Early in the morning, two young patients, twin sisters, arrived in the waiting area. The children were only eight years old, second graders in elementary school, each carrying a large school bag. The young mother complained: The two babies had painful urination in the past few days, and urine stains were found on their underwear. The urine test showed: no abnormalities. I scheduled another routine pediatric gynecological exam for the babies. The mother was a little confused, but was cooperative. After the test, I told the mother that the babies had infantile vaginitis and needed treatment. The mother said, “How can a baby have vaginitis? Isn’t that a disease that only adults get? Besides, the children’s underwear are all ironed separately and washed every day. I am a very clean person, right? I reassured the mother: this is a common disease of female babies, and not your fault, it is the biological characteristics of the children caused, do not be nervous, the treatment effect is also good. ”What? Vaginitis is a common disease in baby girls?” The young mother grew her mouth. Infantile vaginitis, or infantile vulvovaginitis, is a very common disorder in female infants and children, mostly between the ages of 2 and 9. Treatment is often delayed due to poor self-reporting ability and parental neglect in infants and young children. The anatomy of young girls is characterized by poorly developed vulva, which cannot cover the urethra and vaginal vestibule, making it easy for bacteria to invade, low estrogen levels, thin vaginal epithelium, low glycogen, high pH, and few lactobacilli, making it susceptible to infection. Etiology Common pathogens include Staphylococcus, Streptococcus and E. coli. Trichomonas or Candida can also cause infection. The pathogens can be transmitted through the clothes and bath tubs of sick mothers, caregivers or kindergarten children. It can also be caused by poor hygiene, unclean vulva, frequent contamination by stool or direct contact with dirt. Inflammation can also be caused by injury or scratching of the vulva, especially in cases of pinworm infection, and by misplacing foreign objects in the vagina. Symptoms The symptoms are often seen by parents who notice purulent discharge from diapers or underwear, or by children who cry in pain during urination. The main symptoms are pain, itching and increased discharge from the vulva. Gynecological examination The mucous membrane of the vulva, clitoris, urethra and vaginal opening is congested, edematous, and has purulent discharge. There are often purulent dry scabs forming on diapers or underwear, or traces of dilute watery appearance, and the vulva is red, edematous, and even skin peeling. There are local scratches and bleeding. In severe cases, the labia minora are adherent and the urine stream becomes thin. Examination reveals that the labia minora adhesions are thinner and more translucent. Vaginal discharge is examined with a cotton swab to look for trichomonas and mycobacteria, while noting the presence of foreign bodies in the vagina. The stool is checked for pinworm eggs. Diagnosis can be confirmed based on clinical symptoms and bacterial test results. Treatment The first step is to exclude specific infections and send the discharge for trichomonas and mycobacteria. If necessary, bacterial culture can be performed to determine the causative organism and appropriate antibiotics can be administered. Localized sitz bath with appropriate proportion of potassium permanganate and topical antibiotic ointment should be applied to keep the vulva clean and dry. Prevention Infants should be kept with a clean and dry vulva. For small babies, cotton diapers are the best choice because they are soft and breathable; it is better not to use diapers when you are not going out. Change diapers promptly after urinating and defecating, and insist on washing the vulva one to two times a day, paying special attention to washing and gently wiping dry the labia and skin folds. As they enter early childhood, little girls generally no longer often sleep in cribs or sit in carts and seats, but mostly walk and play, and often wear crotch pants, sitting casually on the floor or carpet, when dirt, dust, and even small bugs are prone to pollution and stimulation of the vulva; riding small bicycles, or sitting on hard objects can easily damage the vulva. Therefore, parents should pay attention, try not to let children sit and lie on the floor, wear dead crotch pants as early as possible, do not wear tight pants, high socks of chemical fiber; clothes should be soft, loose, comfortable. Cleanliness after urination and defecation should not be neglected, especially after urination, soft toilet paper should be used to wipe the urethral opening and surroundings, and attention should be paid to the posture of urination to avoid flowing into the vagina from front to back. After defecation, use clean toilet paper and wipe from the front to the back to avoid wiping the fecal residue into the vagina. In addition, children’s bath tubs and towels should be used exclusively for children to avoid cross infection with adults. If you take the above precautions seriously, you can effectively prevent the occurrence of vulvodynia in infants and children.