Hello Lactnetters,

    There is physical therapy for incontinence which could help this mom
without interfering with breastfeeding. The therapy involves exercises which
strengthen the entire lower half of the torso and kegel-type exercises.
There is also an electronic stimulator which is inserted vaginally and used
to directly activate the correct muscles causing them to tighten.
Biofeedback can also be used with a monitor placed vaginally which measures
muscle contraction in various positions. a good physical therapist should be
able to provide this for the mother. I have done this myself to treat a
cystocele with good results.

    I am aware of vaginal estrogen cream as a valid treatment for
incontinence. If mother chooses to use a vaginal estrogen cream she could
possibly try one that is natural estrogen cream rather than the synthetic
one. I don't know if it would translate the same, but personally I found
that using natural hormone supplementation of estrogen and progesterone
orally did not affect my milk supply nearly as much as a  low dose synthetic
birth control pill (Allesse) did.

    Depending on severity of the problem, maybe mother could put off drastic
measures for 3 months or so to see if the pelvic floor tightens up on it's
own. My personal experience has been that it sometimes takes up to 6 months
to get pelvic muscle tone back.

   Judy Gutowski, BA, IBCLC

Breastfeeding Matters in Western PA


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