Monday, December 14, 2015

What my baby and a fancy piece of dairy equipment from the Ukraine have in common...

Fun fact: I'm a lactation consultant.  In addition to being a family physician.  So I care an awful lot about helping other moms to breastfeed.  And as for me breastfeeding my own children... well, there's no doubt about it.

Soon after Monica's diagnosis and really understanding it, I began to think about what we would do if we had another child with LPLD.  At what age would we check our baby's cholesterol levels?  And most of all, once we checked, what would we do if he or she had LPLD?

I feel strongly that if you're not going to CHANGE something after checking a medical test, be it an image or a lab, then you shouldn't check it in the first place.  Knowledge is nice, but at least medically, knowledge without a plan of action is a waste of money and effort.
I can't give this up.  So how can I make breastmilk work for my special little LPLD baby?
After a diagnosis of LPLD, could I continue to breastfeed my baby in good conscience?  Or should I switch to the non-fat formula that is available?  What is the impact of a non-fat diet to a growing infant?  Baby brains need fat to grow!  There's just no research on this.  I wanted to try to breastfeed and feed my baby only human milk.  But I wanted to know if she had LPLD sooner than I did with Monica, to give her the best chance of achieving a healthy diet sooner and never having pancreatitis.  So, with discussion with our geneticist, I developed a plan.  I would check a lipid panel at 6 months.  I wanted to feed regular old breastmilk for at least the first 6 months of life.  Monica had had no symptoms in the first 6 months, so I doubted that, at least with the gene combinations of my husband and I, that the triglyceride levels would rise dangerously in the first 6 months for any of our children.

Obviously, if my baby had already had a case of pancreatitis, I would quit breastfeeding and feed the nonfat formula.  The danger to her life from pancreatitis is too great to mess around with, especially when that little and delicate.  But given that she was still healthy and gaining weight those first few months, we would just do breastmilk and check TG levels at 6 months, as we were starting complementary first foods.  From then on, since I had to work and have my husband feed my pumped breastmilk anyway, I would separate the fat out of my breastmilk from then pumped milk.  I would breastfeed from the source when I was with her, so make sure she got some fat for brain development.  But I hoped that by decreasing her fat intake from my milk in this way, it would decrease her chance of having symptoms of LPLD.  For me and my baby, it's a balance between brain growth and lifelong benefits of breastmilk, and avoiding symptoms, rather than relying on the TG numbers.  Monica, after all, didn't develop symptoms until around 18 months, and even then they were rather minor.  The new baby would have the added benefit of knowledge of her diagnosis, so the complementary foods we would feed her, from the beginning, would be low fat.  Plus, instead of whole milk being added after 1 year of age, we could go right to skim.

I went to a small conference many months back hosted by NORD and asked them about my plan.  Luckily, even the lipid and genetic specialists knew already that the health benefits of breastmilk are huge, especially for a baby who has another serious health problem, like LPLD.  They had never imagined a mom willing to go through the craziness I proposed to breastfeed her baby, but they were interested and supportive of my efforts.

And that is how I came to buy a milk separator.  The kind used by small dairies to get skim milk and cream from their milk.  But I'm not using this on cow or goats milk.  I'm using it... on my own milk.

This. Is. So. Weird.
Without further adieu, I would like to introduce you to the latest member of our family! Shipped right on over from the Ukraine, our milk separator!  Keep posted to learn about our earlier experiences with her!

1 comment:

  1. Triacylglycerol lipase is an enzyme with system name triacylglycerol acylhydrolase. This enzyme catalyses the following chemical reaction:triacylglycerol + H2O↔ diacylglycerol + a carboxylate. lipase