Our main concern in intrapartum (or during delivery) administration of antibiotic was whether the administered antibiotic will kill mother's good bacteria and deprive the baby these bacteria, especially in natural vaginal delivery. If yes, then it would defeat the purpose of natural birth! It has been known that natural vaginal delivery provides babies with good gut flora and minimize allergy in later development (see subsection on "Acquisition of gut flora in human infants" by Wikipedia), whereas C-sections reduces the diversity of baby's gut flora.
Sometimes, I think hospitals are being too overzealous in their effort to beat infection (or prescription of antibiotics). This effort can be more harmful than helpful, considering that depriving babies of good gut flora weakens their gut health and not to mention, babies abilities to acquire immunity against these bacteria. FYI, we can use gut bacteria because we are immune to them and able to rein in any "rebellious" bacteria by an immune response. To deprive babies of early exposure to gut bacteria will deprive them of this immunity.
If hospitals strive to encourage more "bubble babies" (babies in sterilized condition), then they are not doing any good to patients (or mankind). I was let down that SGH went down-the-road of trying to sterilize mothers' womb by prescribing antibiotics when there was no indication/suggestion that babies were immunocompromised/immunodeficient. Why would SGH want to prevent good "infections". Note that there was no indication that my wife was having any infection (i.e. the vaginal bacteria was at "normal" titer/amount rather than overran by them during infection).
Since when did "infection" (exposure to mild titer of bacteria or microbes) become a bad thing? We are constantly fighting (or balancing) "infection". That is how we grow stronger (rather than weak and dependent on antibiotics).
Fortunately, a study showed that intrapartum administration of antibiotic (specifically penicillin) has minimal effect on microfloral transmission of babies undergone vaginal delivery. Read "effects of intrapartum penicillin prophylaxis on intestinal bacterial colonization in infants".
However, in contrast, another study showed that regardless of antibiotic-type, intrapartum administration of antibiotic due to rupture of membrane (or water broke) caused significant drop in transmission rate of good bacteria (e.g. Lactobacillus) in infants. Note that good bacteria is responsible in preventing the development of allergic diseases later in life, so... it's no wonder that in developed countries, many people are having one or several kind of auto-immune diseases. We are just too darn clean!
Now, my question is that, do we have a choice when it comes to "medical intervention" that do not require our consent? As patients, are we well represented by doctors and the medical team? I mean, did these doctors judged correctly the risk-over-benefit criteria before prescribing treatments to us?
Another example is that during my wife vaginal swap to test for presence of Group B Streptococcus, which seemed to be a contributing factor in infection in newborn babies (or in worst scenario, septicemia or infection in blood), the test tested negative but there was presence of fungi. The doctor gave the good news, and then shocked us to the news that my wife has fungal infection! FYI, our body is constantly covered with Strep and Fungi, and as long as we are healthy and strong, we are not at risk. Also, Strep presence in our body do come-and-go and today's test is negative doesn't mean that it will be negative tomorrow. How the hospital earned from us for this test is funny because it did not help us a bit during expected delivery date (EDD) where by then, Strep tested earlier is nullified by time!
What was alarming was the suggestion by this doctor that she could help my wife administer medication to rid of the Fungi. Oh my goodness, what is wrong with doctors these days? We might as well be living in a bubble from now on, no?
According to CDC Prevention of Perinatal Group B Streptococcal Disease: Revised Guidelines from CDC, 2010, one thing that is lacking in this report is the mention of harmful effect of the measures taken to fight Strep on babies (i.e. post-treatment effects). There are always benefit-over-risk and vice versa and giving the right information to patients is always appreciated.
As a parent, what I can hope for now is to allow my kids to be exposed to as much of environmental microbes as possible (naturally), so that their immune system will be an efficient machine that manages host-microbe interactions to their favours.
As for the TV commercials frightening the populace with overblown picture of infections so that more of us will buy their antiseptic cream, spray, soap, mouth rinse etc., these companies are not helping one bit in protecting us from infections. Best protection is to overcome the infection rather than "hiding" from it.
Being too clean has been shown to pose health problems (see Hygiene hypothesis by Wikipedia). However, in practice, it's not possible to be completely clean from microbes, fortunately.
Just a thought.
No comments:
Post a Comment