Misinformation Surrounding Placenta Encapsulation, by Melanie Belk

What reason does the medical community have for spreading misinformation about Placenta Encapsulation? Is it because they don’t profit from it? Every so often a news article, blog, or opinion comes out with misinformation about the practice in an attempt to discourage women who might benefit from it. Sadly, most people read headlines but don’t get into the research, and the misinformation spreads. For the past few days a new post has been going around where an IBCLC with West County Health Centers in Northern California, Sarah Hollister, takes the podium to tell women placenta encapsulation will dry up their milk, contrary to self-report studies and research.
You can read her blog here: https://www.happygoatproductions.com/…
It took me a good while to go through all her claims and look at the research behind them, but I did and here are my (Melanie Belk)  thoughts:
(First let me state that I have personally done around 1200 encapsulations and have never received a complaint about lactation issues, and these patients included midwives and lactation consultants who are quite capable of self-reporting problems and would have done so, as we are colleagues.)
  1. This is both an unscientific and unprofessional opinion based on the singular experience of one health professional. She inaccurately uses anecdotal observations, based on her experience alone as a lactation consultant, and makes a claim of a quantitative decrease in milk supply without any quantitative data to back it up
  2. Her sample size is SKEWED and consists entirely of women with low milk supply and breastfeeding issues. She claims she went back and interviewed those who were never able to establish a milk supply to see if they had engaged in placenta encapsulation. She did not go back and ask those with an abundant or healthy milk supply if they had done placenta encapsulation. She cannot claim any conclusive results about the effects of placenta encapsulation on milk supply without considering the effects of placenta encapsulation on women with a healthy milk supply or even an oversupply. This is not how the scientific method works, and it is unprofessional to present such results as conclusive of an issue.
  3.  The research she cites is either flawed, inconclusive, or she is simply reading them wrong. She also fails to mention any studies that conflict with her opinion. See below for specific details–it’s long so I separated it out.
  4.  How is it possible, if she worked so closely and diligently with her patients, that she was unaware they were taking placenta capsules for five years until a colleague pointed out a potential link to her? She had to go back and interview previous clients. Any professional lactation consultant who spends that much time with her patients would know immediately that they were consuming their placenta. I find it hard to trust any of her claims at how extensively she works with her patients if she missed the simple factor with all of her patients. It seems more likely this lactation consultant was not very successful in helping her clients to establish a healthy milk supply and is using placenta encapsulation as a convenient scapegoat.
  5.  If we are going with anecdotal evidence, let’s consider the many other birth professionals who work closely and long-term with new mothers who have seen the benefits of placenta encapsulation. Lactation consultants who have not only recommended encapsulation to their patients and reported positive results in those patients they knew to be consuming their placentas, but have even consumed their own placentas. Or let’s consider the number of second and tthird-time mothers who are choosing placenta encapsulation for their subsequent pregnancies after doing it in a previous pregnancy. Mothers who reported overwhelmingly positive results, including healthy milk supply. And more often than not, if there were reported problems with milk supply in those engaging in encapsulation, it was an oversupply. This has been my observation in encapsulating 1200 placentas, which surely is as valid as her sample of a few hundred mothers.

 Understanding the research (from point 3)

New trend and not ancient wisdom: Ms. Hollister claims that placentophagy was not explored until 1970’s and then a mega-trend in 2005. She states that it was not practiced before then. This is inaccurate, and indicates she either did not read all the relevant literature or cherry picked that which she thought supported her false claims. A simple search finds there are two articles in scientific journals appearing in 1954 and 1918 concerning the effect of placentophagy on human milk supply. Both these articles cite the practice of eating placenta as a reason to explore the link.
Benefits purported are only from business marketing with no valid evidence to support. Again, this is an inaccurate, and a rather ironic statement, as can be easily be found with a Google search or visiting an encapsulation specialist’s website. Actually several articles on placentophagy in animals, and the few studies existing on placentophagy in humans, are cited and available for anyone to read. Studies include:
Placenta as a Lactagogon. Soykova-Pachnerova E, et. Al. (1954). Gynaecologia 138(6): 617-627
The effect of Ingestion of Desiccated Placenta on Milk Production. Hammett, Frederick. S. 1918. The Journal of Biological Chemistry, 36. American Society of Biological Chemists, Rockefeller Institute for Medical Research, original press: Harvard University.
McNeile, Lyle G. 1918. The American journal of obstetrics and diseases of women and children, 77. W.A. Townsend & Adams, orinigal press: University of Michigan.
Placentophagia: A Biobehavioral Enigma. Kristal, M.B. 1980. Neurosci. Biobehav. Rev. 4(2) 141-150.
Placenta ingestion by rats enhances y- and n-opioid antinociception, but suppresses A-opioid antinociception. Jean M. DiPirro, Mark B. Kristal.
Effects of placentophagy on serum prolactin and progesterone concentrations in rats after parturition or superovulation. Blank MS, Firesen HG.: J Reprod Fertility. 1980 Nov; 60(2):273-278.
Etc…
2016 Study showing no iron benefit for moms in consuming encapsulated placenta: Again Ms. Hollister makes false claims that do not exist in the literature. I’m not sure if she actually read this study or just looked at the headline, but had she read the study before citing it she would have realized there are several fundamental flaws which makes the study essentially meaningless. Most importantly, the “placebo” is not inert, so all conclusions must be qualified with a comparison to dehydrated beef, which is in itself a source of iron. The study in fact found considerably higher average concentrations of iron in the placenta capsules versus that of the beef placebo. Another flaw in the study is that not only was there a small sample size (23 women total), but of that sample size there was variability in the number of days each woman had taken her placenta before receiving some of the blood tests because they had trouble procuring the placentas. The levels of iron in the blood could not be meaningfully compared to each other, nor to the women receiving the placebo, as they had not been ingesting the capsules for the same number of days. Lastly, this study only looks at placentas prepared TCM style, meaning steamed then dehydrated, and does not consider the more commonly used method of encapsulation that involves only dehydration, which would be expected to retain higher levels of iron as well as other hormones and nutrients.
Effects on human maternal placentophagy on maternal postpartum iron status: a randomized, bouble-blind, placebo-controlled pilot study. Gryder, Laura K. et al. 2016. Journal of Midwifery & Women’s Health. 68-79. http://onlinelibrary.wiley.com/doi/10.1111/jmwh.12549/full
Another example of Ms. Hollister making false claims that are not present or addressed in this study are found in her reference to a recent 2016 study showing what hormones remain in placenta pills- she claims only progesterone and estrogen are retained and active after encapsulation. This claim is false and makes it clear Ms. Hollister did not in fact read the studies she is referencing. The study measured the presence and concentration of 17 hormones in human placenta after steaming and processing. However, it has a huge limitation—it ONLY measures steroid hormones in the placenta—including progesterones, estrogens, cotisones, testosterones, and melatonin. It DID NOT test for oxytocin, prolactin, or human placental lactogen, all of which are significant to lactation. So Ms. Hollister’s claims in this regard appear purposely misleading. Also, again this study only looks at TCM prepared capsules and does not consider capsules that have been dehydrated only which is the most common method of placenta encapsulation in practice.
Presence and concentration of 17 hormones in human placenta processed for encapsulation and consumption. Young, Sharon M., et al. 2016. Placenta, vol 43. 86-89
Progesterone and estrogen inhibit prolactin. Here we see a poor understanding of physiological processes by Ms. Hollister. She is correct that progesterone and estrogen inhibit lactation during pregnancy, and that the physiological act of the placenta detaching from the uterine wall after birth is what triggers prolactin and milk production. However, once that trigger been pulled, it is not un-pulled. Lactogenesis II has begun. It is true that retained placenta will delay milk production, but once the placenta has detached and lactogenesis II has started, there is no evidence to say that taking small daily doses of placenta pills containing progesterone and estrogen will inhibit or delay milk supply, just as, according to the study she herself referenced, there is inadequate evidence to make an evidence-based recommendation regarding hormonal birth control.
ABM Clinical Protocol #13: Contraception During Breastfeeding, Revised 2015. http:/www.bfmed.orgMediaFilesProtocolsContraception%20During%20Breastfeeding.pdf
2017 CDC Released Case Report on infant re-hospitalized in NICU for GBS bacterial infection from same strain of GBS in placenta capsules mom was taking. Again it appears obvious she did not bother to read the actual study. There was no GBS found in the mother’s breastmilk, which would have been the only mode of transmission between the mother’s placenta capsules and the baby. The baby was infected at the time of birth, was given antibiotics, and was reinfected. The CDC could not rule out the baby being reinfected by a family member or friend, or whether the antibiotics did not fully kill the infection in the first place. There is no evidence that the placenta capsules had anything to do with the infection. This, in essence, is another example of for-profit medicine seeking a scapegoat for a failure to provide safe an adequate care.
Aside from falsely interpreting the research she does reference, Ms. Hollister fails to reference relevant research that does not support her opinion. She omits the clinical study on human placentophagy that does look at milk production, which found that 86.2% of the 210 mothers had “good” or “very good” results in terms of an increase in milk production, and only 13.8% had negative results.
Placenta as a Lactagogon. Soykova-Pachnerova E, et. Al. (1954). Gynaecologia 138(6): 617-619. As this is the one known study of its kind on this issue and impossible to overlook, it is telling that she completely disregarded it in her blog.
She also does not mention the UNLV survey of 189 women engaging in placentophagy that found 96% had a “positive” or “very positive” experience consuming their placenta, with no reported side effects, side effects which would have definitely included decreased breast milk product if it were occurring. This level of positive feedback is far beyond anything reported by most other interventions offered to mothers who struggle with lactation issues or post-partum depression and more.
Selander, Jodi, et al. “Human maternal placentophagy: A survey of self-reported motivations and experiences associated with placenta consumption.” Ecology of food and nutrition 52.2 (2013): 93-115.