Your Group B Strep Questions — Answered!

July is Group B Strep Awareness Month.

I wrote last week about Group B Strep and GBS Awareness Month. Please read (and share) that post if you haven’t already.

I promised to answer YOUR questions about Group B Strep during July, right here on the blog. I was thrilled to get some great questions almost immediately, but I know there are more out there. Please let me know if you have questions — tweet me, FB me, email me. You ask, I’ll answer!

I was strep b positive with Cora, what does that mean for future babies? (you can answer in a post if you’d like) — Kristine (@KristineBrite) July 1, 2012

Because you were GBS+ does not mean that you will be GBS+ with any future pregnancy. Your status changes over time, as the bacteria “colonizes.” You will be tested between 35-37 weeks in your next pregnancy and antibiotic protocol will be followed according to that test.

CDC protocoldoes state that if you have a baby who contracts GBS, you should be treated in any subsequent pregnancy. GBSI advocates you and all pregnant women be screened for GBS bacteriuria (GBS in urine) in early pregnancy and treated if positive.

I’d like to know if its possible to pass gbs to the babe with a c-sec. I honestly thought it was only passed through the birth canal — Nicci (@Sticky41284) July 1, 2012

Yes. It is possible, but not as likely, to pass GBS to the baby with a c-section. In these cases, the womb becomes infected by one means or another. Bacteria could be introduced to the womb by internal exams, excessive monitoring or from what I call, random, natural means. It can happen and it does happen, but it’s rare, especially when the c-section is started before your water breaks or labor begins.

If you know you’re GBS+ and your doctor tells you that since you’re having a c-section you won’t need antibiotics, you CAN request them. Talk to your doctor about the risks v. benefits of having antibiotics before your incision is made.

Why don’t they test once you go in labor? Isn’t that the only way to be truly accurate? (and thank you, mama) — Sara (@SaraJOY) July 1, 2012

There are highly effective point of care or bedside rapid (less than 1 hour) tests available in a small number of hospitals. Yes, testing RIGHT THEN is obviously a way to get an updated, accurate reading. But unfortunately hospitals haven’t grabbed on to the rapid tests like we, the GBS community, wish they would.

The CDC and ACOG states that if a woman has not had the GBS test results given to her and a rapid test isn’t available, antibiotics will be administered based on the following risk situations:

    • baby born before 37 weeks
    • water broken for 18+ hours (12+ increases the risk)
    • you have a fever higher than 100.4°

@revsmf why don’t they automatically test all babies for group b strep postbirth? My daughter died at 2 days old, likely due this! — Sarah (@revsmf) July 1, 2012

I asked Dr. James McGregor, our best friend in the GBS fight, about this question. He said that, unfortunately, nobody has studied this. The community is interested in invasive disease and it just hasn’t gotten there yet. He hopes that one day this will be studied. One avenue of research for early onset (pre-signs and symptoms) include GBS antigen or infection biomarkers in the newborn’s urine or blood

This leads me to mention that the GBS bacteria moves quickly. If you feel like something is “off” in your baby, ask about it. Get him or her checked out. Know the symptoms (which are symptoms of other things as well).

Remember, your gut is rarely wrong.

Knowledge is power and your doctor is there to help you.

Do you still have questions? Ask and I shall answer!

Tweet me, ask on FB, ask in the comments, email me at janasthinkingplace@me.com!

 

July is Group B Strep Awareness Month

I struggle with being extremely vocal about Group B Strep awareness. I would love to scream, “DANGER DANGER” from the rooftops, but for me personally, I don’t like to frighten people.

I struggle with knowing when to step in and say, “You really should head to the doctor since your baby has x, y and z symptoms because those are signs of GBS.” I’ve done it a few times on Facebook and Twitter and in real life, but the bottom line is, I don’t want to say anything because I don’t want people to think their baby is going to die just because mine did.

I struggle with being able to spout statistics, because statistics are bullshit. Yeah, the chances of a baby contracting early onset GBS are slim. It’s even more slim to contract late onset GBS. And it’s downright rare for a baby to die from late onset GBS. But when YOU are the statistic – the rare one – it’s often hard to tell someone of your experience without causing sheer panic.

I don’t struggle with talking about grief. But I do struggle with talking about Group B Strep.

July is Group B Strep Awareness Month.

So I’m here to talk about it.

For those who don’t know and who may stumble across this page, let me first tell you about Group B Strep.

What is Group B Strep (GBS)?

Group B strep (GBS) is a type of bacteria that is naturally found in the digestive tract and birth canal in up to 1 in 4 pregnant women who “carry” or are “colonized” with GBS. Since levels of GBS can change, each pregnancy can be different. Carrying GBS does not mean that you are unclean. Anyone can carry GBS. (Quoted with permission from Group B Strep International)

When will they test me for Group B Strep and what does that even mean?

CDC’s guidelines recommend that a pregnant woman be tested for Group B Strep when she is 35 to 37 weeks pregnant. The test is super simple. It’s simply a swab of the vaginal area and rectum. Results are typically back at your next appointment. At that time you’ll be told whether you’re positive or negative.

A pregnant woman who tests positive for GBS and gets antibiotics during labor has only a 1 in 4,000 chance of delivering a baby with group B strep disease, compared to a 1 in 200 chance if she does not get antibiotics during labor.

Any pregnant woman who had a baby with GBS disease in the past, or who has had a bladder (urinary tract) infection during this pregnancy caused by GBS should receive antibiotics during labor.

What’s the difference between prenatal onset, early onset and late onset Group B Strep?

Prenatal onset of Group B Strep happens before your baby is born.

Early onset relates to cases from birth to 7 days old.

Late onset typically relates to cases from 7 days old to 3 months (or later in some cases, but that’s the typical timeline for GBS to infect a baby).

 What do I look for?

Symptoms of Prenatal Onset Group B Strep:

    • decreased fetal movement or no movement after 20 weeks
    • unexplained fever in mother — signals infection

Once born:

    • High-pitched cry, shrill moaning, whimpering
    • Marked irritability, inconsolable crying
    • Constant grunting as if constipated
    • Projectile vomiting
    • Feeds poorly or refuses to eat, not waking for feedings
    • Sleeping too much, difficulty being aroused
    • High or low or unstable temperature; hands and feet may still feel cold even with a fever
    • Blotchy, red, or tender skin
    • Blue, gray, or pale skin due to lack of oxygen
    • Fast, slow, or difficult breathing
    • Body stiffening, uncontrollable jerking
    • Listless, floppy, or not moving an arm or leg
    • Tense or bulgy spot on top of head
    • Blank stare
    • Infection at base of umbilical cord or in puncture on head from internal fetal monitor

What is the outlook for a baby who contracts GBS?

Babies can be infected by GBS before birth and up to about 6 months of age due to their underdeveloped immune systems. Only a few babies who are exposed to GBS become infected, but GBS can cause babies to be miscarried, stillborn, or become very sick and sometimes even die after birth.

GBS most commonly causes infection in the blood (sepsis), the fluid and lining of the brain (meningitis), and lungs (pneumonia). Some GBS survivors have permanent handicaps such as blindness, deafness, mental challenges, and/or cerebral palsy.

(Quoted with permission from Group B Strep International)

Now we’re all caught up on what Group B Strep is. So here’s where I’m honest with you.

I don’t believe in scaring people. I believe in educating people and arming them with the information that will allow them to make informed decisions.

Unfortunately, I can’t make decisions for everyone. If that were the case, nobody would ever have their membranes stripped, internal exams after finding out they were GBS+, scalp electrodes during labor, long labors without c-sections, or choose to not have antibiotics during labor with a positive GBS status.

In short, I would put everybody in a GBS-proof bubble.

As long as there is life on Earth, there will be baby loss. There will be mothers dying during labor, babies taking one breath, babies spending weeks and months in the ICU because of life-threatening conditions. As much as we want to eradicate it, it’s a fact of life.

I’m armed with more information about GBS than most doctors, but that doesn’t mean that you shouldn’t talk to your doctor about Group B Strep. Because the incidence rate is smaller and smaller, a lot of doctors do the test at 35-37 weeks and just throw out the positive or negative results without much of an explanation. Make them explain it to you. Talk to them. Understand it.

Use your mommy and daddy instincts and USE YOUR PEDIATRICIAN. That’s why they went to high-dollar schools for a bazillion years. To help you when you need them.

The baby does something you don’t like or understand? Call them. Go in.

BE THAT MOM!

I can’t underscore this enough. YOU know your baby better than anyone and have to follow your instinct. If it says, “call the doctor,” then by God, call the doctor.

Your gut is rarely wrong.

Anyway, in honor of Group B Strep Awareness Month, I want to answer your questions.

Leave a comment (or Tweet it to me or ask me on Facebook) with any question about GBS you may have. If you don’t want to do it publicly, email me at janasthinkingplace@me.com.

I’ll post a few times this month with answers to them. And together, we will make the world AWARE OF GROUP B STREP!

The Knot.

**kleenex warning**

Conversations are swirling in my head, making about as much sense as they did during those 3 long days 9 years ago. A lot of words were said. Hope was tossed around. Hope was taken right back, like that “gimme five,up high, down low, too slow” game.

The thoughts in my head, they’re getting knotted up and confusing.

The knot formed by all the swirling thoughts gets tighter in my stomach as I’m remembering.

Remembering.

That’s a funny thing. I want so desperately to remember. But I want so desperately to forget.

The things I want to remember are the simple, tangible, normal moments.

The moments where we walked the track in Byron at Relay for Life, with me wearing a baby and only letting people touch his little toes. The moments where Jason grabbed the camera and snapped pictures of us while I blushed because I hate having my picture taken.

I want to remember bringing him home from the hospital on Memorial Day after he had to stay because he was jaundiced. I want to remember my friends coming to visit and oohing and aahing over him.

The moments I want to remember are the ones that are slipping away. The sounds of him sleeping, the smell of his fresh-bathed skin, the feel of his fuzzy hair. I long for those details to stay with me. But they are the ones that are slowly drifting away.

I want to forget the words that were said in the hospital, sentences that will forever be engraved in my memory. They’re the memories that tie my stomach into a double knot and force my heart into my throat because I start thinking of the enormity of it all.

I want to forget the memory of sitting with the funeral director choosing a tiny casket on the day he was supposed to be born. That day also happened to be Father’s Day.

I want to forget the sight of my strong and brave husband standing at the pulpit of the church giving a eulogy for his first-born son. I never want to forget what he said, though.

Really, I don’t want to forget those moments so much as I want for it to never have happened.

I want to trade the knot in my stomach that holds all my pain for just a little more time with my Charlie.

But I can’t.

It wasn’t and isn’t in my cards. 

Image via Flickr, Creative Commons

Surprised By The Anger

Yesterday started with the alarm on my iPhone going off. I hit snooze, rolled over and snuggled up with Henry. Jason’s out of town so he stays in my bed when we’re home alone. I figure I can save him faster if something happens.

The morning routine went really well, especially considering lately it’s been a yell-fest in the mornings. It was a morning full of “yes ma’ams” and “okays.”

Maybe the promise of field day and birthday cake helped. I don’t know!

Charlie’s birthday cake was pulled out. The candle was lit. We sang “Happy Birthday” in our off-key morning voices and cut two big pieces of cake for breakfast.

We celebrated a 9 year old who will forever be 24 days old. Our son, Henry’s brother. Our Charlie.

And it was everything we hoped it would be!

I shuffled the kiddo off to school and sat down, taking time with my Starbucks chai and taking in all the love pouring in from FB, twitter and the comments on yesterday’s post.

You know how I’ve talked a lot about grief being like a rock in your shoe? Well, that rock in your shoe can come in any of the stages of grief. Today I was saddled with Anger.

It crept in slowly, invading my thoughts more and more each minute.

I’m angry.

Mr. Angry

I’m angry because it’s just completely unfair that ANY parent should have to live the rest of their lives without their children.

I’m angry because WHY was my family the one in a bazillion whose child will die from late onset Group B Strep?

I’m angry that I didn’t have the foresight or someone to tell me that I needed to take pictures of us as a family in those last hours.

I’m angry because as much as I’ve tried to rid myself of any guilt over “possibly” being the cause of his death, it sneaks in and makes me doubt myself. I don’t like feeling guilty for something that can never be known. Yet I do.

I’m angry because I have friends who, because of Charlie, are scared that THEIR child is going to die. While he’s helped so many, he’s also made people realize their children aren’t promised for a lifetime either.

I’m angry because I have to wait (hopefully) a long time to see him again.

I’m angry that Henry will never know him.

I’m angry that he’ll never go to prom, get married, have a job, have children, HAVE FUN.

I’m angry because I want new friends to know him.

I’m angry because I don’t want a guardian angel with a name. I WANT MY BABY BACK.

I’m mostly angry that I’m angry.

Nine years later, I’m still angry. How will I feel in 50 more years? Will it still cut me to the core like it did yesterday?

Most days I feel like I’m okay. I mean, I AM okay.

But yesterday? I was angry and it caught me off guard.

Today?

Today is a new day. One that will bring a much-needed shower, healthier food, my husband back from backpacking and answers to a question that’s been looming for a few months. And the best part is, I woke up not feeling angry.

I’m sure it’ll be a good day.

 

Nine. 9. IX. Nueve.

9 years.

3288 days.

78,912 hours

284,083,200 seconds.

That’s how long it’s been since you entered this world.

After hours and hours of labor, you came screeching into our lives.

Pink and skinny. A few weeks early.

Hungry and squirmy. Glad to have room to move.

The light of our lives. The answer to our prayers.

Our hopes and dreams were handed to us in a pink and blue striped blanket, swaddled as tight as a burrito.

At 9:19pm on May 21, 2003, we became a family of three.

Complete. Whole.

Blissful.


Happy Birthday, Charlie!

May Heaven be extra sparkly and the source of endless chocolate cake today.

Don’t forget to share with your friends! 

We’ll be celebrating with chocolate cake and pizza and wishing you were here to enjoy it.

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