From the Guidelines
Preventing Group B streptococcus (GBS) during pregnancy through holistic approaches can complement standard medical care, but the most effective method to prevent GBS colonization is maintaining optimal vaginal pH through probiotic supplementation, particularly Lactobacillus species (15-25 billion CFU daily), as it creates an environment less hospitable to GBS 1.
Holistic Options for GBS Prevention
The following holistic options may help reduce GBS colonization:
- Dietary modifications including reducing sugar intake and consuming fermented foods like yogurt, kefir, and sauerkraut to support beneficial vaginal flora
- Using garlic (eaten raw or as supplements) for its natural antimicrobial properties
- Taking cranberry supplements (400-500mg daily) to help prevent bacterial adhesion in the urogenital tract
- Practicing regular hygiene, such as wearing cotton underwear, avoiding douches, and wiping front to back after using the bathroom to reduce contamination
- Using essential oils like tea tree oil diluted in carrier oil (never used internally during pregnancy) topically around the perineal area
Importance of Medical Screening and Antibiotic Prophylaxis
It is essential to note that while these holistic approaches may reduce colonization, they do not replace medical screening at 35-37 weeks gestation or antibiotic prophylaxis if GBS-positive, as recommended by the CDC guidelines 1.
Key Considerations
- Intrapartum antibiotic prophylaxis is the most effective method to prevent early-onset GBS disease in newborns, with an efficacy of 86%-89% 1
- Women with GBS bacteriuria during their current pregnancy or who previously gave birth to an infant with GBS disease should receive intrapartum antimicrobial prophylaxis 1
- The risk-based approach or the culture-based screening approach can be used to identify candidates for intrapartum chemoprophylaxis 1
From the Research
Holistic Options to Prevent Group B Streptococcus (GBS) Colonization
- The use of probiotics, specifically Lactobacillus strains, has been suggested as a potential method to reduce GBS colonization in pregnant women 2.
- Oral probiotic supplementation has been proposed as a possible alternative to antibiotic therapy to reduce maternal GBS colonization 3.
- A double-blind parallel group randomized trial is currently being conducted to compare GBS colonization rates in pregnant women who receive a daily oral dose of probiotics with those who receive a placebo 3.
Current Preventative Measures
- Universal prenatal screening by vaginal-rectal culture is recommended between 36 0/7 and 37 6/7 weeks of gestation to identify women who are colonized with GBS 4, 5.
- Intrapartum antibiotic prophylaxis is recommended for women who are colonized with GBS, unless a prelabor cesarean birth is performed in the setting of intact membranes 4, 5.
- Coordination with pediatric care providers is necessary to ensure effective prevention of GBS early-onset disease 4, 5.
Limitations of Current Preventative Measures
- Intrapartum antibiotic prophylaxis can prevent early-onset neonatal disease, but not chorioamnionitis, preterm labor, stillbirth, or late-onset disease 2.
- The use of antibiotic therapy can have negative consequences, such as the development of antibiotic-resistant bacteria 3.
- There is a need for alternative approaches to reduce maternal GBS colonization, such as the use of probiotics 3.