by Anne Eglash MD, IBCLC, FABM
Why do women ingest their placenta and how does this effect breastfeeding? A recent review of placentophagy (consumption of the placenta after birth) has shed some light on the history of this behavior, motivation for it, and evidence. According to the authors, although there is no contemporary human culture that incorporates placentophagy as part of its traditions, most mammals ingest their placenta. According to Google Trends, they found that searches for the term ‘placenta encapsulation’ peaked between 2013 and 2015, implying that the practice reached its greatest interest a few years ago.
Researchers are suspecting that most mammals consume their placenta because of an analgesic effect mediated by a protein termed the ‘placental opioid-enhancing factor’ (POEF). Studies with rats ingesting human placenta did not yield the same analgesic effect.
Proponents indicate that human placentophagy can improve mood, reduce symptoms of postpartum depression, and improve iron status, milk supply, and energy. The most common way to prepare the placenta is by steaming and dehydrating to approximately 115-160 degrees F, then encapsulating, although mothers have been known to eat it raw, cooked in food, prepared as a tincture, or blended in smoothies.
One case of harm has been reported in an infant who suffered 2 bouts of group B sepsis (blood infection). The source of the Group B strep bacteria was believed to be the placenta capsules, not the mother’s milk, based on culturing both sources for the bacteria. It is possible that the placenta was not heated adequately during preparation. Mothers have complained about headaches from placenta capsule ingestion.
What statements do you think are accurate according to the authors of this review of placentophagy? (choose 1 or more)
- A small randomized controlled trial of about 23 women found that women who took placenta capsules in comparison to those who took placebos had improved iron status.
- The FDA has not issued regulation regarding how to process the placenta for ingestion.
- It is likely that placenta caps have bioactive hormones that might effect maternal mood.
- Facilities that allow mothers to take their placenta home require that the mother is free of infection.
- The largest study on placenta capsule ingestion and milk supply that was published in 1954 found that 86% of 210 mothers reported a good or very good increase in milk production.
See the Answer
All are true except A
Human placentophagy: a Review
Farr A, Chervenak FA, McCullough LB, Baergen RN, Grünebaum A
Am J Obstet Gynecol. 2018 Apr;218(4):401.e1-401.e11. doi: 10.1016/j.ajog.2017.08.016. Epub 2017 Aug 30.
Abstract
Placentophagy or placentophagia, the postpartum ingestion of the placenta, is widespread among mammals; however, no contemporary human culture incorporates eating placenta postpartum as part of its traditions. At present, there is an increasing interest in placentophagy among postpartum women, especially in the United States. The placenta can be eaten raw, cooked, roasted, dehydrated, or encapsulated or through smoothies and tinctures. The most frequently used preparation appears to be placenta encapsulation after steaming and dehydration. Numerous companies offer to prepare the placenta for consumption, although the evidence for positive effects of human placentophagy is anecdotal and limited to self-reported surveys. Without any scientific evidence, individuals promoting placentophagy, especially in the form of placenta encapsulation, claim that it is associated with certain physical and psychosocial benefits. We found that there is no scientific evidence of any clinical benefit of placentophagy among humans, and no placental nutrients and hormones are retained in sufficient amounts after placenta encapsulation to be potentially helpful to the mother postpartum. In contrast to the belief of clinical benefits associated with human placentophagy, the Centers for Disease Control and Prevention recently issued a warning due to a case in which a newborn infant developed recurrent neonatal group B Streptococcus sepsis after the mother ingested contaminated placenta capsules containing Streptococcus agalactiae. The Centers for Disease Control and Prevention recommended that the intake of placenta capsules should be avoided owing to inadequate eradication of infectious pathogens during the encapsulation process. Therefore, in response to a woman who expresses an interest in placentophagy, physicians should inform her about the reported risks and the absence of clinical benefits associated with the ingestion. In addition, clinicians should inquire regarding a history of placenta ingestion in cases of postpartum maternal or neonatal infections such as group B Streptococcus sepsis. In conclusion, there is no professional responsibility on clinicians to offer placentophagy to pregnant women. Moreover, because placentophagy is potentially harmful with no documented benefit, counseling women should be directive: physicians should discourage this practice. Health care organizations should develop clear clinical guidelines to implement a scientific and professional approach to human placentophagy.
IABLE Comment by Anne Eglash MD, IBCLC, FABM
Although it would make sense that consuming placenta capsules would improve iron status, the amount of iron in placenta is relatively low, and no robust research has been done to show that consuming the placenta is beneficial for iron status.
Placenta capsule ingestion became relatively commonplace in my community about 7-8 years ago. I believe that placenta ingestion has been a cause of insufficient milk supply in a small number of patients seen in my lactation practice. My observation is based on not identifying any other cause of low supply, and a gradual rise in milk supply by stopping the capsules without having to employ other interventions. I have met women who believe that they have more milk due to taking the placenta capsules, as compared to their supply with the last infant. However, women typically make more milk with subsequent infants unless they have a change in health status such as marked increase in pre-pregnancy weight or preterm birth, so measuring the effect of placenta capsules based on comparing supplies from one baby to the next may not be 100% valid. My suggestion is that if you are working with a mom with a low supply, ask about placenta ingestion, and if she has been taking placenta, ask her to consider stopping it, to see if her supply gradually increases over time.
Tytina Sanders-Bey
This is the most I have learned about placenta use after birth….and now I know that I need to learn more.
Emily
This makes sense to me! With my first child, I had my placenta encapsulated. It did not take long for me to discontinue using the pills because they gave me terrible headaches, and I didn’t observe any particular elevation in mood either. Interestingly enough, my daughter was very slow to gain weight – so now this makes me wonder if the short amount of time I ingested the placenta pills contributed to her slow weight gain in the beginning! It certainly makes sense (knowing much more about lactation now than I did back then).
Lyn Hrivnak RN IBCLC
It might be interesting to consider that in nature animals consume the placenta immediately postpartum and all at once rather than over an extended period of time. Since consumption over time is not a natural process in any other species, could it have negative consequences for humans and what would they be?
MilkMob
I agree, I think this is an important consideration!
Christina Smillie
And it may well be that mama mammals consume the placenta perhaps not so much for any particular maternal advantage, but rather for her infant’s survival, her own survival, and indeed, survival of the species: to avoid leaving clues for predators that there is a vulnerable defenseless* delicious newborn nearby. ,
*Actually only intermittently defenseless, especially if a “cache” mammal: Newborns are well protected by fierce mama with her oxytocin-mediated strength and maternal behaviors. Would be interesting to investigate if high oxytocin at birth is responsible for the placentophagy….
Allison Laverty Montag
Thank you for writing this question! This is something that I hear of regularly in my practice. I will make a point of asking women about comsuming their placenta in the future!
Paula Hart
Very interesting article! I have also had this come up often in my practice. I do not encourage it since I have not read any reliable research on this topic until I read this. I also have wondered if the “processing” of the placenta would actually disrupt any hormonal benefits that the mother might experience, and I do agree with the previous comment that in the wild mammals consume it right away, and not over time.
Since the CDC information I try to discourage my patients use of this practice.
Chris Sheppard
This practice of consuming the placenta has not sat well with me as a midwife of 47 years. However recent examination of the advantages mothers claim and looking the the research presented to me by an Epidermologist in all things “birth”, more controlled studies need to be done to provide women with as much accurate information to make informed decisions about this practice for them. Having said that, in view of the risks to the baby of bacterial illness or even death is significant enough for me to still not favour it over counselling women it other ways to improve milk supply, treating or preventing anaemia and improving mood disorders. Simply taking pills even ones made from placental components seems to be the quick for this generation.
Margaret Turano, IBCLC
Low milk supply with mothers who have ingested placenta is very common in our community. This is due to the large number of women who encapsulate and ingest their placenta here; it is extremely popular and heavily promoted. Unfortunately, this has given us many case studies to explore and work with.
Sarah Hollister
I am an IBCLC working in the outpatient setting. Over the past 5 years, I have had many cases of moms with low milk supply following placenta ingestion. Like Dr. Eglash noted, I also find that after the woman stops taking the pills, I can see a gradual increase in milk supply. I also see women before they start the placenta pills who have a normal supply, and I see how when they start the pills, their supply begins to decrease. Starting the placenta pills is the only changing factor in these cases. I find that the placenta pill effects on milk supply are easier to recover from the sooner they are discontinued. I agree that now that this is becoming a popular practice for new moms, it will be necessary to include asking about the use of placenta pills in our lactation assessments.
Emma
Hi Dr. Eglash. As I recall, the 1954 study doesn’t hold up very well. Yet you’re mentioning it here, suggesting its outcome was valid and women should be ingesting their placenta to increase milk supply. Could you address this? Thank you!
MilkMob
I actually didn’t review the study. It was a study that was cited in the review.
Thanks for your comments on this.
Susie McCulloch, IBCLC
I am so glad to see the issue of placenta ingestion lowering breastmilk supply being addressed. As an IBCLC working in the WIC setting, I have seen placenta ingestion have a detrimental effect on breast milk supply. In fact, I have added a line on my intake form to specifically ask about placenta ingestion, as Moms don’t mention it when I only ask about medications, herbs, supplements, etc.
Breastmilk supply is too precious to be gambled with, which is what happens when Moms ingest their placentas, as we can’t predict what the outcome will be. I am happy to see that the Academy of Breastfeeding Medicine has included placenta ingestion as a risk factor for low milk supply in their revised protocol on galactogogues.
Most Moms are getting their information about placenta ingestion from the people who profit from their business of placenta encapsulation, so there is an inherent conflict of interest. It is important that as the experts (IBCLCs) in the lactation community, we provide education to our clients about this issue, so they can make an informed decision.
Ellen Lasser
I have been wondering about this practice and I haven’t found that any patients have benefited fron doing this…it just had seemed to me to be another thing for new moms to worry about and pa y for in the scheme of things So I am grateful for the article and education Thanks
Ellen IBCLC
Miles
Ingesting your placenta in anyway = a DECREASE in milk production up to 50%. This means you may have a very fussy baby esp. when they are feeding because the baby can’t get enough milk which means much less sleep for you. I’m an RN but this is also our personal experience. We wanted to make placenta art which I thought was awesome and fun! We also wanted to try to ingest the placenta because being in the medical field I know postpartum depression is very real… and I heard it had great benefits for energy also. When I asked someone I trusted very much who has been working with mom and babies for over 50 years said be careful eating the placenta because it has been known to decrease milk production. Listening to her warning we waited to try placenta smoothies (mixed with berries) until after the 4 day of the baby being born. This is when all her milk came in. Her breast were full and leaking like crazy. The next day my wife then began to take 2 inch pieces of placenta and putting it in a smoothie every day. It has no taste so she enjoyed it like a normal smoothie. We noticed that she had a more stable energy and stable emotions than the 4 days after delivery. But after the 5th day of drinking the smoothies our baby was so fussy we realized after examining her breast that her milk production went down big time and the baby clearly wasn’t getting enough milk to be satisfied. This meant less sleep for us. I would make the recommendation that a woman could keep her placenta in the freezer or pills in case of an energy or emotional emergency. And take a small amount if she really felt like she needed it. I can NOT recommend taking it continually. It makes a mother feel inadequate when she doesn’t feel like she can produce enough milk for a baby which ends up being counterproductive on the depression issues for the main reason for taking it in the first place. Use the placenta if you really need it otherwise don’t. It’s not worth the frustration inhibiting your milk production and dealing with the problems it causes. If you have already taken placenta in anyway and having problems now stop taking it and do frequent feedings, lots of skin to skin, and grazing which is letting the babies mouth play with your nipples even when they are not feeding. Your milk production will boost in 24 hours… and you will have a very significant increase within the next 48 to 72 hours. Please don’t get angry with me sharing my experience. Everyone’s body is different biologically so this is not a one size fits all topic. Some people love peanut butter and for others it can kill them. Lets respect and learn from each others experiences. Miles RN
Laura
what about effects on baby nurseing ? high bilirubin level big issue for new daughter, is it possible that placenta capsules contain things removed as toxins, now being ingested and fed to her are to much for her to keep up with, can’t breakdown from breastmilk ??
IABLE
I would not expect that toxins from the placenta would be affecting the infant.
Shannon McLaughlin
Anne, I am listening to your IABLE course Breastfeeding Support for the NICU/ PICU Dyad and you mentioned that ingesting placenta can have a negative effect on milk supply or insufficient milk supply. Can you let me know your source for this info? It makes sense as retained placenta can delay Lactogenesis 2- but I am curious what studies are out there for my education! Thanks so much for your help!