Question of the Week Responses: Group B Streptococcus
Q: How are midwives treating group B streptococcus-positive women wanting a homebirth? I am having trouble establishing a protocol that I feel comfortable with. - Debra
A: I have used the Natural Pregnancy Book (Aviva Jill Romm) protocol several times. I usually reculture a GBS-positive woman from 35-36 weeks, again in labor, or culture the baby after birth to see if GBS can be detected. These protocols have not been studied. Goldenseal is known as an herb to combat GBS. This protocol is not endorsed by CDC. - Vanita Lott, CNM
California
A: We have tried using olive leaf orally to treat the infections, and there has been discussion among some of the midwives in our state about using prophylactic antibiotic IVs, but it is out of the legal scope of practice for licensed midwives. A few midwives have talked about using nurse practitioners or CPMs to administer the IVs. Some believe that prophylactic antibiotics do not work.
We emphasize education about GBS and ask our clients to make their own decision once they understand the possibility of GBS respiratory distress in the newborn.
I apprentice with 3 different midwives, and they all have a different take: one treats herbally, one educates and one prefers to risk out of care.
- Lisa-Ann Colton
Arkansas
A: Recent research indicates that a vaginal flush during labor with antiseptic soap (chlorhexidine) helps prevent neonatal illness. (J Matern Fetal Med 2002 Feb;11(2):84-8)
Some healers recommend using 3 tsp colloidal silver per day. Other healthcare practitioners are concerned about silver toxicity and don't recommend it.
A naturopathic physician told me that treating GBS infections with large oral doses of probiotics is all that is needed to eliminate GBS as a vaginal pathogen.
I have begun using the following protocol of naturopathic treatment for GBS-positive women. As yet, not enough have taken this treatment to see if it indeed eliminates GBS. But a few women have had success in being clear of the bacterium in the weeks after a positive test at 36 weeks.
Twice a day, with breakfast and dinner:
1) acidophilus: 4 billion cells per dose
2) echinacea: two 350 mg capsules
3) garlic: two 580 mg capsules
4) vitamin C: 500 mg
5) grapefruit seed extract: 15 drops
We then culture weekly to see if the bacteria are decreasing. The reading taken closest to delivery is supposedly the most reliable. If this regimen is successful at eliminating GBS, I would suggest staying on it until birth to give the best possible likelihood that it will not be present in your vagina at the time of birth.
A: My midwife treated me with 1,000 mg vitamin C daily and colloidal silver that was soaked in a tampon and inserted vaginally at night for four weeks before my EDD.
- Ginger
A: Have B strep-positive women insert a tampon soaked in diluted tea tree oil. After three days, they will no longer test positive! An alternative that takes longer is the vaginal use of acidophilus capsules for six weeks.
- C.G.
A: During my second pregnancy (my first homebirth) the doctor said if I was B strep positive I would have to have a hospital birth. This is completely false! IM treatment for group B strep with penicillin G benzathine is just as effective as intrapartum treatment. The recommended dose is 1.2 million units once a week for four weeks before delivery. The recommended treatment schedule is 1.2 million units in weeks 35, 36, 37 and 38. Study results have determined that penicillin levels are high enough to inhibit the growth of B strep for four weeks after the last injection.
The following articles should help you educate yourself and your clients:
http://www.findarticles.com/cf_0/m0B...09/print.jhtmlhttp://www.findarticles.com/cf_0/m32...49/print.jhtmlwww.gentlebirth.org/archives/gbsabs.html
- Erika Obert
A: Here in British Columbia, Canada, where midwifery is integrated into the public healthcare system, GBS+ women in my practise are offered:
1) Herbal treatment as soon as possible (when the positive culture comes back) to help reduce colonisation, with full informed choice that this is not evidence-based and no research is available. It consists of 2 acidophilus tablets inserted vaginally at bedtime and 3 orally per day. E-mail me for a douche formulation (midwife@shaw.ca).
2) Women choosing antibiotic prophylaxis are given the first dose in hospital in case of anaphylaxis. My opinion about this vacillates because a) death from anaphylaxis is the main risk of the prophylaxis to the mother but b) it is so rare (1 in 100,000); I'd rather give informed choice about where the first dose is given. Subsequent doses are administered at home. Obvious practical difficulty exists for an anticipated quick labour. Some women in my practice choose against prophylaxis only because of having to go to hospital in labour for the treatment. It is important to know that once antibiotics are given they must be continually given until birth due to the risk of antibiotic resistance developing.
3) In B.C., we carry epinephrine, Benadryl, and are trained in treating anaphylaxis.
- Barbara Barta, RN
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Offer a GBS herbal treatment to women who swab positive and wish to decline IV antibiotics in labour, or who wish to do the herbal treatment then re-swab, or who would like additional possible protection for their newborn. I am clear to my clients that there is no research on safety or efficacy for this.
For 7 to 10 days: Douche with Nutri-Biotic (grapefruit seed extract) 1-3 drops in 6-8 oz water. Garlic orally 2 tabs three times a day. Acidophilus orally 2 tabs 3 times per day and acidophilus inserted vaginally 1 tab per night. Then repeat the culture on day 14.
GBS Herbal
This is my own ordinary herbal protocol for GBS: I have Mom take 30 drops Echinacea Premium extract (NF Formulas is my favorite), and 30 drops pure Propolus every3 hours while awake. (I know, that is a LOT of echinace and propolus!!!) I also make sure that my Mommies are taking a really good prenatal vitamin, and again my favorite is Prenatal Fort's by NF...it has a pretty good amount of Vitamin C in there, which I like a lady to also have to combat the GBS. I also have her trade off inserting a ****carefully peeled***** garlic clove with a large cotton-ball soaked with liquid colloidal silver. I have her start with the garlic clove and leave it in place for 4 hours. Take a 2 hour break and then insert the silver cotton ball, leave in place for 4 hours, take 2 hours off, start over with a fresh garlic clove. If a Mommy is not certain that she will awaken during the night, I don't have her insert anything at bedtime because I don't like things left in for a whole night. At the same time I highly recommend my Mommies keep a tub of baby wipes by their potty so they can be meticulously careful about hygiene...the last thing they need to be doing is just transplanting more bacteria from back to front when they use the toilet. Incidentally, I have often seen ladies pop up with Trichomonas WITH GBS, and I suspect it is because the presence of GBS does cause the vaginal ph to climb, which provides the perfect environment for Trich to thrive in. Since it too is often transplanted from the lower bowel, cleanliness is again a very important thing...and the garlic is NOT friendly to Trich organisms! If I suspect Trich is co-existing with the strep bacteria I might suggest a half-full capsule every other day to help acidify the vagina, which will sometimes clear a trich problem all by itself, as Trich cannot survive in an acidic environment.
GBS Herbal
Twice Daily
Acidophilus- 4 billion cells per dose
Echinacea- 350 mg capsule X 2 capsules
Garlic 580 mg capsulesX 2 capsules
Vitamin C 500 mg with 200 mg bioflavnoids
Grapefruit Seed Extract- 15 drops
I use an excellent grade of colloidal silver (CS) all through the pregnancy, is have had prior GBS. You use it orally, just 10 drops under tongue 3 x's/day.
If Mom has symptoms and has never had GBS, I put her on the CS, 10 drops every 2 hours while awake for 1 week. Then the above dose until birth.
I also find that keeping the body alkaline, there just simply is no GBS or any other problems. I do this through using SuperGreens with Prime pH drops and getting very strict with their diet. Here is a website if you want to check it out. "
http://64.4.8.250/cgi-bin/linkrd?_lang=EN&lah=9923e467ab728a9f81c06973935f95 10&lat=1055020879&hm___action=http%3a%2f%2finnerli ghtfoundation%2eorg%2f"
If you or any other professional would like to order, just contact me and I can get it wholesale for you.
Have a great day!
Jill Peck-Colin, CPM
Las Vegas, NV
Judy Sloan suggests that Garlic can be used par vaginum for group b Strep. You can read more at
www.midwiferytoday.com/enews/enews0505.asp
MoonDragon Birthing
Propolus can be taken daily, either in capsules or tincture, 3 to 4 times daily.
Echinacea root (Augustofloria) can be taken either as a tea or tincure, 3 times daily. To make the tea, use 1 oz of the root to 1 pint of boiling water and steep for 6 to 8 hours. Echinacea root is specific to staph and strep infections. It stimulates the body's defense mechanisms as well. A strong tea may also be diluted and used as a douche. When douching in pregnancy, extra care must be taken to avoid forcing water up into the uterus, causing infection and other problems.
Safe Douching During Pregnancy
·Fill douche bag with cooled tea, attach cleaned vaginal tip.
·Hang bag 10 inches or less from the floor.
·Lay in the bathtub and gently insert the nozzle into the vagina no more than half way in.
·Very gently release the hose clamp and allow tea to run in and out of the vagina, do NOT attempt to retain water in the vagina in pregnancy.
·When finished, clean the equipment thoroughly.
Douching should never be attempted if there is any question that cervical dilation, placenta previa or prematurely ruptured membranes are present.
Essential Oil Protocol to get rid of GBS (From "
http://thebirthsource.homestead.com/gbs.html"
It's imparative that the oils are of highest quality. Young Living oils from "
http://www.essentialoilsrus.com/youngliving/" are one source that has been recommended.
Put the following in a Double "O" gelatin or vegetable capsule:
5 drops Lemon Essential oil
3 drops Oregano Essential oil
5 drops Mountain Savory Essential oil
Take one capsule 3 times daily.
Additionally do the following:
Soak an ORGANIC tampon in...
15 drops Lemon Essential oil
9 drops Oregeno Essential oil
15 drops Mountain Savory Essential oil
1 tsp carrier "
http://freshorganicessentials.com/youngyiving/massageoils.html" oil
Leave soaked tampon in overnight. Insist on being retested. Do this daily for the last six weeks of pregnancy.
V-6 Vegetable Mixing Oil:
V-6 Mixing Oil combines food-grade vegetable oils for mixing with essential oils to create blends, formulas and massage oils. Grape seed oil, wheat germ oil and vitamin E are nurturing to the skin as natural antioxidants. V-6 is also excellent for cooking and making salad dressings. Blendi 15-30 drops of an essential oil to 1 oz. mixing oil. V-6 is good for mixing massage oils, creating your own blends and formulas, for cooking and making salad dressings, etc. The ingredients of V-6 Mixing Oil are sesame seed oil, grape seed oil, almond oil, wheat germ oil, sunflower seed oil and vitamin E.
Another GBS Remedy (From the archives at "
http://www.gentlebirth.org/archives/gbs.html":
3 capsules of Congaplex by Standard Brands 3 times a day for a week, then reculture. If negative, no more Congaplex. If positive, 1 cap a day until the end of pregnancy.
Congaplex Ingredients: Bovine thymus Cytosol™ extract, carrot root, ribonucleic acid, bovine bone, nutritional yeast, defatted wheat, bovine adrenal, dried alfalfa juice, oat flour, alfalfa flour, bovine kidney, veal bone PMG™ extract, mushroom, dried buckwheat juice, buckwheat, peanut, soy bean lecithin, mixed tocopherols and carrot oil.
Do not take if you have "
http://www.moondragon.org/health/disorders/allergies.html" to any of these ingredients.
Congaplex is available at:
·"
http://www.humandiamond.com/hdpub3/store/store0100.html" (1-800-366-5992)
·"
http://shop.store.yahoo.com/spinelife/congaplex.html"
·"
http://www.cedarcanyonclinic.com/PDFs/CONGAPLEX.pdf"
Take 500 mg Vitamin C every 4 waking hours.
1 acidophilus (4 billion micro-organisms or higher) capsule every 4 waking hours.
Acidophilus is available at:
·"
http://www.customprobiotics.com/ppricing.htm"
·"
http://www.elixa.com/nutrient/colonizer.htm"
Take Congaplex, vitamin C and acidophilus daily for the last six weeks.
Insert an small ORGANIC tampon or a cotton ball, whichever is more comfortable, soaked in a combination of 10 drops of tea tree essential oil and Olive oil. Leave the tampon in for 4 hours each day for 6 days.
More suggestions for GBS:
EHB by NF Formulas given over a 10 day period (6 caps per day) ("
http://www.emersonecologics.com/ProductInformation.asp?BrowseBy=E%2EH%2EB"), and Tea tree oil vaginal suppositories 3 to 4 x daily for that time (see above). This mom was re-tested at two weeks after positive culture (3 to 4 days after last EHB taken), two weeks after that (2 1/2 weeks after first positive culture), and on one occasion was tested again 2 1/2 weeks later (5 weeks after positive culture) because of a prolonged ROM with no labor.
Then insist on retesting to see if the GBS has gone away. Midwives have seen heavy colonization completely cleared with these treatments, although there is no scientific study to support it.
Another midwife had a case of a mom's GBS culture at 36 weeks yielded a result of 2+ colonization, which was the same at 38 weeks. She had her take 500mg Vitamin C every 4 waking hours, 1 EHB (NF Formulas) capsule every 4 waking hours, Propolis 4x daily, and she inserted a tampon soaked in 2% Tea Tree oil solution (2% Tea Tree essential oil, 98% Olive oil). She left the tampon in for 4 hours each day for 6 days. Culture at 39 weeks was negative for GBS. She had a long labor, a high leak for 72 hours, then a rapid active phase and 2nd stage, healthy baby, normal placenta, and normal recovery. The midwife has become a believer in Tea Tree oil for a variety of infections, though in this case she believes it acted synergistically with the other natural therapies the mother used. She has used it as a spray on throat infections, as well as for vaginal yeast, trichomonas, and gardnerella, all with great success. Not much is seen about Tea Tree oil in midwifery literature, but it may well be worth a try for other GBS+ moms who are averse to standard antibiotic therapy.
Another recommendation for GBS:
1. Boost Vitamin C in your diet, such as eating 2 grapefruit per day. Other good sources of Vit C: red peppers, oranges, kiwi fruit.
2. Drink a cup of Echinacea tea or take 2 capsules of echinacea every day
3. Get extra sleep before midnight. Slow down your schedule. Take it easy and eat well. Follow a nutritious "
http://www.moondragon.org/nutrition/diet/pregnancydiet.html".
4. Take 3 teaspoons of Colloidal Silver per day. Take it between meals. Hold the liquid in your mouth a few minutes before swallowing. Colloidal Silver can be purchased in most health food stores. It is silver suspended in water. It is antibiotic in nature and safe in pregnancy.
5. Plan ahead for extra warmth after the birth for both you and baby. Hot water bottles, heating pads, hot packs, big towels dried in a hot dryer during the pushing phase--will all help you and baby keep extra toasty after birth and reduce stress. Have a friend or family member assigned to be in charge of the "Mother/baby warmth team".
6. The colostrum from your breasts is the best antibiotic treatment your baby could ever get. The colostrum is very important for your baby. Breastfeeding your baby is the best thing you can do to keep your baby healthy since you pass on your immunities to your baby through the breastmilk.
7. Other good prevention tips: Keep vaginal exams to a minimum--0 is best. Do not permit artificial rupture of the membranes. After the membranes have broke, keep vaginal exams to a minimum, again 0 is best if possible. If not possible, use extreme care and sterile technique if an exam is absolutely necessary. Any exam has the possibility of introducing GBS into the cervix of the mother if she has a positive GBS test result. Do not allow children of other families to visit the new baby for the first 3 weeks. Keep your older kids healthy so they are not sneezing and coughing on new baby.
I did what my Father recommended (for those who are new and don't know, my father is an alternative medicine M.D. who specializes in nutrition, allergies, and preventive medicine. His website can be found here: <A HREF=""
http://64.4.8.250:80/cgi-bin/linkrd?_lang=EN&lah=b33ce2d9aa28522dfa7d8b4636b39b 65&lat=1060090855&hm___action=http%3a%2f%2fwww%2et ahoma%2dclinic%2ecom")">"
http://64.4.8.250:80/cgi-bin/linkrd?_lang=EN&lah=b33ce2d9aa28522dfa7d8b4636b39b 65&lat=1060090855&hm___action=http%3a%2f%2fwww%2et ahoma%2dclinic%2ecom")</A>. He said to take a tampon, soak it in olive oil, then soak again in tea tree oil, then put it up my vagina twice a day for 30 min. each time. He also said to do the same with a q-tip and put it up my anus for a second or two each time. He said the tea tree oil is great at killing group b strep and also helping with yeast infections too!! So, anyway, I did that for two weeks and then asked my midwife retest me. She did and the test came back negative!! Woooooo Hooooooo!!
