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.
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.
Milk Mob 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.