I am acting for a number of families whose lives have been devastated by their babies being infected with the group B Strep (GBS) bacteria. Each family’s story is different, but each is tragic and has shattered their lives and each now wish they had been aware of GBS.

One family’s baby died shortly after birth; other clients’ babies have been left with serious life-changing injuries as a result of infection with GBS. They regret not knowing about GBS, and particularly about the dangers it posed to their babies and are, understandably, upset that they did not know or were not told about what could be done to reduce the risks to their then unborn children.

With that in mind we have drafted some questions we think it would be useful for all parents-to-be to ask when expecting their baby and have provided some initial information so that you can be as informed as possible when discussing GBS with their midwives or the wider maternity team.

What are the risks if I am carrying GBS when I am pregnant?

GBS is a common bacteria, which we carry without coming to any harm, but in babies it can cause death, or life changing disability. On average 66 babies a month are diagnosed with group B Strep infection in the UK and Republic of Ireland. Most recover but tragically of those 66, four die and six are left with long term physical or mental disabilities.

How will I know if I have GBS whilst pregnant?

There are no symptoms that show you have GBS, so most people won’t know if they carry it. However, there are tests available to check if you are carrying group B Strep when pregnant. Unfortunately, testing is not routinely offered in the UK, but you can sometimes get a test on the NHS. Please ask your midwife. If you are not entitled on the NHS, you can pay for a test if you can afford it. Read more about testing and, in particular, the best sort of test you should have here.

What can I do if the test for GBS is positive?

If your test reveals you are carrying GBS you should be offered antibiotics when you go into labour.

When should I be given antibiotics?

The National Institute for Health and Care Excellence (NICE) advise that pregnant women whose babies are at risk of infection should be offered antibiotics and given the first dose as soon as possible after the start of labour.

Should I be worried if I or my baby had GBS in a previous pregnancy?

If you have previously had a baby who developed GBS infection, then you should be offered antibiotics during your labour in your subsequent pregnancies. Given that, if you know you or your baby had an infection in a previous pregnancy, ask what that infection was and whether it was GBS.

If GBS was found in a previous pregnancy and your baby was unaffected you should be offered a test to see if you are carrying GBS in your current pregnancy. If the test is positive, you should be offered antibiotics, if negative your risk is low and you would not automatically be offered antibiotics.

What happens if my baby does get infected with GBS?

If your baby shows signs of GBS infection after birth, they should be treated immediately with antibiotics.

What does infection with GBS look like in a baby?

In the UK, most babies infected with GBS show signs of infection within the first six days of life. The symptoms that could be suggestive of GBS infection that new parents might see in their baby include:

• Grunting or noisy breathing
• Increased effort in breathing
• Sleepy/lethargic
• Floppy
• Not feeding well
• Too hot or cold/ too high or too low temperature

Monitoring or testing done in hospital may also reveal:

• Abnormal heart rate
• Abnormal respiratory rate
• Low blood pressure
• Low blood sugars

If you have concerns about any of these symptoms raise them with the maternity team. If necessary, ask for a neonatologist (a doctor who specialises in conditions affecting newborns) to be called to examine your baby urgently and ask if anti-biotics need to be given.

Some babies can present with symptoms after six days, most often after parents and baby have left hospital. Then, the symptoms to look out for in your baby include:

• Irritability
• High pitched cry/moan
• Floppy
• Blank stare
• Dislike of bright lights
• Pale or blotchy skin
• Jerking movements

If you are worried that your baby has any such symptoms, you should seek medical help immediately. GBS can be treated but treatment is needed as soon as possible.

We hope that the above questions and answers arm you with enough information to ask questions of your maternity team, to request a test and/or antibiotics if you want and need to and help you to identify when your baby might have GBS infection and needs help.