Cleaning baby boys
Moms View Message Board: Parenting Discussion: Archive January-June 2003:
Cleaning baby boys
My 8 month-old son was not circumcised at birth. I am the one that gives him his bath, and mostly change his diapers every day but I never do anything specific to clean his penis, aside from just wiping it down from what ever pee residue that may be on the outside.
I have no idea what else to do, and my husband tells me not to do anything specific. I just want to make sure I'm doing the right thing.
At what age do you pull back the skin and start cleaning?
Do you have any recommendations?
From: http://www.drgreene.com/21_513.html
My 19 month-old son was not circumcised at birth at my husband's request. I am the one that gives him his bath, and mostly change his diapers every day but I never do anything specific to clean his penis. I've heard that I'm supposed to but have no idea what to do, and my husband tells me not to do anything specific. I just want to make sure I'm doing the right thing. Do you have any recommendations?
Texas
Today in the office, a great mom asked me about her son's newly acquired habit of licking garden snails. Little boys often have a very different sense of hygiene than their mothers. They delight to splash in muddy water, and think nothing of the trail of mucus running down the nose that prompts many mothers to action. Most little boys will not spontaneously wash their hands or clean their penises.
If this conflict weren't enough, sources of childcare information have very different recommendations for care of uncircumcised penises. Some advocate aggressive wiping using cotton swabs and alcohol to clean under the foreskin. At the other extreme, some authorities suggest doing nothing at all until puberty, saying that the collection of cheesy material under the foreskin is natural and desirable. One popular childcare book even differs from itself, saying in a caption, "The uncircumcised penis requires meticulous hygiene; the circumcised penis ... requires no special care," while the accompanying text says, "Contrary to what was once believed, no special care is needed for the uncircumcised penis."
I recommend a more moderate approach.
Structurally, the penis consists of two main parts, the shaft and the head (which is called the glans). Urine and semen exit the body through a tiny opening at the tip of the glans. At birth, the shaft and the glans are covered by a single continuous layer of skin. If circumcision is performed, the part of this skin that covers the glans is cut off. Immediately after circumcision the glans appears swollen, tender, and vivid red, since the foreskin was firmly attached to the glans before it was forcibly separated and then cut off.
In uncircumcised boys, the foreskin at first remains firmly attached to the glans, but gradually over time the attachments are broken (mostly by the stretching resulting from repeated normal erections). In 90% of boys the foreskin is loose and mobile by age 2, but the process can sometimes take five or more years. When the foreskin has separated from the glans, the foreskin can easily be retracted, or pulled back, to leave the glans exposed. Throughout life, a cheesy white material called smegma, consisting primarily of dead skin cells and secretions from sebaceous glands, will accumulate under the foreskin.
In uncircumcised boys, forcibly ripping the foreskin from the glans in the name of hygiene can lead to pain, scarring and adhesions. Do not try to forcibly retract the foreskin or to clean under an adherent foreskin with swabs, antiseptics, or even water. On the other hand, even though doing nothing at all may be considered natural, similar reasoning would lead to not cutting the hair, trimming the nails, washing the hands, or cleaning the bottom after a poop. Gentle hygiene enhances health.
Only the outside of the foreskin needs to be cleaned during the first year. It should be cleaned and bathed with soap and water just like the rest of the diaper area. After his first birthday, you might want to very gently pull back on the skin of the shaft to see if the foreskin retracts. If it doesn't at all, don't worry -- and don't force it! There is certainly no rush. If urine can flow freely, the hole in the foreskin is big enough. As long as the foreskin doesn't easily retract (even in a ten year old), only the outside needs to be washed. If the foreskin retracts a little, it would be okay to gently clean the exposed part of the glans with water (but don't use soap while the foreskin is still partially attached to the glans, since this can irritate this tender area). After cleaning, always pull the foreskin forward to its usual position. This is very important -- otherwise it can get stuck and lead to serious damage.
Once the foreskin has completely separated and retracts freely, begin to teach your son to retract his own foreskin and clean underneath it when he bathes, or at least once a week. For most little boys this personal cleaning will not become a habit unless you encourage it. Mentioning it positively and frequently throughout the years can instill an important sense of responsibility, prevention, and health that will benefit him for years to come.
Your bathtimes together are precious now, but the habits you help your son develop might also reduce sexually transmitted diseases and cancer of the penis (and cervix in his partner) when your little boy becomes a man.
Just to add one other thing: neither of my boys are circumcised (5 and 7). During the baths they each retract the skin and wipe the area on their own. But when they were the age of your son, I didn't do anything other than clean the outer section as I knew retracting the skin could cause more harm than good.
HTH!
DS isn't circumsized and I don't do anything different when he has his bath - he's three.
My Son is circumsized, so I don't know what the Dr's etc. suggest on the issue of cleaning the uncirmsised penis. But, My husbands two brothers are uncircumsized. His mom taught them well to keep it clean etc. At age 9, his youngest brother almost had to be circumsized. He just wasnt pulling it back and cleaning it well enough. He was constantly in for infections and re-attachment proplems etc. But DH other uncircumsized brother kept himself really clean and followed all instructions and hasn't had any problems at all. I'm sure this doesn't help much, just thought I'd share! I would say if my son was not circumsised, that I would just really really really push keeping it clean as he got older etc. The article that Melanie posted looks pretty helpful.
Oh my Goodness! This board is terrific! I have a baby boy who IS circumcised, and my husband and I have different views of taking care of his penis.
My husband insists that it be scrubbed clean with a wash cloth. I mean really get around it (the head). Even when he dries him, he makes sure to clean the head with the dry towel. My son hates this.
I usually just take the wash cloth and wash it like any other part of his body. It gets "cheesy" sometimes, and I try to get it as clean as I can. I just pat him dry and let him run.
Now, my father's mother is a clean freak. She had my girls cleaning their belly buttons with a Q-tip until they (belly buttons) were red. This is how he (my husband) grew up.
This is my first "boy", and I have asked the doctor, and he said just "wash it".
Do I really have to get in there "between the ring and the head" and scrub everytime he takes a bath? He really REALLY hates this. Does the "cheesy" stuff hurt anything? I notice he "itches" his penis once in awhile, but is this a normal boy thing (scratching their penis)?
I have never asked my friends because, well, I am a little embarassed about this. Thanks for any help.
Oh, I'm sorry. My boy is four. I call him my "baby boy" and probably will until he's forty.
Please contact your Doctor and ask his advice on how to clean your son. Doctors have heard it all.
Sickpuppy, yes, as the mother of three boys I can tell you it is normal to scratch, rub, and handle - anywhere from age 9 months to 9 years. All boys do this, and are sometimes surprised (and pleased) by the results they get. My decision, when my oldest started rubbing himself, was to tell him that this was a private part of his body and only to be touched in the bathroom or bedroom.
I will never forget one time - I guess he was about 6 - when he forgot the rules. We were at the breakfast table and my parents were visiting, and my father was eating breakfast with us. Dad looked over, and kind of "looked" at me. I looked over and said "Honey, you know that is something you can only do in the bathroom or in your bedroom", and he stopped, and said "sorry, Mom". My dear father, bless him, never said a word.
BTW, girls do this too, sometimes, but usually have a better sense of privacy - maybe because the plumbing is built differently.
As for the cleaning, sounds like your dh is the victim of a "clean freak", and needs to develop some perspective. If your doctor said, just wash like everything else, then your dh should take that as gospel and stop trying to pass on his mother's hangups.
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