Pat writes:
> If a mother has antibiotics for 4 hours before the birth of her baby, does
> the abx cross the placenta?  Will a baby be more likely to develop thrush
> because of this pre-birth treatment of her mother?

Yes, I believe it does cross the placenta, that's why we use the 4 hours as
a guideline for abx in GBS+ moms.
Risk factors for early onset neonatal group B streptococcal infection
include:
Intrapartum maternal fever of  > or = to 38 degrees [100.4 F]
Rupture of membranes > or = to 18 hours
Mother with a previous infant with GBS infection
Preterm labor [< 37 weeks]
Maternal GBS bacteriuria

In my experience, [no study in hand] babies of treated moms don't have a
higher occurrence of thrush.
Even if they did, I'd MUCH rather treat thrush than GBS sepsis.

My textbook gives the attack rate of  7.6 per 1000 and mortality rate of 33%
for GBS infected infants who are less than 2500 grams, had ruptured
membranes greater than 18 hours and maternal temperature greater than 37.5
degrees.
For infants without the above risk factors the attack rate is 0.6 per 1000
and the mortality rate is "only" 6%.
These babies can get very sick, very quick.

Gail Hertz, MD, IBCLC

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html