Labial Adhesions In Infants

carmen · 01-17-2007, 05:17 PM

I am a CBE and a former student of mine sent me this email:
"O.k. I need to ask if anyone knows anything about labial adhesions in infant girls. The doctor wants me to put estrogen cream on Madeleine to make the area more tender so that he can open it up again in three weeks. I don't like the idea of using the cream but I don't know what alternative treatments there might be. Anyone have any ideas? Thanks."
Do any of you doulas have any suggestions? FYI - Her daughter is almost one.

Tiffany · 01-17-2007, 05:31 PM

I went through this with my daughter Natalie. We used the estrogen cream and it worked like a charm, no side effects. you only put a tiny tiny bit on there with a q-tip every night. I chose to do that over her possibly having a problem later in life!! when that fuses there is also the possibility it will fuse right over the urethra and cause problems urinating. Sorry for the quick typing.. gotta go get DH from work!

MindOverLaborDoulas · 01-17-2007, 06:58 PM

We had to use the cream with my niece. I would just put it on every night after her bath. Very easy and tell her rest assured, it's not *not normal*. It happens a lot. I think my mom said that my sister had to have cream on her when she was little, too.

Acacia · 01-17-2007, 09:41 PM

My neice had to have it as well and it worked very quickly for her. I think it is fairly common and helps avoid problems later on in life.

MothertheMother · 01-17-2007, 10:54 PM

a friend of mine had this happen with her daughter. When I had my little girl I asked the postpartum nurse about it and I was told that unfortunately, women are always told how to care for their circ'd boys but no one ever tells women how to care for their daughters. Come to think of it I don't know that I've read it in any of the books I've been through either?? What my friend was told after the fact and this nurse confirmed for me was when you change your little girls diaper you should spread the labia far apart when you are cleaning to keep this from happening. I haven't researched it or know it for fact so I'd like to hear if anyone else knows more on the topic. This could be important information we should give our clients with little girls.

AussieDoula · 01-17-2007, 11:43 PM

Quote:

Originally Posted by MothertheMother

This could be important information we should give our clients with little girls.

I talk about adhesions, genital swelling, "hymenal tags", and bleeding/discharge in infant girls.

Stacie · 01-18-2007, 01:19 AM

There is controversy over using estrogen cream, though, and that is important to note. Many don't feel comfortable applying hormones to babies. Often the damp, dark environment of a diaper lends itself to the labia minora fusing shut. I have heard other doctors recommending no treatment unless urine flow is restriced.

At about two, baby girls start producing estrogen, and this often solves the problem. If not, more estrogen naturally is produced as girls get older -- this is often resolved on its own before 6 or 7 years of age.

Just the flip of the coin.

Acacia · 01-18-2007, 08:29 AM

Quote:

Originally Posted by Stacie

There is controversy over using estrogen cream, though, and that is important to note. Many don't feel comfortable applying hormones to babies. Often the damp, dark environment of a diaper lends itself to the labia minora fusing shut. I have heard other doctors recommending no treatment unless urine flow is restriced.

At about two, baby girls start producing estrogen, and this often solves the problem. If not, more estrogen naturally is produced as girls get older -- this is often resolved on its own before 6 or 7 years of age.

Just the flip of the coin.

But then how do you know it has corrected itsself? I know when I was 6-7 I was very private and would have died if my mom or doctor wanted to look at my parts to be sure they had opened correctly. It literally would have gone kicking and screaming to every doctor after that.

Liebe Mutti · 01-18-2007, 09:12 AM

Hi gals,
My daughter had this too. Our pediatrician perscribed some kind of cream (not sure if there were hormones in it. That's not typical here in Germany. A lot is natural medicine.) Anyway, I had mixed feelings. I put it on her a few times, but felt strange about it. We were supposed to spread her legs apart too. My DH absolutely refused to apply the cream. He felt it was unnatural. I for myself figured it was not big deal and left it altogether. Within a few weeks, everything looked normal to me. I on the other hand am just a mom and not yet a doula.

A good friend of mine has two girls and her oldest had labial adhesion and her doctor was really brutal. He picked up the little one, her back to his stomach and with a quick jerk spread her legs wide apart and checked.... it's ok now! My friend changed doctors.

Stacie · 01-18-2007, 02:31 PM

Quote:

Originally Posted by Liebe Mutti

Hi gals,
My daughter had this too. Our pediatrician perscribed some kind of cream (not sure if there were hormones in it. That's not typical here in Germany. A lot is natural medicine.) Anyway, I had mixed feelings. I put it on her a few times, but felt strange about it. We were supposed to spread her legs apart too. My DH absolutely refused to apply the cream. He felt it was unnatural. I for myself figured it was not big deal and left it altogether. Within a few weeks, everything looked normal to me. I on the other hand am just a mom and not yet a doula.

A good friend of mine has two girls and her oldest had labial adhesion and her doctor was really brutal. He picked up the little one, her back to his stomach and with a quick jerk spread her legs wide apart and checked.... it's ok now! My friend changed doctors.

First of all. being a mother is primary when you have dealt with this issue with your family. My neice had this a few times, and the first time, the doctor did the same thing -- he forcefully opened it without any prior warning to mom or baby. Then he said, "You do the work to keep it open or I'll have to do that again." The forceful opening of the labia can actually make it adhere again, because of extra irritation and the body's need to heal.

About the 6 or 7 year old: If you knew it was a problem, someone could figure out a way to check, whether it's mom or doctor. Doctors are there to help our kids, and yes, they often have the task of checking out places we don't normally or routinely check.

This usually resolves on its own as prepubescents start releasing more estrogen. If a girl had trouble urinating, that would be a clue she might need further intervention.