Vagina
When girls are born their labias can be quite swollen. Akin to how when boys are born their scrotums can also be swollen. This is due to the fact that babies are born with a lot of extra fluid in their tissues to maintain hydration until the breast milk let down occurs a few days after birth. Over time the swelling will go down. As the swelling goes down, and mom’s hormones leave baby girl’s body, there can be some vaginal discharge or a small amount of vaginal bleeding. This is normal and can be wiped away gently the same way you wipe when you change a dirty diaper.
Labia in females can become fused. Due to dryness and irritation the labias can fuse but this gets corrected naturally as a female enters puberty. The body’s natural hormones and secretions will allow for the separation of the labial fusion. But if the labia are fused in a way that it is painful or block the urine stream, we often apply a daily steroid ointment to mimic the body’s hormones, promote separation of the fusion, and allow for a normal urine stream, while preventing recurrent pain or irritation.
In older female children, the vagina can get irritated (vaginitis) to the point that it hurts to urinate mimicking a urinary tract infection. Things that cause this irritation are drying agents like soap and bubble baths, staying in a swimsuit for too long after swimming, running around a lot when it’s hot, or really anything that can cause irritation to that sensitive area. Often, we will see a kiddo in clinic and note that the vaginal opening and labia are irritated, but when we check the urine for bacteria, we only see cells representing irritation, not infection. Unlike a yeast infection vaginitis, that pubertal and post pubertal females can get due to the pH of the vagina and vaginal secretions during and after puberty, we treat irritant vaginitis with sitz baths 2-3 times a day for 10-15 minutes at a time. We just have the kiddos sit in a plain water bath that covers their bottom and after the bath pat the area dry and immediately place the kiddo in clean breathable cotton underwear. This will usually clear up the irritation over the next 3-5 days.