Last week, a statement from the CDC made many in the birthing world sit up and take notice. An infant diagnosed with late-onset GBS infection had undergone testing and the GBS strain they were infected with was linked to the placenta capsules being consumed by the mother.
Now, the statement from the CDC is missing vital information that would help those of us who encapsulate to understand exactly what had happened. But based on the information they did provide, we can make some logical guesses as well as have a broad picture of what occurred.
The very start of this occurs in the last few weeks of pregnancy, when the mother was tested for Group B Strep bacteria. This occurred when she was 37 weeks pregnant according to the CDC, which is actually 1-2 weeks later than this test is done in GTA hospitals. In this case, the mother was tested and found to be GBS negative. According to the Ontario Midwives, the Group B Strep test is accurate 87% of the time. This means that there is a 13% chance of either a false positive or false negative. There is also a chance that a GBS infection will develop in the 3-5 weeks between testing and a person’s estimated delivery date.
In the case being commented on by the CDC, the placenta was encapsulated somewhere other than the home of the person who gave birth. We have no way of knowing if this was done in an encapsualtors home, or (less likely) in a dedicated encapsulation space. This matters because it is not only possible for cross contamination to occur, it is more likely if it is a space where multiple placentas are or have been processed.
Systemic reviews of different bacteria have shown that strep bacteria can last anywhere from a few days to a few months on an inanimate surface. In certain conditions, it is possible that a previously encapsulated placenta could leave behind bacteria in the sink, on the counter, or on the equipment – which could have contaminated the placenta in question. This could be a possible account for a negative GBS screening at 37 weeks, but placenta capsules that tested positive. However, it is also possible that the initial test was a false negative, or that someone else in the family was colonized and infected the baby and the pills were not contributory to the infants infection at all.
When a placenta is encapsulated in the home of the person who gave birth to it, cross contamination is less likely to occur. That is because the bacteria in the home are bacteria that the person has already been exposed to, it is their bacteria. The birthing person also has the assurance of knowing that their placenta was stored appropriately, because they stored it, and that the surfaces it was prepared on were sanitized, because they can see the process.
In this specific case, the baby had been treated for early-onset GBS, and then several days later, returned to the hospital for late-onset GBS infection. When it was revealed that the mother had been consuming placenta pills, various tests were taken to try and determine the source of the infant’s infection. We know from the CDC statement that the mother’s breast milk tested negative for the GBS strain that the infant was infected with. However, the pills tested positive. How exactly the infant was infected by the pills when the bacteria was not present in the breast milk is unknown for sure, but one possibility is placenta dust on the outside of the capsules which was then present on the hands.
The actual process for encapsulation used by the encapsulator in this case remains somewhat unknown. The CDC statement hazards several guesses but we cannot know for certain. One thing that is known is that the methodology used was raw processing. This means that the placenta was not steamed or cooked first, it was dehydrated without being heated prior. This is not the process we use or that we recommend. In order to adhere to food handling safety standards, we recommend that a steamed process be used, in which the placenta is steamed to 140-160F prior to being dehydrated. The dehydration should then occur between 140-160F. It is possible that in the CDC case, this temperature was not reached, either intentionally or because of faulty equipment.
There statement also says that the processed capsules were stored at room temperature. While we do recommend that tinctures be stored at room temperature, like many perishable foods, we recommend that capsules be stored in the refrigerator to prevent bacteria growth.
The CDC has come out hard and recommended that placenta consumption should be avoided as eradication of pathogens cannot be ensured. While we respect the position of the CDC, particularly in light of an industry with little to no regulation or oversight, we continue to believe that our process meets with the highest safety standards according to both food handling safety protocols and blood borne pathogen protocols.
In order to feel confident in the safety of your placenta capsules, and to protect yourself and others, we recommend the following:
- Know who your encapsulators are, what credentials they hold, and if they are insured
- Understand the process they use, confirming that the placenta is cooked, and dehydrated, to at least 140F
- Ask questions about their equipment such as how often it is replaced, how it is sanitized, and how they prevent cross contamination
- Only have your placenta encapsulated in your own home, and never let someone take your placenta from your possession
- Ensure that your encapsulator asks about infections and other health concerns both prenatal and during labour – there are some conditions that make it unsafe to encapsulate
- Practice good hygiene, including washing your hands thoroughly after consuming your capsules
- Store your capsules in the refrigerator
- If you or your child become ill, inform the physicians that you are consuming your placenta
- Follow any recommendations made by your doctor regarding ceasing or reducing your consumption
At Toronto Family Doulas, we believe in following the absolute best practices in order to keep everyone safe. We are happy to answer any questions you may have about the CDC statement, placenta encapsulation, or our process. For questions to ask your encapsulator, start here.