Author: Jiang Zhuangliang, Jiangxi Provincial Maternal and Child Health Hospital
Source｜Medical World Obstetrics and Gynecology Channel
The famous philosopher Socrates once told his disciples, "Whether or not one uses curiosity correctly is often one of the important factors that determines a person's fate."
Having been immersed in clinical practice for many years, especially when facing some special situations, I deeply appreciate the wisdom of the master's words.
We all know that children have a very strong sense of curiosity. Driven by this curiosity, coupled with their still-developing minds, they will use their mouths to explore various things, supplemented by their hands and feet. Touch is a primary means for many babies to understand the world, and the lips and hands are the most sensitive areas for touch.
For a 3-month-old baby, the oral cavity plays a crucial role. First, through sucking, they learn about the existence of their hands and their grasping abilities. Once the baby realizes they can grasp things, they will put everything they grab into their mouth to "examine" it. This process completes and develops their oral cavity's role in exploring the world, until their hands are fully developed. When a baby begins to explore with their mouth and hands, their world begins…
My own niece swallowed a one-yuan coin when she was 3 years old. My sister and brother-in-law were so worried that they were constantly running back and forth to the children's hospital. Fortunately, she eventually passed it on her own, thank goodness.
If you pay close attention to the instructions for some small items, you'll see a friendly reminder like: "Not suitable for children under three years old; contains small parts; keep out of reach of children." However, even this precaution has a loophole. Why?
Because in this world, many things are truly unpredictable. After being a doctor for a long time, you encounter all sorts of strange and unusual things. There are also quite a few "accidents" caused by curiosity that are both laughable and frightening.
There's a saying, "One learns about fish by living near water, and about birds by living near mountains." Because I work in the medical field, specifically obstetrics and gynecology, I'll share some knowledge about obstetrics and gynecology, which I'm more familiar with.
Let me start with a case study...
Once, while on duty, I encountered a young mother rushing into the Provincial Maternal and Child Health Hospital with her 5-year-old daughter for treatment.
The older brother inserted a foreign object into the younger sister's vagina while they were playing. The mother noticed the abnormality and immediately took her to the hospital for examination. An abdominal X-ray revealed a metal object inside the vagina!
The girl was then taken to the operating room for vaginal foreign body removal surgery, where a rusty magnet was removed. Thanks to the timely intervention, the vaginal mucosa and hymen were not damaged during the surgery, and the child was discharged from the hospital that afternoon after the operation.
Foreign bodies in the vagina are not uncommon in clinical practice among young girls. They are most common in children under 8 years old. It is frequently observed that children, either while playing, out of curiosity, or to relieve vulvar itching, insert small plastic or rubber plugs, children's toys, tampons, or other small objects into their vaginas, either by themselves or with the help of friends. This is especially true in rural areas where children often wear open-crotch pants and sit on piles of wheat, rice, or sand, making it easy for grains of wheat, rice, or sand to enter their vaginas.
I said the girl in the picture above was lucky. First, she had a careful mother. Second, it was metal, because metal is easily visualized and located on abdominal X-rays and CT scans when the abdomen is upright. If it were an eraser, plastic, cotton ball, or even grain, it would be difficult to visualize, and therefore more likely to be missed.
Therefore, when encountering a child with nonspecific bacterial vaginosis, especially a child with persistent and difficult-to-cure vaginitis, the first thing to consider is the possibility of a foreign body in the vagina.
What are the dangers of foreign objects in the vagina?
If foreign objects in the vagina are not removed in time, prolonged retention in the vagina or improper handling can lead to recurrent infections, bleeding, vaginitis, vaginal adhesions, or even vaginal atresia. In particular, the entry of sharp instruments may puncture nearby organs, such as the intestines, ureters, or bladder, causing serious consequences such as perforation!
Of course, as new parents, you may encounter situations where your baby girl experiences vaginal bleeding. Some of these are normal physiological phenomena, but others are related to gynecological conditions. This requires you to acquire more knowledge about obstetrics and gynecology, developing keen insight like Sun Wukong to distinguish the truth from the false.
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A small number of newborn girls may have a small amount of bloody discharge from their vagina when their diapers are changed 5-7 days after birth, which may last for 1-2 days. This is because the mother's estrogen is transferred to the fetus through the placenta, and the fetus is affected by estrogen after birth, resulting in increased vaginal discharge.
If the baby's feeding, sleep, and bowel movements are normal, parents don't need to worry; simply change diapers frequently and keep the area clean. However, if the bleeding is heavy, the discharge has an unusual odor, lasts for a long time, or is accompanied by bleeding from other areas, it is essential to seek medical attention immediately.
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Some girls may experience intermittent vaginal bleeding during early childhood. Experts point out that the causes of vulvar and vaginal bleeding in infants and young girls can be divided into two main categories: hormonal and non-hormonal. Hormonal bleeding is mainly due to precocious puberty, which is relatively rare; while non-hormonal bleeding accounts for about 80%. Parents need to pay close attention.
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Children are more active than adults and have a poorer sense of self-protection, making traumatic vulvar and vaginal bleeding more common.
The injury is usually caused by falling from a height or hitting the vulva on a rock, iron object, or the corner of a stool. In some cases, it may be caused by hitting the vulva while sitting on a spittoon to urinate. After the vulva is injured, there is local pain, hematoma in some cases, vulvar skin laceration in others, and even laceration of the vaginal opening mucosa and vaginal wall. The amount of bleeding varies.
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Another type is vulvovaginitis. In infancy and early childhood, girls' vulvas are not fully developed, estrogen levels are low, and the vaginal epithelium has strong resistance. Since the vagina is close to the anus, it is easily infected by bacteria, leading to inflammation. Pathogens can be transmitted through the clothing, bathtubs, and hands of infected mothers, caregivers, or kindergarten children. It can also be caused by poor hygiene, unclean vulva, and frequent contamination with feces. Symptoms often include vulvar redness, swelling, pain, itching, and purulent discharge; some may experience recurrent vaginal bleeding.
In recent years, young girls have been experiencing gonococcal vulvovaginitis through indirect transmission, which should raise awareness. Pediatric gynecological diseases have also received increasing attention in recent years.
How to prevent vaginal foreign bodies and vaginitis?
First, use highly absorbent and breathable diapers, change them frequently to maintain hygiene, and clean the vulva after each bowel movement to prevent fecal contamination. Start using closed-crotch pants as early as possible to reduce the chance of genital exposure and contamination. Young girls should be showered with clean water after swimming. Second, provide early education for children, guiding their curiosity appropriately and explaining that they should not insert objects into their vaginas to prevent foreign objects from being inserted. For children with obvious deformities causing recurrent infections, surgical repair should be performed early. Mothers should actively treat any infectious diseases of their reproductive system to prevent transmission to their children. If a child exhibits vulvar redness and swelling, increased discharge, or vulvar itching, be highly vigilant and take the child to a doctor promptly.
We would like to remind all parents once again to strengthen safety education, pay attention to protection and supervision, and avoid accidents!
Dear parents, please slow down your own pace of development and grow alongside your child, like taking a snail for a walk, to rediscover the world with your child. I believe that if you are willing, you will find that letting go is not a sacrifice but a gain. Let go but don't lose sight of your child, let go but don't let go of their heart. Being a parent with medical knowledge will provide your baby with an extra layer of protection for their safety and health.
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