Bacteria at Birth
If you have had a pregnancy and live in Canada you have probably heard about Group B Streptococcus (GBS). GBS is a naturally occurring bacteria found in the gastrointestinal tract in both men and women, and the vagina in women.
In Canada, women are screened between 35 and 37 weeks gestation to determine if they have the bacteria in their body. The screening typically consists of swabbing both the rectum and vagina, and if the bacteria is found the woman is considered to be GBS positive.
A review published in the British Medical Journal earlier this year has concluded that, based on current evidence, routine screening for GBS colonization in late pregnancy should not be introduced in the UK, as the potential harms of unnecessary treatment with antibiotics may outweigh the benefits.
The study’s authors explain in the background to their review: “The media and politicians regularly call for universal antenatal screening for GBS as an alternative means of selecting women for prophylaxis. Advocates point to countries across Europe and North America where screening is recommended and where reductions in early onset GBS infection have been observed. But the evidence shows that the effectiveness of screening, using established screening criteria, is uncertain and that screening has potential harms. Here, we explain why the UK National Screening Committee decided not to introduce routine screening in the UK — namely, high levels of overtreatment, unknown potential hazards from screening and intrapartum antibiotic prophylaxis treatment, and uncertain benefit.”
There are many reasons a woman may choose to have the screening and subsequent antibiotics. Approximately 10 to 35 percent of all pregnant women are colonized with GBS and will test positive. And 1 to 2 percent of babies will develop early onset GBS disease. The risk of death associated with GBS positive babies is 4 to 6 percent.
But women have a choice. There are reasons to consider declining the screening and/ or antibiotics. As discussed in the study referenced above, the chance of a baby getting GBS is very small, whereas overtreatment is high. The study shows that “in 2014-15, under risk-based prevention, 138,933 term pregnant women were colonized with GBS, but only 350 term neonates developed early onset infection, meaning screening would have led to overtreatment of 138,583 (99.75 percent) women in labour.”
Oral probiotic use is known to stop the growth of GBS bacteria. Probiotics are the good bacteria and are safe in pregnancy. Dr. Sara Wickham wrote in her book Group B Strep published earlier this year, “Recent research shows that not only are bacteria beneficial, but they need to be passed on to the baby during birth via its mother’s vagina and have an important part to play in future health, especially relating to the gut and digestion, but in many other areas of wellbeing as well.”
Working with a registered nutrition consultant practitioner or naturopath who specializes in women’s health can help with dietary changes and supplements to support your and your baby’s microbiome.
It’s also important to note that yeast infections and thrush are common after using antibiotics, in both mother and baby, which can present as a barrier to establishing breastfeeding and may need treatment to offer relief for mom and/or baby.
New research highlights the need for practitioners to be aware of the alternatives to antibiotic usage, sharing all options for mother’s to make an informed decision. Moms who know they have options are empowered mothers.
This article originally appeared in the Fall 2019 issue of The Holistic Parent.