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Hi there, my sister's first child is due in two weeks. Her doctor's appointment today revealed she has Strep B and will therefore need to take antiobiotics via IV during childbirth so as not to transfer the bacteria to her baby.

I know this isn't a very Paleo question, but I'm wondering about the safety of taking antiobiotics right before you intend on breastfeeding. Is this is a routine practice? Are there any safer alternatives?

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She can get some excellent probiotics and start taking them now throughout the post partum period. Intake of D, A, zinc should be carefully assessed. Eliminating all sugar, the worst plant toxins (grains, legumes etc), and vegetable oil may help her system so that she is able to keep yeast in check while her flora repopulates. A fecal transplant, while seemingly extreme, is at least something worth reading about • lucastafur.com/2011/11/fecal-bacteriotherapy.html • en.wikipedia.org/wiki/Fecal_bacteriotherapy • – Katherine Nov 23 2011 at 20:25
Read whole article at the link though • perfecthealthdiet.com/?p=269 • "Fecal transplants can be done without a doctor’s help: someone else’s stool can be swallowed or inserted in the rectum. If taking feces orally, swallow a great deal of water afterward to help wash the bacteria through the stomach and its acid barrier. Dogs and young children sometimes swallow feces. It is unpleasant to consider, but desperate diseases call for desperate measures. Perhaps one day, healthy stools will be available in pleasant-tasting capsules, and sold on supermarket shelves. Not yet." – Katherine Nov 23 2011 at 20:27
Note: the above is not to be construed as medical advice, nor a recommendation, just offering the information for further investigation. Additionally, I answered under Anastasia's reply below. – Katherine Nov 23 2011 at 20:28

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Hi Renee. Strep B is of the commonest causes of sepsis and meningitis in newborn babies with a mortality rate of around 20%, even higher in hospitals without specialised neonatal care units. I have seen much devastation caused by it. This is one those scenarios where the benefits of antibiotics greately outweigh any possible risks. Please please please have your sister take the antibiotics.

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 I agree. While there are valid alternatives, they aren't generally available or widely accepted. A couple years ago, I came across a study regarding high dose penicillin injection at 39 weeks as one option. Some friends at Emory (school of public health and CDC) are working on various intravaginal applications of...uh dilute chlorine washes and chlorhexidine. Some of it may already by published. So yes, there are options but one would have to be extremely committed to them to get a hcp on board. – Katherine Nov 23 2011 at 20:18
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 The unfortunate thing I see is that about 50% of moms who need IV abx in labor end up with thrush which is generally very very difficult to treat. Increasingly, it's resistant to nystatin and diflucan and even gentian violet. Still, given the choice, I'd definitely do an appropriate evidence based therapy to treat the the GBS...no doubt about it. Anecdotally, I have yet to have a mom with a great diet (grain, sugar, veg oil free), with sufficient D and A intake who has GBS colonization. Who knows... – Katherine Nov 23 2011 at 20:20
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 I'm a big fan of the chlorhexidine washes, and did that when I had a homebirth. I'm glad to hear people are studying it because it shows a lot of promise in addressing the limitations and side effects of antibiotics (for example, needing two doses at least for hours apart to be considered adequate protection - many women aren't in labor that long!). (Personally, had antibiotics during two labors with no problems with thrush, but it's definitely is a risk.) – jess6 Nov 23 2011 at 20:50
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 What do you disagree with? I said I'd do an 'evidence based therapy" - the chlorhexidine option is a good one. But it's hard to argue that it could be very frustrating to get a mainstream hcp on board with it. – Katherine Nov 23 2011 at 21:49
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 One benefit of chlorhexidine washes is that it is available over the counter. You can just do it, regardless of whether HCP is on-board or not. The hospital cannot force antibiotics if you refuse. They can keep the baby longer for observation however, and I'd personally be hesitant about refusing an OB's recommendations for fear of retaliation unless I had good reason to trust their integrity. This is a good reason to choose a HCP who is respectful of your right to make your own choices, if not in total agreement. – jess6 Nov 24 2011 at 0:14
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I planned a home birth for my first son and tested positive for group B Strep. My midwife gave me a strict regime to follow and it got rid of it. She tested me again before the birth and it was gone and she said it has worked on 100% of her clients. If she chooses to use this regime make sure she is tested once again before birth, because as others have stated the use of antibiotics has saved lives in many cases and you don't want to put the baby at risk.

Daily:

  1. Mega Foods Mega Floral Optimal Potency Probiotics Formula 20 Billion Cells per capsule.

  2. 400 mg Echinacea with breakfast

  3. 5,000 mg vitamin c (crystal form disolved in 1/2 gallon of water and consumed throughout the day)

4.200 mg grapefruit seed extract (disolved into water with the vitamin c)

5.Reduce consumption of refined sugar, increase fresh raw foods.

Vaginal treatment: 1. Three days: Tea tree oil for 4 hours. this is a mixture of 2% teatree oil and 98% virgin olive oil on a cotton ball inserted into the vagina.

  1. Next 2 days: "re-seed" one capsule of probiotic dissolved in 1 tsp plain organic yogurt inserted with a medicine syringe before bed

  2. Next 2 days: insert one clove of pealed organic garlic before bed remove in the morning.

Repeat steps 1 and 2 for the next few days.`

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How long did you have to follow this protocol to get rid of it? – Gazelle Nov 23 2011 at 22:07
I only had 2 weeks and was able to clear the infection, but it could take up to a month. She retested me after 2 weeks and I was negative. I think the vitamin C really helped with my recovery as well. I ended up having a c-section after 50 hours of labor and failure to progress. The doctors were amazed how quickly I healed and they let me out of the hospital early. – monaLisa Nov 23 2011 at 23:46
Thanks for the response. Glad to hear you healed so quickly. – Gazelle Nov 24 2011 at 10:37
Excellent protocol. Thx for sharing this. Yes, vitamin c is responsible for your quick healing. My wife has same experience with 10g per day vitamin C - doctor was amazed by how quickly she healed. – majkinetor Nov 24 2011 at 14:42
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Well we just had a Paleo baby and my wife did all the research on everything and our (her) conclusion was that we were going to turn down all medical interventions EXCEPT antibiotic if she had strep b. Luckily she didn't have it, do we did it sans modern medicine; however, we were ready for that in the case of strep because it's so serious.

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Unfortunately, if you opt for a hospital birth, this is standard hospital protocol in the States.

There are alternatives, but your sister would have to be willing and she'd have to request a re-test closer to her due date if she chooses to give birth in the hospital.

Here's a helpful blog post with an alternative treatment & links to studies: http://www.drmomma.org/2009/09/chlorhexidine-hibiclens-protocol-for.html

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And yes, it's not a brilliant practice for establishing healthy gut flora in the baby. But then most standard hospital protocols are not supportive in this way. – Dragonfly Nov 23 2011 at 19:41
And here's a link to MDA's blog post on the general topic of antibiotics: marksdailyapple.com/… – Dragonfly Nov 23 2011 at 20:21
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I'm training in obs & gynae so perhaps I'm biased but for crying out loud guys, are people really suggesting eating other people's sh*t as a valid alternative?!

Group B strep is serious. Tell your sister to take the damn antibiotics!

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Goddamn idiots downvoting this. Go drown in each others feces. I draw the line at retarded advice when it compromises a baby's life. But maybe if you don't take antibiotics, have your own child die, you'll remove yourself from the gene pool and hopefully end up in jail. – conciliator Nov 23 2011 at 23:30
OK, maybe my answer was strongly phrased, but I stand by it. I doubt very much that many of the people on paleohacks are in a position of taking significant responsibility for other peoples lives. If anyone wants to train along side me to make life or death decisions for expectant mothers and their babies on a daily basis and STILL suggest "fecal transplanting" as a treatment for GBS, let me know. The big difference between an obstetrician and a nutritionist/holistic guru/whatever is we DO take full (legal) responsibility for people. That kind of clarifies the mind a little. – Tom Nov 24 2011 at 14:08
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If you can find out what the specific abx is, you can look it up on the Kellymom site: http://www.kellymom.com/health/meds/aap-approved-meds.html#Antibiotics

So, anyway, to answer the other half of your question: breastfeed. The benefits of breastfeeding (and establishing breastfeeding immediately) outweigh the breastfeeding-with-abx issue.

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