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The doctor says my baby daughter has labial adhesion. What's that?
It means the inner lips of her vagina — her labia minora — have become stuck together. The area that's joined may be just a small section, or it may be extensive. This happens to about 2 percent of girls up to age 6 in the United States, and while the condition can be unsettling for parents, in most cases it's nothing to worry about.
What causes labial adhesion?
Some baby girls just seem predisposed to it. Experts think adhesion happens when the labia become irritated and raw — possibly from wet or dirty diapers or scented detergent or soap — then fuse together as they heal. Estrogen also seems to play a role: Adhesion tends to develop at about 3 months, just after the estrogen a baby received at birth from Mom has tapered off. (The hormone affects the skin cells of the labia.)
What can be done to treat it?
In most cases, nothing needs to be done. Don't try to pull your daughter's labia apart: That could hurt, and the labia will probably just grow together again. Unless the adhesion is causing problems, it's best to leave it alone — in time, it usually goes away on its own.
If the adhesion extends to cover the opening of the urethra and is trapping urine in the genital area, though, you'll definitely want to see your baby's doctor about treatment. Trapped urine can cause irritation and possibly infection. You can tell whether your daughter's labial adhesion is covering the urethral opening just by looking at it. Her genital area may also look irritated.
An estrogen cream is usually prescribed to treat the condition. Your doctor will tell you to apply this cream directly to the affected tissue, and in about two weeks — sometimes more, sometimes less — the labia should unseal.
Apply the cream with a cotton swab to the fusion line, and try not to get much on the surrounding tissues. Some doctors suggest switching to a nonprescription lubricating ointment like petroleum jelly or baby salve after you stop using the estrogen cream, to reduce risk of readherence.
How can I prevent this from happening again?
Be vigilant about keeping your baby in a dry diaper. You might also apply a thin coat of petroleum jelly or baby salve after each diaper change to prevent irritation. Avoid scented soaps or detergent that may cause irritation, too.
Even if you do all you can, your daughter might continue to have adhesion on and off throughout childhood. But when she reaches puberty and her estrogen levels rise, the condition should disappear. Until then, there's no reason to be concerned about the adhesion if it's not causing any problems. Many little girls never even know they have it.