Intact versus Circumcised Baby Care
In Ask Dr. Sears an accurate discussion of care of the infant foreskin. Parents and doctors need to keep in mind that the foreskin of an intact child should NEVER be forcibly retracted.
Pediatrician answers: How do I clean my baby's genitalia? Should I retract it myself?
We Americans have been indoctrinated with the belief that whole babies require inordinate amounts of cleaning. Is this really true?
Contents
How do I care for my young son's intact penis?
The intact penis needs no special care.
The foreskin should never be retracted by force.
During the first few years of a male's life, the inside fold of his foreskin is attached to his glans, very much the way the eyelids of a newborn kitten are sealed closed. The tissue that connects these two surfaces dissolves naturally over time - a process that should never be hurried.
The foreskin can be retracted when its inside fold separates from the glans and its opening widens. This usually happens by age 18. Even if the glans and foreskin separate by themselves in infancy, the foreskin still may not be retractable then because the opening of a baby's foreskin may be just large enough to allow for the passage of urine.
The first person to retract a child's foreskin should be the child himself.
A very young boy usually pulls his foreskin outward. This is normal and natural and no cause for concern; he won't hurt himself. Once a boy discovers that his foreskin is retractable (a wondrous discovery for an intact child), he can easily learn to care for himself. Telling your son about retractability beforehand will keep him from becoming alarmed the first time his foreskin retracts.
When a boy is old enough to bathe himself, he can wash his penis when he washes the rest of himself. Simple instructions may be helpful.
- Gently slip your foreskin back (if it is retractable).
- Rinse your glans and the inside fold of your foreskin with warm water.
- Pat it dry if you like.
- Slip your foreskin forward, back in place over the glans.
At puberty, you can let your son know that with hormonal activity comes new responsibility, including genital hygiene.
Foreskin retraction
What is phimosis?
The Greek word phimosis means muzzled and is used -- often incorrectly -- to refer to a foreskin that cannot be retracted (for whatever reason). A comprehensive discussion of phimosis is beyond the scope of this pamphlet. What parents should know is that almost all babies have non-retractable foreskins, that this is normal, and that the foreskins of most males become retractable by the time they are 18. It is also important to know that many adult males with non-retractable foreskins are perfectly happy with them that way. Adult males with non-retractable foreskins who would rather their foreskins were retractable can easily and safely stretch their foreskin opening until it is large enough to slip comfortably over their glans. A non-retractable foreskin is not, in itself, an indication for circumcision.
What happens if someone retracts my son's foreskin prematurely?
Forcing the foreskin back can be very painful and can cause problems.
Tearing the foreskin from the glans leaves raw, open wounds, which can lead to infection.
Raw surfaces on the foreskin and glans can heal together, forming adhesions.
Small tears in the opening of the foreskin can heal to form non-elastic scar tissue, passibly causing acquired phimosis.
The foreskin can get "stuck" behind the glans (paraphimosis). By squeezing the glans, the foreskin can be brought forward again, without circumcision.
| “ | The foreskin therefore can be likened to a rosebud which remains closed and muzzled. Like a rosebud it will only blossom when the time is right. No one opens a rosebud to make it blossom. – H. L. Tan, M.D. |