In June 2017 the Centre for Disease Control published an article in their Morbidity and Mortality Weekly Report. This article, found here, was a case study that involved a mother that tested negative for GBS at 37 weeks, after the baby was born the baby was found to have a GBS infection. After 11 days of treatment, the baby was released. However, 5 days after that the baby was readmitted with an infection and was again found to be infected with GBS. The mother had opted to encapsulate her placenta, at the request of the doctor the pills were tested and found to contain the same strain of GBS that had infected the baby. The baby was treated and again released.
The team of doctors involved in this case theorized that the pills contributed to heavy colonization of the mother which led to the reinfection.
Both the placenta and the circumstances surrounding the birth should have been assessed to see if all was appropriate for consumption, and then the placenta should have been properly prepared. A maternal or infant infection at or immediately after delivery indicates that an active infection was present. The mother should have been counseled against encapsulation directly after birth. The second major issue in this case is that proper food safety protocols may not have been followed (specifically, the temperature at which the placenta may have been heated to during steaming or dehydrating). This likely led to the capsules containing GBS bacteria and potentially causing reinfection.
APPA’s public rebuttal can be found here. While many people are focused on the fact that the pills are an unlikely source of the GBS infection, we do know that GBS was found in the pills. As professional placenta arts specialists, we should recognize that we need to reduce any and all organisms that could be present in finished products.
We know that proper steaming and dehydration temperatures will drastically reduce microbial counts, thanks to research from Jena University. Even in the case of GBS colonization (not infection), we can confidently say that properly prepared placenta capsules will be safe for consumption.
GBS is a bacteria that is found in many people’s intestines, vagina, or rectum. It typically has no symptoms but can occasionally cause urinary tract infections. In the USA and Australia women are tested between 35 and 37 weeks pregnant to see if a colonisation is present. A positive test shows that the bacteria is present in the vaginal canal, and does not indicate an infection. If a true infection (of any kind) is present it is a contraindication to encapsulation.
Having a GBS test come back positive alone is not an indication to not encapsulate. To learn more about GBS you may consider reading this article at Evidence Based Birth: https://evidencebasedbirth.com/groupbstrep/
GBS and the Encapsulation Process
GBS is a bacteria that lives on everyone’s skin and especially thrives in mucous membranes. Colonization does not mean that a mother has an active GBS infection. A positive result from a GBS test means that there is an abundance of GBS bacteria in the vaginal canal; this may lead to a newborn infection if the baby is also colonized during the birth process. Most babies that are exposed to GBS are healthy and do not become infected. However, when newborn infection does occur it can be dangerous and should be taken very seriously.
First and foremost, due to the immediate onset of newborn infection in the above case, this placenta should not have been encapsulated. Maternal or fetal infection at or immediately following the time of delivery is an absolute contraindication to encapsulation. It is unsafe to encapsulate in these cases. The encapsulation specialist had a responsibility to verify with the client that an infection was not present, but failed to do so.
If an infant or mother has an infection at or immediately after the delivery the placenta is not viable to be encapsulated and your encapsulation will be declined.
GBS is caused by the bacteria Streptococcus Agalactiae. GBS will survive in a dry environment for months, so dehydration alone is not adequate for reduction of GBS bacteria. We know GBS is killed with wet heat that is applied at temperatures at least 55°C for at least 30 minutes. When prepared with the Traditional Method (TM) we are required to steam heat the placenta to at least 71°C and then dehydrate for a minimum of 12 hours at 72°C. We can scientifically prove that TM of preparation is safe if GBS is present.
In the case of high-temperature Raw Method preparation, the research is not solid. We know that Dr. Sophia Johnson did not find any pathogenic bacteria, but we do not know what bacteria she did find in the raw encapsulated placenta. She also prepared the placenta at a significantly lower temperature than is required by APPA, so we can speculate that the APPA approved method will result in an even further reduction of bacteria.
Low-temperature dehydration of the placenta is not part of the APPA standard because it is not food safe and can potentially hurt the client, the client’s family, and the placenta encapsulation community. There is a risk of foodborne diseases when consuming raw or undercooked products. While high temperature raw preparation has been shown to greatly reduce bacterial counts, food safety guidelines recommend steaming prior to dehydration which will result in further reduction of bacteria.
Preliminary data that was released by Dr. Sophia Johnson from Jena University in Germany found that in properly prepared placenta capsules, there were no unsafe organisms found. The steaming and dehydration process was found to drastically reduce microbial counts. In addition to microbial testing, the study also looked at potential toxins, such as heavy metals, and also found that the levels were all well below acceptable limits. We hope that this initial research spurs further funding to continue to look into the safety of placenta encapsulation.
Dulcie Lane and APPA
The CDC points out that no standards exist for placenta encapsulation. This is true—there are no national, statewide, or unified industry-wide standards. However, APPA has created the highest standards in the placenta industry and continually updates them based on evidence and best practice. APPA strives to set those standards and train professional placenta arts specialists.
Mothers and birthing people who are seeking out placenta encapsulation should be encouraged to find properly trained encapsulation specialists. Specialists should be trained, not only in the physical encapsulation process, but in bloodborne pathogens and food safety.
It is APPA’s goal to make sure that GBS or any pathogen is not spread through placenta capsules. We are confident that our placenta arts specialists are trained in methods and procedures that will not allow the spread of infection. If you are looking for a placenta arts specialist who has a truly comprehensive training and a focus on safety, look No further than Dulcie Lane Placenta Encapsulation, a trained certified placenta encapsulation specialist with APPA.
You are in very safe hands when it comes to Dulcie Lane with extensive training and certifications in Blood Borne Pathogens, COVID 19, Food Handling Safety, as well as a thorough client health questionnaire and client contract. This facilitates complete transparency between Dulcie Lane and the client, when preparing to encapsulate a placenta.
Resources and Further Reading:
1.Buser GL, Mató S, Zhang AY, Metcalf BJ, Beall B, Thomas AR. Notes from the Field: Late-Onset Infant Group B Streptococcus Infection Associated with Maternal Consumption of Capsules Containing Dehydrated Placenta — Oregon, 2016. MMWR Morb Mortal Wkly Rep 2017;66:677–678. https://www.cdc.gov/mmwr/volumes/66/wr/mm6625a4.htm
2.Streptococcus agalactia E, Pathogen Safety Data Sheet, Public Health Agency of Canada. April
3.Schuchat A. Epidemiology of Group B Streptococcal Disease in the United States: Shifting Paradigms. Clin. Microbiol. Rev. July 1998vol. 11 no. 3 497-513
4.Cunningham R. Recurrent group B streptococcal disease in infants: a possible explanation. Clin Infect Dis. 2000 Aug;31(2):627. Pubmed PMID: 10987746
5.Johnson, S. A scientific approach to placenta remedies: What hormones are found in placenta tissue? Preliminary Research Results. April 11, 2017. https://experiment.com/u/DKKnUQ