T.V. writes:
question on this. I'm step +. With my last baby, I was told by the
> midwives that the procedure is to give introvenous antibiotics during
labor.
> SO, I did. IF you were to not have antibiotics and instead monitor baby's
> temp after birth, and the baby does develop a fever (strep b infection)
> aren't things really dangerous? IN other words, for my next baby, would I
be
> taking a huge risk if I were to turn down the antibiotics during labor or
is
> the baby completely safe as long as the infection is caught immediately?

I'd say "No". I've seen babies at good facilities and of good, careful
parents, die or have serious morbidity because of GBS. I tell my new parents
that "little babies can be very sick, without showing very obvious signs"
when talking about newborn illness.

The AAP Red Book says; "Without maternal prophylaxis, early onset disease
... occurs in approximately 1 infant per 100 to 200 colonized women. Case
fatality ratios range from 5% to 8% but are higher in preterm neonates."
Late onset disease occurs from 7 days to 3 months [average 3-4 weeks].
"Transmission from mother to infant occurs shortly before or during
delivery. After delivery, person-to-person transmission can occur."

It can be tough for people to see the need for maternal GBS prophylaxis [or
car seats or gun safety], if they've never seen the outcome it's trying to
prevent. Or in the case of not breastfeeding [to tie this all in], they see
the outcome as "the norm".

Gail Hertz, MD, IBCLC

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