Often when a baby is refusing pumped milk, the baby is refusing the method of feeding, not the milk itself. To find out whether a baby is refusing the feeding method or the milk being fed, some mothers experiment to see if the baby will take freshly-expressed milk instead of previously-stored milk. If the freshly-expressed milk is not accepted, and the problem appears to be the feeding method rather than the milk, you can try offering breastmilk in other ways such as in a cup, syringe, or even a spoon. Some mothers find that they need to try a variety of methods or even different bottles in order to determine what works best for each baby. Below is some information that you might find helpful:
How to bottle-feed the breastfed baby
One way to determine whether it is your milk or the feeding method that is causing your baby to refuse expressed milk 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,” but your baby is willing to accept, it is most likely fine. A change in smell or taste could be related to the milk’s 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 best to discard it.
The next step is to determine whether or not your storage system is at fault for the milk’s spoiling. The best place for long-term storage of your milk is in the freezer or, even better, a deep freezer (they maintain temperature better, and the milk is stored at a colder temperature, so it may be stored longer). If ice cream stored in your regular freezer is frozen hard, your freezer is cold enough. Before you begin expressing, wash and dry your hands and be sure to wash pump parts, bottles, caps and anything else the milk will touch in hot, soapy water. Dry them thoroughly in the air or with a clean towel. Be sure your storage container is well-sealed and that you do not store milk in the freezer door, along the sides, or directly on the floor of the freezer. The defrost cycle can cause the milk to defrost slightly and refreeze repeatedly, and the result may be either spoilage or a unsavory taste and texture.
You may feel confused if your milk smells and tastes spoiled or is being refused, but your freezer seems to be working, and you’re following the proper storage and handling guidelines. The answer may lie in the makeup of the milk itself. Lipase is an enzyme found in breastmilk and in the digestive systems of adults and children; it works to break down fats into smaller particles so they may be used for energy and growth. Is having lipase in your milk a good thing, or is it a problem?
In some research, authors suggest that lipase levels are higher in the mothers of premature infants. Higher levels of Lipase may aid in the digestion of the milk for babies with less-developed digestive systems. So the younger your infant, the more lipase there may be in your milk.
When you are pumping milk for your baby, you may find that the lipase in your milk begins to break down fats before you are ready to serve it. Unfortunately, when the lipase activity in milk is high, it may also cause an unpleasant change in the milk’s taste and smell after the milk has been stored for days or weeks. When you are breastfeeding without pumping and storing milk, you never need to worry about lipase. The trouble comes when you are attempting to store the milk for later use. Some mothers find that they are able to keep expressed milk in the refrigerator for a few days, but they are unable to freeze it without a change in the taste, and others find that their milk smells “off” even after refrigeration for more than a few hours. The good news is that there is a simple way to prevent excess lipase in your milk from changing the taste while the milk is stored.
Studies suggest that scalding (15 seconds at 165-170 degrees Fahrenheit) halts the activity of lipase. Possibly because lipase activity differs from one woman to the next, some mothers find that scalding at one temperature works better than at another. If you wanted to find the best possible time and temperature for you, you could divide some expressed milk into small test batches in order to experiment. You could reduce the amount of time at the given temperature (14 seconds- 12 seconds at 170, etc.) and see which combination works best for you. However, you may also waste a lot of 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, a week in the freezer, etc. If you do not wish to experiment to see which method works best for you, simply scald your milk for 15 seconds at 170 degrees, quickly cool the milk, then freeze it afterward. Make sure that you try this method with one batch and test it after a week has passed to make sure that it is working for you.
You can scald your milk 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 to your desired temperature. Typically, to get to scalding temperature in a bottle warmer, you will require more water than the manufacturer’s instructions suggest for the 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, and you will need to heat the milk just until you can see tiny bubbles around the edge of the pot before it is hot enough. 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.
- 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, ensure that you are using proper hygiene before expressing your milk and that everything that touches your milk is clean.
- be sure that your freezer is at a low-enough temperature–you will know it is cold enough if your ice cream is frozen hard.
- ensure that your breastmilk-storage containers are well-sealed.
- consider changing storage containers (for example, if you are using plastic bottles, try storage bags instead).
- consider keeping a box of baking soda in your freezer to help absorb food odors, if you think that your milk may be taking on smells from the air around it.
- ensure 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 to avoid deactivating enzymes. If the milk gets too hot, the immunological parts of the milk may also be lost, and the breastmilk may not last as long.
( c ) Serena Meyer, IBCLC- All Rights Reserved