Vaginal Discharge in children
A nursing mother once ran to our clinic to be
treated for sexually transmitted disease
because she thought her two-month old baby
girl acquired STD from her. The baby girl was
having a whitish vaginal discharge. The mother
was checked and tested for evidence of STD at
her request. The test was normal. She was
reassured that the vaginal discharge her baby
was having was not STD but it was as a result
of hormonal withdrawal. This does not require
treatment, as it will cease after a period.
Another mother brought her seven-year-old
daughter who has much vaginal discharge. The
mother said though she bathed the baby every
day, at the end of the day, her panties were
always messy with somewhat greenish tinge
but without offensive smell.
The genital examination showed that the
hymen was intact. A laboratory test (swab) of
the discharge was sent for culture and came
back positive for Eschericcha Coli, which
suggested a faecal source, probably from
improper toilet hygiene.
A nine-year-old girl, accompanied by her
mother, presented to the clinic with a
recurrent history of green vaginal discharge.
She reported no other symptoms. A thorough
history and physical examination was done,
including inspection of the vagina.
The genital examination showed that the
hymen was not present. A test (swab of the
discharge) was sent to the lab for culture and
came back positive for Neisseria gonorrhea,
which suggested gonorrheal infection.
Her parents were informed of the possibility
of sexual transmission, but they claimed no
history of such. This requires an urgent
Baby girls who are less than three months old
often have vaginal discharge and may
sometimes develop vaginal spotting or
bleeding. Both conditions are temporary and
normal. These changes are caused by
exposure to maternal estrogen, a hormone
that crosses the placenta and enters the
baby’s bloodstream before birth.
And because a newborn baby’s body takes
longer than an adult female’s to remove this
hormone, it remains after birth. The hormone
has the effect of making a newborn’s body
“think” that she is in puberty, and discharge
and bleeding occur. As the hormone levels
drop, the effects disappear. No treatment is
The causes of vaginal discharge in older
children include irritation from bubble baths
or the use of strongly scented soaps. Wearing
tight-fitting nylon underwear can also result in
Again, pinworm can cause vulvo vaginitis by
coming out of the rectal area. When that
happens, the tiny worms can cause vaginal
Constant or repeated rubbing, pressure or
abrasion in the genital area can also result in
vulvo vaginitis. Examples include
masturbation, frequent or prolonged contact
with play equipment (saddles on play horses)
or sitting in sand boxes.
If a young girl inserts a toy or other article
into the vagina, this can lead to an infection,
resulting in foul smelling discharge.
Infection is another cause of vulvo vaginitis.
The bacteria usually come from the rectal
area. It is shocking to find that some sexually-
transmitted infections have been detected in
young girls — an indication that sexual abuse
Sexual abuse (rape) should be considered in
children with unusual infections and recurrent
episodes of unexplained vaginal discharge
with no hymen. This is because the hymen is
supposed to be protective against any
Neisseria gonorrhoeae, the organism that
causes gonorrhoea, produces gonococcal
vulvo vaginitis in young girls and it is
considered a sexually-transmitted disease. If
lab tests confirm this diagnosis, young girls
should be evaluated for sexual abuse.
No treatment is required; both of these
changes are normal in a three-month old
infant. However, seek medical intervention if
the amount of the discharge increases in a
three-month old infant, or if the discharge
becomes foul-smelling and blood-stained
The usual treatment for vaginal discharge in
older girls seems fairly satisfactory, because
with ordinary measures ensuring cleanliness
and mild antisepsis, the condition is apt to go
on its own.
Some may benefit from antibiotics, depending
on the result of high vagina swab done in the
Sexually-abused girls will need to be given
psychological support, in addition to
Improved perineal hygiene is necessary to
help healing and to prevent future re-infection
for those whose infections are caused by
bacteria normally found in stool.
Young girls should be taught how to clean up
after defecating. They should be taught to
clean their perineal area from front to back
and not vice versa. They must also be taught
to wash their hands before and after using the
Sitz baths (a bath in which a person sits in
water up to the hips) may be recommended.
It is often helpful to allow more air to reach
the genital area. Wearing cotton underwear
(rather than nylon) or underwear that has a
cotton lining allows greater air flow and
decreases the amount of moisture in the area.
Removing underwear at bedtime may also