1 Is your child's genital area uncomfortable or itchy?

2 Does your daughter have a thick, white, and lumpy vaginal discharge?

3 Does your daughter have a greyish-yellow or greenish discharge?

4 Does your daughter have intense itching around the genital and anal area that is much worse during the night?

5 Does your daughter use bubble bath or wash her genital area with soap?

6 Is your daughter over 9 years old, and does she have a thin, white or yellow vaginal discharge?

7 See your doctor within 24 hours

Possible cause Your daughter may have vaginal thrush, a fungal infection. This is especially likely if she has recently been taking antibiotics to treat another condition.

Action Your doctor may want to take a vaginal swab to confirm the diagnosis. He or she will probably prescribe an antifungal cream or oral antifungal drugs. To avoid a recurrence, follow self-help measures for preventing genital problems in girls.

8 See your doctor within 24 hours

Possible cause and action A bacterial infection in your daughter's vagina is possible. This sometimes occurs for no reason, but, in an older girl, a forgotten tampon may be the cause. Your doctor may take a swab to confirm the diagnosis and will probably prescribe antibiotics. If your doctor suspects a foreign body is present, he or she may arrange for your daughter to be examined by a specialist.

9

Possible cause Your daughter may have threadworms. These tiny, white worms, about 1 cm ( 1/2 in) long, infest the intestines and lay eggs around the anus at night, leading to intense irritation of the anus and genital area. Although harmless, they may be passed on from one person to another or picked up from contaminated food. Consult your doctor.

Action Your doctor will examine your child. If threadworms are diagnosed, he or she will recommend drugs that will kill the worms. All members of your family should be treated to prevent reinfection. Make sure your daughter takes extra care to wash her hands thoroughly after going to the toilet and before eating.

10

Possible cause and action Your daughter may be sensitive to the bath products or soap that she is using. Make sure your daughter washes her genital area using only water. Once the symptoms have disappeared, she can start using a mild, unperfumed soap (see Preventing genital problems in girls). However, if the irritation persists, consult your doctor.

11

Possible cause and action An increase in hormonal activity as a girl approaches puberty often produces this type of discharge. As long as there is no irritation, this is probably normal and no cause for concern. Reassure your daughter and make sure that she understands all the changes that are taking place in her body.

12

See your doctor within 24 hours if you are not able to diagnose your daughter's problem from this chart.

13

See your doctor within 24 hours if you are not able to diagnose your daughter's problem from this chart.