Infant vaginal exams - Page 3

[Marsupialmom]

I think we need to remember there are people that have NO clue what an adhesion is and what a normal vulva should look like or infant vulva.

I knew what labial adhesions are because my mom helped a girl out that had them. Almost got arrested for it also. DG had suffered a few years with horrible periods and all her life with UTI's. Her doctor never checked. And her mom was very very weird about a lot of things, including sex.

My mom sat us down and talked about how normal parts should feel like (pre internet don't think she had pictures), when to worry and not. My mom was very open but she sat down and made sure we knew.

So a quick check (peek) does not bother me. I do have to ask the OP does your baby have a lot of fat that hides her labia? There is a lot of difference in parts and exposing the clitoris is not necessarily extreme for some girls.

I would ask the doctor why he/she is checking. They might have noticed abnormality at appointment 1 and just doing a quick note scan not realizing at appointment - that it had changed.

OP, I would ask myself why I am not comfortable talking to the doctor about this.

[Cherry Alive]

Originally Posted by Marsupialmom

OP, I would ask myself why I am not comfortable talking to the doctor about this.

Are you insinuating that the OP and any of the rest us who don't want doctors doing vaginal checks on our DDs have body "issues"?

411 on Labial Adhesions:

http://www.drgreene.com/azguide/labial-adhesions

Regardless of how familiar a parent is with normal infant genitals or not, I think most parents can tell when something is wrong. It's not exactly rocket science, KWIM?

Uncirced boys have the same issues with the potential of fusion (w/ their foreskin around their urethras) to the point it can interfere with peeing and cause UTIs, but no one here would ever advocate doctors needing to check under a boy's foreskin to look for problems—even if the doctors are gentle and don't pull the foreskin from the penis. The same rule of thumb can apply to little girls. If it ain't broke, don't be trying to fix it.

For the record, I have no body issues (and, yes, I've seen all of DD's "parts" during poopy diaper changes—inner and outer labia, clitoris, etc... ), and I still won't allow extensive vaginal checks w/out a really good explanation from the doctor (and "preventative care" is not a good explanation).

As I've said before, they can be invasive, potentially painful to the child, and they are *not* necessary unless the child is having problems or the doctor suspects there's something wrong (for which they should at least say something before they even check). Even with a nice doctor, I think it pays to ask about these things if you don't agree with them. If you can't speak up with a doctor you have a good chemistry with, you and/or your child will have bigger problems when you run into a doctor who's not so decent.

[november]

Ummmm ... that seems weird to me. My doctor (nor nurse practioner) has ever looked at my daughter's vagina. On the two week appt, my doctor checked for a diaper rash, but didn't look at her vagina closely, just a quick glance of her diaper region to make sure it was clear of diaper rash.

I check occasionally just to make sure things are looking right down there.

[cheryllynn]

I think this is misleading as it isn't an internal vaginal exam at all. I wouldn't call it a vaginal exam at all, but more of an external genital observation.

My DD's female ped has done this check on each visit. She did not mention adhesions, but did mention looking for infections, yeast infections, or discharge.

It was not any more invasive than wiping for a diaper change.

I did have a friend whose dd had adhesions, so I was aware of this.

This part of the exam didn't bother me at all.

Maybe for some it might have something to do with the doctor doing the exam.

[Quinalla]

Originally Posted by Evie's Mama

Our ped will unhook one side of the diaper and take a quick look for rash and that's it. No touching or anything. I would not be comfortable with that.

Yes, same here too, though there was a more thorough exam just after birth. I could definitely see a more thorough exam if there was cause for concern (either because of past problems, something off in the quick glance, or something the parent brings up), but it seems kind of strange to do that thorough of an exam at every WBV.

[basje]

OP checks back in

First off I posted this because I wanted to learn about other parents experiences with this before mentioning asking my doctor about it. I'm no fool that sometimes the doctor's explanation is in their best interest, or leaves out a key bit of information. I started thinking about it when I was reading under the no-circ boards, and how many mothers were stunned by their practictioners ignorance about caring for an entact penis.

It seems from all the pp that about half of you don't have doctors doing this at all or on a regular basis. I imagine that there is a great variation on the "standard of care" for newborn sexual organs. I think they likely are looking for adhesions. Her exceptionally typical vulva is examined by me with daily cleaning. My daughter will be lucky to be taught about caring for herself from a mother with hours of experience teaching about self vaginal exams, when she is old enough to take care of her own body. In the meantime, I will be asking that they note to discontinue examining her vulva. There isn't any reason for the nurses to be sodding there way around the chubby bits looking for problems, in my opinion.

The same as if she had an intersex condition I or labial adhesions I don't want the doctor anywhere near while she's naked. I am a firm believer in the "leave the damn kids genitals alone" movement and would not choose to have medical interventions on my child's sex organs without their consent. Until my daughter is at an age and intellect that she can voice her own opinion about vaginal exams (even external exams) I will decide for her, and it seems further exams are unnecessarily invasive.

I'm glad we all got to talk about this though.

[MaterPrimaePuellae]

The Np checked DD at her 18 mo checkup-- DD did have a pretty severe labial adhesion, and no, I hadn't really noticed. It happened (despite regularly changing and cleaning!) so gradually, and I didn't spend much time studying her vagina at diaper changes; it didn't interfere w/ peeing.

I'm glad the nurse checked, because I had no idea that labial adhesions even happened... but that's because of my own ignorance. I would much rather they had taken a moment to do a little parental education (since they took the time to explain to me that my 9 mo should not watching TV or be drinking more than 8 oz of juice a day...:eyeroll).

Anyway, now that I know, I agree w/ the OP-- the MW checked DS for descended testicles at birth, and now that I know those are in order, I won't be taking his diaper off at the HCP (if we ever end up going...) There's just no reason to mess w/ something that is clearly functioning well.

I just want to add, too, that you do NOT have to use estrogen creams for labial adhesions. I used California Baby diaper rash cream applied w/ a qtip and mild pressure over the adhesion, and I dried her vagina off w/ a hair dryer after baths for a few days. The adhesion opened within days and was totally resolved with a month or so. I was shocked by how quickly it went away.
I cannot imagine using premarin on a baby (or... well... on anyone). Certainly, if anyone is considering it, you should read the side effects first. Very, very scary, IMO.

[AllyRae]

Originally Posted by Momalea

That strikes me as really odd. My dd is 9 now, so my memory is fuzzy but I only remember her having one quick visual vaginal exam soon after she was born.
You're totally in your right to tell your health care practitioner that she has had a vaginal exam, she is having no issues, and you'll decline any future exams unless there is a medically necessary reason.

Yeah, this. Neither of my 2 DDs ever had a vaginal exam at a well baby check. The ped opens the diaper to check the lower abs for hernias, but never once stuck his hand near her genitals. I guess if I came in there asking about a concern I had with their genitals, he'd check, but otherwise he doesn't see the need.

[KBinSATX]

Okay this is probably kind of an ignorant question but if the adhesion isn't noticable (in other words doesn't affect current function such as urinating, etc.) and in the majority of cases resolves itself as the child grows (much like the male foreskin being fused with the glans) why would something need to be done, creams or pressure or otherwise, etc.
Couldn't you just wait and see if it detaches over time?
I mean I can see intervention would be necessary if the child couldn't pee, etc. But if it doesn't impact function or comfort and most likely detaches later anyway, why mess with it?

[KatWrangler]

Originally Posted by Maluhia

It's to check for adhesions which get much worse with time and are easier to treat if caught early. Less painful in the long run.

This.

[KBinSATX]

I get the reason why they are checking for this . What I don't get is why they would interfere anyway.
Here's a quote from Dr Sears:

Commonly during the first year or two you may notice that the slit-like opening in your daughter's vagina begins to close. Mention this to your doctor during your baby's regular checkup. Called labial adhesions , this condition occurs because the sides of the vaginal opening are so close to each other that they begin growing together. This does not cause baby any discomfort or harm. Oftentimes these adhesions open by themselves. But if the adhesions are becoming thicker or obstructing the whole orifice enough to block the flow of urine, your doctor may gently open the adhesion. If they continually grow back, the doctor may prescribe an estrogen cream to be applied around the edges to prevent further adhesion. Around two years of age, as your daughter begins producing her own estrogen in this tissue, the labial adhesions will subside.

My point is if it's not the case of impacting function and it most likely resolves itself at around age 2 without intervention then why bother with the exams.
If it did impact function then it seems the parent would notice and then intervention would make sense.
But as a routine measure it still seems odd to me.

[KatWrangler]

DD2 had one. I had no clue. I was actually embarrased when the Ped pointed it out to me.

She did prescribe a cream but forgot to give me the script to take just in case. It went away on it's on after a couple of months.

[MsVyky]

I had no idea this happened until I read this thread. So I made a mental note to see if ours did!

My daughter had a WVB on Monday, and the ped did check for adhesions. BUt it was super quick, no studying it, he just very quickly and slightly moved her labia and moved on to check her for inguinal (sp?) hernia and her hips for dysplasia

[tzs]

yep, same here. maybe i skipped that day in health class but i had no idea this existed until this thread and ya know what...i still don't think i'd know what to look for.
my ped does do quick checks and since they were so unobtrusive i never questioned them before and now i'm glad she's doing them.
i mean, she's also checking all the other parts so why would i be especially concerned if she checks this one? i don't really see why the vagina should be a forbidden zone for the doc when i could care less that she's also probing say, the ears.

[amydiane]

Originally Posted by MsVyky

I had no idea this happened until I read this thread. So I made a mental note to see if ours did!

My daughter had a WVB on Monday, and the ped did check for adhesions. BUt it was super quick, no studying it, he just very quickly and slightly moved her labia and moved on to check her for inguinal (sp?) hernia and her hips for dysplasia

This. I'm actually familiar with adhesions, but I never noticed our ped doing a vaginal exam, and you'd think you'd notice something like that. So I watched even more carefully yesterday at her WBV, and he did, but it was just like you said, and very quick and non-invasive. I can see how it wouldn't have really registered to me before as a "vaginal exam."

[ians_mommy]

Originally Posted by LaLaLaLa

I believe my kids' doctor knows what she is doing, and knows better than I do the kinds of things to watch for. If she asks to check my kids' genitals and my kids are tiny and don't care one way or another who sees them naked, I can't see refusing her request. A medical doctor doing an examination of an infant's genitals at a doctor's office during a visit I've scheduled for the purpose of making sure the infant's body is healthy doesn't show up anywhere on my mom radar.

This.
I picked my pediatrician because I trust him and feel comfortable with him. He takes diapers off at every visit. He has always acted completely professional and so I find no reason to question him.

ETA: I need to point out that the OP is using incorrect terminology. What she describes is an exam of the external genitalia- NOT a vaginal exam. A vaginal exam involves either a digital or visual (using a speculum) exam of the vaginal vault. That would be inappropriate in a child unless there was suspician of abuse, injury, or other abnormality (i.e. imperforate hymen)

[TzippityDoulah]

if it makes you uncomfortable tell them. if you're worried about sounding weird or setting of some kinda doctor alarm (some docs overeact as assume everyone who opposes them must do it for diviant reasons) then give them a simple explanation. "she has been checked already and comfirmed that all is well so we don't need anymore checks." or something similar. my old doctor used to lay out gowns for my kids to put on but my son was uncomfortable with changing so we just told him he's be keeping his clothes on and he'd lift up his shirt if the doctor needed. they usually shrugged or rolled thier eyes are worst and left it at that. Not everyone in the medical community feels like a person's right to privacy counts when they are little... or sick. (or birthing! lol but that's another topic!)