GBS: Group Beta Strep (Streptococcus)

Group B Strep or Group Beta Streptococcus (GBS)  is a harmless bacteria that can colonize in the vagina as well as the gastrointenstinal and respiratory tracts. Approximately, 25% of pregnant women have GBS in the vagina or rectum.  GBS can become hazardous if it colonizes in the urinary tract and causes a urinary tract infection or if it colonizes on the skin of a newborn. This is why all women are screened at 35-37 weeks for the presence of GBS in their vagina and rectum. If a woman is positive for GBS, she will be given antibiotics through an IV during labor to prevent the bacteria from being able to colonize on the newborn's skin.
Screening
All pregnant women are screened at 35–37 weeks of gestation unless preterm labor is suspected. Women are screened by obtaining a single swab (cotton tip) specimen from the lower vagina and rectum. 
Treatment
If a woman's culture comes back positive for GBS, she will be treated propholactically in labor with IV antibootics to prevent the bacterial from colonizing on her newborn's skin. Common antibotics useed are penicillin and ampicillin. Clindamyicin may be used if a patient is allergic to penicillin. Be sure to notify your provider of all medicataion allergies. If  a cesearean is planned, she will not need antibotics for GBS.

Mental Health, Gun Control and Homeland Defense

Maybe I'm a dreamer, but I wish mental health care were as easy to get as, say, a gun. - Andy Borowitz

While I've used this blog mainly for the purpose of giving out information to my patients and to comment on the state of maternity care in the US or talk about child birthing and midwifery, I break now to talk about one thing political that I feel is utterly important. Yes, gun control is an issue here and is a serious issue in relation to what happened today, but so is the lack of mental health services in America.

Today, I need to say something about the state of mental health in our country. I've always told my husband that If we ever won the lottery, I'd like to devote most of these talents to fighting global warming, human trafficking or slavery, and improving mental health in America. For a country that is so "rich" we are so poor when it comes to mental health services.

In 2005, a NIH $20 million study found that one-quarter of all Americans met the criteria for having a mental illness, and fully a quarter of those had a serious disorder that significantly disrupted their ability to function day to day.  This puts American in the number 1 slot for mental health issues in the world.  We also are an "epic fail" when compared to other industrialized countries on mental health services.
Mental illness is really a disease of youth.  Half of those who will ever be diagnosed with a mental disorder show signs of the disease by age 14, and three-quarters by age 24.  However, less than half of youth that need treatment, get it. Those who seek treatment usually don't do so until a decade or more.  The reason for delays include insurance restrictions and lack of access. And the treatment they receive is usually inadequate. These are real brain disorders and they desperately need treatment.

And yes, I'm just going to come out and say it that it is a travesty when you think about how much we spend on defense in this country when we have sick people out there who are like ticking time bombs.

Obama was wrong when he said that the United States spends more on defense than the next 10 countries combined, we spend more the next 13 countries combined. When we allow mental health to rage out of control, we have a real threat to our neighborhoods and schools. We have what happened today in Newton, CT. Good God be with us now, when we are in trouble.

It brings me to a second issue and that is gun control. I'm going to also come out and say: I can accept the right to bear arms. But, my question is: what do you need to bear arms for?  I get that you want to protect yourself, but are you starting up your own military?  The weapons that were used today were a .223 caiber rifle and a Glock, which can carry up to 32 rounds of magazines.  Is that your plan when someone breaks into your home to attack you? To go through 32 rounds? Hardly, the most appropriate weapon for homeowner self protection.  Sure, a handgun or a pistol, but a rifle?  We have to think about when the second amendment was written, they didn't have these types of weapons. Come on, let's get serious about homeland defense and get a little bit more serious about gun control.

 .223 caliber rifle

Pump it up!

Ways to Increase Breast Milk Production

There are several theories about how to increase breast milk production.  What breastfeeding really comes down to is: supply and demand. Breastfeeding is generally a supply and demand situation.

The more demand there is on the breast for milk either from a little babe or a pump, there more milk will be made. Women's bodies are capable of adapting to a newborns desire for an adequate milk supply.  Only very few and rare circumstances with prevent a woman from being able to make enough breast milk for her babe. There are some women who are very gifted and are able to make enough milk without even batting an eyelash, and there are other women, myself included, that have to struggle to keep the milk supply flowing.

Here are tips for keeping increasing lactation

 

1) Drink 12 glasses of fluids a day:  This is so important to keep up an adequate milk supply.  In this case: water makes milk.  Don't go 1 hour without drinking at least 8 oz.

2) Pump in between feedings: Start pumping 1 hour after the morning feeding, when milk supply is at it's peak. Then gradually increase it to three times a day.  It's usually best to pump 45 min - 1 hour after emptying a breast at a feeding.


3) Keep stocked: Have plenty of breast pump supplies, bottles, or breastmilk bags clean and ready. The last thing you want to keep you from pumping is having to continually clean breast pumping supplies.  Having a good stock and washing them all at once, makes the pumping process easier

4) Get a good electric pump: Advent, Medela and Playtex all make great electric pumps. It is pointless to waste precious time pumping on a hand or manual pump.

5) Fenugreek - fenugreek is an herb that will increase milk supply. It comes in teas, pills and powder forms.

6) Mother's milk tea: Mother's milk tea is made by Traditional Medicinal and is sold at most Whole Foods or health food stores. It is also available online. It has herbs that promote lactation like fenugreek and anise.

7) Use heat: After a hot shower or after heat packs are applied to a breast, the will have more milk due to the increased circulation. Take advanteage of a hot shower or apply a heat pad before pumping or feeding.