Let's Talk About Labial Adhesions

I know what you're thinking.  What the heck is a "labial adhesion"?!  It's when the labia minora stick (fuse) together.  It's identified by a white line down the center of what looks like a membrane that covers the opening of the child's vaginal opening, and shows that the two sides have adhered to one another.

Labial adhesion occur most commonly in girls who are between 3 months to 6 years of age; these adhesion can persist until puberty. Some children with labial adhesion will have no symptoms, while other girls may have pain in the genital area, difficulty urinating, or frequent urinary tract (bladder) infections.

It's estimated that up to 10 to 20 percent of girls have these labial adhesion at some time in their first six years of life. For most girls, these adhesion resolve on their own in six to twelve months, without any treatment.

I never even knew there was such a thing until my baby girl developed this around 4 months old.  I took her in for a well-baby check-up, and the Dr. noticed it.  He told me that he was going to prescribe a hormone cream to put on it, and that when combined with "gently pulling the two sides apart", this could be "cured" within a few weeks.  He told me that after it separated, I should be putting Vaseline along the folds of her vagina to keep the two sides from fusing again.


My daughter's vagina had almost completely closed up, leaving only a pin-hole size opening at the top.  Urine had still been passing, so I never noticed anything wrong with her.  (I don't look THAT close when I wipe her, so if my Dr. hadn't noticed, I never would have known.)


At the time I was kind of blind-sided, so I just stood there thinking about how every word he said seemed to be exactly what I have heard Dr.'s say about circumcising boys.  "Something needs to be done to prevent a possibility of problems in the future"..."if it fuses back together in the future, it could close right up and require her have her labia cut apart"..."gently pull the two pieces of skin apart, and when it has been done, put Vaseline there to keep it from healing together again".  My inner intactivist was screaming the whole time.


Even in what was very close to a state of shock (How had I not noticed?!  Is there going to be something wrong with this perfect baby too?!), all I could think was that I trusted him with my son's genitals, and he proved to me that he was not to be trusted.  Here I was again, two years later, standing in his office doubting that he knew what he was talking about. 


As we left, I had to tell my husband that he just seemed too eager to have me fiddle with her privates...exactly like when my son was an infant and he told me to "gently retract the foreskin" of his penis.  I listened to him back then.  I wasn't going to make the same mistake again.  So I looked into it further, and asked around. 


Thankfully I found someone who had 3 daughters who all had the same thing occur, and who had it happen to her when she was an infant as well.  She sent me some links that explained that the reason it happens can be anything from irritation from diapers (when they're older) to hormones from mom exiting the baby's body (as I'm sure was the case with my 4 month old), and that it can fix itself without the use of hormone creams.  When girls start making their own hormones, it completely fixes itself on it's own.

"The adhesion will often resolve spontaneously when girls are out of diapers or pull-ups both day and night. When labial adhesion persist, the estrogen surge at puberty will correct the problem."
That was found HERE.

Since hormone creams are made from the urine of pregnant horses, it's probably not a great idea to jump on that wagon unless you have no other choice.  (And I mean for REAL have no other choice.  Not just because your Dr. scared you into believing that it had to be done even though it's not completely closed up.)
"If there are no complications, such as infections or obstruction, the adhesion do not need to be treated.

Never attempt to separate the labia forcefully. This is painful and traumatic. Moreover, it usually results in even worse adhesion than before." 

"If you do use an estrogen cream, you should be aware that some girls will have other transient estrogen effects, including increased breast tissue and darkening of the labia and/or nipples. These resolve when the estrogen applications stop. Stopping the estrogen also sometimes causes a brief 'mini-period,' or vaginal bleeding."

Again, that was found HERE.

So, although there are surely cases that have gone so far that the labia has completely closed up and is blocking the flow of urine and would actually need some intervention, it is a last resort.  We live in a society of cutters, so we need to be educated and informed of the facts BEFORE we're faced with this situation.
My daughter's labia is almost completely separated now, simply by giving it a couple of extra wipes at diaper changes.  It's just hanging on by a tiny thread of skin.  No cream.  No tugging at it.  Just wiping.  So, it can be done.  If it had closed up more, and I had been wrong to question my Dr., I could have used the cream.  But I didn't need to.  And because I am now aware of it, I can keep an eye on it and prevent it from closing back up. 


Sadly, if you want to research this, you're going to have to swim through an ocean of mis-information.  The AAP suggests the Dr. tug the two sides apart, and the parents keep Vaseline on the raw skin to keep it from healing back up.  (No mention that it can cure itself, or that the irritation of it being torn apart causes more irritation which can cause it to fuse again...)


Anyways, that's that.  It's normal.  It happens.  And it is not a big deal unless your child is unable to pass urine. 

Infant Carriers, Slings, etc.

My baby girl in her Mai Tai carrier.

I've seen all types of baby carriers out there.  I don't mean "car seats", which apparently is also something that is called an infant carrier.  I mean things like slings, wraps, and other carriers.

It kind of stresses me out now when I see babies in those "crotch danglers".  I never even knew what that term meant until I ran across a blog that was talking about them.  It's the ones we see everyday, where the baby is in it, legs hanging straight down, being supported by it's crotch.  I don't know about you, but I don't think that could be very comfortable!  That's when I looked into alternatives.  I don't have a whole lot of "extra" money-- who really has "extra" money?! --so when I found this one on Kijiji, I jumped all over it.  I got it for $15. from a mom I'd sold some baby clothes to in the past.  (Which also makes the saying "don't burn any bridges...you might need to cross them later on", just that much more true!)

I am going to post a few links here to some different carriers.

This one is from "Cheeky Monkey", and it's called "Lulujo Lightly Padded Ring Sling".  It is intended for babies up to 25 lbs., and the patterns you can choose from are pretty neutral.  They cost $69.99, but they are out of stock until the end of July, 2011.  They really are nice, so it's no wonder they're out!  


These ones are "Maya Wrap Baby Ring Slings".  They cost a bit more at $84.98, but come in 12 different colour-patterns, and are good for babies and toddlers 35 lbs. and up.

This one is much more up my alley.  I have never had much success with the typical ring slings, and I don't know if it's because the ones I bought were too big for me, or what, but this one looks fool proof.  It's from "Hotslings Adjustable Baby Slings", and they are on sale right now for $49.98.  It's suitable for infants to toddlers 30 lbs. and up.


I've always heard lots of talk about the "Ergo Baby Carrier".  They can be worn on the front, back, or side.  These are good for infants (with infant insert...costs extra), all the way up to 40 lbs. or more.  They cost $199.98, but if you follow that link, it's free shipping WITHIN CANADA ONLY.

Wow.  As I go on here, they're getting more expensive!

I found this one.  It's called a "Beco Baby Carrier, Beco Butterfly II".  Yes, they are very nice to look at.  And the baby's legs are in a good position to be carried around.  It's a little rich for my blood though.  They cost $149.98, and do come in a variety of very nice patterns.  They are good to wear on front or back, and are suitable for babies from 7 lbs. up to 45 lbs.

My older daughter in the mai tai.  2 1/2 yrs. old.

Of course, another big name is the "Moby Wrap".  It's suitable for preemie through 35 lbs., at a cost of $63.00.  They come in a variety of colours, and can be worn five different ways.

These are "Freehand Mai Tai" carriers.  They are priced from $79-$99 and are great for infants and toddlers, newborn to 35 lbs. plus.  As soon as I get a chance to sit down for any length of time, I will be making these, and selling them for a fraction of that price!

And then, there are pouches.  I'm not a fan of these for several reasons.  The most important reason I'm not a fan is because of what I was told in the NICU by the nurses there.  Infants have very little tone in the first few months (which is why they aren't crawling or sitting up on their own that early on), and when they are in something that folds them up, their ribs can crunch down into their bellies, and cut off oxygen.  (Much like an accordion.)  At first they may look okay, and as time goes on, they get less and less oxygen.  IMO, they just aren't a great idea, but since I'm trying to post all of the options, I'm simply stating my opinion while still showing what the pouches are.

Here you can see a "Hotslings Classic Pouch".  It is "suitable" for newborns to toddlers (35lbs+).  They are on sale right now for $30.

Now there are many many varieties of "good" slings and carriers.  I've seen some homemade slings that are nicer than any for sale online, and I'm sure they didn't cost more than a few dollars to make.  If you're crafty, there are tons of YouTube videos that can give you instructions on making your own.


And just as I was about to nag about "Snugli" carriers being crotch danglers, I see they DO have one kind that is called a "Seated Snugli Soft Carrier" that does in fact carry baby by the bum, rather than the crotch.  A great example of a crotch dangler is shown here.  There are many, but here are links to three... the "Front Snugli", the "Front and Back Snugli", and the one I got in a bunch of clothes I bought on Kijiji, the "Snugli Hug".

So, bottom line.  When you're looking for an infant carrier, make sure it supports their bum and hips, and doesn't put all of their weight on their crotch.  Make sure it allows baby (and/or toddler) to be in the position that is natural to them...froggied legs, open to hang onto momma.  Make sure you get one that lasts a long time, and is made from something that isn't going to rip or tear with normal wear.  Our babies crave our touch, and carrying them against our bodies is the most natural way we can do that.  I'm not against using strollers, but I think that there is a time and a place for that, and most of the time, our babies deserve to be carried on our bodies as nature intended.

Here's a little bit more info on "crotch danglers".

Infant circumcision causes 100 deaths each year in US

April 26th, 2010 by ICGI

A new study published yesterday in Thymos: Journal of Boyhood Studiesestimates that more than 100 baby boys die from circumcision complications each year, including from anesthesia reaction, stroke, hemorrhage, and infection. Because infant circumcision is elective, all of these deaths are avoidable.

The International Coalition for Genital Integrity applauds that, for the first time, a rational attempt has been made to estimate the scale of the problem, and is simultaneously appalled by how many baby boys needlessly die each year in the United States.

The study concluded: “These boys died because physicians have been either complicit or duplicitous, and because parents ignorantly said ‘Yes,’ or lacked the courage to say ‘No.’” And called the deaths “an unrecognized sacrifice of innocents.”

The study found that approximately 117 neonatal (first 28 days after birth) circumcision-related deaths occur annually in the United States, one out of every 77 male neonatal deaths. The study also identified reasons why accurate data on these deaths are not available, some of the obstacles to preventing these deaths, and some solutions to overcome them.

Previous studies estimated the death rate as low as two per year to as many as 230. The study collected data from hospital records and government sources to attempt to provide a more accurate magnitude of the problem.

To put this in perspective, about 44 neonatal boys die each year from suffocation, and 8 from auto accidents. About 115 neonatal boys die annually from SIDS, nearly the same as from circumcision.

Because of the inadequacies of the death-certificate system and the apparent lack of investigation, it is easy to see how the medical system could either unwittingly or intentionally obscure the true cause of these deaths.

To hospital residents, the birth of a boy is celebrated as an opportunity to practice surgery, but a resident’s first surgery upon a live human being does not always go as planned.

Many factors combine to explain the lack of reliable mortality data or why this problem has not received more attention. To ignore or hide the likely cause of so many infant deaths for so many years requires a significant amount of denial or obfuscation—by: parents, physicians, hospital staff, insurers, medical associations, and legislators.

Boys have been lost to circumcision in the United States from the time it was first practiced to the present day, for a variety of reasons, as the following examples illustrate. The first two, known reported circumcision-related deaths were in New York City, in 1856 and 1858, where circumcision was introduced.

For more information on this study, inquire here.