Circumcision: Caring for baby's uncircumcised penis

My husband is not circumcised and he did not want our son to be circumcised. I have been given very different and confusing information as to the care of the uncircumcised penis. I do not want to hurt my son, but I also do not want to ignore something that would cause him to undergo a medical procedure that would be painful. We also do not want to have him circumcised later in life because my husband feels very strongly about the benefits of remaining uncircumcised.

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Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

The care of your son's uncircumcised penis is as important as any other part of his body, yet parents are often hesitant to ask questions about this "private" area. So, I am glad you asked these important questions. Fortunately, when it comes to taking care of your infant's, your toddler's, or your older child's uncircumcised penis, leaving it alone is probably the most appropriate suggestion. But understanding the anatomy of the infant's uncircumcised penis will help in realizing why this is.

The penis is essentially made up of a shaft with a bulb at the end of it called the glans. The glans is covered by a layer of tissue called the foreskin or prepuce. The part of the foreskin that faces the outside is made of the skin similar to that of the rest of the body. The inner part of the foreskin (the part you usually can't see on an infant) is made of soft mucous tissue with the similar consistency to that of the cheeks inside the mouth. When the penis is first developing, the glans and this inner layer of foreskin are fused. As the cells of the inner layer of the foreskin are shed, the foreskin becomes more mobile. While the foreskin may retract somewhat during erections which normally occur during infancy, it often takes years for this cell shedding to progress to the point that the foreskin will easily retract. And, in fact, forcing the foreskin to retract can cause bleeding which may lead to more problematic attachments called adhesions.

Where do these shedding cells go? They collect into little white beads which work themselves out from under the foreskin. Note that I say this occurs on its own. In other words, it does not require special cleaning to get rid of these beads called smegma. In fact, any probing or vigorous cleaning could actually cause damage to the relatively fragile inner layer of the foreskin leading to adhesion formation. Eventually, the foreskin will completely retract. Most boys will have a foreskin which fully retracts by about age five. However, everyone is different, and it may not be until he is a teenager before the foreskin completely retracts.

Following are a few dos and don'ts:

DO:

  • Wash the penis with soap and water like any other body part. No special attention is needed.
  • Realize your son will reach an age of discovering his body and will try to retract the foreskin himself. This is normal, and I would encourage you to use that opportunity to teach him about his body parts and how he will eventually need to clean himself under his foreskin.
  • Teach your child how to clean under the foreskin. Once fully retractable, cleaning under the foreskin with soap and water during the shower or bath is sufficient.

DON'T:

  • Force the foreskin over the penis
  • Use cotton swabs, special cleansers, or other maneuvers to probe under the foreskin during cleaning
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