Basically my question is if you retract the foreskin or not? I have two boys ages 5 and 17 mo and have never been told to do anything other than wash the outside as any other body part. When it begins to separate on it own then you can begin to wash underneath. Everything I've read says that retaction is not necessary and can even be harmful in some cases. My 17 mo old developed an infection and the dr basically could not believe that I was never told to retract and he is saying that it should be done. What are some of your thoughts on this?

No, you should never retract your son's penis. The only one that should do it is himself. You are doing the right thing by just washing the outside. Many doctors can give wrong information on this. Don't let them do it. It can cause many problems and a lot of unecessary pain for your son.

Thats what I thought. This dr ws basically accusing me of causing my son's infection.

dannysmom, Please dont let the doctor make you feel bad, keep cleaning his penis just as you have been. Every little boy is different as the seperation of the foreskin can occur anytime from birth to 18 years old. As you already know that you arent supposed to force the foreskin back, it will seperate and retract on its own. Just wash it with warm soapy water and clean in and around the fold at the tip. You can also clean the glans (head) if the foreskin retracts back over it.

Sounds like you are doing a great job and the Pediatrician needs to get himself educated on the appropriate care of a little boy!

Good Luck,
Valley

I asked a pediatrician this one day who was not my son's doc. He said if you want the honest truth...half of docs say do it and half say don't. Great, just the answer I wanted. My son is uncut and I had never done anything to it. I did pull it back the other day just to see if I could (make sure the skin hadn't grown together) Well, we both freaked out. I won't be doing that again! I think about all of the men throughout history and I'm sure that most didn't have doctors in the deserts, jungles, etc. telling their moms to pull the skin back.

:nono: I'd find another doctor. The infection may have nothing to do with how it's cleaned. It might have a lot to do with how the diaper ointment is used. Never put diaper ointment of any kind on the penis, or it can cause an infection. Also make sure that poop/fecal matter doesn't get on it. We caught a day care worker putting diaper ointment on our son when he was an infant. Once we had her stop doing it, the redness went away. Never put anything on the penis..no vaseline....no baby oil....no powder....It can cause an allergic reaction and be mistaken for an infection. It doesn't even start to separate until they are 2 or older.

I have been thinking of what may have caused the redness. Every night he wets out of the top of his diaper and we have been trying different brands and even some things called diaper doublers. Maybe there was something in one of those things that he is sensitive to. Up until this point he has never had a problem and I'm not cleaning him any different than I have in the past. Just a thought. About the dr.....we are military and when we go to the dr for an acute appointment you don't have a choice who you see. You get whoever has an opening. It sucks cause your child rarely sees the same dr more than once. I know I will not go to see this dr again. I don't think he liked me anyway since I questioned him and argued with his advice. :mad:

My impression is that the docs who say to retract the foreskin have been cut themselves and almost want you to do harm to the organ so then they can point to it and say, "See, you should have sliced off part of his penis!"

Okay, I'm being extremely snide. However, in the US, I'd almost bet that the uneducated doctors who say to retract have been cut themselves and have had the surgery done to their sons and have absolutely no idea how to care for a natural penis.

Actually, I was told by a foreign-born urologist (who most likely is natural himself) that American doctors really don't have much experience in dealing with natural organs and just keep passing the same bad advice on to everyone.

In short, leave well enough alone.

You are being snide. You are also not far from the truth. This was a long time ago, but my 3 year old son had a little redness. We took him to the doctor, who advised us that he had a tight foreskin, and that he would spend the rest of his life getting infections and feeling like he was wearing several condoms, unless he had a circumcision. I asked him point blank if there was any chance the problem would correct itself over time. He said, "No". Just to be sure, we got a second opinion, and then a third. They all said the same thing. We reluctantly had him circumcised. A couple of years later, when I learned that boys are able to retract their foreskins at different times in their lives, I was furious. I remember the smirks on some of the doctors' faces. The medical community is not well informed about foreskins. They really can't be blamed, it is institutionalized, and systematic. My adult daughter's Anatomy and Physiology textbook shows no foreskin, and several drawings of a circumcised penis. That is why I try and post on the web, to answer peoples' questions.
The doctor needs to have his superior officer informed that he is giving out damaging medical advice. Forcibly retracting a foreskin at that age can tear where the foreskin is attached to the glans, and can actually cause an infection. He really needs to be corrected, and not just avoided, so that he cannot harm the next child.
Good luck with your son.

I have heard that if you can retract the foreskin easily then you should do it. However I personally have never retracted my son's foreskin. I feel that it would probably do more harm than good. My son is three and he has never had an infection. As long as you take care to wipe front to back (it applies to boys as well, especially if they are uncut) and wipe well, I don't think it is necessary to try to hold your son in a full nelson in order to pull back a piece of skin that may PROTECT the penis from infection. Yes, sometimes uncut boys get more infections that circd boys do but that all depends on hygiene. The only other concern that I should point out to you is that you try to pull the foreskin back ONLY to see if it will come back because my son has a condition called phimosis, which is a tightening of the foreskin which makes it difficult to pull back. And since boys will be boys and play down there, phimosis can cause major problems; such as when your son gets an erection, the foreskin can get stuck behind the head of the penis and cut off blood flow. It is important to check for that. But as far as cleaning goes, cut or uncut, male or female, we all are equal ooportunity incubators for bacteria.

you should never, ever try to force the foreskin back on a child. doing this can damage them, and cause an infection.
it is normal for a three year old to have phimosis. that is how the foreskin protects the glans. it is also normal for that phimosis to go away, so that the glans can be seen, somewhere between birth and puberty.
as far as uncut boys getting more infections, the statistical difference is small, and circumcised or uncircumcised, less than for girls. paraphimosis only happens when the male has phimosis, forces the foreskin back, and the foreskin swells so much that he can't get it forward again. it is rare.

I did not suggest forcing the foreskin back. I suggested seeing if you could pull the foreskin back, if not leave it be. Phimosis is not common or normal in a three year old. My son is potty trained and he has been pulling his own foreskin back during "play" and it is so tight that I have had to take him to the ER for it. He was diagnosed with phimosis and has to get circumsized due to the fact that his foreskin can be retracted with ease but is too tight to roll back on its own.

Woe there. You should make sure you never put any ointment, powders, k-y jelly, or anything else on your infant's penis at all. Many times this is the biggest mistake care givers and parents do and it never dawns on the Ped. or Dr. that this is the actual cause of the irritation/infection. Sometimes also, people see a little redness when the skin starts to separate on its own and they automatically think it's an infection, but it's not. Care of an uncirc.'d infant and child is much easier than a circ.'d infant. Just swish, swish in the bath water. For the child, just make sure the child uses toilet paper and washes his hands.

Wait a minute. Phimosis can't be diagnosed before puberty. This tightness will very likely fix itself on its own, without any medical help whatsoever. Please, spare your child the pain, and read up on phimosis. Your doctor is ignorant. Trust me, I've been there. I had my three year old circumcised, because three doctors (none of whom knew normal human anatomy) told us we needed to have it done. We didn't find out until later that phimosis is perfectly normal in a kid his age. There are two kinds of phimosis...
Phimosis in most but not all infants is physiologic rather than pathologic, whereas phimosis in older children and adults is more often pathologic than physiologic. Some have suggested that physiologic infantile phimosis be referred to as developmental nonretractility of the foreskin to more clearly distinguish this normal stage of development from pathologic forms of phimosis. Different management is appropriate.

It has been widely recognized by the medical profession for most of the last century that normal male infants have foreskins which are incompletely separated from the epithelium of the glans penis2. They cannot be easily retracted. There have been four types of medical responses and attitudes toward this "normal" infant phimosis:
Some physicians, especially in the first half of the twentieth century, recommended that the foreskin be repeatedly retracted, if necessary with some force, to free it from the glans. It was thought that ensuring separation early could prevent later (pathologic) phimosis and urinary problems in older boys, since it permitted washing of the glans and foreskin. Poor hygiene was thought to predispose to pathologic phimosis. This approach is now rarely recommended by physicians.
Some physicians, particularly in the middle of the twentieth century, used avoidance of phimosis as justification for routine neonatal circumcision.13 Circumcision does prevent phimosis, although by some incidence statistics, at least 10 to 20 infants must be circumcised to prevent each case of potential phimosis. If one believes even lower phimosis incidence estimates, far more must be circumcised to prevent each case of phimosis. Although there are proponents of this view, it is not considered a compelling argument for routine neonatal circumcision by most pediatricians.
In the last three decades, as the circumcision rate in North America has declined, the most common "official" recommendations and guidelines from medical societies, as well as infant care books written by "experts," have emphasized that it is normal not to be able to retract an infant's foreskin fully and that it need not be done. The American Academy of Pediatrics recommends gentle soap and water cleaning, but specifically recommends against forcible retraction. There is now some suspicion that forceful retraction that results in inflammation may actually contribute to pathologic phimosis at an older age. Although the rate of surgical treatment of phimosis (usually circumcision) is falling, some pediatric urologists have argued that many physicians continue to have trouble distinguishing developmental non-retractility from pathologic phimosis, and that phimosis is overdiagnosed.
Finally, it should be noted that phimosis is sometimes used as a justification for circumcision so that it will be approved or covered by a national health system or private insurance plan. The definition may be stretched by a physician as a favor to a family who wants to have an older child circumcised after declining or deferring it in the neonatal period. At least in North America, post-neonatal circumcision is most often often performed as minor outpatient surgery by a pediatric urologist or other surgeon, rather than by a child's pediatrician or primary care provider, making it much more expensive than the neonatal procedure and not always covered by insurance without a medical reason (such as phimosis)

There are several management approaches to infant phimosis. Most cases of simple physiologic phimosis need no "management" but will disappear with time or simple stretching of the foreskin. Various topical steroid ointments have been effective at hastening separation without surgery

In other words, it is perfectly normal in a young child.
Hope this helps.

i agree with tommy124. phimosis can't be diagnosed in a child that young. also you should never try to force a child's foreskin. it can cause them great pain and harm. at some point the foreskin becomes retractable on its own. this can take a few years and is normal.before then it's sufficient to just wach it with warm water in the bath.
this topic makes me really upset too because doctors in the us are so pro-circumcision and most people blindly follow their advice. we are expecting our first child, a boy, in two months and i've had a heck of a time convincing my husband that routine circumcision is not necessary. but i'm glad i persevered. after some of the things i've seen and read, there is no way i'd put my son through that.

After reading these posts I just had to share this story of mine. My 3 year old son is not circumcised. Anyway, last year (he was 2) he was saying that it hurt when he peed. The very tip of his penis was red, but I didn't know what to think so I took him to his pediatrician. Keep in mind that the pediatrician is in his late 50s/early 60s and pretty old school. So at the office he pulled down my son's foreskin to see if it was red, etc. and said it was probably just some kind of irritation, no big deal. So we finish up and go home. My son was whining the whole ride home like he was in pain and I couldn't figure out why. So we get home and I go to change his diaper and the doctor had LEFT HIS FORESKIN PULLED DOWN!!! I can only imagine how much pain my poor son was in all the way home! I was trying to make it right and he was crying and it was like it was stuck. Finally I got it and he was fine after that. Oh my god I was so angry. How do you accidentally forget to fix the foreskin after an examination??? So the point of my story is this...don't mess around with the foreskin. It can be extremely painful for your child.

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I didn't say I was a medical professional...I just said i worked at a hospital.

camtorres,
that's so aweful. your poor son :( i'm so worried that the pediatrician that we choose will be like that. he's in his late 30s i think but you never know. thanks for sharing that story. it will make me be that much more vigilant.

Thank you tommy124. I have switched doctors thanks to your advice and spared my son the pain of being circumsised at an age where he will remember the pain. My new doc agrees with you and my old doc was wrong. Thanks again.

I am so glad that you brought it up. I am so happy for you, that you switched doctors, and got some better advice. But mostly, I am so happy for your son.
Thank you, for being open minded when it comes to your son's wellbeing.