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Why do I feel so sleepy when I nurse? →

Posted on August 23, 2010 by Serena Meyer

Often when a baby is refusing pumped milk it is the method of feeding that is being refused, not the milk itself. Some mothers experiment with freshly expressed milk to see if their baby will take it instead of previously stored milk. If the freshly expressed milk is readily accepted and the issue appears to be the feeding method rather than the milk, you can try offering breastmilk in other ways while you are separated, such as cup, syringe, or even spoon feeding the milk. Some mothers find that they need to try using a variety of methods or even different bottles in order to determine what works best for their baby. Remember that everyone is different and this also includes your tiny baby.  Below is some information that you might find helpful:
How to bottle-feed the breastfed baby

One way to determine if it is your milk versus the feeding method is to examine some of the properties of your milk. How does it smell? How does it taste? If your milk is smelling a little bit “off” and your baby is willing to accept it even if it has a faint taste of something else, it is most likely fine. A change in smell or taste could be related to the milk absorbing odors from other foods in your freezer. If your milk tastes or smells rotten (like soured cow’s milk) and your baby refuses it, it probably is time to discard it.

The next step after is to determine whether or not your storage system is at fault. You want to be able to store your milk in the freezer, even better if you have a deep freezer (they maintain temperature better because they are opened less). If ice cream is frozen hard, your freezer is cold enough. Before you begin expressing, be sure to wash pump parts, bottles, caps and anything else the milk will touch in hot, soapy water. Dry thoroughly. Also wash and dry your hands before you begin. Be sure your storage container is well sealed and that you do not store milk in the door, along the sides, or directly on the floor of the freezer. The defrost cycle can cause the milk to slightly defrost and refreeze repeatedly, resulting in either spoilage or a unsavory taste and texture.

So you may feel confused about what is happening to your milk if your freezer is working fine, you’re following the standard storage and handling guidelines and yet your milk is still being refused. The answer may lie in the milk itself. Lipase is an enzyme found in breastmilk and in the body of adults and children; it works to break down fats.

So lets talk about lipase and it’s purpose: in some research papers, they suggest that Lipase levels are higher in the mothers of premature infants. The thought behind this is that higher levels of Lipase aid in the digestion of the milk. So the younger the infant, the more Lipase you tend to find.

Lipase: friend or foe?

When you are pumping for your baby you can run into issues with Lipase digesting your milk before you are ready to serve it. When you are breastfeeding without pumping and storing milk, generally you never need to worry about the activities of Lipase. The trouble comes when you are attempting to store the milk that your Lipase is so happily breaking down for you. (Similar to the word lipid, lipase breaks down fats. Most enzymes have an -ase at the end of them.)

Studies suggest that scalding (15 seconds at 165-170 degrees Fahrenheit) halts the activity of Lipase. Some mothers find that the results of scalding at one temperature differ than their results scalding at another. This could be because of differences in the amounts and activity of lipase in milk. If you really wanted to make a science project out of it,  you could divide some expressed milk into small test batches in order to do your own research. You could reduce the amount of time at the given temperature (14 seconds- 12 seconds at 170 etc) and see which works best for you.  The problem I can foresee with lots of test batches is the wasted milk. You will need fresh milk to work with, and you will need to store your small batches with labels and see how the milk tastes and smells at a few hours, days and then at a week in the freezer etc. If you do not wish to experiment to see which method works best for you, simply scald for 15 seconds at 170 degrees, quickly cool the milk, then freeze afterward.

You can scald with a bottle warmer: Pour the water into a bottle warmer. Add to the warmer a bottle that contains about as much water as you would normally have of expressed breastmilk (2 oz, for example).  Using a new/clean cooking thermometer as a guide, run the bottle warmer until the thermometer placed inside the bottle reaches 165-170 degrees F. This way, you can ascertain how much additional water you will need in the bottle warmer to get your desired temp. Typically, to get to scalding temperature in a bottle warmer, you’ll require more water than what the manufacturer’s instructions suggest for gentle warming of a bottle.
Here is how one mother scalds her milk using a bottle warmer:
Excess Lipase: Scalding Breastmilk

You can also scald in a pot on the stove top. The scalding point is just around 170 degrees Fahrenheit. This means to heat the milk just until there are tiny bubbles around the edge of the pot. When these bubbles begin forming, immediately remove the milk from the heat. Do not continue heating to a rolling boil (212 degree Fahrenheit). Boiling damages some components of the milk, and deactivates some enzymes and proteins completely.

Note that it is not recommended to scald in a microwave because it heats unevenly.

Important points:

• if your baby is refusing your previously frozen expressed milk, first determine if he is refusing the milk itself or the feeding method.
• if your milk smells or tastes strange, assure you’re using proper hygiene before expressing your milk and that everything that touches your milk is clean
• be sure your freezer is at a low enough temperature–you will know it’s cold enough if your ice cream is frozen hard
• assure your breastmilk storage containers are well sealed
• consider changing storage containers  (for example, if you’re using plastic bottles, try storage bags instead)
• consider keeping a box of baking soda in your freezer to help absorb food odors
• assure that your milk is stored away from the door, walls, and floor of your freezer in order to avoid partial defrosting and refreezing
• if changing your storage routine doesn’t help, try scalding
• scalding (heating to about 170 degrees F) halts or slows the activity of lipase
• after breastmilk is scalded, quickly cool and store it properly. Deactivating enzymes means that you are also deactivating the immunological parts of the milk as well. This would result in more rapid decomposition than fresh breastmilk

More information:
If breastmilk tastes sour, metallic, or soapy, lipase may be the cause
My expressed breastmilk doesn’t smell fresh. What can I do?

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Why do I feel so sleepy when I nurse? →