IV antibiotics during labour - preventing thrush

[Spiritedwolf]

Hello ladies,

I'm 39+2 weeks pregnant. I am likely to get IV antibiotics during labour (as long as we get to hospital in time!) because of a Group B Strep UTI earlier in pregnancy.

When I was given antibiotics for the UTI, I ended up with truely awful vaginal thrush that was really uncomfortable and didn't begin to lessen until a couple of days after my third pessary.

I'm guessing that having antibiotics during labour is likely to result in vaginal thrush again. Is this also likely to cause thrush in my breasts and orally for baby? If so, are there preventative measures I can take?

If not, what symptoms do I need to look out for and what treatments are available?

I really want to give breastfeeding every chance of success and it sounds like thrush would be rather unpleasent for me and baby.

(Apologies if I am completely mistaken in linking vaginal thrush and antibiotics with oral thrush in babies, just assuming because it shares the same name...)

Erm, at the risk of being very, very controversial, prophylactic anti-biotics aren't recommended for GBS+ mothers (as per Cochrane Review) unless there is additional risk factors - e.g. fever in labour, previous GBS infected babies, prolonged rupture of membranes, premature birth, etc - so just because you have been previously colonised with Group B Streptococcus bacteria doesn't mean you need anti-biotics during labour (as you have had the anti-biotics and the infection went are you even still a carrier?)

You can pay privately to have a very accurate test done at 36w to see if you are colonised before making a decision either way as you may be GBS- now.

I am pretty sure the thrush I got on my nipples by day 6 was due to the IV antibiotics I had in labour.

Don't think you can prevent it, I'm afraid, but if it does happen, the symptoms I had were red shiny and slightly itchy nipples, and a sensation like my nipples were being stabbed with tiny needles (between feeds, not just when feeding). I managed to be seen the day I after I developed symptoms and was given daktarin cream to apply. DS didn't show any symptoms, but was given nystatin drops and canesten cream for his bottom prophylactically, and didn't develop any signs.

Have a look at some of the other threads here about thrush, might give you some other perspectives.

Fingers crossed you don't need the IV ABs, and if you do, you don't get thrush after

you can drink pro-biotic yoghurts in vain hope :o I have just had a course of antibiotics for an ear infection, whilst bfing 5 week old, and drank a yoghurt or two a day - no signs of thrush so far...

IS it really true that antibios aren't recommended for GBS + women now??! Eek. I had GBS both times, had the IBs with dd, but labour was too quick with DS for it to be possible. He was fine.

OP, I didn't have thrush after getting the ABs with DD, so it's definitely not a given.... :)

I didn't get thrush either and neither did DS :)

narmada - according to Cochrane Review (the meta analysis bods that often inform NICE guidelines) giving anti-biotics when the mother is just colonised with GBS isn't the best option. Giving anti-biotics when the mother is colonised AND has risk factors such as prelonged rupture of membranes (i.e. waters going but no labour starting/long labour) is the best option.

I refused the anti-biotics when I tested GBS+ with DD3 as I was worried about the risk of maternal death from the anti-biotics (not for my sake but for my existing two children, I figured they'd rather me than a newborn sibling) which seemed to be greater than the baby's risk of death from not having anti-biotics.

It may well have been a good thing I did as I had an allergic reaction to IV anti-biotics not that long ago which meant I had to be sedated until it was over as I couldn't have any anti-histamines.

I do realise that others will make different choices though

ooh thanks for that truthsweet, should I ever have any more babies (not that I will....) I won't feel obliged to have the ABs. Cochrane review is the gold standard, isn't it?

Pretty much it's the world standard for childbirth related stuff!

I wouldn't refuse anti-biotics for risk factors or for an ill baby btw, I just wouldn't have them as a 'just in case' measure. Funnily enough I wasn't even offered them when in labour with DD3 any way and we were under observation after she was born either (even though we were a HB transfer due to mec. in waters!). I had a bit of a fight with the CMW about it but I think they realised I wasn't a complete nut when I started quoting Cochrane Review guidance at them

sorry 'we weren't under observation'