Tuesday, February 20, 2018

Placenta Encapsulation: You're Going To Eat Your What Now?

Natural birth methods and techniques are becoming more and more popular amongst women who are choosing to have hospital deliveries.  As women become more educated and aware of their choices regarding pain management, interventions and delivery, they are also learning more about their postpartum care options as well.  Placentophagia, or the act of consuming one's placenta after delivery, is starting to be less of a fringe activity and more mainstream for mothers who are looking for natural alternatives for hormone, mood and physical recovery in the postpartum period.  

What exactly is placentophagia?

Simply put placentophagia is the act of mammals eating their placentas after the birth of their young.  Almost all species of mammals, with the exception of humans, routinely practice placentophagia.  There are hormones present in the placenta, namely prostaglandin and oxytocin, that may help shrink the uterus down to it's pre-pregnancy size.  This combined with the need to hide anything that may attract predators near a new mother and their young is why most mammals engage in this activity.  Humans have little to no fear of predation while recovering from birth, which is one of the speculated reasons that we no longer have the urge to consume our placentas right after delivery.  

Why would I want to eat my placenta?

While there have been no studies showing the benefits of placentophagia in humans there is an overwhelming amount of anecdotal evidence to be found from women who have ingested their placentas in the form of capsules, tinctures, edibles or even raw.  The most commonly reported benefits of placentophagia are:

  • Increased milk production
  • Shortened recovery time postpartum
  • Decreased postpartum bleeding
  • Anxiety and stress relief
  • Increased energy
  • Decreased Baby Blues symptoms
  • Decreased Postpartum Depression symptoms  

How does placenta encapsulation work?

Most women are put off by the thought of even looking at their placenta, let alone blending it in to a postpartum smoothie.  That is where placenta encapsulation comes in.  A professional with special training or experience will come and collect your placenta shortly after you deliver.  They will then transport it to their home or office where they have set up a hygienic space to process and encapsulate placentas.  Alternatively if you have a home birth they may even process it in your own home if you so desire.  After transportation, they will prepare the placenta for dehydration, dehydrate it and then grind it into a fine powder.  The powder is then placed in to capsules which are ready for you to take as needed for postpartum symptom support and relief.  

What are the risks?

The CDC (Centers For Disease Control) and ACOG (American College of Obstetricians and Gynecologists) do not recommend the practice of placentophagia in the form of placenta encapsulation (or any other form, for that matter).   Why is this when there have been few to no studies showing risks to the practice?  

As of now, there are NO REGULATIONS for those who offer placenta encapsulation or processing services.  That means that there are no safety or hygiene standards that they must adhere to when handling your placenta.  This is a problem because the placenta is a blood-rich organ - if health and safety standards are not practiced where placentas from multiple women are processed the risk for blood-borne and food illness increases significantly.  It is vital if you are considering having your placenta encapsulated that the professional you hire practices safety and hygiene protocols to help minimize this risk.  Things to ask the professional who is encapsulating your placenta are:

  • Do you thoroughly disinfect all of your bowls, tools, equipment and workspace after each placenta?  *Note: This does not mean using warm water and an antibacterial dish soap!  A proper bleach solution or something similar must be used.  
  • How soon after my delivery can you come and retrieve my placenta?  **Note:  Most hospitals require that if you are taking your placenta home, you must have it picked up no more than between 1 and 4 hours after delivery.  Check with your hospital regarding their policies.  
  • Where and how do you store placentas for transport and/or placentas waiting to be processed?  ***Note: Like any sort of organ intended for consumption, your placenta must be stored in a cool, dry and clean container or frozen if not used right away.  If the person transporting your placenta is bringing their own cooler, make sure they disinfect the cooler with a bleach solution between each client.  
It is important to note that you should never ingest placenta capsules, tinctures or edibles derived from another woman's placenta.  This greatly increases your and your baby's risk for blood-borne illness.  

Other risks include unwanted side effects.  Again, there are no studies showing adverse side effects from placentophagia.  Anecdotal evidence suggests some women may feel very jittery or have anxious or racing thoughts while taking placenta capsules.  It is recommended if you experience any adverse reactions to stop taking or reduce the amount of capsules you consume in a day.  

If you are interested in placenta encapsulation or have questions regarding the practice of placentophagia, please feel free to contact me at meagan@beltanebirthservices.com!  

Have you encapsulated your placenta?  Or used a tincture?  Made a placenta smoothie?  I'd love to hear your experiences with placentophagia in the comments below!  

Follow me on Facebook!
Questions about pregnancy, birth or postpartum life?
Interested in hiring a doula?
Please feel free to contact me
or check out my website!

Monday, February 12, 2018

Breast Engorgement

Breast engorgement is a common issue that many women experience while lactating.  Besides being very uncomfortable engorgement can lead to other complications, some of which can be serious.  Here I will explore why breast engorgement happens, what to do about it when it does, and what symptoms may point to a more serious issue that requires professional evaluation.

What is breast engorgement?

Engorgement occurs when there is an overabundance of milk in the breasts.  Most women experience engorgement for the first time within the first few days postpartum when the colostrum, that their breasts have been producing since approximately the fourth month of pregnancy, transitions to mature breastmilk.  Breastmilk production is triggered by delivery, so even women who don't plan to breastfeed may experience some engorgement while suppressing lactation.  Breast engorgement is characterized by the breasts becoming heavy, swollen and very firm or hard.  You may even experience lumpiness in the breast tissue and some redness.  Generally engorgement is quite uncomfortable, and can range from moderate tenderness to extreme pain.

What complications can arise from breast engorgement?

Besides being very uncomfortable, engorgement can lead to clogged ducts.  A clogged duct is a milk duct that has become blocked in some way generally by the swollen tissues surrounding it.  When a milk duct becomes clogged a hard, painful lump will appear on the breast.  Clogged ducts can occur with or without engorgement.  Due to the swelling and inflammation, clogged ducts generally go hand-in-hand with engorgement if the issue is not quickly resolved.

If a clogged duct is not properly released and drained it can soon lead to a very serious infection called mastitis.  Mastitis can cause; fever, chills, a warm or 'hot' spot, redness of the breast tissue, and can be extremely painful.  It is very important if you experience any of these symptoms or suspect an infection that you contact your care provider immediately so you can be assessed and placed on antibiotics that are safe for breastfeeding.  If not treated appropriately, mastitis can turn into a breast abscess that must be surgically drained.

Engorgement also poses nursing challenges.  Due to the swelling and inflammation of the breasts the nipple and areola may change shape or become very hard.  This can make it difficult or impossible for a baby to latch and nurse effectively.  A poor, ineffective latch can cause damage to the nipple, pain when nursing above and beyond what is already being experienced with engorgement, and frustration from the baby as they are not able to get an adequate supply of milk.  A poor latch also means that the baby is unable to express and empty the breast fully during a feeding leading to more engorgement, clogged ducts, and possibly result in diminished milk supply.

How do you resolve breast engorgement?

The best way to resolve engorgement is to empty and soften the breast by nursing, pumping or manually expressing your breastmilk.  Nursing frequently and on-demand can help resolve moderate engorgement fairly quickly.  If the engorgement is moderate or the baby is having trouble latching, manually expressing some milk into a towel or a burp cloth, will help to soften the areola and nipple area.  If you are exclusively pumping, simply try pumping more often.  You should be pumping as frequently as your baby would be nursing, so every two to four hours within the first few weeks of life.

Any clogged ducts need to be broken up and released as well.  If you are nursing, position your baby's chin towards the duct.  This allows them to help unclog the duct by using the suction created during nursing.  While your baby is latched and actively nursing, use the ball of your thumb to massage or rub the lump.  This can be painful but it is important to stick with it and go until the duct is clear.  This should be done while you are pumping or manually expressing your milk as well.

If your engorgement is due to weaning, or because you are suppressing lactation, do not fully empty the breast when manually expressing or pumping.  Milk production is a supply and demand system, so the more you empty your breasts the more milk your body will make.  Just express enough milk to soften the breast tissue a bit and relive the pressure.  If you are weaning and you decided to go cold turkey, it may be beneficial to consider weaning down over a few days vs stopping all together if that is an option.  Just decrease the length and amount of nursings daily and watch for engorgement.

Here are some tips and techniques to try to help soothe engorged breasts and achieve a better latch:

1. Choose The Right Bra
A tight or ill-fitted bra with an underwire may be exacerbating the issue.  Find a comfortable nursing bra that provides support without being too snug, preferably without an underwire.  

2. Cabbage Leaves
Applying cool cabbage leaves over your breasts, held in place by a well-fitted nursing bra, can help reduce the inflammation and redness as well as soothe the ache associated with mild to moderate engorgement.  Because cabbage leaves are also used help dry up milk supply you do not want to wear them all the time.  Leave them on for about 20 minutes 2 times a day until the engorgement begins to go away.    

3. Epsom Salts
Some lactation consultants recommend soaking the breasts in a warm water and epsom salt solution to help provide relief.  You can use a basin, sink or anything deep enough for you to be able to fully submerge your breasts.  Fill with warm water and add one to two handfuls of Epsom Salts.  Do not use salts that have essential oils or fragrances added to them as these can be too strong to expose your newborn to.  Submerge and soak your breasts until the water cools or for five to ten minutes.  If you have cracked or bleeding nipples, apply a thin coat of lanolin over them before submerging the breasts so that it does not sting.  After soaking, rinse breasts with cool, clean water.  You can soak your breasts before each feeding or as often as you wish during the day for up to three days.  Most women feel relief within 24 hours of treating with Epsom Salts.  

4. Manual Expression/Pumping
While you do not want to express or pump your breasts so frequently or fully that you end up increasing your supply unintentionally, expressing enough milk to soften your nipple or your breast tissue will not only relieve some of the discomfort of engorgement but also allow your baby to achieve a better and more efficient latch.  This could also help if you have a very forceful let down that causes your baby to choke, sputter, or unlatch and become fussy at the breast.  Keep a small washcloth, towel or burp cloth handy to express your milk into right before latching your baby if you are manually expressing.  Alternatively, you can use a clean container or bottle to catch and store any expressed milk for later.  This video published by Stanford Medicine with material developed by Jane Morton, M.D. demonstrates an excellent method for hand expressing breastmilk.   

5. Reverse Pressure Softening
If your nipple and areola have become so flat or hard that your baby is unable to latch or is struggling to achieve a good latch, reverse pressure softening can help resolve that issue.  First, wash your hands as you are going to want to nurse immediately following this technique.   With one hand, gently cup the underside of your breast.  Using two fingers on your free hand, apply steady, firm pressure on the areola right by the nipple.  Hold for five to ten seconds and then release.  Repeat in a circular motion around the nipple until the areola is softened.  The following short video created by LittleBearLactation shows how to perform this technique.  

Little Bear Lactation, "Relieving Breast Pressure With Reverse Pressure Softening", YouTube, September 28, 2018, youtube.com/watch?v=NMzR_X13Mc8

If you have tried the techniques listed above but are still experiencing engorgement issues or suspect your baby is not latching correctly due to fussiness or your breasts not being fully expressed during feedings, please contact a lactation consultant to evaluate you.  

How do you resolve engorgement while suppressing lactation?

If you are trying to suppress lactation altogether,  wear a firm, supportive bra or bind your breasts with a wide, soft ace bandage.  Keeping them compressed will help them to produce less milk and will also keep milk production from being stimulated by touch or movement.  Keeping cool cabbage leaves on your breasts may help to relieve your engorgement and can help diminish your supply faster.  Ice or cold gel packs placed in your bra can also provide relief from pain and swelling. You may have to manually express very small amounts of milk, just enough to soften the breast and keep lumps from forming, when in the shower or if your breasts become very swollen, hard or lumpy.  Remember that your milk production is a supply and demand system so if you fully empty your breasts or go beyond expressing just enough to relieve some pressure your body will likely increase its production.  Avoid soaking your breasts in warm water, such as in the tub, or prolonged spray from a hot shower as heat can stimulate milk production.  Keep a close eye on possible clogged ducts or mastitis and tell your care provider right away if you develop a fever, redness or signs of infection.

Breastfeeding Resources:

Kellymom.com provides evidence-based research and information regarding breastfeeding and lactation.

ibconline.ca provides educational videos, guidance, information and support for breastfeeding developed by Dr. Jack Newman, a physician specializing in breastfeeding support and advocacy.

Le Leche League U.S.A. provides information and support for breastfeeding families.  Click on the link for more information or to find a local LLL group near you.

Recommended Reading:

Dr. Jack Newman's Guide To Breastfeeding, Dr. Jack Newman & Teresa Pitman
The Nursing Mother's Companion - 7th Edition, Kathleen Huggins, R.N., M.S.

Follow me on Facebook!
Questions about pregnancy, birth or postpartum life?
Interested in hiring a doula?
Please feel free to contact me
or check out my website!

FAQ's About Doulas

What is a Doula? Doula is an ancient Greek word that roughly translates to "a woman who serves." In modern times, the term doula...