Help please, re: recurrent thrush. Gp has suggested dd could be being sexually abused!

[OhWhatAPalaver]

Does this sound reasonable or an over reaction from our gp? Took 6yo dd to Dr because 1% canesten isn't touching her itching right now whereas normally it works. It's much worse than normal at the moment but I'm not sure why. She's been prone to itching down there for a while, I have thought maybe diet related or she need to be careful wiping or drink more water or something but I was shocked when the gp suggested sexual abuse. He said "you may have to ask yourself questions you'd rather not ask, like who else has access to her? Do you know what I mean?" when it dawned on me I told him that she stays with her dad and his family most weekends but he didn't persue it further because dd was in the room, he just said he'd refer to paediatrics. I'm now really really worried and scared that someone could be harming her. What should I do? Can anyone help? Thanks in advance.

Have you treated her for threadworms? That makes them very very itchy.

Ovex medicine from the chemist is worth a try to see if that helps .

What?! Is that genuine medical advice?! Hopefully a doctor will be along soon to help advise but my instinct is the doctor is way out of line.

I was also going to suggest treating for worms. Ask a pharmacist

I think it is a reasonable question for a GP to ask. They do have a legal safeguarding duty of care.

It would also be reasonable for you to consider the question. It would be reasonable to talk to her about the NSPCC pants rule and reiterate that she can tell you anything.

It would be reasonable to ask her father to both consider the question & reinforce the pants rule too.

No harm done in raising the question, surely?

OP this weather isn’t doing anyone with fungalninfections any good whatsoever.

It doesn’t sound like GP trained in best way to approach this even if it is appropriate!

We can’t tell you the answer to that- but perhaps have a think...

I hope someone knowledgeable comes along soon - I don’t have a DD and no idea how common thrush is in young girls

Thanks, I really wasn't sure what to think. She doesn't get an itchy bum particularly and it is red and sore around her vagina and perenium. I'm willing to try anything though!

Does she have any other health issues or symptoms like excessive thirst or frequent urination, tiredness?

I only ask because high sugar levels from glucose intolerance or diabetes can cause frequent thrush.

What soaps does she use? And do you wash her hair in the bath or the shower? Do you bubble bath in the bath?

My dd is 7.5 now but when she was 4/5 she got really itchy and sore bits. Turns out that it wasn’t fungal but it had been irritated by her washing with soaps down there and the nurse I spoke to also said to wash hair in the shower as the shampoo suds in the bath water can also irritate too.

We changed her shower gel to Asda’s little angels one that’s a bubble bath too and we now wash her hair in the shower. She’s just sensitive.

I’m a bit the same though because I can’t use those Andrex toilet wipes or baby wipes down there as it makes me quite sore. Only used the baby wipes once as I went to a public loo that had no loo roll so had to use them. Some can be quite sensitive down there

No other symptoms that would indicate glucose issues. If anything she doesn't drink enough! We don't use anything in the bath and our laundry liquid is surcare sensitive. She does get very hot and sweaty so I'm hoping it's something as simple as that coupled with her not drinking enough water. I have to remind her to drink all the time! She is improving though. I'm really hoping the gp was being overly cautious.

if she doesn't drink much is her wee quite dark? If so that could be irritating her skin .

Are her dad and his family very careful wrt bubble bath, washing powder, not using fabric softener, wet wipes etc?
My MIL was determined to use all sorts of products on dc despite having been told that his eczema needed to be managed very carefully.
I also think threadworms might be the problem.

I had it at age 10 but I also started my periods then and I think it might have been related. You could try reducing sugary foods and giving her natural yogurt with some fruit in for snacks. My mum's gynae suggested yogurt and iirc it helped a lot.

Have they tested for thrush? It could be psoriasis or lichen planus. I was treated for thrush for years before being diagnosed first with one then the other.

I'm not really sure how gp made the leap to sexual abuse - ? I don't know that thrush would be an obvious consequence.

Her wee isn't too dark at the moment, I'm making a conscious effort to make her drink more with it being so hot.
I've just had a quick Google and about 5 different threads on kids with recurrent thrush came up straight away! I think the gp was getting a bit carried away to say the least. I'm wondering if he actually didn't have a clue on the subject so scared the crap out of me and then passed it over to paediatrics!! I'm more angry at the bloody gp now!

No tests done yet either. He didn't even have a look. Thinking back he should have done a swab or something at least, that what a different gp did when I had thrush.

My daughter had that when she had thread worms (Shudders).

Do you know the set up at her DFs. Are there older siblings, visiting uncles, random babysitters. Don’t want to scare you but I don’t think a GP would randomly say that unless they thought that there was s risk.

Agreed he should have done a swab, and I'd have expected him to consider the blood sugar angle as well. My son (3) has recurrent oral thrush and had blood tests for glucose levels after about the third recurrence, despite no other symptoms suggesting blood sugar issues. I've no experience with vaginal thrush (touch wood) but canesten doesn't usually touch his in his mouth either - last time we had to have an unusually large dosage of another drug to properly get rid of it. It might be that you need something stronger to properly get rid of it- in his case unless we hit it hard when he gets it it just moves around his mouth. In any case - paeds will no doubt do a better job of considering all the treatment options, but if there's a long wait maybe ask to see a different GP in the meantime and ask about getting a different cream (and a swab to make sure it is thrush!)

He doesn't know anything about our family or my dd so I'm not sure why he would see risk tbh. He's a bit weird himself! He just said it's unusual for kids to get recurrent thrush. Then said the thing about "who has access to her" and then said he'd refer her to paeds and prescribed 3 tubes of 2% canesten!
The set up at her dad's is just another family home, him, his partner and her kids who are 9&7. No male relatives either. They do however feed her lots of crap full of sugar so it could well be that.

Does she have too much sugar? No idea if it's an old wives tale but was t9ld this gives it the perfect breeding ground.

It is often part of safeguarding training to suggest that recurrent infections can be indicative of sexual abuse... I was asked the same about my DD when she was much littler. It's a horrible thought, but I'm glad they mention it, if it helps one child, it's worth my horror!

Without wishing to upset anyone, it happened in my normal, average, unsuspecting family. Your GP is doing the right thing by being brave enough to suggest it. Please do speak to your DD about the Pants rules.

Unfortunately it is a question that does need to be at least considered in kids with recurrent infections. Remember it is just a question, not a judgment. While it may be uncomfortable to have to think about, the alternative is that by avoiding the question for fear of upsetting adults, kids who are being abused may not get spotted as early as they could be. Hope your daughter's better soon.

Thrush can sometimes be a sign of anaemia though most gps wouldn't test for that!

Hi - I work in Sexual Health. All the suggestions here are sensible - thread worms, diabetes, wash water only definitely no wipes. Wipe front to back. Could be one of the skin conditions mentioned.

As a minimum the GP should dip her urine for sugar ASAP.

The GP is right to raise abuse as a possibility - if only to exclude it. A swab needs taking but GP may not want to do it prior to paediatric exam in case it affects any 'evidence '.

This must be very distressing and a PROMPT referral to paediatrics shold be made now the issue has been raised.

Good luck.

Thanks for the clarity, I understand he should suggest it for safeguarding reasons, even if it does seem horrific to me. She is rarely alone with anyone as far as I'm aware. She shares a room with her step sister who is 7 and her step brother (9) has his own room. I honestly think she would tell me if anything had happened. I've asked her if anyone had ever hurt her down there and she said no. I'm going to talk to her more about it though.