Suffolk mum backs Group B Strep Support’s awareness month campaign after newborn son almost died of the infection

Kate Hoare with all five of her children, in hospital after Libby's birth this year.
Photo: Kate Ho

Kate Hoare with all five of her children, in hospital after Libby's birth this year. Photo: Kate Hoare - Credit: Archant

After a normal pregnancy and straightforward labour Kate Hoare welcomed her fourth child into the world in August 2014.

Francis holding his new baby sister, Libby.
Photo: Kate Hoare

Francis holding his new baby sister, Libby. Photo: Kate Hoare - Credit: Archant

Little Francis appeared to be the picture of health - he scored 10 out of 10 in standard wellbeing checks midwives perform in the first few minutes of life.

But just hours later he was fighting for life.

Unknown to anyone, Francis had picked up a potentially-fatal group B Streptococcus (GBS) infection during birth.

GBS bacteria is carried by up to 30% of adults, most commonly in the gut, and for up to 25% of women, in the vagina, usually without symptoms or side-effects. Occasionally, however, the bacteria can cause infections, most commonly in newborn babies, where it can lead to pneumonia, blood poisoning and meningitis, sometimes in adults and, very rarely, during pregnancy and before labour.

Francis Hoare very ill in intensive care.
Photo: Kate Hoare

Francis Hoare very ill in intensive care. Photo: Kate Hoare - Credit: Archant

Despite this, there is no routine screening of expectant mums in the UK - as there is in many other developed countries - even though administering antibiotics during labour will protect at-risk babies.

What’s more, many mums-to-be, like Kate, have never even heard of group B Strep.

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“I already had three children and considered myself to be well-educated on matters relating to birth and pregnancy but the first time I heard of GBS was when my newborn son was in intensive care,” says Kate, who is backing the Group B Strep Support charity’s July awareness month campaign.

“Francis was born at 2am and by about 5am he was very unsettled. I was so tired I didn’t think too much of it but luckily, a trainee doctor, who must have sensed something wasn’t right, said she would take him to special care to get him checked. Having just given birth, I was not really with it and didn’t think there was anything to worry about. At 7am I went into special care, couldn’t find Francis and then walked into intensive care, where I saw about 10 doctors crowded around his cot. That was my son. It was terrifying. That was how quickly this infection took hold.

“Francis was given antibiotics through the umbilical cord. He had pneumonia and was in intensive care for 10 days and special care for another four days. I was told by my consultant he was lucky to have survived.”

Thankfully, Francis made a full recovery and is about to celebrate his third birthday. Kate, who lives near Framlingham, had another baby, a daughter, called Libby, this year and, because of her history, was closely monitored this time round. Libby was unaffected.

“I do believe there needs to be better education and routine testing, in line with what Group B Strep Support advocates,” says Kate. “I did feel angry about what happened to Francis. Without the vigilance of that doctor, it might have been too late to save him.

“This is an infection that kills and leaves babies with long-term disabilities yet pregnant women are not even routinely told about it in antenatal care or in the information leaflets you’re given after birth, let alone offered a test.

“Luckily for Francis, the infection was spotted quickly and the care we received at Ipswich Hospital was outstanding. What if I had already gone home or it was later onset, as it is in some cases? If mothers haven’t even heard of GBS how can they know what to look for?”

Group B Strep Support says GBS is the most common cause of life-threatening infection in newborn babies, causing meningitis, sepsis and pneumonia. Most of these infections can be prevented but around half of pregnant women haven’t even heard of group B Strep.

During July’s annual awareness month the charity, which campaigns for pregnant women to be told about group B Strep as part of antenatal care and offered a free, sensitive test for GBS carriage in late pregnancy, has been working hard to make more families and health professionals GBS aware.

It says routine testing would allow informed decisions to be taken about what further treatment may be needed to minimise the risk of GBS infection in newborns.

Chief executive Jane Plumb says: “Testing for GBS carriage is not routinely offered in the UK, unlike many other developed countries. GBS-specific tests aren’t widely available in the NHS, but are privately for under £40 for home-testing packs.

“If GBS is detected at any time during pregnancy, you should be offered intravenous antibiotics (usually penicillin) from the start of labour and at intervals until your baby is born. This can reduce the risk of a newborn baby developing GBS infection by over 80%.

“In the UK, on average, two babies a day develop GBS infection, one baby a week dies and one survivor a week is left with disability.

“Most GBS infection in babies occurs in the first 12 hours of life, and they become increasingly uncommon as time goes by. After three months of age, GBS infections are very rare. For more information, ask your midwife, doctor or Group B Strep Support on 01444 416 176.”

You can also visit www.gbss.org.uk.

More about GBS

Group Strep B Support says many developed countries offer pregnant women a simple, safe, GBS-specific test (known as the Enriched Culture Medium (ECM) test that costs around £35). The result of this test, taken at 35-37 weeks of pregnancy, enables antibiotic treatment to be targeted at mothers most likely to be carrying group B Strep when they give birth.

This strategy is effective at preventing group B Strep infection in newborns, with rates of early-onset GBS infection falling by up to 86% in countries that screen. The UK’s prevention strategy, however, involves the use of risk factors to select which women are offered antibiotics in labour against early-onset GBS infection (EOGBS), rather than routine screening. Since 2003 the rate of group B strep infections in newborns has increased by 23%.

A 22-month pilot of antenatal screening for group B strep carriage, which completed in March 2016, found screening reduced the rate of infections in newborns by 83% and saved an estimated £250,000 a year. Despite these findings, the UK’s GBS prevention policy remains unchanged.

Early-onset GBS infection occurs when the baby is up to six days old; a key symptom is the rapid development of breathing problems, associated with blood poisoning.

Late-onset GBS infection – usually presenting as GBS meningitis – occurs between six days and a month old and, more rarely, up to three months. After that, GBS infection in babies is extremely rare.

GBS is recognised to cause preterm delivery, maternal infections, stillbirths and late miscarriages; and preterm babies are known to be at particular risk of GBS infection.

Overall, around one in every 1,000 babies born in the UK develops group B strep infection.