Strep B.. what do I need to know?

[Mommie22]

Just found out I tested positive. I'm trying to wrap my head around it. What should I know? Is there anything I can do now to reduce the risk of complications? :(

[XanaduMama]

In the absence of risk factors (prematurity, extended ROM, fever in mom during labor), the risks to your baby are very low. In most countries, they don't even test for GBS. So honestly--I wouldn't freak out about it. GBS also comes and goes, so you could well be negative by the time labor rolls around. If you're having a hospital birth and/or using an OB, they'll likely "insist" on antibiotics every 4 hours during labor; you should research the risks and benefits of that approach and discuss alternative approaches. Rinsing with hibiclens (chlorhexidine) has been shown to be as effective as antibiotics at eliminating GBS without all the nasty systemic effects, so look into that as an alternative if you feel you want to treat it.

I was positive with #1 (hospital birth) and ended up getting the abx; the second time, I did the hibiclens before testing and was negative. I'm negative so far this time around too, without doing anything in particular, and not planning to test closer to the birth. hth!

[dovemama]

I'm sorry for a + . I know it stinks. I tested positive too.

Basically, in my situation, I had a hospital birth. My OB wasn't willing to let me forgo abx, so I got them. I was really stressed about it, but, it wasn't horrible. I had a hep-lock IV and happened to deliver in time, before they had to give me another dose of the abx.

I know there are things you can do. Maybe someone has some answers.

[Plummeting]

The risk of what complications are you asking about, exactly? The complications of antibiotic exposure or the complications of GBS exposure? Obviously, the answer would be different for each situation. :) As far as abx complications go, you would want to make sure to take lots and lots of probiotics ahead of time and then as soon as you could after labor was over. Some people would also advise giving them to the baby. If you're talking about the complications of being GBS positive, the only real one is GBS disease in the baby, since it can't hurt you. Okay, technically there is a slim possibility that it could make you sick, but this would be very, very, very, exceedingly rare and has nothing to do with pregnancy. You can almost guarantee it's not going to happen. I only mention it to mollify that one person out there who's thinking, "But I know someone who's has intractable GBS vaginitis for years."

So anyway, GBS disease is uncommon, even when mother has a known positive status, but it's very serious if the baby does get it. Some studies show that hibiclens works as well as abx. Some show it doesn't. Some studies show that abx treatment reduces the incidence of GBS disease in the newborn, but not overall mortality rates, meaning that those babies apparently catch something else just as deadly. Some show a reduction in mortality, from what I recall. A couple of studies definitely show that use of abx during labor, even for prevention of GBS disease, means that if the infant does develop GBS disease anyway, or some other infection, it is much more likely to be resistant to treatment. Really, GBS is sort of an up in the air issue. I personally don't believe that the available information gives an obvious answer as to the best course of action. Obviously, other people feel differently about it, but this is my 2nd time being positive and I'm still not sure what I'll do this time. Last time I had planned to do the hibiclens, but my labor was so fast and intense, that I really didn't do it properly. I only used probably 1/4 of the mixture I was supposed to, since standing was too painful. In the end, there were no problems at all, but that could easily be attributable to my very precipitous labor.

[calapitters]

Originally Posted by Plummeting 

So anyway, GBS disease is uncommon, even when mother has a known positive status, but it's very serious if the baby does get it. Some studies show that hibiclens works as well as abx. Some show it doesn't. Some studies show that abx treatment reduces the incidence of GBS disease in the newborn, but not overall mortality rates, meaning that those babies apparently catch something else just as deadly. Some show a reduction in mortality, from what I recall. A couple of studies definitely show that use of abx during labor, even for prevention of GBS disease, means that if the infant does develop GBS disease anyway, or some other infection, it is much more likely to be resistant to treatment. Really, GBS is sort of an up in the air issue. I personally don't believe that the available information gives an obvious answer as to the best course of action. Obviously, other people feel differently about it, but this is my 2nd time being positive and I'm still not sure what I'll do this time. Last time I had planned to do the hibiclens, but my labor was so fast and intense, that I really didn't do it properly. I only used probably 1/4 of the mixture I was supposed to, since standing was too painful. In the end, there were no problems at all, but that could easily be attributable to my very precipitous labor.

Could you post any links to studies that show that hibiclens doesn't work?  I am just learning about this option and would be grateful for this sort of information!  Thanks, mama!

[Plummeting]

I will definitely do that. I just wanted to pop on to say that I have two sick kids right now, and I'm on Hawaii time, so it might be the middle of the night for you before I get the chance, depending on where you live. :)

[Carlin]

Sorry for the positive test. :( I was GBS + last time and it threw me for a loop too. I did a fair amount of research and came to the same conclusion as the previous posters.

Because the risk of infection is so small I planned to avoid antibiotics and go with a hibiclense protocol along with probiotics for the baby post birth as even the hibiclense would reduce how well her system was colonized with good bacteria. As it turned out I had my membranes rupture 48 + hrs before labour started and my temperature was starting to rise which are two of the major risk factors which increase the likelyhood of the baby ending up with GBS so I did end up on pretty massive doses of IV antibiotics while we waited for labour to start. In the long run we were all healthy and didn't suffer any ill effects from the antibiotics (maybe because of the probiotics) so it all worked out in the end.

Oh, I also did a herbal protocol that lasted about 14 days and then re-tested to see if I was still positive and while it didn't make me GBS - I did feel that it probably helped a bit. If you have a naturopath or midwife with some herbalist training you might be able to see if they can put together something similar.

[Plummeting]

Okay, sorry it took me so long, but here are some studies showing that hibiclens might not work. Please note that I am in no way opposed to using it. I tried it once. As I stated, I think this issue could go either way. I'm only providing these studies because I was asked to do so. There are also some studies showing that it does work. :)

http://www.ncbi.nlm.nih.gov/pubmed/15266490 This was an analysis of 5 studies, and found a reduction in GBS colonization of newborns, but not of early onset disease. I'm not really sure how you could reduce colonization, but not disease. That seems illogical, but it is what they found. I don't know if perhaps that means that only the heavily colonized women were the ones who would've had babies who developed early onset disease, and for those women hibiclens just wasn't enough or what. They don't say.

http://journals.lww.com/greenjournal/Abstract/2010/06000/Chlorhexidine_Vaginal_and_Infant_Wipes_to_Reduce.19.aspx This one used wipes instead of a wash. I don't know if that matters or not.

[calapitters]

Originally Posted by Plummeting 

Okay, sorry it took me so long, but here are some studies showing that hibiclens might not work. Please note that I am in no way opposed to using it. I tried it once. As I stated, I think this issue could go either way. I'm only providing these studies because I was asked to do so. There are also some studies showing that it does work. :)

http://www.ncbi.nlm.nih.gov/pubmed/15266490 This was an analysis of 5 studies, and found a reduction in GBS colonization of newborns, but not of early onset disease. I'm not really sure how you could reduce colonization, but not disease. That seems illogical, but it is what they found. I don't know if perhaps that means that only the heavily colonized women were the ones who would've had babies who developed early onset disease, and for those women hibiclens just wasn't enough or what. They don't say.

http://journals.lww.com/greenjournal/Abstract/2010/06000/Chlorhexidine_Vaginal_and_Infant_Wipes_to_Reduce.19.aspx This one used wipes instead of a wash. I don't know if that matters or not.

Thanks, mama!  I always test + and am looking into alternatives to antibiotics.  I know the risk of passing it on is very small (1 in 1000 births), but my youngest was born with congenital hypothyroidism with affects 1 baby in every 10,000.  So someone has to be that one baby, right?  I like to know all the facts before I make a choice like this, so thank you for helping out!