Why do some lactation consultants say that placenta ingestion lowers a mother’s milk supply? 

This is a myth that was started in 2017 based on a blog post by lactation consultant, Sabine Wilms of Happy Goat Productions.  In the original version of the blog she wrote that she estimated that ’50 percent’ of her clients have “lowered milk supply because of placenta encapsulation” but didn’t show us a chart or any evidence of data collecting..she has since re-done the blog with different author, and left out that part, but by then the piece had already been circulating for over 2 years and a portion of the lactation community lagged onto the story, and hence began the myth. 

Here’s my take:  Isn’t one of the main reasons for hiring a lactation consultant for low milk supply? Or, Why does she mention nothing about a dramatic rise in her number of clients? Correlation does not equal causation, and just because placenta encapsulation has become more popular in the last 10 years, doesn’t mean all your low-milk supply clients suddenly have this problem because of placenta encapsulation/placentophagy. 

Yes, it is true that the placenta contains progesterone, but it also contains hormones that aid in breast milk production. 

The other reason I call her theory a myth is that, why, in the over ten years I have been offering this service, I have not once had a client report that they thought it lowered their milk supply?

But if I am being completely unbiased, the truth is that we simply do not have a large scientific study that gives us a clear cut answer either way. What I mean by this is a large sample size of at least 100 women taking their placenta, and at least 100 women not taking their placenta, starting on the same day postpartum, and then comparing their milk supplies.

What we do know is that every land mammal either ingests or reabsorbs their placenta(s)..So we have to ask ourselves, “Why would something like this exist in nature if it lowered their milk supply?” 

We also have large scale anecdotal testimonies,  as well as some smaller studies done in the 1950’s, and 80’s showing that it* increased* breast milk production, and made the breast milk come in at a higher protein.

My personal feeling is that perhaps Sabine wrote the blog she did out of financial frustration. Perhaps she felt the stress of  the lowered amount of clients she was getting, because, as placentophagy behavior in her area rose, less mamas were having milk supply issues, and needing to come to a lactation consultant in the first place.

 Below is a list of these healing substances, as well as a list of actual scientific studies we *do* have related to benefits including milk production. 

  • Estrogen, Progesterone, Testosterone: Contributes to mammary gland development in preparation for lactation; stabilizes postpartum mood; regulates post-birth uterine cramping; decreases depression; normalizes and stimulates libido.
  • Prolactin: Promotes lactation; increases milk supply; enhances the mothering instinct.
  • Oxytocin: Decreases pain and increases bonding in mother and infant; counteracts the production of stress hormones such as Cortisol; greatly reduces postpartum bleeding; enhances the breastfeeding let-down reflex.
  • Placental Opioid-Enhancing Factor (POEF): Stimulates the production of your body’s natural opioids, including endorphins; reduces pain; increases well-being.
  • Thyroid Stimulating Hormone: Regulates the thyroid gland; boosts energy and supports recovery from stressful events.
  • Corticotropin Releasing Hormone (CRH): Low levels of CRH are implicated in postpartum depression. Regulation of CRH helps prevent depression.
  • Cortisone: Reduces inflammation and swelling; promotes healing.
  • Interferon: Triggers the protective defenses of the immune system to fight infection.
  • Prostaglandins: Regulates contractions in the uterus after birth; helps uterus return to its pre-pregnancy size. Anti-inflammatory effects.
  • Iron: Replenishes maternal iron stores to combat anemia, a common postpartum condition. Increases energy; decreases fatigue and depression.
  • Hemoglobin: Oxygen-carrying molecule which provides a boost in energy.
  • Urokinase Inhibiting Factor and Factor XIII: stops bleeding and enhances wound healing.
  • Immunoglobulin G (IgG): Antibody molecules which support the immune system.
  • Human Placental Lactogen (hPL): This hormone has lactogenic and growth-promoting properties; promotes mammary gland growth in preparation for lactation in the mother. It also regulates maternal glucose, protein, and fat levels.

Placentophagy protocol in management of postpartum care

‎”Giving…placenta to a new mother following birth has become standard protocol among a growing number of midwives in the United States. By nourishing the blood and fluids, endocrine glands and organs, Placenta will …reduce or stop postpartum bleeding, speed up recovery, boost energy and relieve postpartum blues.Homes, Peter. 1993. Jade Remedies, Snow Lotus Press, 352.

The American journal of obstetrics and diseases of women and children

‎”It has been shown that the feeding of desiccated placenta to women during the first eleven days after parturition causes an increase in the protein and lactose percent of the milk… All the mothers were receiving the same diet, and to the second set 0.6mg of desiccated placenta was fed three times a day throughout the period. Certain definite differences in the progress of growth of the two sets of infants are to be observed. It is evident that the recovery from the postnatal decline in weight is hastened by the consumption of milk produced under the influence of maternally ingested placenta.” McNeile, Lyle G. 1918. The American journal of obstetrics and diseases of women and children, 77. W.A. Townsend & Adams, original press: University of Michigan.

Placenta as Lactagagon
Soykova-Pachnerova E, et. al.(1954). Gynaecologia 138(6):617-627.

An attempt was made to increase milk secretion in mothers by administration of dried placenta per os. Of 210 controlled cases only 29 (13.8%) gave negative results; 181 women (86.2%) reacted positively to the treatment, 117 (55.7%) with good and 64 (30.5%) with very good results. It could be shown by similar experiments with a beef preparation that the effective substance in placenta is not protein. Nor does the lyofilised placenta act as a biogenic stimulator so that the good results of placenta administration cannot be explained as a form of tissue therapy per os. The question of a hormonal influence remains open. So far it could be shown that progesterone is probably not active in increasing lactation after administration of dried placenta.

This method of treating hypogalactia seems worth noting since the placenta preparation is easily obtained, has not so far been utilized and in our experience is successful in the majority of women.

Placentophagia: A Biobehavioral Enigma
KRISTAL, M. B. NEUROSCI. BIOBEHAV. REV. 4(2) 141-150, 1980.

Although ingestion of the afterbirth during delivery is a reliable component of parturitional behavior of mothers in most mammalian species, we know almost nothing of the direct causes or consequences of the act. Traditional explanations of placentophagia, such as general or specific hunger, are discussed and evaluated in light of recent experimental results. Next, research is reviewed which has attempted to distinguish between placentophagia as a maternal behavior and placentophagia as an ingestive behavior. Finally, consequences of the behavior, which may also be viewed as ultimate causes in an evolutionary sense, are considered, such as the possibility of beneficial effects on maternal behavior or reproductive competence, on protection against predators, and on immunological protection afforded either the mother or the young.

Placenta for Pain Relief:
Placenta ingestion by rats enhances y- and n-opioid antinociception, but suppresses A-opioid antinociception
Jean M. DiPirro*, Mark B. Kristal

Ingestion of placenta or amniotic fluid produces a dramatic enhancement of centrally mediated opioid antinociception in the rat. The present experiments investigated the role of each opioid receptor type (A, y, n) in the antinociception-modulating effects of Placental Opioid-Enhancing Factor (POEF—presumably the active substance). Antinociception was measured on a 52 jC hotplate in adult, female rats after they ingested placenta or control substance (1.0 g) and after they received an intracerebroventricular injection of a y-specific ([D-Pen2,D-Pen5]enkephalin (DPDPE); 0, 30, 50, 62, or 70 nmol), A-specific ([D-Ala2,N-MePhe4,Gly5-ol]enkephalin (DAMGO); 0, 0.21, 0.29, or 0.39 nmol), or n-specific (U-62066; spiradoline; 0, 100, 150, or 200 nmol) opioid receptor agonist. The results showed that ingestion of placenta potentiated y- and n-opioid antinociception, but attenuated A-opioid antinociception. This finding of POEF action as both opioid receptor-specific and complex provides an important basis for understanding the intrinsic pain-suppression mechanisms that are activated during parturition and modified by placentophagia, and important information for the possible use of POEF as an adjunct to opioids in pain management.
D 2004 Elsevier B.V. All rights reserved.

Effects of placentophagy on serum prolactin and progesterone concentrations in rats after parturition or superovulation.
Blank MS, Friesen HG.: J Reprod Fertil. 1980 Nov;60(2):273-8.

In rats that were allowed to eat the placentae after parturition concentrations of serum prolactin were elevated on Day 1 but concentrations of serum progesterone were depressed on Days 6 and 8 post partum when compared to those of rats prevented from eating the placentae. In rats treated with PMSG to induce superovulation serum prolactin and progesterone values were significantly (P < 0.05) elevated on Days 3 and 5 respectively, after being fed 2 g rat placenta/day for 2 days. However, feeding each rat 4 g placenta/day
significantly (P < 0.02) lowered serum progesterone on Day 5. Oestrogen injections or bovine or human placenta in the diet had no effect. The organic phase of a petroleum ether extract of rat placenta (2 g-equivalents/day) lowered peripheral concentrations of progesterone on Day 5, but other extracts were ineffective. We conclude that the rat placenta contains orally-active substance(s) which modify blood levels of pituitary and ovarian hormones.

Baby blues – postpartum depression attributed to low levels of corticotropin-releasing hormone after placenta is gone –

Many new mothers feel depressed for weeks after giving birth. Physicians have vaguely attributed this malaise to exhaustion and to the demands of motherhood. But a group of researchers at the National Institutes of Health has found evidence for a more specific cause of postpartum blues. New mothers, the researchers say, have lower than normal levels of a stress-fighting hormone that earlier studies have found helps combat depression.
When we are under stress, a part of the brain called the hypothalamus secretes corticotropin-releasing hormone, or CRH. Its secretion triggers a cascade of hormones that ultimately increases the amount of another hormone – called cortisol – in the blood. Cortisol raises blood sugar levels and maintains normal blood pressure, which helps us perform well under stress. Normally the amount of cortisol in the bloodstream is directly related to the amount of CRH released from the hypothalamus. That’s not the case in pregnant women.
During the last trimester of pregnancy, the placenta secretes a lot of CRH. The rise is so dramatic that CRH levels in the maternal bloodstream increase threefold. “We can only speculate,” says George Chrousos, the endocrinologist who led the NIH study, “but we think it helps women go through the stress of pregnancy, labor, and delivery.”
But what happens after birth, when the placenta is gone? Chrousos and his colleagues monitored CRH levels in 17, women from the last trimester to a year after they gave birth. All the women had low levels of CRH – as low as seen in some forms of depression – in the six weeks following birth. The seven women with the lowest levels felt depressed.
Chrousos suspects that CRH levels are temporarily low in new mothers because CRH from the placenta disrupts the feedback system that regulates normal production of the hormone. During pregnancy, when CRH levels are high in the bloodstream, the hypothalamus releases less CRH. After birth, however, when this supplementary source of CRH is gone, it takes a while for the hypothalamus to get the signal that it needs to start making more CRH.
“This finding gives reassurance to people that postpartum depression is a transient phenomenon,” says Chrousos. “It also suggests that there is a biological cause.”
COPYRIGHT 1995 Discover
COPYRIGHT 2004 Gale Group

Maternal Iron Deficiency Anemia Affects Postpartum Emotions and Cognition
John L. Beard, et. al.; J. Nutr. 135: 267–272, 2005.

ABSTRACT The aim of this study was to determine whether iron deficiency anemia (IDA) in mothers alters their maternal cognitive and behavioral performance, the mother-infant interaction, and the infant’s development. This article focuses on the relation between IDA and cognition as well as behavioral affect in the young mothers. This prospective, randomized, controlled, intervention trial was conducted in South Africa among 3 groups of mothers: nonanemic controls and anemic mothers receiving either placebo (10 g folate and 25 mg vitamin C) or daily iron (125 mg FeS04, 10 g folate, 25 mg vitamin C). Mothers of full-term normal birth weight babies were followed from 10 wk to 9 mo postpartum (n 81). Maternal hematologic and iron status, socioeconomic, cognitive, and emotional status, motherinfant interaction, and the development of the infants were assessed at 10 wk and 9 mo postpartum. Behavioral and cognitive variables at baseline did not differ between iron-deficient anemic mothers and nonanemic mothers. However, iron treatment resulted in a 25% improvement (P 0.05) in previously iron-deficient mothers’ depression and stress scales as well as in the Raven’s Progressive Matrices test. Anemic mothers administered placebo did not improve in behavioral measures. Multivariate analysis showed a strong association between iron status variables (hemoglobin, mean corpuscular volume, and transferrin saturation) and cognitive variables (Digit Symbol) as well as behavioral variables (anxiety, stress, depression). This study demonstrates that there is a strong relation between iron status and depression, stress, and cognitive functioning in poor African mothers during the postpartum period. There are likely ramifications of this poorer “functioning” on mother-child interactions and infant development, but the constraints around this relation will have to be defined in larger studies.

Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial
F Verdon, et. al.; BMJ 2003;326:1124 (24 May), doi:10.1136/bmj.326.7399.1124

Objective: To determine the subjective response to iron therapy in non-anaemic women with unexplained fatigue.

Design: Double blind randomised placebo controlled trial.

Setting: Academic primary care centre and eight general practices in western Switzerland.

Participants: 144 women aged 18 to 55, assigned to either oral ferrous sulphate (80 mg/day of elemental iron daily; n=75) or placebo (n=69) for four weeks.

Main outcome measures: Level of fatigue, measured by a 10 point visual analogue scale.

Results: 136 (94%) women completed the study. Most had a low serum ferritin concentration; <= 20 µg/l in 69 (51%) women. Mean age, haemoglobin concentration, serum ferritin concentration, level of fatigue, depression, and anxiety were similar in both groups at baseline. Both groups were also similar for compliance and dropout rates. The level of fatigue after one month decreased by -1.82/6.37 points (29%) in the iron group compared with -0.85/6.46 points (13%) in the placebo group (difference 0.95 points, 95% confidence interval 0.32 to 1.62; P=0.004). Subgroups analysis showed that only women with ferritin concentrations <= 50 µg/l improved with oral supplementation.

Conclusion: Non-anaemic women with unexplained fatigue may benefit from iron supplementation. The effect may be restricted to women with low or borderline serum ferritin concentrations.

Have we forgotten the significance of postpartum iron deficiency?
Lisa M. Bodnar, et. al.; American Journal of Obstetrics and Gynecology (2005) 193, 36–44

The postpartum period is conventionally thought to be the time of lowest iron deficiency risk because iron status is expected to improve dramatically after delivery. Nonetheless, recent studies have reported a high prevalence of postpartum iron deficiency and anemia among ethnically diverse low-income populations in the United States. In light of the recent emergence of this problem in the medical literature, we discuss updated findings on postpartum iron deficiency, including its prevalence, functional consequences, risk factors, and recommended primary and secondary prevention strategies. The productivity and cognitive gains made possible by improving iron nutriture support intervention. We therefore conclude that postpartum iron deficiency warrants greater attention and higher quality care.
2005 Elsevier Inc. All rights reserved