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Abby's Magazine - Volume 5 Issue 5 | Page 21 normally inhabit the human intestinal tract. By migration from the intestines, it colonizes the rectum, bladder, and vaginal tracts of many women and can thus be identified in cultures of combined rectal and vaginal swab samples. GBS doesn't seem to play a particularly beneficial role in human health, nor, when kept in check by healthy gut flora, does it usually cause harm. However, in a very small percentage of exposed babies, infection can cause serious illness and even death. Therefore, all women who test positive in pregnancy, and who meet a variety of criteria in labor, receive an IV antibiotic in labor to prevent baby from developing infection. I discuss the pros and cons of this at length in my article Group B Strep (GBS) in Pregnancy: What's a Mom to Do? As well as the controversy around this approach. In all likelihood, if you do test positive, you will receive the antibiotic – which is not at all inappropriate. But what can you do? Well, for one, you can support the health of your gut and vaginal microbiome, thus preventing GBS overgrowth, ideally before and certainly during pregnancy by eating a diet that is low in sugar, processed foods, and processed carbohydrates (i.e., white flour products, baked goods), and if you suspect you are gluten intolerant, go strictly gluten free. These steps can remove triggers that directly and indirectly (via harming the gut lining and causing leaky gut) harm the microbiome. You can make sure to get about 35 grams of fiber daily from vegetables, or if needed, through the addition of 1-2 TBS. of freshly ground flax seed added to your food or a smoothie daily, and add lacto fermented veggies to your diet. And important, you can take a probiotic daily, even starting in the first trimester. For preventing GBS I not only recommend a probiotic containing a wide variety of Lactobacillus and Bifidobacterium strains, but in addition, one that specifically contains Lactobacillus rhamnosus and Lactobacullus reuteri. If you've had GBS in the past, or have a history of yeast infections, BV, or chronic urinary tract infections, this is especially important. Giving mom Lactobacillus rhamnosus[strain GG (ATCC 53103)] also reduces the incidence of atopic eczema in at-risk children during the first 2-years of life. The Cesarean Epidemic It is an unequivocal fact, acknowledged even by the American College of Obstetricians and Gynecologists, that the cesarean section rate in the United States is excessive. In fact, according to a number of sources, including the World Health Organization, no nation's cesarean rate should exceed 15%. Yet we average 34% nationally. Numerous books and articles have been written about this phenomenon, and a number of methods are known to reduce the cesarean rate, including maintaining a healthy, low risk pregnancy, including maintaining a healthy weight, not being unnecessarily or prematurely induced, and having your baby with a midwife. However, given the number of women likely to still have a cesarean in the current obstetrics climate, and the benefits of at least 3rd trimester use of a probiotic by the mother in preventing atopic disease in her baby, I now recommend all pregnant women take a probiotic in pregnancy, at least throughout the 3rd trimester. Protecting Baby After Birth Probiotics Numerous studies including thousands of infants treated with a probiotic starting shortly after birth, and through the first 6 months of life, particularly in babies born by cesarean, show reduced likelihood of developing antibodies to common allergens, as well as eczema. The data in fact, is so overwhelmingly supportive, that I now routinely give a probiotic to all newborns, continuing through 6 months old, if they were born by cesarean, if mom received any antibiotics for any reason during labor, or if baby needed an antibiotic at or after birth. What Probiotic is Best for Baby? In my practice and for friends and family, I recommend an infant probiotic by a company named Klaire (Klaire Infant). It contains the variety of strains that have been found to be most beneficial in helping to colonize the optimal organisms needed for baby's healthy immunologic, neurologic, and metabolic development. Other companies that are often recommended include Jarrow, Now Foods, and Flora Udo's. When to Start and How Often to Give a Probiotic Studies show that starting in the first few days after birth and continuing for 6 months is optimal for colonization of healthy gut flora species in infants. It is generally given daily. How to Give the Probiotic The two most common, and effective ways to give a breastfeeding baby a probiotic is to mix the powder into a couple of tablespoons of expressed breast milk, and administer to baby via an eyedropper. I generally