[mamasiobhan]

Hey mamas. I'm having kid #2, homebirth this time (birth center last time). I'm 34 weeks, and I'm supposed to be making a decision about whether or not I want that Strep test, and then I also need to decide about the Newborn Screening Test (which includes PKU)...

It's hard to find any unbiased info about them, because all the sites I've seen just say "You'll need this at 36 weeks" and "Your baby will have this at birth."

What are your thoughts? Your experiences? Any links to info to help me make a decision?

We're typically very naturally-minded parents... no vaccinations, vegetarian, alternative medicine, etc...

Love
Siobhan

 

[KatSG]

I will say up front that I didn't do any research on the PKU, beyond knowing that the chances of my kid having a problem were very low. That said we went ahead and did it because I believe in diagnostic tests (we don't vax and don't do a lot of medicines, only when really neccesary).

HOWEVER, I will say that my next kid will not get that test unless s/he has the sugar water first. Our hospital did that and dd actually slept through the test. It was amazing. For the follow up, at the ped office, they acted like I was crazy for asking for this and dd screamed bloody murder. We left that ped office.

I also did the Strep B, again because I believe in diagnostics. I was negative, but I know that at the time I decided if I was positive I would have taken the antibiotics. Not sure what I would do today, but at the time I didn't want to put the baby at risk, no matter how small that risk really was. I didn't know at the time how awful breast yeast infections can be. For the next one, if I was positive, I would probably forgo the antibiotics.

 

[Artisan]

We did the PKU test, but had it done when he was a week old. I latched him on to nurse and then let them do it. He whimpered, but it wasn't horrible.

 

[SaraC]

I did the Strep test only because if I had it I need to know early enough that I could do natural things to clear it up. I had a HB transport with my first birth and didn't do the test and my DD was subjected to antibiotics within hours of birth. I am also severly allergic to antibiotics and didn't want to have to do that again in case I had to transport again. So with DD #2 I had the test and was negative.

The PKU test we did at 1 week because I don't feel as though it can be accurate until they have eaten.

 

[Kiki Runs]

Quote:

Originally Posted by KatSG HOWEVER, I will say that my next kid will not get that test unless s/he has the sugar water first.

Why would you give sugar water?? (Not trying to be snarky, I'm truly wondering).

We did the PKU test and, like others, waited till about a week after birth to make sure DS was eating well so the test would be accurate. The nurses in the hospital (and the ped) tried to get us to do a test at 24 hrs and then ANOTHER one at a week. We refused. That's just stupid. There's no need for two tests (unless one was somehow botched up), and 24 hr test wouldn't have been accurate, anyway.

As far as the Strep test, you should probably discuss at length w/your doc what the results will mean for you. Also realize that your status could change at anytime, and that's normal. ALSO realize that (at least in some places) once you test positive, you will be assumed positive for the rest of your life (okay, that may be an exaggeration). Once I tested positive, I took steps to change it and was tested again - negative!! Didn't matter. We got to the hospital and there was NO record of that second test. They tried to push the abx, but I refused.

I have also read/heard that once you test positive w/one pregnancy, sometimes you won't even be offered the test w/future pgs, they'll just ASSume you're positive!! GRRRR....

Do your research and talk w/your doc.

Kinsey

 

[stafl]

I agreed to the strepB test, just in case I had to transport to the hospital. If I didn't have proof of a negative test, they would automatically give antibiotics. So it was a cover my ass sort of thing, just in case.

Baby had the PKU test, but only after my milk came in, at the ped office when she was five days old. My milk was late coming in with my first baby, and she had the pku heelprick like four times...poor baby! The test isn't accurate before your milk comes in. I felt that the life-threatening nature of what the test screens for was incentive enough to have it done.

We declined pretty much everything else that is standard procedure at hospitals, though.

 

[Victorian]

We did both with both children. For ds (born at home) we did the GBS test because my midwives had an entire protocal for dealing with that naturally. The PKU test we did at 5 days and 2 weeks. We nursed during them and he did not cry.

Question for those of you that transported (or planned what would have if you needed too). When you say that they hospital would automatically do antibiotics - you could refuse them right? I don't think that they can force you do them. (not being grumpy, just wondering if they can)

Victorian

 

[3_opihi]

WE skipped the GBS test because my midwife said if it did come out positive then she would be in a position to report it and blah, blah, blah...I had tested negative with my first birth so I wasn't worried about it. As far as hospital automatically giving antibiotics -- I'm not sure about that, maybe it differs from state to state, but they probably wouldn't administer them unless you had a fever. And you could always refuse. There is also some speculation as to whether antibiotics during labor prevents strep B anyways. And they can always give the baby antibiotics afterwards if need be.

As far as the PKU, we did it because we have a family history of thyroid problems. My midwife did it at one week. She used a hotpack on his foot first which made it nice, plump and swollen so the blood just popped out---she didn't have to prick him very hard. He just nursed and slept. I don't know how I feel about this test, I don't like "tests" in general, but this one is not a big deal and its always better to know --especially if you have a family history of any of those type of problems.

 

[ericaz]

i skipped the strep test because i have had HORRIBLE experiences with antibiotics in the past and knew if i was forced to take them i'd immediately would get a yeast infection which would invariably give me thrush whereby possibly making nursing an issue. i didn't want to have to go down that road.

check out this article - it might help you to make an informed decision:
mothering mag's article on group b strep

and this is another great resource for both the group strep b and the pku:

midwife archives - strep

midwife archives - pku

fwiw, i did end up having the pku done to isadora. i was told by my ped to wait 48 hours before administering or run the risk of having a false positive. well, i didn't want to hang out at the hospital for 48 hours so we ended up having it earlier than the 48 hrs and it was negative. still, know that some insurance carriers will have a nurse come out to your house to administer the pku 48 hrs after the birth. look into it.

hth!

 

[Jennifer H]

I have been deciding what to do about the GBS test. My FNP and I discussed it yesterday and I think I will go ahead with it, but ONLY because I can still refuse the antibiotics even if I test positive (and if baby gets sick and I've refused, I'm not in danger of CPS taking my baby... which is a problem in some other states). Her opinion was that IF the baby gets sick after she is born and we had my GBS results it would give the peds a clue about what to/not to look for. That makes sense to me.

We do the California Newborn Screening Test (PKU, Galactosemia, Primary Congenital Hypothyroidism, Sickle Cell Disease and other Hemoglobin Diseases). It has to be done between 12 hours and 6 days of age. It used to have to be done after the baby was 24 hours old, but not anymore. (That is different in different parts of the country). The disorders can be so severe and yet damage to the baby can be prevented with knowledge the test can give, so we do it.

We don't give sugar water, but I nurse them while the heel stick is being done and they have not cried at all.

We also refuse the antibiotic eye ointment, but accept the Vitamin K.

 

[Aura_Kitten]

i'm pretty sure i'll be taking the new sprite into her pediatrician soon after birth for testing + to make sure she's ok health-wise... and to see how much she weighs.

i'm really torn on the group B strep test.

on the one hand, i want to know if i'm colonized, so that i can be sure to watch for signs of infection in the newborn, and also so i have a choice whether to have an IV during labor (although i have to admit, i'm pretty wary that they'd actually honor that as a *choice*)...

on the other hand, there's really not enough known about it... if you go to the CDC's page on it ~ http://www.cdc.gov/ncidod/dbmd/disea...upbstrep_g.htm ~ you see this:

Pregnant women who carry GBS should be offered antibiotics at the time of labor or membrane rupture. GBS carriers at highest risk are those with any of the following conditions:

- fever during labor
- rupture of membranes (water breaking) 18 hours or more before delivery
- labor or rupture of membranes before 37 weeks

... In spite of testing and antibiotic treatment, some babies still get GBS disease.

the antibiotics that are given frequently tie women to an IV ~ and thus keep them hospitalized ~ for the duration of their labor and delivery. it restricts their movement which can lead to more complications during birth.

the biggest risks are those listed above: if the woman has a fever during labor, if the water breaks 18 or more hours before delivery, or if labor starts or the membranes are ruptured before 37 weeks. ideally, all of these can be monitored at home.

also as stated above, even if a woman is tested, and receives antibiotics throughout labor and delivery, her baby might still get GBS. i don't think i like that.

and oral antibiotics before delivery aren't an option, because it has no effect on GBS colonization.

so...

there's the info and my 2 cents.

 

[mamasiobhan]

Thank you all so much for your info and feedback. Klothos, thanks for the links!

I spoke with my midwives today, and they too are saying that so much info is coming out about Strep all the time, that it's hard to keep up. It sounds to me like the medical field really has not much of an idea about any of this. (Sounds like the vaccination issue too, eh?).

It's sounding like Strep is present in the vagina all the time (hence the positive and negative readings in the same woman), it's just an imbalance that needs to be worried about...I think I'll get on a regiment of high-vitamins, high-antioxidants, so that my "flora and fauna" is lovely down there, and I'm less susceptible to any infections, including Strep B.

On a side note, my midwife turned my baby this morning! It was head-down 2 weeks ago, but head-up today! She turned it quite easily, in about 30 seconds. So now I have to make sure I walk at least 1 hour a day to keep that baby's head down! Know of any other tricks to avoid it turning back around?

Midwives rule!

I'm still undecided on the PKU, by the way...

Love to all of you

Mamaste!

Siobhan

 

[Kiki Runs]

Quote:

Originally Posted by klothos and oral antibiotics before delivery aren't an option, because it has no effect on GBS colonization.

??? Do you mean *immediately* before delivery? I took oral abx successfully and got a negative test, but (obviously) it wasn't during labor - it was weeks ahead of my "due date".

Kinsey

 

[Aura_Kitten]

no, apparantly antibiotics taken up to two weeks ahead of labor and delivery ~ which was thought to be effective ~ has been proven to not really have any effect on GBS colonization at all.

what *can* change is the colonization itself, all on it's own. even if a woman tests positive for GBS and then two weeks later delivers her baby, there's no reason to think she's still colonized unless she has the test repeated, because in just a week or two, it can change on it's own.

 

[CryPixie83]

I've skipped the GBS test, because a.) it's too invasive for my comfort and b.) there are too many variables (postive now, neg at the time of birth, false +, etc) and I don't want to be pumped full of antibiotics "just in case". We'll be watching the baby closely for any signs of trouble and of course acting quickly if a problem does arise.

We're getting the PKU. My midwives offer it as a free service and will let me nurse through the heel prick. PKU now tests for something like 28 different problems and DF and I both felt it was an important test.

Good luck!

 

[Kiki Runs]

Geez. I'll admit, I didn't do the kind of in-depth research I should have done before DS' birth. Now that I know better, I'll do better.

I thought I had done well to try to avoid the IV abx.

Looking back, we were SOOOOO incredibly lucky to avoid thrush! Like I said, I took the oral abx (no probiotics, either - didn't know), I ended up with IV abx anyway during labor (long story), after the c/s I was given MORE abx, and DS was given IV abx in the NICU to "treat" his fever (which dropped down to "normal" w/in 30 mins of his birth).

I don't know how we didn't get thrush, but I just must not be a yeasty person (never had a yeast infection in my life). Thank goodness!

Next time, I won't be taking the GBS test, and I won't be having abx unless I meet the risk factors. I won't be depending on luck again.

Kinsey

 

[mamachiquita]

Well, we didn't have the GBS test done - we were having a homebirth, and I wouldn't have taken antibiotics even if the test was positive. We ended up having to transfer to the hospital for complications during the birth, and they were a little concerned that I hadn't been tested for GBS, but they did not give myself or my baby antibiotics. Guess we lucked out on that...

 

[obnurse]

Each woman must make her own decision on these two topics. In terms of GBS, if you are not going to do anything about it, why get tested? If the baby becomes that ill, a full septic workup would be done anyway. GBS is deadly to infants. It is a very scarry thing to see in a baby. I consider myself pretty crunchy, but I definately was tested for GBS after seeing what can happen to babies. The best way to treat the disease in a newborn is to treat the mother. When a baby becomes ill from GBS, it is not the 'sniffles' or a slow progressing infection that responds well to antibiotics. It is extremely fast and very debilitating. The chances of a GBS positive mother passing the bacteria to the baby decreases with 2 consecutive doses on IV antibiotics in labor. I chose to have my IV 'heplocked' in labor, so I was not tied to it. I also breastfed just fine with no thrush.
The newborn screening is a diagnostic test. I also definately wanted to know if my baby had PKU, thyroid disorder or any of the other tested for problems. One of the previous posters summed it up when she said she knew someone with PKU and it hit closer to home for her. I think this is true of many things. If people knew of the devistation that GBS caused, people would feel differently about how they treated themselves. I am glad for all of you that you have not experienced this.

 

[Kiki Runs]

While I am sure that a GBS infection in an infant is horrible, I think we really need to remember that the chances of that happening are incredibly slim, particularly if none of the risk factors are met.

I wish that more health care providers would be upfront about realistic numbers instead of using scare tactics to bully expectant mothers around.

Kinsey

 

[obnurse]

Kinsey, Thank you for insinuating that I am scaring and bullying mama's around! I do believe that I stated reasons why I chose to have these procedures done, not that eveyone else should too!
True that GBS infection is not a huge number. Partially these now low, low numbers are due to treatment. The numbers used to be higher. However, I bet if you were a mama that had been through this tragedy, the 'small' number of infections would not be reassuing. I was merely presenting the 'other' side of the coin!