How to prevent group B strep? - Mothering Forums

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#1 of 15 Old 09-02-2008, 07:54 PM - Thread Starter
 
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I have a question for the midwives out there. Are there things I can do now during my pregnancy to prevent having group B strep or another infection?

I've just been through two sets of serious antibiotics to treat any possible vaginal, bladder, or uterine infection because I'm at high-risk to deliver prematurely and the theory is that infection can play a role. Now that the perinatologist has done his part, I'm wondering what I should do to support my immune system and help my body be as healthy as possible going into birth, whether it's at 28 or 40 weeks?

Thanks!
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#2 of 15 Old 09-02-2008, 08:08 PM
 
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A friend gave me her recipe for recolonizing friendly bacteria in the vagina:

Put a couple of peeled cloves of garlic in the vagina, and leave overnight, then take them out. (She said a side effect is smelling like garlic for a couple of days). Then mix 1 part apple cider vinegar - organic, and with the stringy part (live cultures?) and 1 part plain yogurt and insert using your fingers into the vagina right after you take out the garlic. She was GBS negative. She suggested wearing a pad for leakage.

I haven't tried it yet, I'm waiting until about 34 weeks.

ETA: I'm not a midwife, and neither is my friend, but it worked for her!
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#3 of 15 Old 09-02-2008, 09:14 PM - Thread Starter
 
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I don't know if I can handle the smell of garlic! I'm still queasy at 21 weeks. Last week my husband had pasta with garlic shrimp and I had to avoid him for 2 days...

I'm already eating plain yogurt and taking probiotics.
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#4 of 15 Old 09-02-2008, 10:29 PM
 
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In general, you need to follow healthy vaginal behavior habits. Always wipe front to back; do not use soap between your legs, use only a wet cloth and rinse with plain water; go without panties whenever possible. If the vaginal environment is healthy, GBS should not grow there.
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#5 of 15 Old 09-03-2008, 03:09 PM
 
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IMMUNE BOOSTING PROTOCOL
(please consult with your healthcare professional before using)

Use in the last 6 wks of pregnancy, 2 times a day at breakfast & dinner

-Acidophilus (or mixed probiotics), the kind that require refrigeration, 4 billion cells

-Echinacea tincture, one full dropper, 10 days on, 10 days off

-Garlic, deodorized capsules, 500-600 mgs per day

-Vitamin C, 500 mgs with Bioflavinoids, 200 mgs, can be purchased together or separate

-Propolis, a.k.a. bee pollen, 1 capsule/tablet

-Grapefruit seed extract, 15 drops, preferably with OJ because it is bitter by itself!

: : Candace McCollett, CBE, CLD, student midwife : : : : :
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#6 of 15 Old 09-03-2008, 03:16 PM
 
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I don't agree with this strategy. GBS colonization of the vagina is not an infection, and therefore not an immune system issue. It is a matter of whether or not the vaginal environment is susceptible to letting it grow there.
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#7 of 15 Old 09-03-2008, 03:58 PM
 
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Originally Posted by nashvillemidwife View Post
I don't agree with this strategy. GBS colonization of the vagina is not an infection, and therefore not an immune system issue. It is a matter of whether or not the vaginal environment is susceptible to letting it grow there.
I respectfully agree but this original poster was asking what she could do to prevent an infection, not just a colonization. Wouldn't healthy vaginal habits AND a healthy immune system prevent an over-abundance (infection) of GBS? Therefore statistically decreasing the chance of the newborn contracting GBS because the numbers are lower?

It is also important to know, sbrinton, that frequent vaginal exams during labor and internal fetal monitoring (where a wire is screwed into the baby's head) have also been associated with a greater chance of infection of the newborn.

I defer to your greater experience, nashvillemidwife, I am just trying to understand and learn on my journey. I recieved this immune boosting protocol from the midwife I work with.

: : Candace McCollett, CBE, CLD, student midwife : : : : :
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#8 of 15 Old 09-03-2008, 06:15 PM
 
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I respectfully agree
I'm glad we're all being respectful.

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but this original poster was asking what she could do to prevent an infection, not just a colonization.
Regarding GBS, most people use "infection" and "colonization" interchangeably and I assumed this was the case with the original poster. You are correct, if her concern is UTI or chorioamnioitis, boosting the immune system is the best thing. If she's referring to GBS infection in the newborn, I don't think the maternal immune system can prevent that. If, as I assumed, she is referring to simply being GBS positive, the best approach is a healthy vaginal environment.

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Wouldn't healthy vaginal habits AND a healthy immune system prevent an over-abundance (infection) of GBS?
But over-abundance is not an infection, it's colonization. Infection means that the colonization is causing a disease condition, when in fact vaginal colonization is quite common and not considered to be a disease state. GBS creates pathological conditions only when it colonizes the urinary tract, uterus, or infant - not the vagina. Vaginal colonization occurs in healthy and compromised women alike, lending credence to the idea that the key is specifically the vaginal environment, not the overall immune state.

Statistically, women who are obese and African American women have a high incidence of colonization, and the reason is very straight forward. Proper front/back hygeine can be more difficult for women who are overweight (no flames please, I am overweight myself and very sensitive to the issue, it's simply a fact that reaching those areas can be more awkward), introducing GBS bacteria from the intestines to the vagina in addition to other anaerobic bacteria that lead to pH imbalance. African American women are, on the whole, more likely than other ethnic groups to practice douching, which also alters vaginal pH and creates a GBS-hospitable vaginal environment.
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#9 of 15 Old 09-03-2008, 06:27 PM
 
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Is GBS and bacterial vaginosis both related to improper hygiene? I had continual cases of BV when pregnant with my third. With my fourth, I douched with hydrogen peroxide as a preventative, and inserted garlic several times during the first and second trimesters, and never had a problem with it.

The thing is, I am extremely obsessive about hygiene. I never douche with anything other than the hydrogen peroxide those few times, but I wash myself very well down there (I do use soap, I don't know that I'd really be comfortable using only water?) and ALWAYS wipe from front to back. Most of the time I'll even use wet wipes after going to the bathroom. I'm confused as to why I seemed to be so susceptible to BV?
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#10 of 15 Old 09-03-2008, 09:22 PM
 
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Is GBS and bacterial vaginosis both related to improper hygiene?
I believe so, but there are other factors. I don't know of any studies to point you to, but this has been my personal and professional experience, along with the observation of many other experienced women's health care professionals.

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I wash myself very well down there (I do use soap, I don't know that I'd really be comfortable using only water?)
Why not? What is soap going to do for you that wiping the area with a wet cloth isn't going to accomplish, other than altering the pH balance? I can understand that it may take some getting used to if you've always used soap, but the truth is that normal vaginal secretions should not need to be addressed with soap, and you are only doing yourself more harm than good. If you do insist on using soap you need to make sure that it is lye (acidic) based, which presents its own issues of irritating sensitive skin.

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I'm confused as to why I seemed to be so susceptible to BV?
Like I said, there are a lot of factors. It could be the soap. Semen and blood also alter vaginal pH. Perhaps for some reason you are particularly susceptible to colonization with anaerobic bacteria with a deficit of good lactobacilli. It's impossible to say for sure.
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#11 of 15 Old 09-04-2008, 04:11 AM - Thread Starter
 
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So far in my pregnancy, the doctors have been treating any possible UTI, chorioamniotis, or other infection as I've been having preterm labor contractions. From what I understand infection that leads to inflamation can play a role in this.

So my concern is probably for both a healthy vaginal environment and a healthy immune system, both to prevent preterm birth and also to hopefully reduce the chances of being GBS positive when I do give birth.
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#12 of 15 Old 09-04-2008, 09:08 AM
 
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Originally Posted by sbrinton View Post
So far in my pregnancy, the doctors have been treating any possible UTI, chorioamniotis, or other infection as I've been having preterm labor contractions. From what I understand infection that leads to inflamation can play a role in this.
Have your care providers discussed nutrition with you as related to your preterm labor contractions?

You mentioned in your first post that you were at risk for pre-term labor... I am curoius about that? Would you mind offering more insight.

If you are continuuing to have frequent and uncomfortable amount of contractions even now that the UTI has been treated I would focus on your nutrition and hydration. Increasing your protein intake can be very helpful and drinking water infused with minerals and/or electrolytes could help alot.

Shelly DeMeo Birth Doula/Educator, Massage Therapist, Birth Assistant, Echo Tech, Future CPM! Mom to Dylan (6/03) and Sage Aria (1/06).
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#13 of 15 Old 09-04-2008, 06:19 PM - Thread Starter
 
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To answer your questions...

I am high-risk for preterm labor because I had preterm labor with both of my sons and my younger son was born prematurely. I have several other risk factors - low weight / slow weight gain in pregnancy, short interval between pregnancies, family history of preterm birth, prior D&C. Going into this pregnancy we knew I had a 30-50% chance of giving birth prematurely again. When I began to feel frequent contractions at 12 weeks, it sort of went from "if" to "when" the ctxs would cause cervical change. Based on my cervical length at 20 weeks, I have a 75% chance of premature delivery. I also currently have a partial placenta previa, although most likely this will get out of the way if I can stay pregnant through 32 weeks. For now, my doctor thinks I will be fine to at least 24 weeks and then the new goal will be 28...

Yes, we're doing everything we can to prevent preterm labor. From 12 weeks on, when I began to feel contractions, I've been paying attention to hydration and eating lots of protein. Likewise, I'm working hard to gain enough weight, a struggle as I have hyperemesis the first half the pregnancy. Since then I've been on modified bed rest (okay to be on my feet 5-10 minutes out of an hour or 2-3 hours of the day, but no more). No sex, no lifting my 18 month and 4 year olds, no exercise, lots of baths. I'm taking a high dose of folic acid along with prenatals, as well as extra calcium-magnesium and crampbark tincture if my uterus is irritable.

When my cervix began to shorten more around 18 weeks, my doctor put me on antibiotics and ibuprofen. I had no symptoms of infection, but as we were on the line for needing a cerclage, he wanted to treat this "in case" something was going on. He also put me on a high dose of ibuprofen to slow the contractions (NSAID's like ibuprofen inhibit prostaglandins and can prevent ctxs/cervical change). There are risks to being on ibuprofen so the perinatologist checks the fuild levels and the baby's heart weekly.

For now, things are stable. If my cervix gets shorter than 2 cm before 24 weeks, we'll do a cerclage. If the contractions get stronger and are changing my cervix before 32 weeks, they will put me on hospital bed rest with additional medication. From 32 weeks on, my midwives can deliver the baby at our hospital and if I make it to 37 weeks (Christmas day!!) we'll have the baby at home!

I hate that this is so complicated and wish that I had normal, healthy pregnancies. I love the giving birth part (I really do!) and would do that over and over again. Between my three sons, however, I will have spent a total of 10 months on bed rest...and I'm ready to get back to normal life when this is over!
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#14 of 15 Old 09-05-2008, 07:33 PM
 
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Eating probiotics every day during pregnancy is really helpful in assisting healthy bacteria to colonize the gut, and is especially important if one has had antibiotics. Probiotics are a part of a healthy nutritional diet for prevention of pregnancy complications.

Good probiotics are fermented foods such as kimchee, sourkraut, yogurt, etc. I also love Vitamineral Green.

It may help, and it won't hurt.
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#15 of 15 Old 10-18-2008, 09:49 AM
 
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Originally Posted by sbrinton View Post
To answer your questions...
I also currently have a partial placenta previa, although most likely this will get out of the way if I can stay pregnant through 32 weeks. For now, my doctor thinks I will be fine to at least 24 weeks and then the new goal will be 28...

For now, things are stable. If my cervix gets shorter than 2 cm before 24 weeks, we'll do a cerclage. If the contractions get stronger and are changing my cervix before 32 weeks, they will put me on hospital bed rest with additional medication. From 32 weeks on, my midwives can deliver the baby at our hospital and if I make it to 37 weeks (Christmas day!!) we'll have the baby at home!
Checking in.... I was wondering how things are going for you at this point. Any updates?

Shelly DeMeo Birth Doula/Educator, Massage Therapist, Birth Assistant, Echo Tech, Future CPM! Mom to Dylan (6/03) and Sage Aria (1/06).
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