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Ask Dr. Leah Your Own Question
Dr. Leah
Dr. Leah, Board Certified Pediatrician
Category: Pediatrics
Satisfied Customers: 195
Experience:  9 years of practice in Pediatrics
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my little girl has a strong smell coming from her vagina. gp

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my little girl has a strong smell coming from her vagina. gp tests state no infection is present. help please!!! im scared :(

Dr. Leah :

Hello and thank you for your question. There are a few possibilities that could cause odor, but I have a few questions. What type of tests were performed by her doctor? Does she have any vaginal discharge or just odor?

Customer:

no discharge...she has had urine sample tested with a dip test and sent off for more detailed testing

Dr. Leah :

Ok. It's good that a urine culture was sent. Malodorous urine can be a sign of a urinary tract infection. With no vaginal discharge, a fungal/yeast infection is unlikely. If she is toilet trained and wiping herself when she goes to the bathroom, it may just be a matter of her technique. I have seen many patients her age who, despite the best efforts, just don't get all the urine off of the labia/vulva. This causes a persistent foul odor and sometimes a mild rash or skin discoloration.

Dr. Leah :

I usually recommend a "2 step" method to teach young girls to wipe. I tell them to use a moist "baby wipe" first, then to dry off with toilet paper. This enables them to take extra time to clean themselves and to get more of the urine off.

Dr. Leah :

I would also continue the bathing routine you have already tried.

Customer:

i have been cleaning her for the last few weeks as i thought this myself and she has regular baths to make sure she is clean. its been going on for 6 weeks now though and seems to be getting worse

Customer:

the gp i have seen today advised vaginal swabs and she appears concerned

Dr. Leah :

From what you describe, a hygiene issue is less likely. Vaginal swabs? Bacterial infections in a 3 year old girl is extremely unusual and really only seen in cases of sexual abuse. If this is a concern, I would go ahead and have the swabs done but also make a report to local authorities. If there is no concern of abuse, I think a urinary tract infection is more likely the problem.

Customer:

urinary tract infection? i dont understand...would that not have come up in the urine sample?

Dr. Leah :

A urine dipstick test is not 100% accurate. If there is a moderate to large amount of bacteria in the urine, the dipstick test will be positive. It is less sensitive when there is only a small amount of bacteria present. A urine culture is the "gold standard" for diagnosing a urinary tract infection.

Dr. Leah :

Most urine culture results are finished in 48 hours. Your gp may want to start her on an antibiotic in the meantime until the results are known.

Customer:

they havent mentioned antibiotics. the urine was sent off 2 days ago i went back today. is it possible to be a horemone issue at such a young age? the gp asked about changes in behaviour. sorry for being so confused but im really worried

Dr. Leah :

I see. A hormone issue would present with other signs of precocious puberty such as breast budding or enlargement and hair under the arms or pubic area. Vaginal odor is not typically present.

Dr. Leah :

One other question: does she stool normally? Is there any soiling of her underwear?

Customer:

no she doesnt mess herself but her poo smells abit...her grandad said when she was there at the weekend she spent excessive time on the toilet but her poo seemed normal colour and size....just abit "curly" was how he described it

Dr. Leah :

Ok. The odor probably isn't due to a soiling or constipation issue. It seems like you may need a specialist opinion at this point. I would suggest discussing the issue with your gynecologist to see if he/she has any suggestions. Because of your daughter's age, they would most likely not examine her, but you can at least get a different perspective on the matter. In the meantime, I would monitor your daughter for any rashes or vaginal discharge.

Customer:

ok thank you

Dr. Leah :

You're welcome. Best of luck!

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