July 02, 2015

Q: My 20-month-old girl has started throwing a fit and fighting when we try to clean her after a bowel movement. She has always been sensitive around her genitals, but recently she seems scared or hurt when we try to wipe her. It's not her "normal" way of crying or throwing a fit, like if she doesn't get something she wants; it's as if we're torturing her. Should I be concerned that something may have happened at daycare? The thought makes me sick.

A: Hopefully, there's a more common explanation. Little girls often develop sensitive, irritated skin in their delicate parts, and pee and poop can make the area burn. See her pediatrician quickly because little irritations can turn into urinary tract infections if left untreated.

While I can't speculate about whether your child has been abused, I can say this: Children who are being abused tend to show multiple symptoms, including changes in behavior, mood, sleep, appetite, and energy level over more than a couple of weeks. If you're concerned, do an in-depth check of her daycare situation -- review their licensing, show up unannounced at unusual times to observe, check in with teachers, and ask other parents for their opinions. If you're not reassured, report your findings to your daughter's pediatrician, as well as any daycare licensing board, and change daycares immediately.

Answered by Dr. Heather Wittenberg