During my first trimester, I dealt with what some call morning sickness, but what I believe is more accurately referred to as “all day sickness.” Nausea is the pits, and I wanted to do something about it. Annabelle has worn a baltic amber teething necklace from Inspired by Finn for most of her life, and I have been really happy with its quality. Remembering that they also carried beaked hazelwood necklaces which are said to help with excess acidity in the body and, by extension, morning sickness for many moms, I checked their site out again. Continue reading
|Photo Credit: Veganbaking.net on Flickr|
It seems that people land on the first post I wrote about our experience with labial adhesions quite frequently. It is by far the most popular search term that brings people to this blog, and it seems that it’s a topic that isn’t discussed much, so I wanted to follow up.
See the post referenced above for an explanation of what labial adhesions are if you’re not familiar A refresher on our story: Annabelle’s adhesions were discovered at a well baby visit when she was about seven months old. Her pediatrician immediately jumped to hormones, and prescribed an estrogen cream, which I chose not to use. After several days of twice daily application of coconut oil and one day of flax oil, the adhesion cleared up.
I wanted to follow up, however, because they did readhere. I noticed this right around the time that she turned nine months old. Per the pediatrician, it is not uncommon, even when estrogen cream is used, so I stand by my decision to avoid the route of synthetic hormone treatment. I have gone back and forth when it comes to treatment, and as with many things I have a sort of internal debate on what the best route is. I question the supposed cause of labial adhesions, at least in Annabelle’s case, and I truly do not think they are a problem for her at this time, so I’m hesitant to really treat them.
Labial adhesions are thought to be caused by irritation. Doctors say that it can be something as simple as staying in wet or dirty diapers for too long, but they also show up in the aftermath of abuse. I am thankful that I have almost never had to leave Annabelle in someone else’s care. Since she is with me all the time, I can rest assured that abuse is not a factor. Irritation seems unlikely to me, too, however. Because we practice elimination communication, we very rarely use a regular, fully absorbent cloth diaper. Most of the time we use trainers that are just absorbent enough to catch the urine from one pee, but not so much so that we won’t know immediately if Annabelle is wet. When she does not use the potty, she is still changed within minutes. When I first learned of the supposed cause of labial adhesions, I had some serious mommy guilt, feeling like I had been neglecting my daughter by not keeping her clean enough. The more I think about it, however, the more it seems, for the reasons stated above, that it’s highly unlikely that anything I could have done would have prevented this from happening. With Annabelle, it just seems that she was going to have labial adhesions all along, and that she will have issues with them until she is a bit older. I am frustrated by the thought that other doctors, like ours, may be telling parents that their daughters labia adhered because they “sat in a wet diaper too long.” Anyway, as I explained in my previous post (click to read), most of the time, the condition resolves itself by sometime before puberty, if not much earlier, when the body begins to produce more estrogen.
The thing I constantly remind myself of is that, while Annabelle’s pediatrician is an expert on infants in general, I am an expert on Annabelle. I can tell when she is uncomfortable, and so far it seems that she is not. If treatment becomes necessary, I will know, and I will deal with it at that time. At this point, since she has shown no discomfort and she has had no issues with infection, I feel comfortable waiting it out. I do keep both flax oil and coconut oil on hand, and once every couple of days, or whenever I think of it, I will put a few drops of one or the other in a small bowl (identical to the one pictured above, oddly), and use that to lubricate the area. This prevents any potential irritation caused by dryness or chafing, and protects against more extensive adhesions. So far, I have seen little change and it seems that the wait and see approach is working just fine for us.
|Photo Credit: dmason on flickr|
Those of you who know me well know that I lean more toward natural medicine. I had a hospital birth, but I was very careful to prepare so that I could still birth unhindered, with minimal intervention. Since Annabelle was born, I have successfully treated two eye infections with breast milk alone, and having come down with strep throat myself, managed to bounce back by taking plenty of garlic and grapefruit seed extract. I avoid pharmaceutical drugs wherever I reasonably can. Still, I take Annabelle to all of the regular “well-baby” visits with the base pediatrician.
Many who take a view similar to mine when it comes to medicine choose to avoid seeing, or taking their children to an MD or a Pediatrician. Some feel that doctors are only for the sick, and don’t replace these “routine” visits with anything at all. Still others choose to see a chiropractor, or another type of practitioner. Personally, when I was single and uninsured, I saw an ND (Doctor of Naturopathic Medicine), and that would be my first choice if I had a wide variety of options. Now that I am covered by military insurance, as is Annabelle, and we’re in a location with limited options, for me the family practitioner is the best bet, and for her it’s the pediatrician. I feel fortunate that we have access to this resource, and I don’t hesitate to take advantage of it.
While I know Annabelle best, and I pay careful attention to her growth and development, her pediatrician knows how the “average” child should be progressing at Annabelle’s age, and is aware of a wide array of potential issues that I would not know to watch out for. I have plenty of confidence in our ability to take responsibility for Annabelle’s care as parents, but I welcome the screening tool that we have in her pediatrician. I don’t see this tool as a substitute for being well-informed myself, but simply as another source of information, to be checked against the others I have access to.
The pediatrician alerted me to the fact that Annabelle has labial adhesions and, while I chose not to take the doctor’s advice regarding treatment, I am thankful that she took note of the condition and that I now know what to watch out for. I see the pediatrician as another resource in my journey as a new mom.
I will admit, however, that I have found myself frustrated with this model of care on more than one occasion, and navigating the parent-pediatrician relationship has been a huge learning experience. If I were asked to advise new parents as they choose a care provider, I would certainly recommend that they look for one with whom they share some core values. I have only one option here, so I have taken what I can get, and it’s not all bad, but it’s a challenge at times!
I went to Annabelle’s four month visit happy as a lark, and about as confident as a new parent can be. I left fuming mad. I was nursing when the doctor came in to the room, and he was very good about it, gauging the situation to make sure I was comfortable with his being there, and continuing with business as usual when he realized that I was. A good sign, I thought. I got too comfortable, however, and made the mistake of indicating the fact that we coslept. He jumped in with, “Well, you do know that cosleeping increases the risk of SIDS!?” I calmly replied, “Yes, but there are those who would argue that it actually decreases the risk.” He looked at me like I had at least half a dozen heads and quickly corrected me. “No, it INcreases it.” I smiled, and waited for him to move on, since he clearly was not interested in the other side of the issue. Later, he went through the list of topics that I suppose are standard practice to cover: “Do you use a car seat in the car?” and the like. The whole thing felt patronizing, yet I know he was following the ‘standard of care.’ In any case, it all rubbed me the wrong way and I was very glad when the visit was over.
Fortunately, we won’t be seeing that particular doctor again, and since that unpleasant visit, I have learned a few things. First and foremost: I’m the mama. While the pediatrician is the expert on norms, I’m the expert on my daughter, and the one who ultimately has to live with any decisions made regarding her care. I appreciate the valuable expertise doctors can provide, but I believe that they should be my collaborators, not directors of my decisions as a parent.
Additionally, I have learned that pediatricians are medical experts, but not all can be nutrition and parenting experts as well. Annabelle’s pediatrician suggested months ago that I night wean. If you’ve been around this space for awhile, you can probably guess that it took a great deal of restraint on my part to avoid uttering a loud, “Pffft!” at that particular recommendation. This was just one example of a suggestion offered based on norms. In the doctor’s words, “At her age, she shouldn’t need to eat during the night.” Fortunately I know my daughter, and I know that, age aside, she does need to eat during the night, so four months later, we’re still night nursing. Having read plenty on the subject of breastfeeding and infant sleep gave me the confidence necessary to quietly blow off this particular piece of advice.
Another suggestion that was pushed, this one several times, was the introduction of rice cereal. It was implied that Annabelle would turn out horribly iron deficient without it. I knew that rice cereal is a pretty lousy choice as first foods go, so it was easy for me to disregard this advice, but with my tendency to have low iron levels, I was a bit worried about that particular issue. Not wanting to be irresponsible, I requested that Annabelle’s iron levels be checked at nine months instead of waiting until the twelve month mark, as is the standard here. You see, I was borderline anemic early in my pregnancy, and have had low iron in the past, so as Annabelle’s primary nutrition source, I wanted to ensure that she was getting enough. Her levels were perfectly normal, and at the time she was eating very little in the way of solid foods. My confidence in our feeding decisions was reinstated.
Overall, I value the resource that we have in Annabelle’s pediatrician and I feel extremely fortunately to have such easy access to medical care. More and more every day, however, I’m finding that there is no substitute for informed parenting.
What are your thoughts on “well-child” visits? Does your family use an MD, or do you go the alternative medicine route? What factors have you considered in making your decision? How do you navigate the parent-care provider relationship?
I hope my daughter will forgive me in the future for sharing something so personal, but I feel it’s an important topic for other parents to be educated on. At a routine pediatrician visit last week, the doctor pointed out that Annabelle had developed a small labial adhesion. For those unfamiliar with the condition, it affects one to two percent of young girls and in most cases resolves itself by sometime around puberty when the body begins to produce more estrogen. Adhesions form when the labia experience some sort of irritation – even as simple as the everyday irritation of a wet diaper. Then, the delicate skin of the labia essentially grows together as it heals, covering over the vaginal opening. Most of the time, there are no adverse effects, but if the adhesion is so extensive that it blocks the urethra, it can interfere with urination, possibly even allowing some urine to make its way back into the urethra where it can cause an infection.
Annabelle’s pediatrician did not explain any of this to me. She just pointed out the adhesion and said that it can “cause problems with potty training later” so we needed to treat it with estrogen cream. She prescribed a cream that is made for menopausal women and said that I should apply it twice daily. She explained that there were “no side effects whatsoever,” except that Annabelle “may get breast buds and have a bit of vaginal bleeding.” I would consider those pretty serious effects myself, but maybe that’s just me. Of course the insert that came with the medication listed scores more. I, of course, asked a few questions and inquired as to whether there was any alternative to hormone therapy. I was brushed off and told there was not.
When I came home to look into the matter further, I found the information I shared in the first paragraph, and learned that many pediatricians take the wait and see approach, since there are not generally any complications associated with the adhesions. As long as the area is taken good care of, there is no reason to expect the problem will get worse over time, so there is no reason, at least as far as I can see, to rush into hormone therapy in infancy.
I was careful to use excellent hygiene when diapering and ECing Annabelle, and applied coconut oil often to keep things clean and moisturized and avoid spreading. With a bit more digging, and the help of a friend, I learned that flaxseed oil can be used as an alternative to prescription estrogen cream, as it is a phytoestrogen. I bought a bottle and went back and forth on the idea of using it vs. not. I ended up applying a bit instead of coconut oil once, and the very next day, the adhesion was gone. Obviously the flaxseed oil may not have had anything to do with it, but I was glad to know of a more natural alternative for future reference.
This is one of the now several times that I have chosen to make a decision that is contrary to doctors’ recommendations, and as with every other situation, I have been quite pleased with the outcome. I truly believe that it is so important for us as mothers to trust ourselves and to do our own research rather than blindly following medical advice. That is not to say that medical advice does not have value, but we do know our own children best, and we are the ones who must live with the consequences of our decisions. Whether it’s when to offer solids or how to treat an ear infection – it is up to us to make informed choices.
Do you often, or have you ever, chosen to go against “medical advice”? What was the outcome? Would you make the same decision again?