My little girl has a vaginal discharge.What might be the cause?

Vulvo-vaginitis (inflammation of the external genital area and vagina) is the only common gynaecological problem occurring before puberty. The genital area is red and sore and there may be discharge from the vagina. It can occur at any age but peaks around five years of age. Little girls are prone to poor hygiene as parental supervision is withdrawn and the child cleans herself inadequately: this can result in a little faecal matter entering the vagina. The natural chemical mechanism protecting the vagina from infection during reproductive years (Q 22.1) is absent in the child so faecal contamination of the vagina will rapidly start infection.

Careful hygiene after every bowel action is essential. Bland creams such as Sudocrem or E45 may provide some protection. Your daughter should be encouraged to wipe in a backward direction to avoid faecal contamination of the genital area. Chemical irritation must be avoided her bath should be thoroughly cleansed and rinsed before she uses it and clothes should be rinsed after washing. Leggings and tights should be avoided as they may keep the genital area moist, and underclothes should not be worn at night.

Young children have a tendency to explore their bodies and sometimes small objects may be introduced into the vagina. This may lead to a smelly, blood stained discharge. The doctor may be able to feel such an object by gently introducing a small finger into the rectum. Ultrasound examination may help to exclude a foreign body. If there is any doubt, there are times when the vagina can be checked with a tiny speculum although this usually requires an anaesthetic.

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