Vaginal Discharge in a Newborn

1/8/2008

Today a mom came in with her newborn baby girl, five days old. She was concerned because the baby had a blood tinged vaginal discharge for the past day. The baby was otherwise well.

I explained to mom that a vaginal discharge after delivery is quite normal. Why is this? The baby has been in utero for the past nine months in an environment with lots of circulating maternal hormones. Once removed from this environment, the baby is abruptly withdrawn from the hormonal surroundings. This withdrawal of hormones is often accompanied by a sloughing of the normal vaginal mucosa in the baby. On occasion, this sloughing occurs with blood in the discharge. The vaginal discharge can be mixed with mucous and will sometimes have clots of blood. This self limiting condition is very normal and should not trigger a workup, just some gentle reassurance. Many pediatricians will call this “withdrawal bleeding” referring to the withdrawal of circulating maternal hormones.

      

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