want to heat up a bottle that they are going to feed to a baby.

I used a Munchkin High Speed Bottle Warmer that I purchased at Kmart. They are also available at other



retail stores and on Amazon. One mother told me she had problems with the Munchkin Precision Digital warmer. I don’t have any experience with that particular warmer, the Munchkin Time Saver warmer, or any other brand of bottle warmers. Please visit my resource page for a complete list of links to recommended products.

Someone asked me if the Munchkin bottle warmer would be disruptive in an office environment. When the warmer is steaming the milk it sounds like a pot of water boiling on the stove. It certainly isn’t loud enough to disrupt a conversation. When the water is gone, the warmer beeps three loud but short beeps. I would be very surprised by the insensitivity of your co-workers if they complained about a couple short beeps.

PICKING A DIGITAL THERMoMETER

You can buy a digital thermometer at any retail store. You should look for a cooking/meat thermometer. You do not want the kind of thermometer that you use to take the temperature of a person when they are sick.

If you can afford it, I suggest investing in a waterproof thermometer. Bottle warmers create a lot of steam and my thermometers always had a lot of condensation on them. I didn’t buy waterproof thermometers and I had problems with the display on one of my them and another one completely stopped working. I don’t know if that was because of the condensation or because the battery died.

No matter what kind of thermometer you buy, have an extra battery available. The peace of mind of knowing you have a back up would be nice for anyone, especially working moms or exclusively pumping moms.

Please visit my resource page for a complete list of links to recommended products.

SCALDING IN GLASS oR PLASTIC?

You can use a plastic or glass container for your milk when you scald it. With my first baby I started out using a plastic milk storage bottle that came with my breast pump. However, I noticed a hot plastic smell when I was scalding my milk and it made me nervous. Breast pump manufactures say their bottles are all BPA free, but you never know what other things are leaching out of the plastic and into the milk.

I switched to using glass. For a long time I used a small, empty relish jar. It fit in my bottle warmer perfectly. I used the plastic bottles in the ice bath since the glass would have cracked under the extreme temperature change.

Sadly, my relish jar cracked. I tried another glass jar (it might have been from pickles) and that one cracked

http://simplyrebekah.com/resources/




too. I got fed up at losing my milk to cracked jars and I went back to using plastic. With my second baby I never even tried using glass and only used the plastic bottles.

I completely understand a mom’s desire to avoid plastic, especially plastic that is being heated! I didn’t have the energy to test other glass options (losing milk to a broken jar will zap that energy pretty darn quick!), but thankfully other moms have shared their experiences with me. They suggest experimenting with a half pint canning jar, glass baby bottle, or laboratory beaker. If I have a third baby, I want to look into using a stainless steel baby bottle. You can find links to each of these on my resource page.

IS SCALDED BREAST MILK SAFE FoR My BABy?

It has been medically proven that breast milk is the most beneficial thing to feed our babies. But what happens when we scald that milk? It is still safe? Is it still a better choice than formula?

When I explained to my daughter’s pediatrician the lipase issues I was having, she had no complaints about me scalding my milk. The doctor’s only recommendation was that Grace didn’t drink only scalded breast milk. Since I am a stay at home mom, I was only giving her scalded milk when I left her with a babysitter. I didn’t give her suggestion much thought since it wasn’t an issue for me. However, for working moms or moms who exclusively pump, this might be a bigger concern.

I asked Dr. Ruth Lawrence for her thoughts on scalded breast milk. She explained to me that most of the properties stay the same. There is a slight decrease in vitamin C. Also the heat decreases the white cells a little bit. However, there are no cells in formula. “Scalded breast milk far exceeds the alternative of formula,” continued Dr. Lawrence.

After talking to my own pediatrician and Dr. Lawrence, I believe that it is best for you to feed your baby unscalded milk when possible. The increase of nutrients (vitamin C and white cells) and the mutual bonding that comes with breastfeeding is clearly worth it. However, if unscalded milk is never an option for your baby, then it is still better than formula.

You should discuss your particular situation with your own doctor and/or lactation consultant to determine what is best for you and your baby.

FAQ ABoUT SCALDING BREAST MILK

I tried scalding and it didn’t help. What does that mean?

If your milk doesn’t respond well to scalding then there could be other things going. Dr. Lawrence suggests that bacteria, viruses, or other contaminants could also cause a bad taste.




I did a taste test and my breast milk tastes bad after only a couple of hours. Can lipase affect

milk so quickly?

Lipase can change the taste of your milk quickly. My milk lasts for about 24 hours, but I’ve heard from several women who have to scald their milk right after pumping. That is pretty annoying, but hopefully you’ll get into a good routine soon.

If my baby has never rejected my bad tasting milk, can I skip the scalding process?

If you know you are going to use the milk before it gets the bad taste then definitely skip the scalding. If your baby is accepting bad tasting milk, then you can also skip the scalding process. However, I wouldn’t suggest storing a large supply of unscalded milk in your freezer. Even though your baby is drinking it now, he/she might reject the milk later down the road. I say better safe than sorry. Skip scalding for only the milk you know you will use in the short term and scald anything you store long term.

I called my lactation consultant and she said just to pour milk directly into pan and heat it

until it bubbles around the edge. Do you think that is ok or should I get a bottle warmer?

If the stove method works for you, then go for it! The reason why I love the bottle warmer process is because I don’t have to babysit the stove to be sure the milk doesn’t boil. Once I figured out how much water I need in the bottle warmer, I didn’t have to stand over it and I was free to do other things in the kitchen.

Can I skip scalding if I am going to use my milk soon?

Yes. If you will use your milk before the bad taste forms, then you can skip scalding. You can also experiment with how long your milk stays fresh in the freezer. If you have a high turnover with your pumped milk, then you could possibly freeze without scalding it to slow down the lipase. For example, a working mom who pumps just a couple days ahead for her baby could get away with freezing her milk without scalding it first.

Can I freeze my milk to stop the taste?

Freezing the milk will slow down the enzyme, but eventually the bad taste will develop in your freezer.

When my Munchkin warmer heats up, it boils and steams. Is this okay for the breast milk? I

have read not to boil breast milk, but does that just mean don’t allow the milk itself to boil or

the water around it?

The water around the milk can boil and should boil. It shouldn’t cause your milk to boil, but you’ll want to keep an eye on your thermometer and remove your milk once it gets to your desired temperature.

Why do I get a film/skin on top of my milk?

Milk naturally develops a film/skin on the top when it is heated. This even happens with cow milk. “Stir”



or “swirl” the milk occasionally while scalding it to prevent the film from forming. I always used my thermometer to stir the milk. Dr. Lawrence also suggests that the film/skin is a sign that the milk was heated to too high of a temperature.

Is there a reason you need to do the ice bath versus putting it right back into the

refrigerator or freezer? Is that better for the milk?

I think it is an important step. Bacteria can grow really quickly when the milk is at that high temperature. By cooling it down fast in the ice bath, you lower that risk. There were several times when I didn’t have time to wait for my milk to cool in the ice bath. On those days, I put the entire ice bath with the milk sitting in it, straight into the refrigerator. Then I could leave the house and know that my milk was good until I came home.

Can I put scalded milk in the refrigerator or should it immediately be frozen? And if so, how

long does it stay good in the refrigerator?

After you scald the milk, it should stay fresh just like regular breast milk, which is typically 6-8 days in the refrigerator and 6-12 months in the freezer depending on the kind of freezer you are using. If you are going to keep it for more than a couple days, then I would freeze it.

How long should my scalded milk last in the fridge or freezer?

It should last the same amount of time as regular breast milk which is typically 6-8 days in the refrigerator and 6-12 months in the freezer depending on the kind of freezer.

Is a regular freezer ok? I need my milk to last several weeks.

A regular freezer will be fine for your scalded milk. If you only need to store your milk for several weeks, then seriously don’t worry about using a refrigerator top freezer verses a separate chest freezer. You can store milk longer in a separate freezer than you can in a refrigerator top freezer, but the storage life of your scalded milk should be the same as regular breast milk.

Is it ok to reheat scalded milk? I worry about cooling and warming the milk too many times,

but my baby doesn’t like cold bottles.

In my non-medical professional opinion, I think it should be fine to pump, cool, scald, cool, and then reheat again. I would often cool and reheat my milk. Obviously, if you are using a bottle warmer to reheat a bottle for your baby to drink, you’ll need to use less water than when you scald your milk so the bottle doesn’t get so hot.

I’m on the road a lot for work and I planned on pumping in the car. Do the travel/portable

warmers work the same way? Would I have to scald the milk in the car? Or could I pump

during the day, cool the milk, and then scald all the milk at home?

Everyone has different amounts of lipase activity in their milk. My milk started to taste bad after 24 hours.



I’ve heard from some women that it was as short as 4 hours for them. The amount of lipase activity in your milk will determine if you can wait until the evening to scald it or not. Pump and then leave ½ oz or less of unscalded milk in your fridge. Every couple of hours taste a drop to see when your milk starts to turn. You’ll notice a bad aftertaste first. If you normally store your milk in a cooler in the car then that is how I would test it instead of in the fridge. Cold temperatures slow down lipase, but it doesn’t stop it. Milk sitting on the table will likely start to taste bad faster than in the fridge which will start to taste bad faster than milk in the freezer. That is why I would recommend testing your milk in the condition that it will be in during your drives.

I have no experience with portable warmers. Are you able to get the breast milk hot enough with a portable warmer? I would only pursue that option if you absolutely have to since you’ll also want to cool the milk quickly in an ice water bath, which may be a hassle in a car.


CHAPTER 3

What to Do with Bad Tasting Breast Milk

WHAT To Do WITH BAD TASTING FRoZEN MILK

The most heartbreaking part of having excess lipase activity was losing my entire frozen milk stash to that nasty taste. Grace wouldn’t touch the stuff (and I didn’t blame her), but what was I going to do with all that milk?

I had 575 ounces of frozen milk that my baby wouldn’t drink.

575 ounces!!

Let’s let that sink in for a moment.

I was devastated. What was I suppose to do with all that milk? Throw it away??? I wanted to throw up just thinking about it.

I ended up donating my frozen milk to the OhioHealth Mothers’ Milk Bank. If your baby doesn’t mind the taste of your milk, then please continue to feed it to him/her, but what if he/she won’t touch the stuff? Donating your milk to a milk bank is my number one suggestion for what to do with your milk, but there are several other options.

TIP: Before deciding that all of your frozen milk is “bad,” work backwards through your milk and see if any of your newer milk is still fresh tasting. You might be able to salvage some of your freshest milk.

8 Things you Can Do with your Bad Tasting Breast Milk

1. DONATE TO A MILK BANK

This is my number one recommendation for a couple reasons. First of all, your milk will most likely go to NICU babies that are in great need of the benefits that only breast milk can offer. Secondly, many of these babies are fed through a feeding tube and won’t notice the bad taste. Plus, your milk may be pooled with many other moms’ milk, so the bad taste will be diluted. Dr. Lawrence recommends that you should only donate your frozen milk if you’ve had success with scalding your fresh milk. If scalding doesn’t help your


WHY DOES MY BREAST MILK TASTE BAD? WHAT To Do WITH BAD TASTING BREAST MILK

fresh milk then there may be other reasons why your milk is developing a bad taste and it may not be a good fit for donation.

There are currently three different organizations that are collecting donor milk across the United States; Human Milk Banking Association of North America (HMBANA), Prolacta, and Mothers’ Milk Cooperative. If you are hoping to donate your milk affected by excess lipase activity, HMBANA banks are your only option at the moment.

For a complete list of milk banks that take milk affected by excess lipase activity and their contact information, see the Resource section in the back of the book.

2. DONATE THROUGH PRIVATE DONATION

Do you know friends or family that could use your milk? If not, MilkShare.com is a great resource for people looking to donate their breast milk privately. There are also several Facebook groups for moms looking for breast milk donations. The downside to private donation is that you won’t know if the baby will accept that bad tasting milk unless they are being tube fed. The same recommendation to only donate your milk if you’ve had success with scalding also applies to private donation.

Private Donation Resources:

• MilkShare.com

• Eats on Feets

• Milk Sharing Mamas Support Group

• Human Milk for Human Babies: This is a link to their global network. From there you can find links to a community close to you.

3. MIX IT WITH FRESH MILK

You might be able to convince your baby to drink the bad tasting milk by mixing it with fresh milk. I didn’t want to risk ruining anymore of my fresh, good tasting milk by mixing it with the nasty stuff, so I didn’t try it.

4. MIX IT WITH CEREAL OR BABY FOOD

If you have only a few bags of milk, this might be a good option for you. You can try to disguise the taste by including it in other foods your baby is eating. I had way too much milk to try to use it up this way.

5. USE IT FOR FOOD RECIPES

You can find recipes online for anything, including food made out of breast milk. Ice cream, yogurt, popsicles, bread, and cupcakes can all be made with breast milk. Will the recipes turn out if you are using breast milk that tastes awful? I’m not adventurous enough to find out, but if you do, I want you to email

http://milkshare.birthingforlife.com/

https://www.facebook.com/EatsOnFeetsHome

https://www.facebook.com/groups/211457965699316/

https://hm4hb.net/

http://simplyrebekah.com/contact



me and tell me how it tasted!

6. MAKE SOAP

Believe it or not, you can make soap out of breast milk. I can’t imagine that soap made out of milk affected by excess lipase activity would smell very good. If you enjoy soap making, it could be an interesting experiment.

7. SAVE IT FOR FIRST AID NEEDS

Breast milk has some amazing healing properties. If you have just a handful of bags, consider keeping it around and pulling it out for diaper rash, eczema, or minor burns.

8. THROW IT AWAY

My final suggestion for your bad tasting frozen breast milk is to throw it away. I suggest this is a last resort, but it certainly is an option. Perhaps you don’t have enough milk to donate. Perhaps you don’t have the time to experiment with soap making. Perhaps this whole experience has been so heartbreaking that you just want to be done with the whole thing and start fresh. That is okay! Give yourself the freedom to throw it away and move on, but before you do that … Take a moment to pat yourself on the back for the sacrifice you made by pumping all this milk. You are amazing, and you can do it again! Then ask someone else, maybe your partner, to throw the milk away for you. No mama should have to do that.

My JoURNEy BECoMING A MILK BANK DoNoR

When I realized that I had a problem with excess lipase in my breast milk, I was devastated. I had a ton of milk in my freezer that had a bad taste, and my little girl wouldn’t drink it. I was tremendously upset that I had all this milk that she wouldn’t be able to take advantage of in the future. However, what really brought me to my knees was the thought of having to throw it all away. I just couldn’t. Thankfully, someone in an online Le Leche League forum suggested donating to a milk bank. Once I realized that becoming a milk donor was an option, I knew that was exactly what I wanted to do. I just had to figure out how to do it.

I started out by visiting the website for the Human Milk Banking Association of North America to find a milk bank close to me. I ended up donating to the OhioHealth Mothers’ Milk Bank.

Note: This is about my experience donating to the OhioHealth Mother’s Milk Bank. If you choose to donate your breast milk, the details of your experience, application process, and milk bank may be different.

http://simplyrebekah.com/contact

http://www.hmbana.org/locations/



Becoming a milk donor was a 6 step process.

STEP 1: FIVE MINUTE INTERVIEW

The first time I called the milk bank to ask about being a donor they conducted a brief interview. They covered basic health questions as well as things that might be a red flag for being approved (medications, illnesses, traveling to certain countries, etc).

STEP 2: EXTENDED HEALTH INTERVIEW

After passing the initial interview, I was sent an extended health interview in the mail. Included was a copy of a form that the milk bank sent to my OBGYN and my daughter’s pediatrician to get their stamp of approval for me to donate my breast milk. I felt very nervous when I received my packet in the mail. I went over and over and over the pages to be sure everything was filled out correctly and I didn’t miss anything before I sent it back. Already I could tell that donating my milk could be one good thing that came out of this experience.

STEP 3: BLOOD TEST

Diane, a staff member at OhioHealth Mothers’ Milk Bank, called me to let me know that I had passed the extended health questionnaire. She explained that the next step of the process was a blood test.

Diane said that this part of the process is often the hardest. She sent me the vials and return shipping supplies that I needed, but I needed to find someone to donate a needle, tourniquet, and their time to draw my blood. My first thought was to call one of my nurse friends, but you can’t take a needle home from work without your employer getting a little upset. I had one of my lactation consultants at the local hospital help me. By that point they all knew exactly what I was dealing with and were more than happy to help me out. I shipped my blood off for testing and then waited to hear the final verdict.

I was approved. I clearly remember driving home and listening to the voicemail from Diane telling me that I was officially approved as a breast milk donor. I cried. I called a breastfeeding girlfriend who would understand, and I cried some more. It was a mix of emotions. I was relieved that I wouldn’t have to throw away my frozen breast milk, but I was still sad that my own baby wouldn’t drink it.

A couple days later Nate and I went through the process of figuring out how many ounces of milk I had to donate. I was confident that I had the minimum 200 ounces that I would need as a one-time donor, but I needed to know exactly how much I was sending to figure out how many boxes I needed to ship my milk. Also, I needed to know for my own benefit. I wanted to know exactly how much milk I had “lost” to excess lipase activity.



Nate and I went down to the basement and started pulling bags of breast milk out of our upright freezer. Nate wrote down number after number as I read off the amount of ounces in each bag. Physically putting my hands on all those bags of milk was a bit overwhelming. I was doing really well at holding it all together until I came to the bag from January 6th. I had written “Happy Birthday, Mommy!” on the bag. That simple note broke my heart, and tears slowly started to fall. It was still hard to process that fact that my baby girl wouldn’t be able to use any of this milk.

For the record, I needed 2 boxes to ship my milk. I donated 574.5 ounces of breast milk. It is amazing that I was able to have that much milk to begin with, and it is a miracle that I was able to give it to babies in need when my own baby wouldn’t drink it.



STEP 4: SHIP THE MILK

The milk bank sent me everything I needed to ship my milk. All I had to do was package it and call FedEx to arrange for pick up. The milk was sent priority overnight in a styrofoam cooler inside of a cardboard box. The milk stayed frozen by being packaged well and shipped quickly.



These last two steps are purely optional, but for me they were just as important as steps 1-4.

STEP 5: PICTURES

I took a lot of pictures. I knew that I would write about milk donation on my blog and I wanted some pictures for that, but I really took the pictures for me. I wanted to always remember the moment I donated my breast milk.

STEP 6: PRAY

After everything was packaged, FedEx was called, and the milk was ready to go … I got down on my knees, placed my hands on the boxes, and prayed. I prayed for all those little babies who would receive my milk. I prayed for the families who struggled alongside the babies fighting for their lives. Most of all, I thanked God for blessing me with enough milk to feed my baby and the opportunity to feed others also.

Donating my breast milk that was affected by excess lipase activity was healing for me. It became one of the proudest accomplishments of my life.

FAQ oN DoNATING To A MILK BANK

Donating your breast milk is truly a gift and a sacrifice. Below is a list of questions that you may have about donating your bad tasting breast milk. The answers are based on my own experience donating to the OhioHealth Mothers’ Milk Bank, an interview with Diana Bates from OhioHealth Mothers’ Milk Bank, and an interview with Kim Updegrove who is the president of the Human Milk Banking Association of North America (HMBANA).

Note: These answers are based on nonprofit HMBANA affiliated milk banks. As we discussed earlier, there are other ways to donate milk (privately or through a “for profit” organization), but HMBANA banks are currently the only banks I know of that are accepting breast milk with excess lipase activity. They are also the only style of bank with whom I have personal experience.

Do milk banks even want milk affected by excess lipase activity?

In most cases, yes! When a milk bank receives a donation of milk may be mixed in with many other women’s milk, which helps dilute any bad taste. However, the taste of the milk isn’t an issue in most cases since the milk is usually given to preemies via a feeding tube. There are several milk banks across the country that do not accept milk with excess lipase activity. Those banks are most commonly affiliated with the organization Prolacta and are not HMBANA banks.

http://simplyrebekah.com



Is the milk bank going to sell my breast milk or are they a non-profit?

According to Diane, “All members of the Human Milk Banking Association of North America are nonprofit. Although they are nonprofit, there is a fee for the milk when it is dispensed. This fee varies from bank to bank. The fee helps cover the cost of salaries, equipment, lab tests, shipping, etc.”

Kim also explained to me that this fee is usually covered by the hospital who requests the donated milk. The parents are not responsible to pay that fee while their baby is in the hospital. However, if the parents continue to receive breast milk once their baby is discharged, then they may be responsible for that fee.

Who exactly gets the milk?

According to Diane, “The milk that is dispensed from the milk bank serves families in a variety of ways. Most of the babies who receive our milk have been born prematurely. Many only get donor milk until their own mother has milk to provide. Some get the donor milk longer if mom is ill or chooses not to pump. Some babies will get the milk until discharged and others only according to hospital protocol. This may mean they receive the milk until they reach a predetermined weight or age. We also send milk to families who have adopted babies or had a baby with the help of a surrogate. Occasionally we send milk to families who need the milk because the mom is too ill to provide milk for the baby.”

In some rare cases, HMBANA banks may distribute donor milk to school age children because of various health problems or even to adults who are battling cancer.

Can I find out who receives my milk?

Your milk may be mixed together with many other women’s milk. All of that milk will be given a lot number. The milk bank tracks where all the milk from each lot number is sent. You could request to find out where your lot number was sent, but I’m not sure how freely milk banks release that information. Because of privacy laws, it is impossible to find out who receives your milk, but you might be able to find out which hospitals regularly receive donations from your bank.

Can I request that my milk is sent to a specific hospital/country?

Unless a milk bank is advertising that they are gathering milk for a specific purpose, you don’t have any control over where your milk is sent. In 2010, there was a devastating earthquake in Haiti. Some milk banks were requesting donations to help the orphaned babies there. That would be one type of situation when you can request that your milk is sent to a specific place, but I’m not aware of any ongoing campaigns like that. You can check with your milk bank to see where the majority of their milk is sent if you would like a general idea of how your milk will be used.

Is there a minimum amount of milk needed for a donation?

If you are choosing to be a one time milk donor, then you will need to have a minimum amount. Each milk bank sets their own minimum amount, which is typically between 100-200 ounces. However, if you are a



bereaved mother (your baby has passed away) many banks will waive the minimum requirement.

Who can I ask to draw my blood for the blood test portion of the application process?

I had a lactation consultant at the hospital where I delivered my daughter draw my blood. You could also ask your OBGYN, midwife, family doctor, or pediatrician.

Do I need to drive to the milk bank?

No. If you don’t live within driving distance of a milk bank, then you can ship your donation.

Is this going to cost me anything?

No. I was sent everything I needed to apply to be a donor and to ship my milk. The shipping supplies were provided along with the shipping labels.

If I am going to ship my milk, then how does it stay frozen?

I sent my frozen milk inside a styrofoam cooler that was inside a regular cardboard box. I filled in any extra space inside the cooler with newspaper to help insulate the milk. Diane reassured me that the milk would help itself stay cold during its priority overnight voyage. It is recommended that you schedule a FedEx pick up time for as late in the day as possible so you can keep your milk in your freezer as long as possible. I read one woman’s blog where she showed pictures of her milk being sent along with dry ice. That was not a requirement of my milk bank so it may vary from place to place.

My frozen milk is a couple of months old. How old is too old for the milk bank?

My milk bank requested that my milk be no older than 5 months. This may vary from bank to bank. It also varies depending on if you have a separate deep freezer or if you are using a regular freezer on top of your refrigerator.

How long does the milk donor application process take?

There are several steps in the application process. I started my application in March and sent my milk in the beginning of May. It certainly doesn’t happen overnight! Expect it to take a month or two for you to be approved.

Is it really worth it to donate my milk?

Oh, yeah. Yeah, it is. Having all this milk that my daughter wouldn’t drink broke my heart and donating it really helped me heal from that. But if you still have doubts, watch this YouTube video.

http://youtu.be/fnuYyQJhzSw


CONCLUSIONIn 2010 my second child, Noah, was born. I tested my very first batch of pumped milk to see if the taste would change. The bad taste made the results very clear. Once again I was faced with the challenges of excess lipase activity.

I started scalding my milk right away and I was able to build up a decent stash. After a few months I found myself wondering what I was going to do with all of the milk that I was pumping. I learned my lesson with Grace that I simply did not need to hoard breast milk for my babies. An “insurance policy” of a couple hundred ounces was nice, but I didn’t need to be storing over 500 ounces like I did the first time around.

I suspected that I couldn’t donate milk that I had scalded to a milk bank, so I started thinking about private donation. I ended up donating 150 ounces of milk to my cousin’s little girl. Immediately after donating that milk, Noah started waking up at night and depleted any “extra” milk that I had leftover for pumping each morning. He continued to wake up at night until after his first birthday.

I was frustrated. I had donated nearly all of my backup milk and pumping wasn’t getting me anywhere.

Yet again, God provided and my son nursed well beyond a year. As of writing this, I still have several bags of unused breast milk in my freezer.


WHY DOES MY BREAST MILK TASTE BAD? CoNCLUSIoN

I have been blessed with an amazing nursing relationship with both of my children. Despite “losing” 575 ounces to excess lipase activity with Grace and giving away all of my extra milk with Noah, my children had more than enough milk. They were well fed, well provided for, and well loved.

Take a deep breath, mama. You’ve got this. Right now it might feel overwhelming or frustrating that this one more thing is making your life more difficult. Life is difficult enough without dealing with excess lipase activity, right? You are pumping. You are nursing. Maybe you’re working or taking care of more than one child. Motherhood is hard enough without this extra twist. But, mama you’ve got this!

I’ve been there. I cried over my computer searching for answers. I’ve cried over my freezer counting the ounces of milk that I couldn’t use to feed my baby. I’ve cried over my breast pump thinking that there was no way I could start all over from scratch with my frozen supply. I’ve been there and I made it through the storm. You can too.

You have given your child the beautiful gift of breastfeeding. Nothing can replace this precious gift.

Tomorrow is a new day. Buy yourself a bottle warmer. Snuggle your little one and take a deep breath, mama. You’ve got this.


WHAT IS YOUR STORY?You have the power to impact other breastfeeding moms by providing some much needed research about excess lipase activity. Dr. Ruth Lawrence is collecting data with the hopes of doing formal research on excess lipase activity and she needs your personal story.

If you are a nursing mother with excess lipase activity and are interested in participating in Dr. Lawrence’s preliminary research, follow this link to a brief Survey Monkey form. You’ll be asked 10 questions based on your personal breastfeeding experience.

https://www.surveymonkey.com/s/FFR8X95


ABOUT THE AUTHORRebekah Hoffer is a stay-at-home mom to her two children. She has over forty-six months of personal breastfeeding experience. Each day, Rebekah tries to remember that this time with her little ones is limited and to enjoy the precious moments despite crying, nose wiping, and diaper changes. Her favorite moments are reading to her children, being with her husband, eating Oreos, and watching ridiculous reality television.

Rebekah is also the author of SimplyRebekah.com. She writes about living a frugal and natural lifestyle, parenthood, breastfeeding, and simple recipes. You can connect with Rebekah online at Facebook, Twitter, and on Pinterest.

http://SimplyRebekah.com

http://facebook.com/SimplyRebekah

http://twitter.com/simplyrebekah

http://pinterest.com/simplyrebekah


ACKNOWLEDGMENTSThere are several people that I would like to thank for their contributions to this book and for their involvement in my own breastfeeding journey.

RUTH LAWRENCE, MD DD (H),

Distinguished Alumna Professor, University of Rochester School of Medicine

It was an honor to interview you, Dr. Lawrence, for this book. Thank you for taking time out of your busy schedule to answer my questions and to write the foreword. It means so much to me to have your blessing on this project. Thank you for all you have done for the breastfeeding community of the world. I am so thankful that you “invented” the solution of scalding breast milk in the first place.

DIANE BATES,

Nurse Donor Coordinator at OhioHealth Mothers’ Milk Bank

Thank you for taking the time to explain the milk donation process to me and for bringing healing to my excess lipase activity journey through donating my milk to your milk bank. I appreciate your contribution to this book.

KIM UPDEGROVE, CNM, MSN, MPH,

Executive Director of Mothers’ Milk Bank at Austin, President of the Human Milk Banking Association of North America

Thank you sharing information about HMBANA and the other various milk collection organizations across the country. Above all, thank you for your encouragement.

MARTHA KAUTZ, RN, IBCLC

Martha, you are my breastfeeding angel. My husband and I took your breastfeeding class when we were expecting our first baby. You were there for Grace’s first nursing session, and you helped me overcome Noah’s overbite and latching issues. You have provided me with endless amounts of guidance and support for this book and beyond. You are my personal breastfeeding hero. Thank you!

EMILY, DONNA, KENDRA, KRISTEN, AND TIFFANY

The five of you have always been my biggest breastfeeding role models and supporters. You have listened to me weep over my excess lipase activity affected milk and you understood in ways only breastfeeding moms can. Some of you inspired me to pump in the first place. Some of you inspired me to nurse beyond


WHY DOES MY BREAST MILK TASTE BAD? ACKNoWLEDGMENTS

a year. All of you have been a positive influence on me and my babies. Thank you so very much.

LILA MILLER

This book might have never been written if it wasn’t for you. Thank you for the hours of childcare you provided while I wrote. You pushed me out the door and gave me the sabbatical from motherhood that I needed in order to finish this project. Yet above all, I need to thank you because you gave me life, fed me from your own body, and raised me right. Thank you for being such an outstanding example of excellence, Mom.

NATE HOFFER

Thank you, my darling husband, for the abundance of support you have given me. From the breastfeeding class we took before Grace was born to the several nursing sessions you stayed awake for when we were fumbling with our newborn; from the many tears you endured because of my excess lipase activity to the hours I have spent working on this book. Without your support, breastfeeding our children and writing this book would not have been possible. Thank you for helping me chase my dreams. I love you.

GRACE AND NOAH

Finally, I would like to thank my children for blessing me with our precious breastfeeding relationship. Thank you, Grace and Noah, for “milk drunk” snuggles, good latches, very few bites, goofy grins, admiring eyes, and milk dribbles on your chins. The two of you mean the world to me, and I am so glad I get to be your mommy. I will always love you!


REFERENCESMy education on breastfeeding and excess lipase activity began years ago and well before I ever dreamed of writing this book. It is impossible for me to pin point exactly where I first learned all the information I’ve presented. However, there a few sources that I would like to credit.

Martha Kautz, RN, LC, Personal Communication. April 2012 - March 2014.

Diane Bates, RN IBCLC, Nurse Donor Coordinator at OhioHealth Mothers’ Milk Bank. Personal Communication. February - September 2010.

Ruth A. Lawrence, MD DD (H), Distinguished Alumna Professor, University of Rochester School of Medicine - Telephone interview. June 12, 2013.

Kim Updegrove -Executive Director of Mothers’ Milk Bank at Austin and President of the Human Milk Banking Association of North America. Telephone Interview. December 20, 2013.

Adrianne Weir, CEO of the Mothers’ Milk Cooperative. Telephone Interview. January 3, 2014.

“Scalding Breast Milk Due to Excessive Lipase.” La Leche League International. February 2010. <http://forums.llli.org/showthread.php?297-Scalding-breastmilk-due-to-excessive-Lipase>

http://forums.llli.org/showthread.php?297-Scalding-breastmilk-due-to-excessive-Lipase

http://forums.llli.org/showthread.php?297-Scalding-breastmilk-due-to-excessive-Lipase


RESOURCES

ADDITIoNAL RESoURCES By REBEKAH HoFFER

For a full list of products recommended in this book visit:

Recommended Resources

For more articles on breastfeeding written by Rebekah Hoffer visit:

• Why I Support Nursing in Public

• Curing Thrush with Gentian Violet

• Extended Breastfeeding: My Personal Struggles

• Extended Breastfeeding: Weaning My Daughter Gently

• Babies Don’t Keep: A Benediction to Weaning Moms

MILK BANKS THAT ACCEPT MILK AFFECTED By EXCESS LIPASE ACTIVITy

All of the following banks have drop off locations. They also will provide shipping for those who are too far away to drop off their milk. If you need to ship your milk to one of these banks, I recommend going with the bank closest to you. That will cut down on shipping time, which helps the milk stay frozen.

Below each bank’s contact information, the minimum amount of ounces required for donation is listed. For some banks, they want that many ounces at one time. For others, they request a commitment to provide that many ounces over the course a year or before your baby’s first birthday. However, if you are a bereaved mother, the milk bank may waive the minimum ounce requirement and take anything that you have to donate.

CALIFORNIA

Mothers’ Milk Bank751 South Bascom Ave San Jose, CA 95128 Phone: (408) 998-4550 Toll Free: (877) 375-6645 www.mothersmilk.org


http://simplyrebekah.com/2011/02/03/why-i-support-nursing-in-public/

http://simplyrebekah.com/2014/01/19/curing-thrush-gentian-violet/

http://simplyrebekah.com/2013/07/22/extended-breastfeeding-my-personal-struggles/

http://simplyrebekah.com/2013/11/19/extended-breastfeeding-weaning-daughter-gently/

http://simplyrebekah.com/2014/06/10/babies-dont-keep-benediction-moms-weaning-from-breastfeeding/

http://www.mothersmilk.org


WHY DOES MY BREAST MILK TASTE BAD? RESoURCES

[email protected]

Minimum Ounces Required: 100

COLORADO

Mothers’ Milk Bank PresbyterianSt. Luke’s Medical Center & Rocky Mountain Hospital for Children 1719 E 19th Ave Denver, CO 80218 Phone (303) 869-1888 www.milkbankcolorado.org [email protected]


INDIANA

Indiana Mothers’ Milk Bank, Inc.4755 Kingsway Dr, Suite 120 Indianapolis, IN 46205 Phone: (317) 536-1670 Toll-free: (877) 829-7470 www.immb.org [email protected]


IOWA

Mother’s Milk Bank of IowaUniversity of Iowa Hospitals & Clinics 119 2nd St, Suite 400 Coralville, IA 52241 Phone: (319) 384-9929 Toll free: (877) 891-5347 www.uihealthcare.com [email protected]


mailto:[email protected]

http://www.milkbankcolorado.org


http://www.immb.org/


http://www.uichildrens.org/mothers-milk-bank/




MASSACHUSETTS

Mothers’ Milk Bank Northeast377 Elliot St Newton Upper Falls, MA 02464 Phone: (617) 527-6263 www.milkbankne.org [email protected]


MICHIGAN

Bronson Mothers’ Milk Bank601 John St, Suite N1300 Kalamazoo, MI 49007 Phone: (269) 341-8849 www.bronsonhealth.com [email protected]


Accepts scalded milk – this is not the norm.

MONTANA

Mothers’ Milk Bank of Montana734 Kensington Ave Missoula, MT 59801 Phone: (406) 531-6789 www.mothersmilkbankofmt.org [email protected]

Minimum Ounces Required: no minimum, but prefers at least 60

NORTH CAROLINA

WakeMed Mothers’ Milk Bank & Lactation Center3000 New Bern Ave Raleigh, NC 27610 Phone: (919) 350-8599 www.wakemed.org [email protected]

Minimum Ounces Required: 150 for drop offs & 200 for shipping

http://www.milkbankne.org/


http://www.bronsonhealth.com/


http://mothersmilkbankofmt.org/


http://www.wakemed.org/




OHIO

OhioHealth Mothers’ Milk Bank4850 E. Main St Columbus, OH 43213 Phone: (614) 566-0630 www.ohiohealth.com


OKLAHOMA

Oklahoma Mothers’ Milk Bank Inc.901 N Lincoln Blvd, Suite 330 Oklahoma City, OK 73104 Phone: (405) 297-LOVE www.okmilkbank.org

Minimum Ounces Required: 100, but will possibly take less

TEXAS

Mothers’ Milk Bank at Austin2911 Medical Arts St, Suite 12 Austin, TX 78705 Phone: (512) 494-0800 Toll Free: (877) 813-6455 www.milkbank.org [email protected]


Mothers’ Milk Bank of North Texas600 West Magnolia Ave Ft. Worth, TX 76104 Phone: (817) 810-0071 Toll-free: (877) 810-0071 www.texasmilkbank.org [email protected]


http://www.ohiohealth.com

http://www.okmilkbank.org

http://www.milkbank.org


http://www.texasmilkbank.org/




CANADA

Calgary Mothers’ Milk Bank103-10333 Southport Rd SW Calgary, Alberta T2W 3X6 Phone: (403) 475-6455 www.calgarymothersmilkbank.ca [email protected]


BC Women’s Provincial Milk Bank4450 Oak St Vancouver, BC V6H 3N1 Phone: (604) 875-2282 www.bcwomens.ca


Shipping options are limited.

http://www.calgarymothersmilkbank.ca


http://www.bcwomens.ca/


In the RefrigeratorInstructions: Taste every few hours and make note of any flavor changes. If the milk still tastes

fine after 6-8 days, you most likely do not have problems with excess lipase activity. As a

reference, my own breast milk started to taste bad after 24 hours.

Date/Time Taste (normal, possibly changing, bad, etc.) Date/Time Taste (normal, possibly changing, bad, etc.)


In the FreezerInstructions: Thaw and taste the milk every 24 hours. Make note of any flavor changes and then

refreeze the milk. As a reference, my own breast milk started to taste bad in the freezer after 2

weeks.


At Room TemperatureInstructions: Leave your breast milk at room temperature and taste it every hour. This test is

only necessary if you regularly need to keep your milk at room temperature after pumping.


Documents

BREAST MILK TASTE BAD? - Simply Rebekah...Rebekah Hoffer has captured the drama, the sorrow, and the need for a solution eloquently in these pages. She details with great compassion