Vulvovaginitis: This is the most common cause of itchy vaginal discharge in prepubertal girls, often resulting from poor hygiene, irritation from soaps or bubble baths, or infection. The condition is usually not serious and can be managed with improved hygiene practices and possibly topical creams.

Yeast Infection: Though less common in prepubertal girls than in adults, yeast infections can occur, especially if the child has been on antibiotics or has diabetes. Symptoms include itching, redness, and a white, cottage cheese-like discharge.
Bacterial Vaginosis: More common in sexually active teenagers, but can occur in younger girls, especially if there's been sexual abuse. It presents with a fishy-smelling discharge and itching.
Pinworms: Can cause intense itching around the anus and vagina, especially at night. While not typically causing a discharge, the itching can lead to secondary infections.

Sexual Abuse: It's crucial to consider sexual abuse in any child presenting with vaginal discharge or itching, as it can be a sign of sexual trauma. A thorough and sensitive evaluation is necessary.
Foreign Body: Young girls may insert objects into their vagina, leading to infection, discharge, and itching. Identifying and removing the foreign body is essential to prevent further complications.
Lichen Sclerosus: A chronic skin condition that can cause itching, pain, and discharge. It requires specific treatment to prevent long-term complications.

Vaginal Tumors: Though extremely rare in children, tumors such as rhabdomyosarcoma can present with abnormal vaginal bleeding or discharge.
Systemic Diseases: Certain systemic diseases, like diabetes or immunodeficiency conditions, can predispose children to more frequent or severe infections, including those causing vaginal discharge and itching.