Hello all,
I, too, was GBS + with all three of my pg. With no.1, the protocol was just to treat if there were risk factors (as outlined by a previous poster). My water was broken for almost 72 hrs before I birthed, so I did receive antibiotics. (hospital birth w/mw's)
With pg no.2, the protocol had changed and recommended tx for _all_ + moms. I was homebirthing this time around, but due to PROM with pg1 and the crazy long labor with no.1, I opted to have IV antibiotics on hand, in case I developed risk factors, but NOT to treat otherwise. If I had prolonged rupture of membranes, or some other risk factor, though, I wanted still to maintain the option of staying home, hence we had antibiotics and IV setup on hand. Happily, they were never used and I birthed baby no2 at home with no issues.
With pg no3, I was again + (tested in hopes of having a documented neg. on hand should we need to transfer... oh well!) and was homebirthing again. I opted for IV antibiotics on hand again, but had a super fast labor and birth, with rupture of membranes only minutes before the birth, so no abx were necessary or even possible! Now, this is where things get interesting.
On Wed after the birth on Mon, dd wouldn't nurse. I was very, very, very worried as to WHY she wouldn't nurse and wouldn't stay awake long enough to eat. I wasn't worried about latch, etc, as I'd been nursing 6 yrs and have enought knowledge/experience/support/resources to deal with nursing challenges, I was freaked as to *why* she wouldn't nurse.
Followed my instincts after much thought and worry and took her to ped. No fever, vitals good, baby alert (of course, once we're in the office!) etc. Says it may be difficulty latching due to milk just coming in, got a teeny bit dehydrated, therefore too tired to eat, vicious cycle, blah blah. Sent us home with syringe hookup to finger feed pumped breast milk. She eats well from that. Momentary relief. We pump and finger feed around the clock.
On Fri night, however, dd develops low grade fever. Oh SH*T. My worst nightmare starts to come true. After many calls, time undressed to see if she'd cool down, etc. we go to hospital due to fever. Sure enough, she has fever of 100.8. Staff is **astonished** that we realized so early that she had a fever since it's not all that high. We are **astonished** that they're astonished----- she's my baby! Like sublime birthgirl said, she's with me/ON me nearly 100% of the time- I KNOW her! How could I *not* realize she had a fever?!?! They just kept going on and on about how we were so sensitive and caught it so incredibly early, etc. Whatever.
They do the whole horrific workup (catheter, blood, spinal tap, chest XRay) and find significant infection in her spinal fluid. OH heavens, she has meningitis. Our world crumbled.
: It was, of course, assumed that it was secondary to GBS infection, so while we waited for culture growth results to determine/confirm the source of infection, she was started on abs IV and antivirals. We were told to expect a minimum 2-3 week stay for IV antibiotics, possibly more depending on what complications she developed. (potentially many with GBS and meningitis)
She did amazingly well, and lo and behold, after 72 hrs of NO bacterial culture growth, it was decided by the Infectious Disease team that it must be viral meningits, not bacterial, and that it would be safer for her to recover with us at home!! (they acknowledged the risk of hospital borne infection-shock!-and told us to take her home! -----esp, since they knew we were **so unbelievably sensitive to our baby and would bring her back in a heartbeat if something changed!)
Anyway, one of my points is that I find it *very hard to believe that the OP's client whose baby had GBS meningitis was only hospitalized for 3 or 4 days. If it were truly known to be GBS infection, the *minimum* course of abx rec. is 2 weeks, sometimes 3. Did the baby go home with a central line and abx and nursing care??? (We escaped having a central line placed on our dd by mere hours before they decided to send us home........)
Why/how did they send a GBS ill baby home after 3 days? That seems bizarre and scary. Even I, who avoid abx like the plague, would not want to risk not completely killing the bacteria and having a relapse....... If you know definitively that a baby is ill with the bacteria, you have to make sure to kill it..... Could you please give more info on this, OP?????
I also just wanted to validate the excellent point you made, sublimebirthgirl, about catching something wrong in your baby before a hospital did. Every 4 hours?!?! Like that's vigilant monitoring???
If it had indeed been GBS that infected my dd, her chances of recovery were MUCH higher b/c we caught it so quickly and realized she was febrile so immediately. No hospital would have caught it so quickly, and we wouldn't have either if we parented differently. It was/is an amazing reinforcement to following your instincts and parenting the way we are meant to.
Sheesh, I've written a semi-coherent novel here!
: Sorry to go on- there is just so much to the complex GBS equation that many people overlook, I think. It's scary, but it's not black and white. More abx in labor do not equal fewer sick and dead babies, but may well equal more sick moms (due to pennicillin allergic reactions) and may down the road equal much more virulent and resistant bacteria. So many shades of gray............
That's our experience. Hope it might help someone to read it, though I hope no one here experiences the horror of a really sick baby.
Looking forward to hearing more about the OPs client's baby.
TIA!
