to be really worried - doc asked if DD had brother re abuse

[tetleymel]

or is it standard that GPs ask this sort of question and I shouldn't give it another thought?

DD aged 4 may have a vaginal infection (awaiting swab results). Doc asked if there's an older brother in the house, which there is. He's 15.

As DD didn't flinch when he took a look at her vulva, the doc wondered if there is any risk of abuse. :-(

Op, try changing your washing powder to a fragrance free one, it could be bugging her.

he examined her and took a swab.

I think it is the swab part that made the GP ask questions.

Asking about a brother alerts you to think about any male in the household, or who has access to her.

Can you imagine the Daily Fail headlines if a child who was being abused had been taken to the Dr several times and no one asked any questions?

Try:

Fragrance free and dye free detergent
No fabric conditioner
Toilet paper -- try plain white and no prints
Soap and bubble bath -- eliminate: try showers and only rinse with water
Cotton underpants, no synthetic or cotton mix
Loose and airy clothing -- no leggings or tight jeans or tights, esp no synthetic tights
Trim her nails
Reduce her sugar intake by a lot (watch out for drinks especially, including fruit drinks) and intake of refined carbs (items with white flour including pasta) and yeast. Some people even cut out real fruit. Watch out for marmite, bovril and stock cubes and other products where yeast may be included. Read packets.
Introduce acidophilus supplements/probiotic, and natural culture yogurt into her diet
Give her a children's multi vit and mineral supplement

This sounds like a conscientious doctor doing his job properly. Recurrent thrush can happen due to reinfection through sexual contact. There can be other reasons too that are probably much more likely in the case of your DD but the doctor has to pursue all avenues of investigation.

She may have another strain of candida, not albicans.
Any chance she has diabetes or pre diabetes condition?
Has she been on antibiotics for anything else recently?
Any chance she has an intolerance to wheat?

Also, try non-bio detergent

If you need to give her a bath, look at the product you use to clean the bath with. Has she taken baths immediately after the bath has been cleaned?

Did doc know there is an older boy in the house. That might be why he raised it.

Sadly he had probably just refreshed his child protection training - a friend who is a nurse told me that to examine a small child and ask those questions of the parent there should be certain procedures followed (it happened to us) because those kind of infections are indicators of many many other things too and this should not be the first conclusion drawn. It is very common in small girls too because of soapy, bubble baths, non-cotton underwear etc - hence the fact it was less common years ago.

I would ask to see another doctor next time.

I get horrible thrush if I use bio washing powder/ liquid or fabric conditioner on my underwear or PJs.

Also wearing new underwear without washing it first, bubble bath, baby wipes (even unscented), soap and shower gel make me very sore.

So these simple things might be the cause of the problem.

I've had thrush regularly from being about 5. I was a very keen swimmer and eventually had to stop because the chlorine was making everything worse.

I am surprised that on the strength of the OP everyone is discussing the GPs comment and not the possibility that there is some secret abuse going on.

It is the most common form of sexual abuse I think (though willing to be corrected if I am wrong on this).

I'm sure Tetley that you know your DCs and whether there is a risk of this so not implying that there is a problem but just saying I'm surprised at the responses.

Don't worry. My DD now aged 10 had 2 small instances of spotting whren she was between 2 and 3 years old.

I took her to the GP. The GP said they would refer to a paed but, did I really want a referal because they would definatley ask about abuse. I told her that yes I did want a referal and I could handle abuse questions as I had nothing to hide. Seems strange that she almost gave me "a get out" incase I didn't want to be investigated...

We went to the paed, DD was examined (not pleasant) and then he sent her off with her Dad to get a drink and asked me about who lives in the home/where she goes to nursery/who she comes into contact with etc. Abuse wasn't mentioned but I knew what he was getting at. Turns out the bleeding was due to being a small hormone blip.

They have to ask OP I wouldn't worry.

YANBU. What a horrible experience. However, although this was badly handled by the GP he is doing his job by considering the possibility. He should have waited for the results of the swab before acting on his suspicions.

I took my 4yo charge (am a nanny) to the doctor for the same thing and doctor asked me if I had any concerns. I think it's standard practise.

onebob why would you ask to see a different doctor?

This wasn't badly handled though, was it?

Recurrent infection/thrush/soreness, it doesn't matter what an swabs would show (regarding the abuse question, not treatment!)

Some people seem to be suggesting referral to "a trained professional". Apart from the fact the doctor is one of those, how would OP feel about, rather than a few quick questions in the surgery, getting referred to a "specially trained child abuse professional"?

Sheesh.

Hope your little girl is getting better OP and the shock of the questions is wearing off.

I'm with Mayisout on this one.

If I had a 4yo with a vaginal infection who didn't flinch at examination and who was 'trusting' when all procedures were undertaken in different contexts (OP's word), and the trained professional in this setting asked such questions, I wouldn't be wondering about the GP or believing doolally explanations that thrush comes from bed linen.

Sorry but as many others have posted, you have to think of that as a possibility, as awful as it sounds. And please talk to her about those things in an age appropiate way and reassure her that she can tell you anything and you won't get mad at her, no matter what.

but noone is saying that abuse shouldn't be considered. Just that there is a right and wrong way to ask probing questions as it can affect the investigation later on whether there is or isn't abuse, and it doesn't sound like the GP did it properly

NOT that the GP was wrong to consider it, just that they way they did it was wrong

and tips re treating thrush aren't negating the possibility either, because that still needs to be treated regardless of cause (as well as investigating all possible causes)

I would mind this being questioned as a parent myself as it means they are looking out for the child and much as we like to think we'd "know" as mothers, I don't think that's the reality a lot of the time, BUT no! doctors and nurses are not necessarily extensively trained on how to do CP PROBING questions without totally cocking up the investigation - how the original questions are handled is very important! and there are people available to do it properly!

Must of felt truly awful being asked that OP, but I agree, he had to do it.

Disagree.
Nurses and doctors DO have mandatory training for spotting potential abuse, asking questions, alerting and referring.
Its called safeguarding training.
Im not trying to be argumentative jingle, but you are wrong.
If you work in direct patient contact because of your line of work, i would suggest you clarify your safeguarding responsibilities back in your workplace.

It's not an abnormal question, better to be safe then sorry and somewhere down the line save a child from abuse. Not sure why he didn't ask about new partner for you, usually that's first before brother.

Do you use biological washing powder/fabric conditioner? Use non bio if so. I'm allergic all over to bio but my friend just gets thrush if she wear knickers wash in.

Also make sure she isn't sitting in bubble bath or wash liquid and doesn't use anything but water on her bits. Has she had the cannisten tablet? If not, could be that the thrush is internal, cream won't do much for that.

It does happen though- children are abused by their siblings.
I cared for 2 sisters aged 2 and 4 who both had infections and issues regarding using the toilet. The 4 year old disclosed sexual abuse by her older step-brother.
Apparently the parents knew about it but didn't know what to do. The step-brother ended up being taken into care.
it was very messy and the mum threatened to burn us in our beds.
But at least the 2 sisters are not being abused anymore
The doc is following proceedure- same as when you take a child to A&E- they have to ask the difficult questions, or they will not be doing their jobs properly.

schmoozer in safeguarding training they are told not to probe much themselves, to recognise red flags, NOT do anyting that'll hinder the investigation, and refer properly

The young dd of a friend of mine was examined down there by a doctor. The girl didn't flinch or anything and the doctor spoke to my friend about possible abuse because of her lack of uncomfortable-ness.