Saturday, March 5, 2016
The Color of Colostrum: A Journey of Serendipity
"Colostrum is thick and creamy yellow, as compared with mature milk, which is thin and bluish-white in color." --"Breastfeeding and Human Lactation," by Riordan and Auerbach, Second Edition
Without air conditioning, Florida heat in early September sucks the energy out of you. It covers you in a blanket of moisture and fogs your brain. It was in the early morning hours of September that I gave birth at home to my first child. Those early days are memories of joy and pain. Breastfeeding in comparison to birthing was more difficult and demanding. I struggled with breastfeeding for 11 days and then quit. I learned to use infant formula. But emotionally I spiraled into a dark abyss of depressive thoughts. I felt this yawning gap between my baby and myself. And with each day not breastfeeding, the gap became larger and larger. When my baby cried, my ability to respond to her had slowed. I felt detached and the memories of the closeness we had had when she was first born weighed upon me. During that time I read and reread everything on breastfeeding and focused on relactation. Intuitively I knew that I needed breastfeeding. Infant formula satisfied my baby's hunger, but it did not physically and emotionally satisfy that closeness I remembered from the early days of breastfeeding. If I had not breastfed in the beginning, I would never have known what I had missed.
I remember the day, I went back to breastfeeding. The sunlight streamed through the window and the curtains gently danced in the sea breeze. There was a smell of fall in the air. I sat on the bed and stared at my smiling, calm baby. She had just had a bottle of formula and I decided to see if she would breastfeed. She immediately started breastfeeding as if we had never stopped. The sun seemed to shine brighter, the breeze more embracing and my heart skipped a few beats in joy.
Many weeks later, after some trial and error; we were breastfeeding exclusively. I did not use a pump or all the gadgets that are now suggested by lactation professionals to relactate. I gradually lowered the amount of formula and increased the breastfeeding. There are many obstacles to relactating and many of those obstacles had to do with my ignorance of babies. I thought breastfeeding was only about feeding a baby. When I stopped viewing breastfeeding as a food system with set times and limits, the obstacles started to disappear. And as I learned that crying is an infant's last resort to communicate the need for food or comfort at the breast, I became more in sync with my baby. Knowing those cues and responding to those cues made mothering my baby so much easier.
Over the years I have wondered whether so many untimely weanings from the breast have more to do with our preconceived notions of babies. Whether so many generations of bottlefeeding have distorted and extinguished our mothering wisdom. If I had pumped and bottled my breastmilk, would I have gone back to exclusive breastfeeding? Would seeing the amounts and color of my milk, helped me over the obstacles to breastfeed? Or would I have started to question my milk because its color was not quite the colors mentioned in articles on the subject? Or would I have doubted my milk supply because I could only pump a few ounces? Would I have spent more time pumping and bottling my milk than actually breastfeeding?
I saw an article on Facebook that triggered this journey of serendipity. It was entitled, "Mom's Baby is Sick, Then She Looks At Her Bag of Breast Milk and..." written by Barbara Diamond.
The article was about a mom who was breastfeeding and pumping and noticed that after her baby got sick her milk was an orange color resembling colostrum. There was a picture of her pumped milk before the baby got sick (white color) and after the baby was sick (orange color). The first thing I noticed was the storage bags had the company name, Lansinoh. And then the other picture I noticed was her Evenflo pump. Both companies are known violators of the WHO Code. I thought to myself that it was a strange article because I had never heard that milk would revert to the colostrum color (the orange color that is representative of carotene levels). As a lactation consultant I had only seen the orange colored milk in moms with newborns. And because I never pumped during the newborn days of my babies, I never saw the color of my colostrum. That doesn't mean that I disbelieve that this could happen, but that I had never seen it as a LLL leader for 10 years and IBCLC for 20 years. And it intrigued me and troubled me at the same time. The article seemed to be implying that this was proof that, "Mom's body will actually change the milk's immunological composition, tailoring it to the baby's particular pathogens by producing customized antibodies."
My understanding of the color of colostrum is rather limited. I found myself revisiting some of my text books on human lactation. And wondering about carotene in milk that supposedly is responsible for the orange color of colostrum. Cow colostrum also has an orange-yellow color and is related to a cow's grass-fed diet. Carotene gives grass that green color. But humans are not cows. We get our carotene, a fat soluble orange to red pigment from various veggies, like carrots. Carotene is considered an antioxidant in plants, a precursor to vitamin A in humans. So what is the color of immunoglobulins? Secretory IgA (a major human milk immunoglobulin) is closely associated with the human milk fat globule. So the color may have something to do with the amount of fat in the milk. As volume of milk decreases the concentration of immunoglobulins increase. So the color change in the article may represent the fact that a sick infant nurses more frequently and pumping besides increased nursing would mean that the volume of milk had decreased significantly. If the volume decreased then the infant would get more protection through a concentrated dose of immunoglobulins. Of course this is just a theory in my head because I have not seen what this author documents. And then I start thinking why do we have to "see" a visible change in the milk? How does this help women breastfeed? Will women who pump and don't see this color change presume that something is wrong with their milk. Even though text books on human lactation say that the dose of immunoglobulins throughout lactation is the same, independent of volume. I could imagine that some mothers would never see a color change. Of course that is dependent on the veracity of this article.
The article also discussed, "that when a baby nurses, it creates a vacuum in which the infant's saliva sneaks into the mother's nipple." Then the article mentions "baby spit backwash." I remember reading this in a blog or was it a journal article? And I guess I am feeling my age but "baby spit backwash" sounds so revolting to me that I don't know whether to cry or laugh. In our germ phobic society I am not sure how this term is really helpful in promoting breastfeeding. It does not seem like an apt description of breastfeeding or maybe it is just an unnecessary description. Or maybe I am just a romantic about my own breastfeeding experience.
The importance of color in human milk is predicated on a breast pumping society. It is rather sad that this is the direction in which our society is headed. If one is exclusive breastfeeding, one does not have to be concerned about the color or volume of milk. Your body knows what it is doing and that understanding creates a base of belief in mothering though breastfeeding. When the milk becomes the prime importance, then we look to the milk as the arbitrator of our reality.
That reality will be governed by various industries involved with the collection and distribution of human milk. It will be breast pump companies and milk banks that will determine our mothering or lack of mothering. And it will be these companies that determine whether breastfeeding will survive.
Patent # 7914822, "Method of producing nutritional products from human milk tissue and compositions thereof," owned by Prolacta Bioscience, inventor Elena Maria Medo, filed in 2009
"Colostrum contains high levels of immunoglobulins, a vital defense mechanism that protects the newly born. sIgA [secretory Iga-an abundant immunoglobulin in human milk closely associated with the milk fat globule] provides immediate protection to the infant by lining the gastrointestinal system and providing a first defense against dangerous pathogens like E. coli and other devasting disease organisms. The invention discloses concentrated, processed sIgA for use as a prevention or therapeutic for gut disorders in patients of all ages."
Copyright 2016 Valerie W. McClain