I'm hoping some of you can offer some suggestions for this mother (I have
her permission to post this).

Her baby was born weighing 7 lb. 2 oz. and she had a tear that was repaired
with "a couple of stitches." At 12 weeks, she was still feeling a lot of
pain and it was not healing. The OB told her that it wasn't healing because
she was still breastfeeding, which was lowering her estrogen level, and she
should wean. She wanted to continue breastfeeding, so was given Premarin
cream to use.

At 7 months postpartum, there was still no improvement, so she asked her
family doctor to refer her to another OB. This doctor recommended that she
have an episiotomy done and the whole area re-sutured. During the surgery,
the doctor found a hole in the vaginal wall and an abscess. This second
doctor also told her she should wean to facilitate healing.

The mother still had serious pain in this area, so at 13 months postpartum,
the second OB did another episiotomy and repair. She was told very sternly
that she MUST wean or this will not heal. The doctor told her there was no
reason to be breastfeeding past a year anyway.

The mother wants to continue breastfeeding, but has really suffered with
this problem. She is continuing to use the Premarin cream. Her menstrual
periods have not returned.

Is breastfeeding really preventing this woman from healing? It seems
somewhat unlikely to me, since so many women who have had episiotomies
breastfeed and heal up just fine. Any advice I can pass along? Any
references the mother can give her doctor?

Teresa Pitman, LLL Leader, Oakville, Ontario

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