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In Newborns
The vaginas of little babies always appear puffy at birth, and there may be thick white or even bloody discharge (the equivalent of menses) for the first couple of weeks. This is due to the stimulation of the baby’s vagina by maternal hormones. Clean it as you would the diaper area, with water.

In Infants and Toddlers

Vaginal Fusion
In a small percentage of young children, the lips or labia of the vagina will partially fuse together. Unlike women, girls do not have vaginal secretions, so they are likely to experience dryness, irritation, and possibly fusion. Soap, aggressive cleansing, and even diaper rashes also increase the dryness and further contribute to the disorder. Urination is unaffected.

Vaginal fusion causes no symptoms, and it resolves on its own when girls get older and their vaginal secretions prompt the labia to open spontaneously. Prior to this, some doctors prescribe a topical hormonal cream to increase vaginal secretions. I don’t; such creams only solve the problem temporarily, and they can have rare side effects such as vaginal bleeding, because the estrogen is absorbed through the skin.

In Older Children

Vaginal Irritation
It is not uncommon, after the toddler stage, for young girls to experience burning in the vaginal area, especially upon urination. When this happens, your girl feels like urinating frequently, but nothing comes out. There could be a slight redness and sometimes a smelly greenish discharge. You may initially fear a urinary tract or vaginal infection, but this is probably not the case.

Blame the burning and discharge on simple vaginal irritation. Soap and bubble baths in particular can dry out the vagina of a little girl, which becomes itchy and then irritated. She pees frequently because she perceives the pain as a need to urinate, but any urine she produces stings a little and makes her think she needs to pee more. The genital exploration that starts as early as three years of age may contribute significantly to the irritation [See: Masturbation].

Although vaginal irritation is not the same as a urinary infection, doctors often incorrectly treat the irritation with antibiotics, because germs from the skin contaminate the urine sample and cause inaccurate readings. You can help prevent this condition and the possible misuse of antibiotics by limiting your daughter’s soap and bubble baths, applying a soothing ointment like petroleum jelly, and cutting her fingernails short. The symptoms should disappear within days. If, after a week, the pain persists or even increases, or if she develops a fever, take her to the doctor to eliminate the possibility of a urinary or vaginal infection.

For an older girl, a persistent, heavy, malodorous discharge with occasional blood may indicate that Lucy has inserted something into her vagina, which requires medical attention.