For Parents

Navigating the care of a small child’s body isn’t always easy or straightforward, especially if you are not just new to a child’s vagina, but vaginas in general.

There are the main handful of concerns for parents, with each concern typically connected to a certain age group of child.

We’ve split this section up into age groups, so it’s easier to find what you need.

A great place to start if you’re a bit lost is Gynaecology in children and babies, how children’s vaginas differ to adult women’s, and our special section just for dads.

Doing right by your child

1. Make sure your child has a good relationship with your family doctor or get a new doctor. A female doctor may be preferable.
2. If your child complains about a practitioner, get a new one – trust is imperative. It doesn’t matter who’s right. 
3. Listen to your child’s problems and be kind. You don’t always have to solve things, she may just need your ear. Making an effort to listen and understand goes a long way.

Some vaginal conditions in children include labial adhesion (where the labia stick together, fusing, due to the lack of oestrogen in kids), vulvovaginitis and vaginal discharge caused by irritation or infections, and damage caused by accidents, like hitting the middle bar of a bike.

We also cover hymen injuries. 

Staphylococcal scalded skin syndrome (SSSS) on the vulva

Staph scalded skin syndrome is an infection that causes skin blistering, which can affect the vulva.

Understanding and treating keratin pearls

Keratin pearls, tiny irritants formed by keratin and squamous cells, can cause significant clitoral pain.

Understanding and treating smegmatic pseudocysts

A smegmatic pseudocyst, often confused with a cyst, is actually an accumulation of smegma causing potential infections and discomfort.

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Know your anatomy

Part of knowing the anatomy of a girl is calling things by their real names. You may be calling your daughter’s vagina or vulva by a name other than it’s real name, and now is the time to stop that cold turkey, and start naming body parts accurately. This is about much more than your possible embarrassment, and becomes a safety mechanism that you arm your daughter with.

Naming body parts accurately is important for a few reasons:

• If something goes wrong, your daughter can at least accurately name the area that is causing issues to you or a doctor
• You and your daughter should feel comfortable referring to body parts by their real names, just like you would an arm or a foot
• Using proper names stops kids feeling the shame of their parents around their bodies – don’t give your girl a hangup – she’s already got a pretty hard run ahead of her
• If someone touches her inappropriately, your daughter can confidently speak up – ‘down there’ is pretty vague and can cause either unnecessary alarm or a lack of alarm when it is required
• Teach her the body parts of boys too

You will need to be the judge of how much she needs to know based on her age and comprehension.

The most important names relate generally to the vagina and vulva – the inside is the vagina and the outside is the vulva. There is actually not one single name in English for the whole vulvovaginal area.

This means she’ll also have her words if something happens to her and you aren’t around to translate.

• Teaching kids their body parts
• Anatomy of the vulva and vagina

Anatomical abnormalities and differences in sexual development – newborns to teenagers

As soon as a baby is born, it may be obvious that the child has differences in sexual development, which are variously called anatomical abnormalities, congenital abnormalities, or more recently, different. That is, different to the typical boy or girl who is born looking more or less the same as other boys and girls.

We’ll use the term ‘differences’, since it encompasses all outcomes without judgement as to whether something is abnormal or not.

If anything is clear, it’s that there are a vast range of human bodies, and none is necessarily more normal than any other.

There are some congenital abnormalities that are considered anomalies, discussed further in our section on anatomical abnormalities and differences in sexual development.

•  Anatomical abnormalities and differences in sexual development

Some glitches can occur when a baby is being built in the womb, due to some known and unknown factors.

The end result can be flesh where flesh shouldn’t be, or ovaries where there should technically speaking be testes, a vulva that resembles a scrotum, and a clitoris that seems more like a small penis.

There is a spectrum of genitalia that ranges from entirely female to entirely male, with every possible combination imaginable in existence.

That could be a penis and vagina, two penises, two uteruses, half a vagina, testes instead of ovaries, and on and on. People who are not phenotypically male or female – that is, people who don’t fit clearly into one category – are known as intersex.

There are a lot of intersex people; in fact some numbers put kids born with ambiguous genitalia at as much as one child for every 300-500 live births. That is, for every 400 kids born, at least one of them will have genitals that don’t fit the classic mould.

Then there are the discoveries when a girl doesn’t get her period after about age 15, when it’s revealed that she has blockages (thick hymen, longitudinal or horizontal septum) or is missing some reproductive organs. Thorough investigations will reveal the extent of the differences, and fertility outcomes will be explained.

A child’s vagina has very little bacteria (good or bad) in it, because it is the influence of oestrogen that encourages friendly bacteria to grow. Oestrogen, which only starts at puberty, causes the vaginal cells to produce glycogen (a sugar) that lactobacilli feed on. Without the oestrogen or glycogen, a prepubertal girl’s vagina is very much like her grandmother’s in many ways, sans the wrinkles and greys.

This can mean her putting the wrong things in or close to her vagina (think wiping from back to front, dirty toys or toilet paper, you name it) can cause infections, as there isn’t a lot to defend the vagina from invaders. Vulvovaginitis remains a common affliction of young girls, but usually identifying the cause and removing it/treating it solves the problem quickly.

Low to no oestrogen also makes her vulva and vagina look and behave in a unique way that will change once she hits puberty. This is important, because your relationship will change at this point, and you need to know the signs that she is having hormonal shifts and puberty is impending.

The onset of puberty

Puberty happens over a couple of years, with the first signs puffy, sore nipples and pubic hair. She’ll start to smell different and need a bit of coaching on personal hygiene, and of course some deodorant (and instructions on how to use it).

The pubic hair will start as a fine fluff, and there won’t be much. Usually she’ll have some extra fat on her body, since a girl needs at least 17 per cent body fat for enough oestrogen to be made to trigger ovulation and the menstrual cycle.

It’s important to be very considerate of her changing body and privacy needs. This will signal a change in your relationship where she goes from being an open kid to a more secretive, shy pre-teen. It’s important to have set the scene with her before this happens to ensure that she feels like she can talk to you about things that might concern her.

It’s also useful to have set her up with a female adult, if her mother is not around, so that she has someone to ask tricky questions that she doesn’t want to ask you. If you have educated yourself, however, and show yourself to be knowledgeable, you may just find that she feels comfortable to ask you some things. This is a great spot to be, but most men miss this opportunity.

Keep an eye on:

1. 1. Watch that she gets her period within the allotted time frame (i.e. after age 10 and before age 15 give or take), and if it doesn’t come, take her to the doctor.
   2. Make sure her periods are reasonably regular and fit into the not too close together and not too far apart category (between 21 and 35 days apart, any number between is fine each time).
   3. Teach her how to track her periods using a period tracker app or calendar. The day to record is the day bleeding starts, as that is Day 1 of the menstrual cycle. 
   4. Give her the information she needs to figure out when she ovulates, and how she can learn to feel it (this helps later when unwanted pregnancies are on the cards – knowledge is power!).
   5. Ensure her period pain is managed adequately – teach her how to use self-care to alleviate period pain at home, with or without medication, so that she can treat herself anywhere anytime, and also buy her own drugs. Period pain, especially early on, can be debilitating. 
   6. Take her to the doctor if her period pain is severe or even just really bad – she may have something more going on than just her period.
   7. She has choices regarding what she would like to use as her menstrual hygiene products (pads, tampons, menstrual cup, period undies) but may need someone to teach her how to use them (can be the internet). Make sure she has options. 
   8. Making sure she doesn’t feel embarrassed asking you to buy supplies or give her money to buy her own (and make sure she does). Check if her school has free supplies available. 
   9. Arrange for her to buy new underwear more regularly – periods come unexpectedly and they really do ruin underwear – black or red cotton underwear is a good choice to minimise expense.
   10. Teach her how to use stain remover and wash her own clothes.
   11. Explain period hygiene and etiquette.
   12. Explain what she can expect from her period.

We discuss the physical effects of sexual abuse and infections passed on by sexual abuse of children. It’s useful to know what to look out for in children, and have strategies in place to have a child assessed without causing distress.