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Placenta Encapsulation and Newborn GBS Case Study: Response

On June 29, 2017, the CDC published an article about a case study in Oregon describing a situation wherein a newborn of a woman that had her placenta encapsulated, developed early and late-onset Group B Strep infection. You can read the original article here. The newborn developed early-onset GBS sepsis shortly after birth (before the mother started taking her placenta pills) and was treated for 11 days and then sent home. Several days later the baby was brought to another hospital with symptoms of irritability and later diagnosed with late-onset GBS sepsis. You can read about the difference between early vs late-onset GBS sepsis here. Early-onset sepsis is contracted during the birth process and develops within the first few days. Late-onset can be transmitted during the birth process but also through physical contact by nursing staff, doctors, family members, friends, etc., and develops after the first week.

In this case study, the article’s conclusion, regardless of the fact that baby was already diagnosed with early-onset sepsis and treated, is the late-onset GBS sepsis was contracted secondary to her placenta pills that were tested and confirmed to have been contaminated with GBS.  However, it states that transmission via physical contact with others could not be ruled out. “Although transmission from other colonized household members could not be ruled out, the final diagnosis was late-onset GBS disease attributable to high maternal colonization secondary to consumption of GBS-infected placental tissue.” The mother’s breastmilk was tested and no GBS was found, so ingestion of the pills by the mother could not be the cause of transmission to baby. It is concluded that handling of the contaminated pills increased colonization on the mother and therefore transferred to baby. “Consumption of contaminated placenta capsules might have elevated maternal GBS intestinal and skin colonization, facilitating transfer to the infant.”

The article explains that the company that processed the placenta dehydrates at temperatures ranging from 115-160 degrees F, which is a very wide range and so it is unclear how this specific placenta was processed. According to the CDC article, placental tissue needs to be dehydrated with at least 130 degrees F for 121 mins to reduce bacteria.

Unknown factors in this case study

  • How the placenta was handled/processed, and the sanitation protocol of the equipment by the encapsulation company
  • Could someone else have transmitted GBS to the baby such as a family member, friend, nurse, etc.
  • Could the late-onset sepsis be a recurrence of the original infection that wasn’t completely resolved after treatment
  • Could the mother unknowingly have contaminated the pills herself after bringing them home because she herself was still highly colonized. We know that she had previously been colonized to have transmitted it to baby initially during the birthing process because the baby already had early-onset GBS sepsis

Keep in mind, this is just ONE case study, it is unknown how the placenta pills became contaminated, or how the GBS was transmitted to baby the second time, but we do know that safety protocols, proper sanitation, and eligibility requirements in the encapsulation process is paramount.

My Standards:

  • See my sanitation protocol here
  • I give specific and detailed instructions on how to handle/store placenta after birth until I can pick up, as well as instructions for after you receive your pills. See my instructions/responsibilities of client here
  • I instruct clients they must inform me of any symptoms of infection or diagnosis, during or after birth
  • I dehydrate every placenta at 155-165 degrees F for at least 24 hours and up to 48 hours to ensure complete dehydration
  • I also offer a steaming method of encapsulation before dehydrating, should a client choose this, which is known to be even more effective (aside from proper sanitation/handling and dehydrating at 155-165 degrees F) at killing bacteria, see article here

I am always happy to answer any questions about my process. I pride myself on safe practices and I want my clients to be comfortable and confident with your decision to hire me for placenta services. The safety and health of my clients are top priority.

 

Written by Rebecca Burkett

June 30,2017

Posted in After Birth, General, Placenta Encapsulation.

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