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| |    Vaginal Discharge in Young Girls by Marjorie Greenfield, M.D. reviewed and revised by Marjorie Greenfield, M.D. If you're the parent of a young girl, it is important to know that vaginal discharge (as well as vaginal infection) does not occur only in adult women. It's equally important for you to understand a bit about why they are so common so that you can help your child understand what is normal, what isn't, and what can be done about it. Why is it so common? Girls who have begun to develop breasts can have normal physiological secretions because of hormones. In younger girls, however, excess bacteria in the vagina is the most likely reason for vaginal discharge. Young girls often do not have the best hygiene habits and that, combined with the rectum's close proximity to the vaginal opening, can lead to the presence of a vaginal discharge, which can result from bacteria accumulating at the opening of the vagina. Also keep in mind that harsh toilet paper, residue from fabric softeners or detergents, and other factors can irritate the vulva, which in turn may lead to discharge and an environment that encourages the replication of bacteria. Unfortunately, any factor that leads to discharge can also cause further inflammation of the vulva, evolving into a self-perpetuating cycle. It's not unusual for many girls who have a discharge to also complain of itching or irritation. Dealing with the problem As a parent, it can be disturbing to address these kinds of problems in your young daughter. She may be embarrassed at the idea of being examined, and if she is scratching or rubbing the area due to discomfort, that behavior may embarrass others. The good news is that the whole situation is annoying but not dangerous. (It's very serious, however, if sexual abuse is occurring. For more information, see the section "Vaginal symptoms and sexual abuse" below.) It's normal to have some bacteria in the vagina, and these bacteria do not travel up into the uterus or tubes or cause any long-term damage. An ongoing problem can arise, though, if the child experiences long-term discomfort in this area of her body and the attempts to diagnose and treat the problem become a major focus for the family. While changing habits can be hard--some girls are not happy about being told to take a bath instead of a shower, or to sleep without panties or pajama bottoms--good local care of the vulva is what will most likely resolve the problem. If these measures do not improve the symptoms, a physician who is comfortable with gynecological care of children should be consulted. Resolution of the symptoms Since many types of bacteria can cause a discharge, vaginal culture can be helpful in guiding the initial treatment of the problem. A nurse practitioner, pediatrician, family doctor, or gynecologist who is experienced with the gynecological examination of children can often accomplish this in the office without traumatizing the child. Vaginal secretions are collected by swab or catheter (moms are happy to learn that speculums are not used for young girls) and sent to the lab. In the meantime, as long as there is no concern about sexual contact, you can start by instituting vulvar-care measures. Better care of the vaginal area often can solve the problem within a few weeks. A course of antibiotics sometimes speeds recovery, but the symptoms will recur if you don't eliminate the factors that irritate the area. Many families find that they periodically need to become stricter with vulvar-care measures if symptoms return, loosening up on the restrictions when the child is doing well again. You will probably learn with trial and error which factors (such as using dryer sheets or missing the daily bath) are the biggest culprits in causing the symptoms and which things you can let slide a bit. Vaginal symptoms and sexual abuse One last but extremely important note: If there is any concern about sexual abuse, the child needs to be questioned in a sensitive and private manner, preferably by a professional with experience in these situations. If sexual molestation may have occurred, cultures can be done to rule out sexually transmitted infections. All adults who have professional responsibilities for children, such as teachers, doctors, nurses, and social workers, are by law required to report any suspected abuse (even if not proven) to the child protection authorities so that the situation can be investigated. While it is painful for parents to consider the possibility that their daughter might have been molested, it is clearly better to find out, so she can receive both psychological and medical treatment and get protection from further abuse.
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