We commonly see little girls in the clinic who have urinary and/or vaginal complaints. Parents usually suspect a urinary tract infection (UTI) because the symptoms can be very similar (not wanting to urinate, pain with urination). Sometimes it is a UTI and we usually check the urine, however, more commonly, it is a condition called vulvovaginitis. This condition is essentially vaginal irritation. Little girls who have not been through puberty and have recently been toilet trained are at highest risk for this condition. Vaginal tissues are very sensitive in little girls and this fact combined with improper wiping and poor hygiene leads to irritation.
- Wear cotton underpants.
- Double-rinse underwear after washing to avoid residual irritants.
- Do not use fabric softeners for underwear and swimsuits.
- Avoid sleeper pajamas. Nightgowns allow air to circulate.
- Avoid tights, leotards, and leggings. Skirts and loose-fitting pants allow air to circulate.
- Daily warm bathing is essential. Allow the child to soak in clean water (no soap) for 10 to 15 minutes.
Use soap to wash just before taking the child out of the tub. Limit use of any soap on genital areas. Rinse the genital area well and gently pat dry. A hair dryer on the cool setting may be helpful.
- Do not use bubble baths or perfumed soaps.
- If the vulvar area is tender or swollen, cool compresses may relieve the discomfort.
- Wet wipes can be used instead of toilet paper for wiping.
- Emollients may help protect skin. (Vaseline or Aquaphor)
- Review hygiene with the child. Emphasize wiping front-to-back after bowel movements. Children younger than five should be supervised or assisted in toilet hygiene.
- Avoid letting children sit in wet swimsuits for long periods of time after swimming.
- Timed voiding. Remind your child to sit on toilet at least 5-6 times per day and empty bladder completely. If she has trouble voiding completely, try having her sit backwards on the toilet (facing the toilet). May need to apply emollients prior to urinating for comfort.
Call us if:
- Your child has a fever
- Your child is a boy with these symptoms
- Your child has back or abdominal pain
- The treatment isn’t working
- If your child has pain with urination, bring him or her into the office for evaluation