It may be a taboo topic around the playground, but if your kids are feeling discomfort “down there,” they’re not the only ones. From itchy bums to painful peeing, Michael Dickinson, a paediatrician in Miramichi, NB, explains that genital health issues are quite common in children, especially around pre-school age. “For the most part, they’re not serious or dangerous,” he says. “But they can cause parents a lot of anxiety.”
Some moms and dads may feel shy about discussing symptoms with their parent friends — they may worry that a problem is a sign of poor parenting, or unhygienic conditions at home. “These types of issues arise under the best of circumstances,” assures Dickinson. It’s important to know what to look for, so we decoded the most common symptoms.
1. A diaper rash that won’t go away
Candida (yeast) exists in our intestinal tracts and in small amounts on our skin. But a warm, moist diaper can cause yeast to overgrow, resulting in an itchy, red rash. “Unlike the most common kind of diaper rash, which is caused by urine and stool irritation, this type isn’t tender to the touch,” explains Shirley Blaichman, a paediatrician and spokesperson for the Canadian Paediatric Society. Smaller lesions, called satellite spots, will also be present, appearing close to larger, more defined patches.
Who gets it Children who are still in diapers.
How to deal It can be hard to differentiate between different types of diaper rash. “If your baby has a rash that isn’t improving after a few days of applying a barrier cream, she should be seen by her doctor to determine if it’s yeast,” says Blaichman. An antifungal cream will be prescribed; it should start to work within a few days.
Extra RX Proper diaper hygiene can help keep rashes away. Change diapers often, keep the area clean, use a barrier cream at the first sign of irritation, and allow for plenty of exposure to air.
Quick change Just like babies in diapers, kids sitting in wet swimsuits all day may end up with trapped-in moisture and irritation. To avoid putting a damper on summer fun, switch them into dry clothes when they aren’t splashing around in the water.
2. Redness around the vagina
Vulvovaginitis is an irritation of the external vaginal area, accompanied by pain or itchiness. It’s often caused by constrictive clothing, poor wiping techniques or sensitivity to soap.
Who gets it Preschool-to prepubescent-aged girls. “Low estrogen levels make them most vulnerable,” explains Blaichman. Once puberty hits and their estrogen increases, the vulva thickens and protects against irritants.
How to deal “Local irritation isn’t a big concern, but does need to be addressed before it worsens,” says Blaichman. Dress your daughter in loose, cotton clothes, put her to bed without underwear or pyjama bottoms, avoid bubble baths, and ensure she’s wiping from front to back. Symptoms should resolve in a few days.
Extra RX For a soothing soak, have your daughter sit in a shallow bath of warm water mixed with 1/2 cup of baking soda.
3. Painful urination that’s cloudy or foul-smelling (or both)
A urinary tract infection (UTI) is a bacterial infection in the bladder. Luis Braga, a paediatric urologist at McMaster Children’s Hospital in Hamilton, explains: “UTIs are commonly caused by E. coli, which lives in our bowel but can enter the urethra [the opening of the urinary tract] from the rectum.” Older kids will express symptoms such as a frequent, urgent need to pee. In babies, look for fussiness, lack of energy and low appetite.p
Who gets it Up to 10 percent of children will have a UTI by the time they’re teens. Since a girl’s urethra is shorter and closer to her perineum than a boy’s, it can be easier for bacteria to travel to her bladder. While the bacteria normally flushes out when kids pee, it can also grow. Toddlers and schoolchildren are often so distracted that they hold in their pee, which allows bacteria to flourish. In babies, UTIs can be accompanied by fever — it’s called a febrile UTI — and this may indicate a more serious, upper urinary tract infection, in the kidneys instead of the bladder. “Thirty to 40 percent of babies with a febrile UTI are suffering from urinary reflux,” says Braga. Reflux is a condition — often congenital — that pushes the infected urine up toward the kidneys, instead of out the urethra.
How to deal Your child’s doctor will collect a urine sample to test for bacteria. If a UTI is identified, oral antibiotics can be used to treat the infection. While symptoms should subside within a few days, extra fluids will flush bacteria faster, and will dilute the urine to make peeing less painful. Doctors generally don’t test babies for reflux until a febrile UTI recurs.However, reflux usually resolves on its own by age two, and can be managed in the meantime.
Extra RX Constipation is another factor for UTIs, says Braga, since a full rectum can keep the bladder from properly draining, resulting in residual contaminated urine. Keep your child “regular” with fibre-rich foods, such as whole-grain breads, beans and berries.
4. An itchy bottom, especially at night
Pinworms are white, barely visible parasites that live inside the rectum, and crawl out only at night to lay eggs on nearby skin, causing irritation. “They’re not dangerous in any way,” says Dickinson. “But a child who has pinworms will be very uncomfortable.”
Who gets it Anybody can catch pinworms, though it’s most common in preschoolers and in densely populated settings like daycares, where close contact facilitates the spread. After an infected child scratches his bum, he traps the worms under his nails and transfers them to shared toys — where other children pick them up and ingest them. “Since eggs can survive for two weeks outside the body, the rate of reinfestation is high,” says Dickinson.
How to deal If you suspect your child has pinworms, his doctor may ask you to collect a sample of the eggs during the night, when they are outside the body. (Use a piece of clear tape, a cotton swab or the collection kit provided by the doctor.) A one-time antiparasitic oral medication will be prescribed, usually to the whole family, and repeated two weeks later as an extra precaution. Symptoms should disappear within a week.
Extra RX Eliminate eggs from the house by cleaning toys and laundering bed linens all on the same day. Enforce proper hand-washing hygiene with your little one. Dealing with these symptoms may not be for the squeamish, and it’s likely not what you envisioned before becoming a parent, but it’s all part of the experience of raising a happy and healthy kid. A year ago, when Sarah Gordon* learned that her four-year-old daughter had pinworms, the news was so unsettling that the Toronto mom immediately burst into tears. “When I look back at my reaction, I have to laugh,” she says now. “As soon as my daughter started to feel better, it didn’t seem so bad anymore.” That’s why it’s important to keep perspective and to know that most of these problems are minor. And if it’s not something you can treat on your own, your paediatrician is there to help.
*Name has been changed