IV Antibiotics at Delivery: The Aftermath

You may have had IV antibiotics without even knowing it

If you had a C-section, if you were GBS positive, if you went into labor before 37 weeks, if your membranes were ruptured for over 24 hrs, if you ran a fever during labor...for any of these reasons, you likely received intravenous, or IV antibiotics during your birth. It may have been announced to you, or you may have missed it. Regardless, there was a medical reason for the administration of these very strong antibiotics, which are used to prevent infection. But in the aftermath, you'll want to consider the potential side effects.

You've had antibiotics before. They came in pill form; some were massive and hard to swallow. Occasionally you were warned by the pharmacist, "These might be hard on your stomach so take them with food." Many women develop vaginal yeast infections following a course of antibiotics, especially if they are simultaneously taking hormonal birth control. Bummer. You know the cure - fun little tubes of white antifungal cream that you insert into your vagina every night for a week. Or possibly you treated a vaginal yeast infection orally, with 3 antifungal pills that you took spaced apart several days. Why do women have to deal with this? Don't we endure enough hassle with our monthly periods? Oral antibiotics can disrupt the colonies of healthy, beneficial bacteria in your gut and vagina, and when that happens, it wreaks havoc. So you've been through this before, only now the circumstances are a little different.

IV antibiotics are the "big guns" of the antibiotic family, and you bet they can disrupt your normal flora. They will obliterate it. What happens next is not usually a vaginal yeast infection. And Thank God, because that area has seen enough action and deserves a break! Postpartum vaginas are not prone to yeast, but guess what? Postpartum nipples are! First of all, milk is coming out of them and keeping them wet. Leaky breasts inside a bra are the perfect environment to breed yeast. Yeast is actually a part of your healthy flora, but under certain conditions, it BLOOMS. Yeast is opportunistic, and usually kept in check by healthy bacteria. So when the bacteria police get wiped out, yeast takes advantage. And when it does, you won't appreciate it. A nipple yeast infection or "thrush" will cause sharp, shooting, stabbing pains in your nipples, while you're nursing and even in between nursing sessions. Nipples may burn, itch, or appear reddened. This nipple yeast can invade the milk ducts and cause breast pain as well. And then as your baby plants his little mouth over your nipples a dozen times a day, he gets it too! His yeast infection manifests itself in the form of oral thrush, and/or a very red and painful diaper rash.

Sounds like a lot of fun, huh? What a bonding experience, sharing a fungal infection! First let's talk about how to prevent a yeast infection following IV antibiotics, or even oral antibiotics that are needed at any point during lactation. You'll need to replenish your beneficial bacteria with Probiotics. (no prescription necessary!) This is not an urgent situation, so if you're still in the hospital after giving birth, it can wait until you're home. If you get prescribed oral antibiotics for a urinary tract infection, or mastitis, you can start taking the probiotics right along with your prescription. The blooming of yeast takes a little time, for some, about 3 weeks. If you complete a month's worth of probiotics, you can hopefully prevent the yeast overgrowth. The two beneficial strains of bacteria that you want to take are: Limosilactobacillus fermentum, and Ligilactobacillus salivarius.* (brands of probiotics below) These two strains are also thought to contribute to a healthy flora within the lactating breast, possibly reducing the likelihood of clogged ducts and mastitis. New literature indicates that a build up of bacteria inside the milk ducts, which narrows them, is responsible for clogged ducts and mastitis. So you'll be doing yourself a favor in many regards by introducing these beneficial strains of bacteria into the mix.

The second recommendation to prevent a yeast infection, is to slather up your nipples with coconut oil. Get the kind that's used for cooking, if you like. Plain, organic coconut oil, which is a solid at room temp and turns slippery when it's warm, is easy to apply, and soothing to sore nipples. Coconut oil has anti-microbial properties and creates a hostile environment for yeast. The IV antibiotics put out a Welcome mat for yeast, and the coconut oil hangs a sign that says, "Go Away."

What if you've already GOT yeast? HERE'S HOW TO GET RID OF IT: If you are unlucky enough to develop a nipple yeast infection and share it with your baby, you both need to be treated with antifungals. Fortunately direct breastfeeding does not need to be disrupted at all while you're dealing with this. The obstetrician will prescribe mom topical cream that contains an antifungal, and if the yeast is causing deep breast pain as well, a daily, oral antifungal will also be necessary. Ductal yeast can be very stubborn, so the recommended course of oral fluconazole is a loading dose, and then 100 mg twice daily for at least 10 -14 days. (this medication is compatible with breastfeeding) For baby, the pediatrician will prescribe Nystatin drops to squeeze into his mouth several times a day, and an antifungal cream for the rash, if he has one. In some cases, baby is asymptomatic, with no signs of thrush anywhere! However, it's still recommended to give the nystatin drops as mom is being treated. This is due to the fact that the infection can be without symptoms in baby, but still harbored in his mouth, and then passed back to mom once her treatment is complete. Parents hate the idea of giving their baby a medication, but be reassured that nystatin drops are weak, and virtually harmless. In fact, if your baby has a really severe case of oral thrush, nystatin probably won't even be effective at eradicating it. He may need an oral antifungal like fluconazole.

Aside from medications, one must consider that yeast can live on objects and in fabric as well. Anything that comes in contact with baby's mouth or mom's nipples should be thoroughly washed once a day. Pacifiers, bottle nipples and pump parts should be sterilized, and bras should be washed in hot water and dried on high heat, or in the sun. It takes some work to eradicate yeast, but hang in there, and remember that anytime you're lactating and need to take antibiotics, you'll want to add a course of probiotics to keep all your floras healthy and thriving!

-Member's Mark Women's Daily Probiotic Capsules (PINK box, not orange) $19.98 for 90 count (Sam's Club) This is the cheapest and best option, so I hope you know someone with a Sam's Club membership!

-Seed DS-01 Daily Synbiotic $49.99 for 30 count https://seed.com/daily-synbiotic

-Legendairy Milk Lacta-biotic ($36.99 for 30 count, only contains L. Fermentum) and Legendairy Milk Hot Girl Ish ($39.99 for 30 count, only contains L. Salivarius) In order to get both strains you have to take both kinds. Not very cost effective!

Last updated Dec '24

*as if the names of the bacterial strains aren't long enough already, they were updated and given prefixes. They were formerly referred to as lactobacillus fermentum, and

lactobacillus salivarius. You'll notice that above, I included the new prefixes, but you may see them listed without the prefixes in your probiotic ingredients.