Caring for Intact Boy
Your Intact (Non-Circumcised) Little Boy
by Rosemary Romberg
illustrations by Sharon Smith
Circumcision (i.e. cutting off the foreskin), when done for non religious reasons, is actually a most unusual practice when looked at worldwide and throughout history. Routine (non-religious) circumcision of babies and young boys began as a result of the anti-masturbation hysteria of the late 1800’s. Later when masturbation was proven physically harmless (and circumcision was proven not to prevent masturbation anyway) the anti-cancer arguments of the 1920’s and 30’s took over. Also as more and more people began to give birth in hospitals during those years, usually with parents having extremely little knowledge or control over the practices therein, increasing numbers of babies were circumcised shortly after birth. During the decades that followed, especially when the baby boom generation of the ’40’s, ’50’s, and ’60’s were being born, almost all babies were born in hospitals and nearly all baby boys were circumcised. Although the cancer prevention and other medical arguments for circumcision were by this time being refuted in medical journals, the practice still persisted. Parents seldom knew why their babies’ foreskins were cut off. People rarely thought about it. Often people believed all boys had to be circumcised, or that it was a mandatory hospital procedure. Many people had a vague idea that circumcision was supposed to be cleaner, although few could explain how or why. Most people had the idea that the foreskin, if left in place, was extremely difficult to take care of.
Routine circumcision and accompanying attitudes like those described above have been almost entirely confined to the United States, and in some cases to a few other English speaking countries such as Canada. (In most parts of the world circumcision is not practiced, or if it is, it is done as a religious ritual rather than a medical one. Jewish baby boys are normally circumcised on the 8th day of life. Moslems usually perform circumcision later during childhood or adolescence.) Most people throughout the world leave the foreskin intact and give the matter scarcely any concern. Most of these people would find American attitudes about foreskins and circumcision extremely strange, if not appalling. This is no different from the way we usually feel about people in other countries who mutilate the genitals of little girls out of similar beliefs about cleanliness.
Today, at the start of the new millennium there are many more American parents choosing not to circumcise their baby boys than there were ten to twenty years ago. There is a steadily growing trend away from it so that by now in many parts of the United States more American baby boys are being left intact than circumcised. This has gone hand in hand with increasing parent involvement in birth (such as natural childbirth and father participation during delivery), a trend towards more natural choices in people’s lifestyles (such as choosing to breastfeed, planting gardens, etc.), a growing awareness and concern for the baby’s rights as a human being (only he should decide whether to keep or do away with a part of his body.)
Unfortunately, however, like the struggling nursing mother of a couple of decades ago, faced with a bottle feeding oriented society, and finding little support or correct information for her choice, parents choosing to leave their sons intact today may similarly face criticism, curious remarks, and immense misinformation about the correct care of their child’s penis.
Most Americans know very little about foreskins. Information may range from total ignorance (some people, especially women, do not even know the meaning of the term circumcision!) to the oft repeated myths about the foreskin being terribly fraught with problems. Even parents of intact sons or intact men themselves may know very little about the correct care of the foreskin or are seriously misinformed about it.
Like the bottle feeding oriented doctor of former decades, whose primary knowledge about infant feeding came from formula advertisements, many American physicians today know practically nothing about foreskins except how to cut them off. Information about correct care of the foreskin appears not to be commonly taught in medical schools. Medical articles on foreskin care and development during infancy and early life frequently have come from foreign sources such as Great Britain. The fact that medical schools, doctors, and other medical practitioners frequently contact private lay organizations which oppose infant circumcision (such as Peaceful Beginnings and NOCIRC) for information, strongly indicates the lack of such information elsewhere among their educational resources.
The Normal Foreskin
The foreskin is simply a continuation of the skin along the outside of the shaft of the penis. In most individuals the foreskin extends over the glans or “head” of the penis (in its flaccid – non-erect state) and tapers off somewhat at the end. In many infants the foreskin may seem quite long, extending well beyond the head of the penis. Be assured that this is normal. As the little boy grows older his penis will become larger and will soon “fill up” the seeming excess of covering. In fact there are some intact (non-circumcised) males whose penises may look similar to the penises of males who have been circumcised, especially since some practitioners do a loose “partial” circumcision which leaves much of the foreskin still in place.
Also, some babies, when circumcised in infancy may seem to have plenty of skin left at the time, but when they grow up may have too tight of a circumcision with discomfort during erection because the penis has grown more in proportion to the surrounding skin. (This is another argument in favor of delaying circumcision until adulthood – if the operation must be done at all. At least at that age he can get a custom fit.)
The foreskin is not a useless piece of tissue. It has a protective function, much the same way that eyelids protect the more delicate eyes. The glans or head of the penis in the intact individual is normally moist and sensitive. It is intended to be an inside organ and is made of tissue similar to that of the inside of the mouth or the lining of the vagina. If a baby’s foreskin is retracted (which we do not recommend!), the glans appears as a bright purplish or reddish structure. The intact baby’s or young boy’s glans may look somewhat different from those of his circumcised peers. When a small baby is circumcised the head of his penis usually appears raw and red for the first several days while it heals. Later, as the outer skin of the glans becomes desensitized from continual contact with diapers or outer clothing and air it acquires the appearance and texture of outside skin. The foreskin consists of thicker and (on the outside) less sensitive skin. It obviously protects the glans from urine and feces in his diapers and from contact with outer clothing. In a similar manner it undoubtedly protected our ancestors from brambles, cold, sunburn, and other elements.
“Leave it Alone”
I have received so many phone calls and letters from worried parents of intact sons, often after they have experienced mis-advice or inappropriate action by a health care provider, that I have considered writing my own rendition of the old Helen Reddy song: Leave it alone, won’t you leave it alone! “Leave it alone, please leave it alone!…”
Most people make the mistake of messing with the foreskin too much, trying to work it back and make it retract before it is ready to do so. Once the foreskin has become retractile, washing has usually been too frequent and over-vigorous. Apparently some people reason that if a body structure such as the foreskin is so threatening that most people cut it off, then the foreskin must pose many potential difficulties. Therefore, well-meaning parents sometimes have thought that frequent, vigorous retraction of the foreskin and continuous, conscientious cleaning will somehow remedy these alleged problems before they start. Ironically, most foreskin problems occur as a result of over concern about cleaning and retracting the foreskin. (Probably if someone gave similarly obsessive attention to any other body part such as ears, toes, or belly buttons, with continuous washing or bothering of that area, it too would have numerous problems with irritation or infection.)
Phimosis (Tight Foreskin)
Two major problems associated with foreskins are infection and tightness (medical term – “phimosis.”) Both conditions should be discussed in detail:
There are three reasons that a foreskin may be tight:
(1.) It is normal for a newborn baby’s foreskin to be tight, with a tiny opening at the end. A baby’s foreskin and glans are usually not completely developed at birth or during infancy. During early infancy the foreskin is almost always sealed to the glans and the opening is so small that the foreskin cannot be easily retracted. This is not true phimosis because it is normal. However, some authorities, including some doctors and midwives, may mistakenly think that there is something wrong with it because it does not retract.
A baby’s foreskin, if left alone, will gradually loosen and become retractile of it’s own accord. Natural loosening of the foreskin is a process which can take anywhere from a few months to several years. According to one study of 100 newborns and 200 young boys up to age 5, at birth 96% of all the babies had foreskins which could not be retracted. At age 6 months, 80% of the babies still had non-retractile foreskins. By age 2 only 20% of the little boys’ foreskins could not be retracted. By age 3, 10% still had tight, non-retractile foreskins. (This study took place in England where circumcision is not normally practiced and people know to leave the foreskin alone.) (1.)
(2.) A second condition is called “congenital phimosis” although authorities disagree on what this truly defines. (The word congenital implies that it is a birth defect. The suffix “-osis” usually refers to an abnormal condition.) Congenital phimosis is used to describe the case in which the foreskin, when left alone during infancy and early childhood, still remains tight and non-retractile as the boy grows older. Some authorities want to label the remaining 10% or so of young boys whose foreskins are still tight past age 3 as having congenital phimosis and believe that this small percentage of boys should be circumcised, or have their foreskins forcibly retracted. However other studies (2.) have described many instances of foreskins first becoming retractile during late childhood or the teenage years with no problems at all. Therefore, it appears to be wrong to label the foreskins that remain tight throughout childhood and adolescence as problematic. Normally during adolescence a boy’s penis grows to adult size. When this happens his foreskin will inevitably free itself from the glans if it hasn’t done so before. Also, some tight foreskins are not actually sealed to the glans, but only have small openings making retraction difficult.
(3.) The third condition is acquired phimosis. This is the “problem of a tight foreskin associated with not circumcising” that people in this country sometimes hear about and usually fail to understand. Literature on correct care of the infant’s foreskin that is distributed by groups such as Peaceful Beginnings repeatedly emphasizes the importance of not retracting the foreskin before it has naturally loosened from the glans. Forceful retraction is usually extremely painful for the child. Parents (who have often consciously decided against circumcision to spare the child the trauma of the operation) are often quite distraught and angry when a health care provider has made the mistake of prematurely forcing back the child’s foreskin. But even more importantly, repeated forcible retraction is what causes acquired phimosis. When two adjacent surfaces of skin are forced apart, this causes tearing, bleeding, and exposure of raw skin surfaces, the same as if a layer of skin were pulled off of any other body surface. Then, when the two fresh, raw, bleeding skin surfaces are placed back together, such as when the infant’s foreskin is replaced over the glans, these two surfaces heal together creating scar tissue, leading to a troublesome, abnormal attachment of the prepuce to the glans.
Again acquired phimosis usually develops after numerous repeated forcible retractions of the child’s foreskin, often over a period of months or years. (Some parents have been given the mistaken advice to retract and clean under the baby’s foreskin every day, or even with every diaper change. Usually the unfortunate child in this position will have undergone much more pain and trauma to his penis than the circumcised child. At least circumcision normally happens only once!) However, sometimes parents are worried that acquired phimosis will develop after one episode of forcible retraction (usually by an unknowledgeable health care provider). If this happens one should still continue to leave his foreskin alone after that. (See the section in this article entitled “What if the Seal is Broken?” by Jeffrey R. Wood for further information.) Usually the unfortunate child is in considerable pain from this event and is quite resistant to having his foreskin retracted again.
Yet another problem associated with the foreskin is called “paraphimosis.” This is also caused by forceful, premature retraction of the infant’s tight foreskin. This happens when the foreskin has been pushed back, fully exposing the glans, and then constricts in back of the glans so that it cannot be replaced. Usually the penis and foreskin swell and the infant is in considerable pain. Some doctors will perform immediate circumcision to remedy the situation. A less drastic surgical cure is simply to snip a small area of the foreskin in order to loosen it enough to free the constricting band. However, others have found that the foreskin can usually be gently eased back into place without resorting to any kind of surgery. Sometimes soaking the baby’s penis in warm bath water will ease the swelling so that the foreskin will return to its normal place over the glans. In any event, this too should strongly emphasize the importance of not forcibly retracting an infant’s normally tight foreskin.
Prospective parents are often worried about the “dangers of infection” if they choose not to circumcise their sons. Much is casually said about infection being a “common troublesome problem” for intact males. But in the course of my research I have found surprisingly few resources that even discuss the matter.
During infancy the foreskin may on occasion appear reddened and swollen. Usually this is simply a local irritation of the tissues rather than a true infection. This is most commonly caused by irritation from ammonia from urine in the child’s diapers. All babies in diapers can develop this type of ammonia irritation over all parts of the diaper area. This is extremely common but can be kept to a minimum simply by changing the baby as frequently as possible. (Commercial industries make a fortune on diaper liners, baby powders, and diaper rash ointments designed to take care of this problem!) If cloth diapers are used, they should either be sent to a diaper service (which uses extremely hot water, much hotter than what is available in the home), or if diapers are laundered at home they should be washed and rinsed thoroughly at least twice each, using the washing machine’s hottest setting. Ammonia residue in cloth diapers which was not washed out during previous washings, can contribute to the problem.
For the circumcised baby the problems caused by ammonia irritation can be considerably worse. The glans of the penis is made of skin that is much more sensitive and delicate than most other outside skin. Therefore it is particularly vulnerable to irritation from ammonia when the child is still in diapers. This condition is called “meatal ulceration.” The “meatus” is the opening in the glans where urine comes out. Ulceration means that it gets extremely sore and eroded. Often the delicate tissues become blistered. The problem can persist for months, and due to constant contact with urine can be difficult to cure. For some little boys, meatal ulceration may not entirely clear up until they are out of diapers.
However, if the child still has his foreskin, and it becomes reddened or swollen due to diaper irritation, this is simply a much milder form of the more troublesome problem of meatal ulceration. The glans is not normally intended to be exposed to wet diapers or outer clothing. The foreskin is a thicker, less sensitive type of skin which is designed to protect the glans from this type of irritation. Therefore, if the foreskin becomes reddened, swollen, or irritated, this actually indicates that it is doing its protective job and is a very good reason not to circumcise.
For the older child and adult, whose foreskin is loosened and retractile, virtually all problems with foreskin irritation or infection can be prevented by simple, regular washing. For most boys, this is rarely a concern until adolescence when adult body odors begin to occur.
Some males have had problems with their foreskins because they haven’t know how to clean this part of their body. Although retracting one’s foreskin while bathing is extremely simple – no more difficult than washing one’s ears or cleaning one’s fingernails – in our society where circumcision has been the norm, the intact male may grow up never knowing that his foreskin should be retracted.
However, sometimes irritation can occur as a result of too much attention to cleaning, particularly over-vigorous scrubbing or soap irritation. (3.)
All parts of the body can become infected or irritated, or can cause other problems. If a body part does not exist, obviously it cannot become infected. But what other part of the body do we routinely cut off simply because it might become infected?
As I have pointed out in my book Circumcision: The Painful Dilemma, “Much of the need to inform the public about the correct care of the intact penis is similar to the need to enlighten and educate the public about breastfeeding. The doctor who advises that every infant male should be circumcised because `He might develop an infection of the foreskin’ (or urinary tract) is very much like the doctor who advises that every mother should bottle-feed because otherwise `She might develop sore nipples or a breast infection.’ Some doctors, upon treating breastfeeding problems (which can be much more troublesome than foreskin problems!) conclude that `Breastfeeding is too fraught with difficulties for today’s mother.’ Those of us who seek the benefits of more natural choices for our children prefer positive alternatives rather than such a defeatist attitude.” (4.)
“What is Smegma?”
Smegma is an odd sounding word for a simple, harmless body substance. Smegma is the substance that can collect between the foreskin and the glans. It consists primarily of dead skin cells. Women and girls also collect smegma on their genitals. Circumcised males may also have some smegma although in smaller amounts than their intact counterparts. Numerous laboratory experiments with animals have failed to indicate that smegma can cause cancer.
Most babies and young children have very little if any smegma, and what they do produce has hardly any odor. During adolescence and adulthood, most people develop stronger body odors due to hormones and increased skin secretions. Therefore, smegma in the adolescent or adult may have an unpleasant odor. This is normally not a problem unless the individual does not bathe regularly. (Of course, if someone does not bathe regularly, his armpits, feet, and most other parts of his body will also have an offensive odor!)
Some individuals produce very little or no smegma. Others produce a moderate amount, and others a great deal of it. This is probably based on different types of body chemistry and may be hereditary (similar to the way different people produce different amounts of earwax.) Some have suggested that diet may relate to smegma production. Also, some people have observed that over-frequent washing of the genitals, with frequent retraction of the foreskin seems to stimulate more smegma to be produced, while leaving it alone results in considerably less smegma production.
Smegma should be no greater of a concern than earwax or any other normal body substance. But “body substances” (not to mention mud, dried up food, and the like!) become a regular occurrence that all parents of infants and young children must deal with — hopefully as calmly as possible. During the first few years of their child’s life parents will change hundreds of wet and dirty diapers and then must conquer potty training. Most babies spit up regularly and drool when they are teething. When the child has a cold the parent is usually wiping the child’s “snotty” nose several times a day. When solid foods are begun, baby food usually gets smeared everywhere. And almost all children occasionally become ill and vomit. Most parents become strong stomached and nonchalant about these matters. In contrast to all of this, smegma is an extremely minor concern.
“Okay, I understand not to retract the baby’s foreskin when he is little and it is still tight. But how do I know when it has become loosened? What do I do when it is ready to retract? How do I clean under it? And how do I teach him to clean it as he grows older?”
As was previously stated, people in other countries where the intact foreskin is normal would find such concerns as these quite curious. (Imagine if lengthy treatises such as this were available about how to clean one’s ears or blow one’s nose!) But in a culture such as ours where circumcision has been the norm, (and most American fathers have been circumcised themselves and therefore don’t know what to teach their intact sons) people have not been certain what to do about the intact penis and sometimes imagine that it is much more troublesome than it is.
“How Long Should I Leave the Baby’s Foreskin Alone?
In the first edition of this article, Peaceful Beginnings okay-ed the practice of either leaving the child’s foreskin entirely alone for the first several years, or very gently retracting it during infancy and early childhood to see how far the foreskin would retract. We now no longer recommend the latter practice. In a circumcision oriented society, the public has been lead to believe that the intact foreskin can be fraught with terrible difficulties. Therefore, new parents who have been “brave” enough to leave their sons intact have sometimes felt compelled to “do something” about their baby’s foreskin. Also, some parents, especially mothers, may have an abnormal, inordinate curiosity about their baby’s foreskin since with our primarily circumcised adult male population, this may be the only foreskin that they may ever have the opportunity to see or investigate. However, this is not a psychologically healthy way to treat one’s child. Children should never be used, however seemingly innocently, to satisfy adults’ sexual curiosity. All infants and children deserve respect and privacy concerning their bodies (save for instances of absolute medical necessity and necessary simple washing procedures). This should include not only sparing them from questionable surgical intervention of their genitals, but freedom from unnecessary manipulation by adults as well.
Additionally, while we have thoroughly warned against the common medical problems associated with vigorous forcible retraction of the infant’s or young child’s foreskin (i.e. phimosis, paraphimosis, and infection), we now also suspect that even very gentle attempts to retract the foreskin may lead to difficulties as well. Considerable media attention, much of it frightening and distorted, has been given to the possibility of urinary tract infections among intact baby boys. (A detailed, medically documented article on this subject has been added to the revised version of my book, Circumcision: The Painful Dilemma. I am considering providing it as an additional article on this site.) Among many considerations is the possibility that the bacteria that can cause urinary tract infections may become introduced under the baby’s foreskin by misinformed parents or caretakers who attempt to retract it during diaper changing or bathing.
Peaceful Beginnings’ position on this is now one of “total hands off.” In most parts of the world where the intact foreskin is the norm, people do not worry about retracting it at all. Eventually during childhood the boy learns to do this by himself. We have not witnessed any medical documentation of unusual or numerous foreskin problems in other countries where circumcision is rare. Therefore, it appears that the “leave it alone” practice is much less likely to cause problems than the excessive retraction and cleaning that many people falsely believe they must .
How Can I Explain to my Son About Why He is Not Circumcised?
Circumcision has been so common in this country that virtually every intact boy will have some friends and/or relatives who lack their foreskins. Therefore, at some time you probably will have to explain why his penis is different from his father’s, brother’s, or friend’s.
All children are naturally curious about everything. Curiosity about foreskins or lack of them poses no more difficult of a question than when a child asks about the anatomical differences between males and females or children and adults. A normally curious child who asks sensitive questions about sex or gender, may, practically in the next breath, ask other questions with the same fervor and lack of discrimination about toys, cars, trees, or animals.
As parents we are continually challenged to answer our children’s question about a wide variety of subjects. When the question of penile differences comes up, the parent should simply answer honestly that every baby boy is born with a foreskin covering the end of his penis. Depending on the situation, one should then simply explain that some people think or used to think that this skin should be cut off. (For example, “When your older brother was born we thought it should be cut off.” “When your friend was born his parents thought…” or “When Daddy was a baby, Grandma and Grandpa thought…”) Most importantly, to avoid bizarre fantasies about how the “cutting off” is done, you should explain simply that it is usually done by a doctor who cuts off the skin and usually this is done shortly after a baby is born, while he and his mother are still in the hospital. (If any one of the individuals concerned is Jewish, however, you may wish to explain about the Jewish ritual ceremony.) You should explain that the name for the operation is “circumcision” or “being circumcised.”
From there it is very simple to explain that today many people believe that this piece of skin should stay there, so “when you were born we decided it would be better if the doctor didn’t cut that skin away.” If this is explained in a positive manner, encouraging him to feel good about having all parts of his body, and emphasizing the loving, concerned reasons for not wanting him to be hurt, your child should feel perfectly okay about the matter. (Peaceful Beginnings has two booklets, one entitled “A Booklet For Boys” and the other “Answers For Boys”, both by J.C. Jensen, which help explain to children the differences between the circumcised and intact states. They are both worded in a simple, straight-forward, non-judgmental manner.) The content of both of these booklets are available on this website and may be downloaded. (Right click on booklet link below, choose “Save As” or “Save Link As” for the Microsoft Word .doc file)
In our predominantly circumcised society the intact male has sometimes felt like the odd man out. But in the future, with more and more people choosing against circumcision for their sons, the tables sometimes may turn against the circumcised male. The emotional repercussions for him could be much more devastating than they used to be for the intact male. Therefore, it is most important to encourage your son to be accepting and understanding of others who may not have something that he has.
In some cases it may be the circumcised boy who asks his parents why he is “different’ from his friends. When this happens, the parent may be particularly challenged for an answer and the situation may be a poignant one (particularly if the parents and/or the son have become aware of the present arguments against infant circumcision.) “Why was I born with that skin but don’t have it now?” “Why did you have that cut off of me?” For a parent like myself, whose three circumcised sons were born back in the 1970’s, I can honestly tell them that we did not know anything about it at the time, and back then nearly everybody thought it was the right thing to do. But parents whose babies are being born today, with the topic out in the open and informational materials on the subject in abundance, may be harder pressed for an honest, satisfactory answer if they choose circumcision for their sons anyway.
Conclusion: and a Sharing of Personal Experience
Numerous changes in child rearing practices and other lifestyle choices have taken place during the last few decades. Choosing to leave one’s son intact is but one of these choices. It has followed in the wake of larger-scoped, more complex issues such as natural childbirth, breastfeeding, natural foods, and wholistic health care. At times some of these choices may seem merely faddish, especially if they are not carefully considered and sincerely followed out of a desire for what is best for one’s self or one’s child. But the undercurrent of all these choices may seem almost too simplistic when analyzed. It is part of a movement that has been borne out of a sincere desire for life to be uncomplicated, peaceful, free from traumas and difficulties, and filled with happiness. Not cutting off a part of the body without good reason is but one small factor towards the fulfillment of that ultimate goal. Leaving one’s son intact does have one major advantage over many other wholistically oriented choices. It is extremely, almost ridiculously simple. In contrast, plans for natural childbirth may go awry in the face of medical complications, and a commitment to breastfeeding – while filled with joyous rewards – still can present numerous possible difficulties such as sore nipples, engorgement, sleepless nights and breast infections, especially during the first few weeks of the baby’s life. While many mothers do nurse their babies with little or no difficulties, for some it can take immense, iron determination to refrain from using bottles and go on to successfully breastfeed. But leaving one’s son intact requires practically no action at all. (When I first became the mother of an intact son, I was amazed at how easy the matter truly is. I find it incredible that I wrote a 452 paged book and numerous articles about something so absurdly simple!)
As parents we make our choices about how we give birth and raise our children, with the hopes that our decisions will have a positive effect on the ultimate outcome of the child. New parents may be extremely idealistic about every choice. Seasoned parents live in a world of dirty socks, scattered toys and muddy floors and wondering if any of it makes any difference! Decisions surrounding birth and the immediate newborn period often become sources of horrendous controversies. Endless debates surround such things as whether to cut the cord early or late, or whether to give the baby an injection of vitamin K. We cannot know for certain whether or not any of these practices truly make any difference in the ultimate outcome of the individual. Even some people who oppose routine infant circumcision for other more easily defined reasons may express doubt over whether the trauma of the circumcision operation itself, when performed during infancy, makes any long lasting difference one way or the other. But even if circumcision could be proven to have no negative effect (from a pain/trauma standpoint), the experience of being raised intact within a family context of love and acceptance, with assurance that his foreskin was left in place out of sincere concern for his feelings and respect for his wholeness, is bound to have a positive effect on the child.
After many years of researching and writing about circumcision and care of the intact child, I became the mother of an intact son when our fifth child and fourth son, Kevin, was born on Oct. 19, 1985. There was much healing for me to finally be able to have a little boy that I could leave undamaged. And after his birth I finally felt qualified to be an authority on the subject. Thus far he has had no problems with his foreskin. Leaving him intact has been a far simpler matter than dealing with the troublesome problems with meatal ulceration that his brothers experienced. There have been no problems in our family so far about Kevin’s “looking different” from his father or his brothers. (Ironically Kevin now wears glasses, which is a greater concern over “looking different” than his intact foreskin. – But we’re not going to fit the other kids with glasses so that they can all “match.”) Kevin became a happy, healthy little boy and now a grown man who hopefully will remain keep his whole and complete body throughout his entire life.
1. Gairdner, Douglas, D.M.
“The Fate of the Foreskin”
British Medical Journal, Dec. 24, 1949, p. 1433-1437.
2. Oster, Jakob
“Further Fate of the Foreskin”
Archives of Diseases of Children, Vol. 43, 1968, p. 200-202.
3. Topp, Sylvia
“Why Not to Circumcise Your Baby Boy”
Mothering, Vol. 6, January 1978, p. 73.
4. Romberg, Rosemary
Circumcision: The Painful Dilemma
Bergin & Garvey Publishers, Inc.
S. Hadley, MA., c. 1985, p. 343.
1. The foreskin of a newborn baby is normally tight. In most cases it has a very tiny opening and is sealed to the head of his penis. As long as the baby can urinate, this is fine. (It is extremely rare for a baby not to be able to urinate!) A newborn baby’s foreskin should never be forced back. This is what causes most of the problems associated with the foreskin. A baby’s foreskin, if left alone, will naturally loosen of its own accord over time. (This is similar to the way a puppy or kitten, normally born with its eyes sealed shut, will open its eyes naturally after a few weeks.) Among normal intact (non-circumcised) babies, about half will have a loose, retractile foreskin by the time they are a year old.
Although the first printing of this article okay-ed the practice of gently retracting and cleaning under the baby’s foreskin if it has already become loosened and easily retractile, we now recommend totally leaving it alone until he is old enough to clean under it himself. Some doctors and other health care providers may not know this. You may have to ask your doctor or health care provider not to force back your baby’s foreskin. If you are expecting a baby and are planning to leave your baby intact, you should discuss this matter with your doctor or midwife and make sure he or she does not retract the baby’s foreskin shortly after birth. A tactful way of doing this is to calmly say, “I’m sure you know not to retract the baby’s foreskin.” This can be followed with a discussion and/or sharing of written material.
2. a. The foreskin of a little boy is usually loose and can easily be pushed back by the time he is four or five years old.
You may also notice that while a baby’s foreskin is often very long, extending far beyond the head of his penis, as he gets older the boy’s foreskin may seem shorter as the rest of his penis develops and he grows into it.
b. By this age a little boy can usually push back his own foreskin easily. Again, this normally only needs to be done when he has a bath. (In a similar manner, children are taught to brush their teeth and to attend to cleaning all other parts of their bodies.)
If his foreskin is still partially tight, the child can be encouraged to loosen his own foreskin. (This will be much more comfortable for him than to have this done by a parent or a doctor.) However, for the small percentage of little boys who still have tight or partially tight foreskins at age 4 or 5, it is usually okay to continue leaving it alone. A very few boys do not have fully retractile foreskins until they are 8 or 9 years old, or even in their early teens. This also does not need to be a problem. Most foreskin problems are caused by giving it too much attention.
By the way, teaching a child to retract his own foreskin for cleaning does not encourage masturbation. Virtually all children handle their own genitals – girls and circumcised boys as well. This is rarely true masturbation. It is as innocent as a child inspecting his toes or putting his fingers into his ears.
During the late 1800’s and early 1900’s people believed that masturbation led to insanity. Circumcision was one of many drastic measures used to “cure” children of masturbation. Today it is known that most masturbation is physically harmless. Most individuals with an obsessive need to masturbate probably come from backgrounds where matters concerning sex and genitals were extremely “hush-hush” and forbidden.
WHAT IF THE SEAL IS BROKEN?
by Jeffrey R. Wood, INTACT Educational Foundation (Revised, Dec. 1985)
INTACT’s* literature stresses the importance of leaving the infant’s foreskin completely alone until it becomes retractable all by itself — which normally happens between the ages of 1 and 4. Up until that time the area beneath the foreskin is naturally “sealed” and requires no attention.
By far the commonest problem that people write to us about is premature retraction of their baby’s foreskin by a misinformed health care provider. This often happens in the doctor’s office or clinic before the mother realizes what is going on, and the child’s response to it is nothing less than horrifying. In some cases, the trauma experienced by the infant is comparable to that of circumcision without anesthesia. The question is, what is the best course from that point on? Here are three possibilities:
1. Continue retracting the foreskin with each bath, to keep it from re-attaching itself and to clean underneath.
2. Retract the foreskin only as far as it will go without hurting, and clean the best you can.
3. Leave the foreskin alone, just as if it had never been retracted.
The first choice listed above — continued retraction — is not recommended, especially in the case of a very small infant. the repeated trauma can be emotionally harmful, while the constant overstretching of the underdeveloped foreskin opening irritates it, predisposes it to infection, and may even “toughen” it — making retraction progressively more instead of less difficult and leading to a recommendation for circumcision.
The second choice may at times seem appropriate for an older baby whose foreskin has developed past the “pin point opening” stage. It depends on the particular individual’s needs.
The third choice is probably the best and should by no means be thought of as neglectful. When a child is raised in an otherwise healthy and loving atmosphere, an occasional isolated instance of severe stress (accidents do happen) can usually be tolerated quite well, after which the forces of nature work to bring things back to normal, both physiologically and psychologically. Adhesions which may persist because of medically caused origin are more easily diagnosed and freed at a later stage of development.
Fear of infection is paramount in the minds of most uninformed parents. In reality, not washing under a child’s foreskin does not alone cause infection. Usually it is the result of ever-present germs, entering a raw or torn apart area that is consequent to “messing with” an incompletely separated prepuce. Thus, if an infection does not soon follow an abusive incident, it is unlikely to occur later on — provided the foreskin is left alone until the early stage of its development is completed. Some redness around the urethral meatus and preputial orifice is to be expected. A doctor can readily determine whether this is normal or a sign of infection. Whitish bands of material which may be observed under an infant’s partially retracted foreskin do not constitute true smegma but are a sure sign that normal separation is occurring — and should not be disturbed.
After the foreskin becomes retractable, it will probably remain fairly “tight” (by adult standards) until puberty development is complete. This is normal. While the foreskin may be easily retracted for cleaning when the penis is flaccid, when the organ is erect, retraction may remain difficult or impossible until he male is sexually mature.
(* Mr. Wood is no longer actively working in the current movement opposing routine infant circumcision, and INTACT Educational Foundation ceased to exist in the mid-1980’s. Many of Mr. Wood’s writings and other works continue to appear in the publications of Peaceful Beginnings, NOCIRC, and similar organizations.)
The following are excerpts from letters and interviews which appear in Circumcision: The Painful Dilemma by Rosemary Romberg, c. 1985, Bergin & Garvey Publishers, Inc., S. Hadley, MA
“Occasionally we’ve heard comments such as:
1.) `They won’t look like’ their Dad. Won’t that cause problems?’
It hasn’t so far. Our two sons have accepted easily the rational and loving reasons for not having something cut off.
2.) `The other boys will make fun of them.’ No problems so far.
A couple that we know with two intact sons who did foreskin retraction for cleaning. Their sons had bad smegma build up. the doctor had advised them to practice daily retraction and cleaning. I wonder … perhaps if you start doing it you have to do it continuously after that? but if the foreskin is left adherent, no smegma problem? Or is smegma build up related to a general state of lowered resistance? I never saw smegma on our boys’ penises.
I never paid any more attention to our sons’ penises than I did to their ears, noses or toes. They got baths once a week or so with hardly any soap used, just plain water, the best foods we knew how to feed them and lots of exercise and fresh air. Their health has been very good.
I’m glad there’s so much more information around today and that more babies are being spared that pain and insult.”
Diane & Stephen Brandon
W. Burke, VT
(parents of two intact sons)
“From what I know now, the foreskin doesn’t collect smegma as long as you leave it alone. I had been working with (my infant’ sons’ foreskin) to get the foreskin to retract. Now I know that smegma builds up because people bother it.
I’ve had no problems with my kids getting infections or getting it dirty. I find them sometimes in the bathtub pushing their foreskins back and there’s no trauma. One time when Cyrus was four he woke up and the end of his penis under his foreskin was swollen and red. I thought `Oh dear, he’s got an infection!’ So I put him in the bathtub and had him soak in warm water and his foreskin retracted easily. By the end of the day the swelling was gone. He had slept in his underwear that night and it may have bound him. Maybe some mothers would have gone running to the doctor to have their kid circumcised over something like that.
When you clean a baby girl you’ll find smegma in the labia. You just wipe it out. It’s very simple. I have never forced back my baby girls’ clitorises to clean out smegma from under the hood. It never occurred to me to do so, nor on myself. It’s so ridiculous because we never worry about it. I suppose they could offer similar arguments for female circumcision, that it would prevent vaginal infections or problems later.”
Los Angeles, CA
(mother of four intact sons and two daughters)
“I have friends in France and in Denmark. They have said that it is practically unheard of (in Europe) to mess about things like that (foreskin retraction or cleaning.) Everyone there seems to know that by age three or so the foreskin loosens naturally.”
North Hollywood, CA
(mother of two intact sons)
“My midwife, (an elderly lady) told us that the baby had adhesions between the head of the penis and the foreskin and that some of these adhesions should be broken with a probe inserted into the opening. We were also told that this opening was too small for the head to be forced through and that we would probably need to have his penis circumcised.
Since then we’ve learned that the head should not be fully exposed by force. We got the opinions of three doctors, read two articles (which were hard to come by) and talked to some intact friends with intact babies before we decided that our son is a perfectly normal, healthy little boy with no reason to have this unnecessary operation performed on his sensitive little body.
We now know that the foreskin should be gently pulled back when bathing and that the head of the penis usually will not be completely exposed until approximately three years of age.”
Viki and Philip Morgan
Canyon Country, CA
(parents of one intact son)
“I felt I could be able to teach my son cleanliness and to feel at ease with his body. When he got to be 1 ½years old he was getting real squirmy about it. He’d get ornery and wrestle with me and giggle. So I gave him the cloth to clean it and he started getting involved and mellowed out. I pull his skin down, he squeezes warm water on his penis, then I wash it and quickly check it and then pull his skin up. We do this after a bath along with cleaning toenails, fingernails, etc. It only takes a few minutes. Gradually he’ll grow into caring for his cleanliness and his foreskin will be part of that.
When Ansel was five months old he was in for a check-up and the doctor felt I should have circumcised Ansel. I explained my feelings. He said, `Well, okay, if that’s how you can do it.’ but he felt that I should let him separate the membranes that were keeping the foreskin attached to the penis. He said if I didn’t do this now, I’d run into problems later with infections. Under pressure, misinformed and wanting to do best, I agreed. What an agonizing few minutes we spent!! Ansel was tense, red, and screaming with pain!! I felt helpless, and `Oh no! What did I do?!!’ As soon as it was done, Ansel collapsed in my arms exhausted and frightened.
Now I know that that was an unnecessary cruel thing to do. Now I know the membranes naturally separate by the time the boy is 3 or 4 and that he cannot get infected underneath skin that has not separated yet.”
(mother of one intact son
“Elisha has never had any problems with his penis. When he was two months old we moved and took him to a new doctor for a check-up. this doctor, while professionally reassuring us `he didn’t believe in circumcision either’ and that `this wouldn’t hurt,’ he’d `just break a few adhesions so we could clean beneath the foreskin to prevent infection’ — forcibly yanked back Elisha’s foreskin, causing it to bleed! It did seem to hurt a great deal and he screamed whenever he urinated for a day. We still can’t retract the foreskin, are no longer concerned with doing so, and he has had no infections.
I would advise any concerned parents of an intact son not to succumb to the `line’ that this doctor handed us. The treatment is unnecessary and quite painful. If he gets an infection, it could hardly be worse than the `prevention.’* Cure it then, when (and if) it happens.
We know two adult men who are not circumcised and who have had no problems with their foreskins. Both say they took no special care of their foreskins till school age, when they learned to clean beneath the foreskin.”
(mother of two sons, one circumcised and one intact.)
*Repeated forcible retraction of an infant’s foreskin is more likely to cause an infection. An intact baby is less likely to develop a penile infection if his foreskin is left alone. – R.R.
Additional Thoughts From the Author:
How many people have a pet dog? If the dog is a male, do you retract his foreskin? Do you make plans to teach him to retract it himself when he washes or urinates? Does it occur to you to worry about it in any way? Has a dog ever been circumcised? Do dogs ever think about their penises at all – other than “Where’s the nearest tree?” or “How can I jump that fence and get to that lady dog?” Does this whole discussion sound unbelievably absurd?
How do we think the animal world survives – with no knowledge of soap, opposable thumbs, or conscious attention to the matter? – R.R.
2nd printing: 1989
3rd printing: 1992
(Revised – 2013)