Vaginal Bleeding in a Child

Vaginal bleeding in a young girl or infant can be a cause for concern and these days, it often raises questions about sexual abuse. However there are a few conditions where abnormal vaginal bleeding may be harmless or could be attributed to serious medical conditions that is unrelated to sexual abuse.

Given the prevalence of sexual abuse of young children, any sign of trauma with or without vaginal bleeding and often accompanied by changes in personality should be investigated. A medical doctor will confirm or exclude any possibility of trauma as a result of sexual abuse. Other causes of vaginal bleeding will then be considered if there are no signs of abuse.

Causes of Abnormal Vaginal Bleeding in Children

Infant – Baby and Toddler

Some of the causes of abnormal vaginal bleeding in babies may include :

• Hormones. Vaginal bleeding in an infant, usually within the first 2 weeks of life, may occur as a result of hormones from the mother. These transplacental hormones may have a residual effect in the child’s body until it is metabolized and removed from the system. The vaginal bleeding is usually ‘light’ like spotting and will only last for a day or two. This phenomenon occurs in the early weeks of life and resolves spontaneously with no complications.

• Infection. The urethra of females is much shorter than in males. This increases the chances of urinary tract infections especially from microorganisms with fecal matter. Infrequent diaper changes, poor hygiene and ‘wiping’ the female baby from back to front can transfer fecal matter to the front of the pelvis which may then lead to urinary tract infections (UTI) or vaginal infections (like bacterial vaginosis). Vaginal bleeding may be apparent although it will present as ‘light’ spotting and is usually accompanied by other symptoms associated with an infection.

Young Girls, Female Child

Some of the causes of abnormal vaginal bleeding in young girls before menarche may include :

• Trauma or injury to the vagina which is one of the most common causes of sudden vaginal bleeding in children. This may be related to sexual abuse or self-inflicted trauma which may be linked to psychological disorders or mental retardation or may just occur accidentally or as a result of childhood curiosity and experimentation.  A foreign body in the vagina may also be a possibility.

• Early puberty is another possible cause of abnormal vaginal bleeds in young girls. While the onset of menses (menarche) may begin as early as 10 years of age, there are instances of early puberty leading to menses before the age of 10 years.

• Warts on the vagina or cervix may cause a vaginal bleed. The development of these warts may be related to HPV (human papilloma virus) infection and could be attributed to direct contact rather than sexual contact as seen in adults with genital warts.

• Urethrocele or prolapse of the female urethera may occur as a rare  birth defect in children.

• Tumors in the genitourinary organs which is not common in children.

• Urinary tract infections (UTI’s) are a common occurrence that can affect young girls although it tends to occur more frequently in teen girls and adults. Vaginal spotting may be accompanied by discharge and other signs and symptoms of an infection.