Basic CARE OF THE Intact PENIS

Ease of Care / The Basics / Bathing / Bubble Baths / Common Occurrences / Foreskin Retractability

It's so Easy!

How do you care for the intact penis of a baby or child?

"If intact, do not retract. Only clean what is seen."

You may want to do a quick external wipe during diaper changes. It's certainly not a requirement, but any baby sitting in a pee filled diaper might appreciate a gentle wipe-off. 

And dip that baby in a warm bath once or twice a week. No soap. No manipulating the foreskin. No problem. That's all.

If it's so easy why is there so much information on proper "intact care"?

Unfortunately, the majority of American doctors are still using outdated medical advice and are uneducated on normal, whole penis anatomy and are prone to giving misinformation that can actually harm your child. Forced retraction is the cause of almost all problems seen with intact children.

Proper care for an intact (not circumcised) child:

• Wipe gently from base to tip or rinse with warm, clean water — no soap.

• Never push a child's foreskin back to "clean” under it for any reason, not even "a little.” This is called forced retraction.

• The foreskin is naturally fused to the head of the penis, sometimes through puberty.

• The only person who should EVER retract a child's foreskin is THE CHILD.

• Forced retraction can be painful and can cause bleeding, infection, and other complications.

• Catheters can safely be inserted without retraction in children whose foreskin is still fused to the head of the penis.

• More information available at YourWholeBaby.org/for-healthcare-providers

What’s OK and What’s Not

This is a super helpful article written by Angela Saltalamacchia, BSN RN, Your Whole Baby Advisory Board Member…

Should I Worry?

Learn what's normal and what's not. What you should and should not worry about...

Books & Videos

Dr. Adrienne Carmack, urologist, mother, and author, has a wonderful booklet to keep on hand for your own knowledge and when discussing intact penis care with your child's doctor. Purchase a copy of The Good Mommy's Guide for your peace of mind and your child's well-being. 

A soak in a warm bath is all that is needed. 

“Soap irritates mucosal tissue and dries it out… Don’t wash your baby’s foreskin with soap… just rinse the outside of the penis gently, from body to tip, as you would wash a finger,” explains Dr. Adrienne Carmack in her book, The Good Mommy’s Guide to Her little Boy’s Penis.

The Canadian Urological Association describes, “The uncircumcised penis requires no special care… It is important not to retract the foreskin forcefully for any reason. Some parents feel the need to pull the foreskin back to ‘clean under it.’ Since the young boy’s inner foreskin and the glans are initially fused, there is no space to clean.”

Doctors Opposing Circumcision details that boys and girls, “… needs only warm water gently applied to the outer, visible portions of his or her genitalia… No intrusive or interior cleaning of the genitalia . . . is ever needed or desirable, and aggressive hygiene is destructive of developing tissue and natural flora, and is harmful as well as painful.”

Once a person's foreskin has become retractable, they can simply pull back the foreskin and rinse with water, no soap, when bathing/showering. While this step can be suggested if a child is retractable before puberty, it should not be forced, as it still might cause discomfort to pull back the foreskin.

Can my intact baby ever take a bubble bath? Bubble baths are a staple of childhood!

The reality is, some people's genitals are incredibly sensitive to soaps in their bath water. Some children with vaginas cannot sit in a bubble bath without getting a UTI. Some children with penises can't either. Some children may get a little irritated or experience a burning sensation, but recover easily. And, some children can take a bubble bath and experience no issues from it. The only way to really know is to try it and pay attention to how your child's body reacts.

Weird things happen with all human bodies. Mostly, we take these weird things for granted. "Sleep" in the eyes. Boogers in the nose. Body odor in the arm pits. We could go on.

Genitals are no different. Smegma is naturally created by all genitals, regardless of sex. Yeast can overgrow in people with penises or people with vaginas. Ballooning occurs as a normal part of development for many whole penises. Educate yourself on these naturally occurring events so that you don't become fearful over something that is really nothing.

It's unfortunate, but we have heard too many stories of an intact child going to the doctor for a simple yeast infection that ended with forced foreskin retraction, an unnecessary catheter insertion, and a recommendation for circumcision. Imagine if that happened to your child with a vagina when they had a yeast infection that could be treated with an over-the-counter remedy! (A child with a penis can be treated with the same over-the-counter remedy!) 

More than once we've heard of doctors telling parents they need to have their child circumcised because of yeast, smegma, or the foreskin being “too tight” and causing ballooning. In a country where even doctors have been culturally conditioned to fear the whole intact penis, and many are not educated in normal development and treatment of common concerns, it is crucial that parents educate themselves fully. It is entirely possible that you will know more about the normal development of your child's genitals than their doctor will. 

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. (1)

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. (2,3)

While some medical professionals may mistakenly assume the naturally adhered foreskin of a patient is problematic, “The fused mucosa of the glans penis and the inner lining of the prepuce separates gradually over years, as a spontaneous biological process”(4) and should not be forced apart. This natural fusion, sometimes incorrectly referred to as “adhesions,” dissolves on its own with hormone production and self-exploration.

Do you know a doctor's office that forcibly retracts patients or instructs parents to retract to clean their child's penis? We will send educational material to the doctor's office. In addition, contact Doctors Opposing Circumcision to file a formal complaint.

References

1. Thorvaldsen MA, Meyhoff H. Patologisk eller fysiologisk fimose? Ugeskr Læger 2005;167(17):1858-62.

2. Ishikawa E, Kawakita M. Preputial development in Japanese boys. Hinyokika Kiyo. 2004;50(5):305-8.

3. Kayaba H et al. Analysis of shape and retractability of the prepuce in 603 Japanese boys.  J Urol. 1996 Nov;156(5):1813-5.

4. Cold CJ, Taylor JR. The prepuce. BJU Int 1999;83 Suppl. 1:34-44.

Additional Resources for Proper Care of the Intact Penis*

* The sources above are included because we understand it is difficult to find reliable information from respected sources. Some of the above sources have sound advice for proper care of the intact penis. Some of the above sources have *some* sound advice mixed in with outdated suggestions, such as using soap on the genitals. If you feel unsure, join our Facebook "Community of Learning" to ask parents, nurses, and intact adults for their opinions.