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So your daughter comes to you and says, "It hurts to pee." Is it automatically a urinary tract infection? Not so fast. Girl parts are super-sensitive, especially between the ages of potty-training to puberty, and there could be a few things going on. So how do you know what the problem is?
Diagnosing UTIs in Children

First, your daughter would need to be seen. We cannot diagnose urinary tract infections in girls over the phone. We need them to actually come into the office and pee so we can do a urinalysis test. That will show if she has a UTI or if she's dehydrated and her burning with urination is due to concentrated urine.

It will also show if there is blood in the urine or any signs of diabetes as well, which doesn't cause burning with urination, but does cause frequent urination, which is another sign of a possible UTI.
Treatments for UTIs in Children

If your daughter does have a UTI, we can treat her with antibiotics while sending her urine off to get a culture at the lab and find out what type of bacteria is causing her UTI and make sure she's on the correct antibiotic.

If your daughter does not have a UTI, then we need to ask a few more questions, like is she drinking enough water? Does she take bubble baths? Is she wiping too hard? Is she wiping at all? Is she wiping in the right direction? Does she have any vaginal symptoms? And yes, we have to ask if anyone has touched her inappropriately down there.

Based on those answers, we can talk about treatments. Will drinking more water help? What about cranberry juice? Which may or may not help, depending on what's going on. Does she need any special creams for her private area? Does she need to work on better hygiene? If she is sexually active, do we need to test for chlamydia or gonorrhea? Is this not a urinary issue but more a vaginal issue?
What NOT to do for Your Child's UTI

Everything is in such a small space in that area that it can be hard to figure out what is going on and what the correct treatment is.

I've had parents ask me about certain home remedies that I can tell you, you should not do. Don't do the following. Don't have your daughter douche to clear out the UTI.

Similarly, I had one mom tell me that she was told to soak a tampon in probiotic kefir and insert it in her vagina to treat a UTI. Neither of those will help because a UTI is in the urinary system and inserting something into the genital system won't help. Just because they're in close proximity doesn't mean that they are treated the same.

Don't put random creams in or on your daughter's privates without finding out what the main cause of her symptoms are. Sometimes, that will make the problem worse.

And don't give antibiotics that were left over from a previous infection, because not all antibiotics will treat urinary tract infections.

So if your daughter has girl-part issues, please bring them in to be seen by their pediatrician. We can help you figure out exactly what is going on and what is best to help them feel better.

Parents will often bring their kids in to see me for skin issues, and I also get a lot of phone calls about rashes. Well, the hard part is I can't see your child's rash over the phone. Rashes are one of those things that your pediatrician will need to see in person or through a video visit in order to determine what the cause of the rash is and what to do about it.

Babies and diaper rashes are one very common concern. Babies get diaper rashes very easily, even within days of being born, because their skin is super sensitive. In fact, their skin is not fully developed until about 6 months old, which is why we say no sunscreen or bug spray until then.

Babies are also in diapers and they pee and poop a lot. Diaper rashes are basically contact skin issues due to the diaper fibers and due to the normal body chemicals and bacteria in the urine and stool.

Some babies are okay with just having diaper rash cream put on their bums. Others get more like burns. We used to even make our own diaper rash cream for our older son. His skin was so sensitive we joked that he would get a diaper rash if we looked at him wrong. We ended up using burn cream mixed with zinc oxide for him.

Parents often ask which diaper cream I recommend. My answer? Whichever works for your baby. I don't have a personal preference, and some creams work better for some babies than others.

If the diaper rash is red and bumpy, though, that's a yeast diaper rash. It's more in the front of the diaper area and less on their bottoms. Any over-the-counter yeast cream can help with that.

Then there are dry skin issues. Every winter, I have parents bringing their children to me for an all-over body rash that can be itchy. That's often either just dry skin dermatitis or eczema. For both, start with a cream that says "dry sensitive skin." And you can try mixing a little over-the-counter hydrocortisone with it and apply it twice a day for a few days.

Some kids with really bad eczema end up needing prescription creams, and that's when a trip to your pediatrician is needed.

There are all sorts of rashes. Most are viral, some are bacteria, but for all other rashes, it's best to have your child seen so we can check it out and see what treatment is needed.

Viral rashes need no treatment. They'll go away on their own. Bacterial ones sometimes just need topical antibiotics, but sometimes need a prescription for oral antibiotics.

If you have a concern about your child's skin, go ahead and bring your child in to see their pediatrician. Chances are we've seen your child's rash before and are able to help.

Many kids, especially athletes, will complain that their feet hurt at some time. Heel pain is especially common and especially during growth spurts.

Heel pain in athletes who are growing actually has a name. It's called calcaneal apophysitis, otherwise known as Sever's disease. It is most common between the ages of 9 and 14 and is seen in athletes who do a lot of running and jumping. My teenage soccer player has this and actually so do several of his teammates, or the teammates of my younger son who will probably end up having this also. Basically, what it is, is inflammation of the growth plate of the heel bone. The bones, muscles, and tendons in that area all grow at different rates during puberty. And when they're out of sync, the muscles and tendons pull too hard on the growth plate and that causes the inflammation.

So what can your child do to help once the pain has started? Well, to be honest, the pain will improve most once your child is done with their growth spurt. Also, it's best to stop any activities that cause pain. But, of course, we know that's not going to happen, especially if your child is on a competitive or a school athletic team.

So other things that help include having an ice pack in a towel and icing the heel for 15 minutes every one to two hours during flare-ups. Have your child take an anti-inflammatory pain medicine, like ibuprofen or naproxen. But be sure to check with your child's pediatrician on dosing. Gel heel cups and shoes with good support are also helpful. They help put less pressure and less stress on the heel. Your child's pediatrician can also give you exercises that can help with stretching and which can help with the pain and help keep the condition from getting too bad.

If the pain continues, your child may be referred to a physical therapist. And if all else fails, then your child will be put into a walking boot and referred to an orthopedic specialist for management of severe cases. Eventually, Sever's disease gets better, but not really until your child has stopped growing and that growth plate closes. Until then, manage the pain and follow the advice your child's doctor gives them.