Q * My daughter is 4. She received bubble bath for her birthday and can hardly wait to use it, but I heard that little girls who use bubble bath can get urinary infections. What should I do? It's in an attractive pink container she adores, so she missed it right away when I tried to sneak it out of her room. To make matters worse, the aunt who sent it is going to visit soon. What should I tell her?
A * We have heard about bubble bath and urinary tract infections too, but we think the link -- if there is one -- probably is overrated. Like any substance added to bath water, bubble bath can irritate sensitive skin.
The area around the urethral opening, which is the hole in front of the vagina through which females urinate, certainly is sensitive. If it becomes irritated by soap, lotion, perfume, bubble bath or even by rubbing, it can become sore and urinating may be painful.
Pain on urinating, or "dysuria," is a symptom of urinary tract infection. In this case, however, chemical irritation -- and not infection -- is the cause, and therefore it would not require the same treatment.
Girls your daughter's age certainly can have urinary tract infection. When girls have fever without other apparent symptoms, urinary tract infection sometimes is the cause and tends to recur. We don't know why some girls are more susceptible to these infections, but it is more complicated than their use of bubble bath.
Most likely, their susceptibility relates to how well bacteria cling to cells surrounding or lining the urethra, which probably relates to heredity.
Bubble bath for children tends to be quite mild. But if your daughter complains of pain when urinating, stop using it and call her doctor.
* Dr. Wilson is director of pediatric primary care of the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.