What is Group B Strep?
What we know:
Group B streptococcus (GBS) is one of the many bacteria that normally live in our bodies and which usually causes no harm and has no symptoms. GBS is found in the rectum or vagina in 20-40% of women, but most will not know that they have it. Very occasionally it can cause serious infection in newborn babies if they are exposed to it during labour.
It is not routinely tested for by the NHS, however may be detected during a vaginal swab or a urine test.
Who is at risk?
GBS infection is more likely if:
Your baby is born before 37 weeks
You have previously had a baby affected by a GBS infection
You show signs of infection in labour, such as a high temperature
You had a positive GBS swab or urine test during your pregnancy
Your waters have broken more than 24 hours before labour
What does GBS mean for my baby?
Around 1 in every 1,750 newborn babies in the UK and Ireland is diagnosed with early-onset GBS infection, according to the Royal College of Obstetricians and Gynaecologists (RCOG). GBS most commonly causes sepsis, pneumonia and meningitis. Obviously, these are very serious infections but most babies recover fully with the right treatment. However, 5.2% will die and 7.4% will be left with disabilities such as hearing or vision loss.
I’ve tested positive for GBS, what next?
If you have tested positive for GBS, you will be recommended to have antibiotics during labour, which are given through a drip to reduce the risk of the infection passing to your baby. Tell your midwife as soon as your waters break or you go into labour. You should still be able to move around during labour even if you require the antibiotics and can still have a water birth.
If you tested positive for GBS from a urine sample during your pregnancy, you may have a urinary tract infection and your medical team will advice if you require a course of antibiotics to treat.
The antibiotics given are usually penicillin so it is important to tell your midwife if you are allergic or have had a reaction to any antibiotics before, so they can give you the safest option.
Is GBS screened for during pregnancy?
Routine screening to test all pregnant women for GBS is not currently offered in the NHS as GBS is an infection that comes and goes. Therefore, if you tested negative on a swab at 34 weeks, you may be falsely reassured by this and actually have the infection by the time you go into labour. Conversely, you may test positive on a swab at 34 weeks and the infection may have cleared by the time you go into labour, yet you would have been recommended to have antibiotics during labour.
Although it is not offered on the NHS routinely, if you are concerned and want to have a test, it is possible to order a home testing kit online. Make sure you choose a supplier which uses the ‘gold standard’ Enriched Culture Medium (or ECM) test for group B Strep. If this shows a positive result then you should inform your midwife who will give you advice.
How will my baby be monitored?
If your baby is born at full term and you received IV antibiotics at least four hours before giving birth, they will not need special monitoring for GBS after birth, however will routinely check your baby for any signs of distress. If you did not get IV antibiotics at least four hours before giving birth, it is usually advised that your baby is monitored closely for signs of infection for at least 12 hours after birth. Midwives will check their general wellbeing plus their heart rate, temperature breathing and feeding.
What about when we take our baby home?
Most babies who develop a GBS infection will become unwell in the first week after their birth. This is called early-onset GBS infection and signs to look out for are:
Baby is very sleepy or unresponsive
Baby is unusually floppy
Inconsolable crying
Not feeding well
A high or low temperature, hot or cold to touch
Grunting or noisy breathing, struggling to breathe
Changes in skin colour
Abnormally fast or slow heart rate.
Low blood pressure and blood sugar (tested at hospital)
Late on-set GBS infection can affect babies up to three months after their birth but this is less common. The signs are similar to those of early-onset but may also include symptoms associated with meningitis such as turning away from bright light or a bulging fontanelle (the soft spot on babies’ heads). Having intravenous antibiotics during labour does not prevent late-onset GBS infection.
Call 999 or go to A&E if you see any of these symptoms.
Can I breastfeed my baby?
The benefits of breastfeeding greatly outweigh any risks of transmitting group B strep through breastmilk. Maintain good hygiene standards by keeping your hands and nipples clean. The intravenous antibiotics to protect newborn babies are also safe for breastfeeding mothers.
Final thoughts:
Many cases of GBS cause no harm but sometimes babies can become seriously unwell.
Early detection of a GBS infection with your baby is crucial as a delay could be very serious, so if you notice any of the signs above after your baby is born you should contact your healthcare professional immediately.
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