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| |    Vaginal Bleeding in Infants and Young Girls by Marjorie Greenfield, M.D. reviewed by Marjorie Greenfield, M.D. While most women understand and are comfortable with the basic process of menstrual periods, vaginal bleeding in young girls is quite a different matter, and without a doubt can be an alarming occurrence for mothers to witness. Whenever vaginal bleeding occurs in young girls, the inevitable questions are raised: Where exactly is the blood coming from, and what does it mean? The potential answers depend on several factors, not the least of which is the age of the child. Normal bleeding during infancy Within the few weeks immediately following birth, some newborn girls will experience a small amount of bleeding from the vagina. This is entirely normal and occurs as the level of the mother's hormones in the baby's system gradually decreases. The result basically is the equivalent of a tiny menstrual period. This type of vaginal bleeding usually lasts less than a day and is not painful. No special evaluation or treatment is needed; and in fact, such bleeding during infancy can be somewhat reassuring, because when a baby girl's body responds in this way to the drop in hormone levels, it's a sign that her system is working properly. The important thing to keep in mind is that neither the presence nor the absence of bleeding in these early weeks is anything to be greatly concerned about. Either situation can be considered normal. Vaginal bleeding after early infancy From early infancy until a year or two after a girl begins to show signs of breast development as well as other signs of puberty, bleeding from the vaginal area is not normal. While quite often the cause of vaginal bleeding is not serious, it always warrants a visit to her healthcare practitioner for evaluation. A visit to your pediatrician or family doctor is probably the best place to start. Genital examination of young girls When it comes right down to it, many grown women don't relish the thought of going for a pelvic examination. So it's not surprising that the idea of subjecting a very young girl to a pelvic examination can be nothing short of horrifying to some parents. It may help parents who are facing this prospect to keep a couple of things in mind. To begin with, adult instruments--including a speculum--are not used for the genital examination of young children. At most, a genital examination of a girl who has not yet reached puberty may involve briefly using a swab inside the vagina to check the secretions for infection, a procedure that can be uncomfortable but not harmful. Also, vaginal examination with the doctor's finger inside the vagina is never done in very young girls. If your child's regular checkups typically include an examination of the external genital area, this part of the evaluation will, it is hoped, seem like part of the normal examination routine and won't be as frightening to her. If your doctor is inexperienced or uncomfortable with doing a genital exam of young children, ask for a referral to someone who is practiced in this field. Fears: your child's or your own If you feel that your child is being traumatized by the exam, or if she refuses to be examined, it may be preferable to wait and have her examined while under the use of anesthesia or sedation. In any case, it's important that your child be checked out. Unexplained vaginal bleeding can be a sign of a serious condition: genital cancer, a vaginal foreign body, or sexual abuse, among others. Don't let your fear of having your child examined prevent you from seeking proper medical care. Choose a practitioner who is compassionate, and have him help you do the right thing and seek the right specialists so that the cause of the problem can be found.
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