Recently, a CDC report was released blaming placenta encapsulation for late-onset GBS infection in an approximately 16 day old baby. Yes, this is a scary thought, but there are some gaps in the research and processing of this placenta I want to break down.
So, we'll start with the issues in the report. First, GBS is a transient bacteria, which means it can come and go throughout a woman's life. So even though the mother was negative at 37 weeks, she could have been positive at birth. On the other hand, how many women are told they test positive, receive treatment, but are not actually colonized at birth?
Second, the capsules did test positive for the same bacteria baby was infected with. The mother's breastmilk, the most likely way the bacteria would have been transmitted, tested negative for the bacteria. The report also notes, "transmission from other colonized household members could not be ruled out".
Three of my colleagues raised excellent points and worded them much better than I can.
"You are also dealing with a severely immunocompromised infant who has just come off of a very rough course of antibiotics and was ill which makes that baby much more susceptible to any infection from any source." -Shannon Mitchell
"A logical conclusion is the initial infection wasn't eradicated and the secondary infection was basically a relapse. There was no gbs in the breast milk. I think that's an important part of the puzzle when assuming the placenta was the cause for reinfection. That said, the placenta doesn't seem to have been processed properly and probably shouldn't have been encapsulated to begin with given the immediate onset of the initial infection." -Deanna Norris, APPAC
"Late-onset GBS has generally been attributed to the presence of GBS in the infant's environment. Did they culture the doorknobs in the family's home? The client's nipples? How about burp rags or swaddling blankets? If the client had it on their hands, then they could have quite easily transferred it to the capsules when they were taking some out of the jar. To suggest that the capsules were the *source* of the organism seems like *quite* a stretch." -Wendy Gordon, Midwife
Now onto the problems with the processing of the placenta by 'Company A'. First, "the company does not ask about intra- or postpartum infections". This is HUGE! I absolutely ask this of my clients. Encapsulators never want you to consume infected tissue! In my practice, I will not encapsulate your placenta if you have chorioamnionitis, a confirmed GBS infection (not colonization- in that case your placenta would be prepared by steaming before encapsulation), or GBS infection of the newborn.
Also concerning is the fact that "according to Company A’s website, the placenta is cleaned, sliced, and dehydrated at 115°F–160°F". Any temperature below 160° is NOT safe for dehydration. Below 160° would keep the tissue in the 'danger zone' where bacteria grow rapidly, easily doubling in 20 minutes. When a placenta is dehydrating for 12+ hours, this is simply unsafe, unsanitary, and unacceptable. This is taught in any food handling course, so it makes me wonder if this encapsulator does not follow safe food handling standards.
In summary, in my practice and experience, GBS is only a concern when the mother or baby has a confirmed infection, or the placenta is prepared improperly.