Circumcision Is Just One Of The Many Decisions New Parents Must Make
One of the first decisions many parents face after birth is whether or not to circumcise the male child. They need to weigh the benefits and risks and come to a decision that is right for them and their child.
The circumcision trend might be partly attributed to the American Academy of Pediatrics 2012 task force report, stating that even though circumcision has medical benefits, it’s not routinely recommended for newborns. It might also be because fewer insurance companies are covering the procedure, according to Ronald Gray, M.D., a professor of epidemiology at Johns Hopkins University in Baltimore.
When To Call Your Doctor
If your baby has any of the following symptoms, let your pediatrician know right away, as they could be a sign of an infection or another problem:
- Persistent bleeding or more than a quarter-sized spot of blood on his diaper
- Redness that gets worse three to five days after circumcision
- Yellow discharge lasting more than a week
- Foul-smelling drainage
- Crusty, fluid-filled sores
- Not urinating or dribbling urine within eight hours after circumcision
From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.
Infants And Young Children
- When you’re able to pull the foreskin back, do so gently. Only pull it as far as it will go. Carefully wash the whole area with warm water. After washing, return the foreskin to its normal position.
- If your child’s foreskin can’t be pulled all the way back by the time they reach puberty, call your doctor for advice.
- If you can’t return the foreskin to its normal position, call your doctor right away.
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How Should You Clean Your Baby’s Labia
Sometimes parents feel a little anxious about cleaning the labial area of an infant, says Leah Alexander, M.D., pediatrician and consultant for Mom Loves Best. But she says it’s important to clean around the labial folds. “This prevents irritation from urine as well as any stool that may become ‘trapped’ in the skin folds,” Dr. Alexandra describes. “The vulva, labia, and perivaginal area can be wiped with a moist, soft washcloth during diaper changes and at bathtime,” she recommends.
If They Are Circumcised
If your son was circumcised, that means the loose skin covering the head of their was removed and the tip exposed.
For the first couple of days after the surgery, your doctor may recommend keeping the area covered with a glob of petroleum jelly on a square gauze pad. Change the pad after poopy diapers to prevent an infection.
Problems are rare, but let your doctor know if:
- Your baby doesnât pee within 6-8 hours after the circumcision
- The bleeding doesnât stop
- Redness gets worse after a few days
Usually once the circumcision is healed, you donât need to do anything special. Just keep the area clean and dry so your son stays healthy and comfortable.
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At What Age Does Foreskin Become Retractable
Current research demonstrates wide variance in normal age of retractability. Some children will be able to retract their foreskins before puberty, while others may not have retractable foreskins until the late teens.
A 2005 Danish study of more than 1,000 children with penises found 10.4 years to be the average age participants were first able to retract their foreskins.
Two Japanese studies, together following 845 children with penises from birth, found that between one quarter and one third of healthy participants ages 11-15 were not yet able to retract their foreskins.
What Happens If Someone Pulls Back My Son’s Foreskin Too Early
Forcing the foreskin back before the natural separation of the foreskin from the glans has happened causes tearing of the connective tissue. This is painful and can lead to problems:
- small tears in the opening of the foreskin can heal to form non-stretchable scar tissue, possibly causing acquired narrowing
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Is Redness And Genital Swelling Normal
As Dr. Buetti-Sgouros points out, a bit of swelling is normal after your child is circumcised, but that shouldn’t endure past the two week healing period. In babies born with female genitalia, a little swelling around the genital area is common, Dr. Buetti-Sgouros adds. This happens because estrogen from the birthing person can cause certain effects on the newborn’s body.
Questions For Your Doctor
- What are some reasons I should have my baby circumcised?
- What are some reasons I should not have my baby circumcised?
- Will my baby feel any pain during circumcision?
- Before circumcision, will you apply the anesthetic as an injection or a cream?
- What soap do you recommend for washing the bandaged area?
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When To Call A Doctor
Call your pediatrician, if you notice any of the following after your babys circumcision:
- the redness persists longer than 1 week
- an increase in swelling and drainage
- significant bleeding
- your baby cant seem to pee
If your baby is uncircumcised, Segura says red flags that warrant a phone call to the doctor include:
- the foreskin gets stuck and cannot return to its normal place
- the foreskin looks red and theres yellow drainage
- theres pain or discomfort when urinating
Why Does My Son’s Foreskin ‘balloon’ When He Wees
Ballooning can be normal but if it is severe so the flow of wee is restricted you should seek advice from your family doctor. Encouraging boys to gently try and pull back their foreskin as part of daily hygiene can help. Sometimes a course of steroid cream is needed. Your family doctor can advise you about this.
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Some Things To Expect
The tip may look red for the first few days after circumcision. And you may notice a yellow secretion. Both mean that the area is healing normally. The redness and secretion disappear gradually within a week.
Note: If the redness persists or there is swelling or crusted yellow sores, there may be an infection. This does not happen often, but if you suspect an infection, consult your pediatrician.
What Causes My Son’s Foreskin To Be Red
If children are still in nappies, it may be part of nappy rash. When bacteria in the poo react with wee, they produce ammonia, which burns the skin and causes nappy rash.
Ways to prevent a reddened foreskin and nappy rash can include the following:
- changing nappies more frequently
- allowing nappy-free times to allow air to circulate and help healing
- soaking in warm baths
- avoiding things that can irritate the skin
- encouraging your child to drink more so the wee is dilute
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Making The Decision About Circumcision
Circumcision is a personal choice for you and your family. You will need to consider the benefits and risks of circumcision. Factors such as your culture, religion, and personal preferences may affect your decision. Talk with your doctor about the benefits and risks. He or she may be able to help you decide. You may want to make a decision about circumcision before your son is born. That way, youll know what to do about it while in the hospital.
The American Academy of Family Physicians recommends that parents talk to their family doctor about the potential benefits and risks of circumcision when making their decision.
The American Academy of Pediatrics says the health benefits of circumcision outweigh the risks. However, the AAP does not think the benefits are great enough to recommend that all male newborns should be circumcised.
How Long Does It Take A Circumcision To Heal
It will take a little time to recover from a circumcision. The operation is simple and straightforward, but as with most surgical procedures, there is a period of recovery. Here are a few things to keep in mind about the procedure.
A health care provider or nurse will explain what can be done to reduce the babys discomfort or distress. Typically, infant formula medications are given to reduce pain and other symptoms. Despite these interventions, it will typically take 7 to 10 days for the baby to completely recover from their circumcision.
Being aware of the best practices for taking care of the site of the circumcision and promoting healing are among the best things to do at this stage.
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How And When The Foreskin Separates
This separation happens for about half of boys by age 5, but for some, it doesn’t happen until the teenage years. The foreskin may separate from the head gradually over months or years or within just a few weeks.
At well-child visits, your child’s doctor might check on the status of the separation by gently pulling back on the foreskin or asking your child to, if he’s old enough and willing. You can check it yourself once in a while during diaper changes, or ask your child to check it himself in the bath.
Does My Son’s Foreskin Need Special Cleaning
- the stream of urine is never heavier than a trickle
- your baby seems to have some discomfort while urinating.
If the foreskin becomes inflamed, a common cause is the fungus monilia, which can cause redness and itching. This can be easily treated with antifungal cream. If the foreskin becomes considerably red or swollen, see your pediatrician. If your son’s foreskin is fully retracted before puberty, an occasional retraction with cleasing beneath will do. Once your son starts puberty, he should retract the foreskin and clean beneath it on a daily basis. It should become a part of your son’s total body hygiene, just like shampooing his hair and brushing his teeth. Teach your son to clean his foreskin by:
- gently pulling it back from the glans
- rinsing the glans and inside fold of the foreskin with soap and warm water
This information should not be used as a substitute for the medical care and advice of your pediatician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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When To Call The Doctor
If your child reaches puberty and the foreskin is still stuck to the head of the , it may be time to call a pediatrician or family healthcare provider. They can prescribe a steroid cream that can speed up the process of separation. It’s a simple treatment that has good results.
At any age, if the foreskin looks red and/or swollen, or if urination is painful, your child may have an infection of the foreskin or a urinary tract infection. It’s important for a provider to treat this infection as it can get worse without treatment.
Sonthalia S, Jha AK. Smegma pearl. Indian Dermatol Online J. 2017 8:520. doi:10.4103/idoj.IDOJ_384_16
Cleaning And Caring For Your Baby’s Genital Area Is Easier Than You Might Think We Connected With Three Pediatricians To Answer All Of Your Questions
Caring for your new baby can be exciting, but it can also be confusing and bewildering. You may be unsure of the best way to clean and care for your baby’s diaper area, for example. You know that infants have sensitive skin and it’s important to keep them clean, but you may be unsure how to do that. You also may feel uncertain about the different changes that a baby’s genitals go through in the early days after birth, and what they mean.
Never fear: Cleaning and caring for your baby’s genital area is easier than you might think. We connected with three pediatricians to answer all of your questions about baby’s genital care, from how to clean the area to how to know if and when something isn’t quite right.
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How Circumcision Is Done
Babies are typically awake during the circumcision, but because theyre given a local anesthetic such as a numbing cream or an anesthetic injection they wont feel very much. Your child may also be given a pacifier dipped in sugar water , which can help soothe him.
If you have any questions about the procedure, including what types of pain control medication your baby will receive, ask the doctor. You can also ask to be in the room while the circumcision is done.
What Is Paraphimosis
Paraphimosis is a condition in which the foreskin gets stuck in the retracted position. This can happen when the foreskin is forced back from the glans. Paraphimosis may cause pain and swelling, and it is a medical emergency.
Watch for the following signs of infection in your uncircumcised child:
- Pus coming out of the foreskin opening
- Urine coming out in only a trickle
- Your baby seems to have discomfort while urinating
Any of these signs may indicate an infection or balanoposthitis .
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What Is Smegma
When the foreskin separates from the glans, skin cells are shed. This begins in childhood and continues through the teen years. New skin cells regularly replace the ones that are shed. Since this shedding takes place in a closed space – with the foreskin covering the glans – the shed skin cells may look like whitish lumps, resembling pearls, under the foreskin. These whitish lumps are called smegma. Specialized glands, called Tyson’s Glands, located under the foreskin are largely inactive in childhood. At puberty, Tyson’s Glands produce an oily substance, which when mixed with skin cells, make up adult smegma. Adult smegma serves as a protective lubricator for the glans.