Vaginal discharge with irritation is the most common gynecological problem in girls before puberty.
Vaginal discharge from girls before puberty can be from a variety of causes. Although, a specific cause is unknown in up to 75% of cases.
When infants have a bit of clear, white vaginal discharge possibly with some blood, it’s related to maternal hormones still in their system and usually stops by a few weeks of age.
Symptoms of vaginitis (inflammation of the vaginal area) in young girls may include vaginal discharge, redness, soreness, itching, pain with urination, and bleeding.
Causes of Vaginal Discharge in Children
● Soap irritation is the most common reason including bubble baths, shampoos and deodorant soaps.
● Poor hygiene. They do not wipe from front to back and some stool may get into the vagina, or they have constipation with leakage of stool that irritates the skin.
● Blockage from skin adhesions. The skin in the genital area sometimes sticks together, and it does not look like there is an opening to the vagina.
● Obesity leading to urine staying on the skin.
● Foreign bodies. Pieces of toilet paper can get stuck in the vagina, or young children sometimes put small objects such as beads inside.
● Clothing (leotards, tights, blue jeans, sleeper pajamas, polyester underwear or underwear with residual detergent or fabric softener, and wet bathing suits) that does not allow air to get to genital area.
● Masturbation can irritate the skin.
● Occasionally, a child may have a urinary tract infection or constipation where she complains of genital pain.
● Girls will start having a thin, whitish, with only a small odor, discharge 6-12 months before their menses (first period).
● Sexual abuse is a rare cause.
What to Do
● Soaking in warm water without soap for 15 minutes
● Not using perfumed soap on the genital area (including bubble baths); rinse the genital area well and gently pat dry.
● Cool compresses
● Petroleum jelly to protect skin
● Non-perfumed, gentle wet wipes can be used instead of toilet paper.
● Spreading legs wide while on the toilet or sitting facing backward to fully empty the bladder
How long does this last?
Irritation and some discharge can last for two to three weeks after identifying a potential cause.
Other Possible Causes of Vaginal Discharge in Premenstrual Girls
• Pinworms, especially if itching at night or having abdominal pain
• Yeast infections (rare: only in 3% of girls of this age)
• Trauma (falling on genital area from a bicycle, skating, etc.)
• Bacterial infection such as strep passed from her own respiratory system
• Sexually transmitted infections (rare)
• Malingering: false reporting by the patient
What about cancer?
Cancer as a cause has been noted in the Journal of Urology (Dec. 2006), but this is EXTREMELY rare. The cancers were rhabdomyosarcoma and endodermal sinus tumor.
Parents still should contact their child’s healthcare provider with these symptoms.
The problem is more emergent if there is severe pain, bleeding, your child seems very sick or the cause is sexual abuse.
Maryanne Tranter is a pediatric nurse practitioner with 25+ years’ experience in primary and urgent pediatric care, and founder of 
