I’m not planning to have my newborn circumcised. How should I care for my baby’s uncircumcised penis?

Answer From Jay L. Hoecker, M.D.

At birth, a fold of skin called the foreskin covers the head of the penis. Surgery to remove the foreskin is called circumcision. If you don’t get your baby’s foreskin removed, you can take simple steps to care for your baby’s uncircumcised penis.

Before your baby is 1 year old, simply wash the penis with warm water during each bath. You also can use a mild soap that doesn’t irritate skin if you like. There’s no need to use cotton swabs or special cleansers. Treat your baby’s foreskin gently while washing. Only clean the outside of it before age 1.

At birth, the foreskin of most babies doesn’t fully pull back, also called retract. So be careful not to force the foreskin back. Forcing it back could cause pain, tearing and bleeding.

Call your baby’s healthcare professional if:

  • Your baby seems to have discomfort while urinating, or urine only trickles out.
  • The foreskin fills with urine or balloons out during urination, and the urine doesn’t pass unless you apply gentle pressure.
  • The foreskin changes color or seems to become itchy or swollen.

As your child gets older, the foreskin slowly separates from the tip of the penis on its own. As this happens, you can start to gently pull the loosened part of the foreskin back. But it may take months or years before the foreskin can be fully pulled back.

Around ages 1 to 3 years, your child’s healthcare professional may tell you that it’s OK to clean underneath the foreskin. Follow these steps if your child’s foreskin has started to retract:

  • Gently pull back the loose part of the foreskin. Stop right away if pulling seems to cause pain or makes your child cry.
  • Rinse beneath the foreskin with warm water. Don’t use soap or leave soapy water underneath the foreskin.
  • Use water and a washcloth to wipe off any white or yellowish material that you find under the foreskin. This harmless buildup of oils, skin cells and fluids is called smegma.
  • Dry the head of the penis.
  • Gently pull the foreskin back over the head of the penis.

By age 5 or 6, try to teach your child to practice these steps once a week while bathing. Encourage your child to follow the same steps through adulthood as part of a daily bathing routine.

Help your child understand that it’s important to pull the foreskin back over the head of the penis after washing. The foreskin may get caught if it’s left behind the head of the penis too long. As a result, you or your child may not be able to return the foreskin to its typical position. This a health emergency called paraphimosis. It can cause serious pain and swelling. And without treatment, it can lead to other health troubles. If your child has symptoms of paraphimosis, take your child to a healthcare professional right away.

 

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