To Your Health

I have tested positive for Group B Strep and I am pregnant, what should I do?

Q. I am pregnant, a little more than eight months along, and I have tested positive for Group B Strep. My OB/GYN insists on an IV antibiotic drip during delivery, but I really don't do well with antibiotics. Is there any other option?

A. The use of IV antibiotics during delivery has left pediatricians in a quandary. An infant infected with Group B Streptococcus runs a risk of developing potentially fatal meningitis. Since about 25% or more of pregnant women test positive for GBS, intravenous antibiotics during delivery are recommended for a great number of women each day. This practice could be easily defended if the results of using IV antibiotics during delivery were all good. Unfortunately, this is not the case.

In August of 2000, an article was published in the medical journal Pediatrics (volume 106, pp.244-250) reporting on a study of almost 278,000 women, some of whom received IV antibiotics during delivery and some of whom did not. The authors concluded, after careful analysis of their data, that the use of IV antibiotics during delivery had no effect on the incidence of GBS infection in the first week of life, but the study did find that all the infants exposed to antibiotics became ill within 24 hours of delivery.

Whether IV antibiotics were used or not, almost all the babies who did develop GBS infection exhibited clear signs and symptoms of infection in the first day of life. The authors found that, for the most part, IV antibiotics during delivery did not protect against GBS infection, and that early detection of infection through careful observation of the several well-known indicators of infection was the superior approach.

Naturally an expectant mother who tests positive for GBS feels like she should do something to protect her newborn. Some mothers elect to have the IV antibiotic during delivery because their OB/GYN finds it necessary to follow the recommendations of the Centers for Disease Control and Prevention and the American Academy of Pediatrics to maintain their hospital privileges. If you and your pediatrician decide to use IV antibiotics during delivery, as soon as your baby begins to nurse you should introduce the "friendly" bacteria that have been killed by the antibiotic. These friendly bacteria, called bifidus, are available in liquid or powder form and are slightly different than the friendly bacteria present in adults, called acidophilus. You can sprinkle the bifidus on your nipple before you nurse, and the baby will take it in.

It would be great if a specific nutrient were available that would take care of GBS infection, as does an antibiotic, but our immune system is much more complex than that. As an expectant mother, no doubt you are eating well and taking your prenatal vitamins. The closest thing to a "magic bullet" among the nutrients may be docosahexaenoic acid, the most critically important fatty acid for babies. DHA is certainly needed for brain development, but also plays an important role in the immune function. You should be emphasizing DHA in your diet now, and after delivery, but giving your baby the whole team of needed nutrients will go a long way toward protecting him or her from all the challenges of life.

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