Genital Care

CARING FOR YOUR BABY’S GENITAL AREA

If You Have A Baby Boy: The genitals of newborn baby boys are normally somewhat swollen and are usually quite large in proportion to their bodies. (Sometimes this is a source of considerable joking on the part of new fathers and doctors!) The swelling in the scrotum is usually caused by hormones from the mother’s body. This should subside within a few days. Rest assured that your son will grow up with normally proportioned genitals. Almost all baby boys have unusually large genitals at birth.

If You Have Your Baby Boy Circumcised:

Circumcision is minor surgery. The operation can be done by the doctor in the hospital shortly after birth. If the baby is born at home or in a birthing center, the baby can later be taken to a doctor’s office, clinic, or hospital to be circumcised. Observant Jewish parents often have a special ceremony for the procedure (called a “brith” or “bris”) which usually takes place on the 8th day of the baby’s life.

    There are no valid medical reasons for circumcising a baby! Many of Peaceful Beginnings’ and other publications describe the procedure in detail, and thoroughly discuss the pros and cons of infant circumcision. The operation is a painful, traumatic experience for a baby. Today increasing numbers of parents are choosing against the operation, as many people are concerned that the procedure may inflict life long psychological damage on the child, and more people strongly question the validity of the many, so called, “social” reasons for the operation.

Nonetheless, if you choose to have your baby circumcised, these are some important things that you should know:

There will be a raw, red wound, all around the edge of the baby’s remaining skin just under the “head” or glans of his penis. This is where his foreskin was cut off. This area will be sore for several days, especially when the baby urinates. Diaper him loosely and don’t place him on his tummy for the first couple of days or so after the operation. Change his diaper as frequently as possible. Today most medical practicioners do not bandage the circumcision wound, but if it is bandaged, he/she will give you special instructions about its care and removal. If there is no bandage (or once it is removed) you will probably be instructed to apply a small amount of petroleum jelly on it with each diaper change to keep it from sticking to the diaper and to keep urine off it. You might wish to leave him undiapered at times (on his back with a clean diaper under him) so that exposure to air might help the healing. Do not bathe the baby in a tub until his circumcision wound is healed, and until his umbilical stump has fallen off.

The glans of the baby’s penis will be bright red for the first few days after he is circumcised. The glans is actually intended by nature to be an internal organ, like the skin in the inside of the mouth or the inside of the vagina. In an intact (non-circumcised) individual, the glans is normally reddish or pinkish like this. With the absence of the foreskin, the glans gradually assumes the color and texture of outside skin.

Also, before the baby was circumcised, his foreskin was tightly sealed to his glans. Therefore his foreskin had to be forcefully torn away from his glans before it was cut off. The fact that this is fresh, new, recently traumatized skin also causes it to be bright red. The skin on a newly exposed, circumcised baby’s glans is like raw, new fresh skin whenever the outer layer has been torn away, such as extremely sensitive, new skin beneath a blister.

Be aware that your baby has been through a painful, stressful experience. Even if a local anesthetic was used during the operation, this quickly goes away. Your baby is still undergoing much discomfort as his wound heals. Give your baby a lot of reassuring and comforting during this time, as he may be fussier than normal during the first few days after the operation while his circumcision wound heals.

Within a week to ten days after the operation, your baby’s circumcision wound should be totally healed. If a plastic clamp was used for circumcision, the remaining skin should dry up and it and the clamp should fall off within a week to ten days. Hemorrhage and infection are occasional complications of circumcision. There should be no bleeding from the wound as it heals. If the baby starts to bleed (any more than just a drop or two) from his wound, contact your baby’s doctor immediately! If the baby develops a fever, or has any swelling, blueness, or pus coming from his circumcision wound, these are signs of infection. Again, contact your baby’s doctor immediately!

A common problem that circumcised baby boys have is called “meatal ulceration.” The meatus is the opening in the glans where urine comes out. With the intact (non-circumcised) baby, the foreskin covers and protects the more delicate glans from abrasions from clothing and from ammonia contact as long as the baby is still in diapers. Babies in diapers frequently develop troublesome ammonia blisters over various parts of the diaper area. With the exposed glans of the circumcised baby, the ammonia from urine in his diapers can cause blistering directly on his glans, often causing it to become eroded and sore. Therefore, if your baby is circumcised, be sure to change his diapers as frequently as possible as long as he is still in diapers. If you use cloth diapers, washing the diapers in a borax solution can help to counteract ammonia build up in the diapers. If meatal ulceration does develop, there are a number of doctor prescribed or over the counter ointments that can be applied to it, but the problem may not entirely disappear until the child is out of diapers.

If You Leave Your Baby Boy Intact (Non-Circumcised):

Increasing numbers of parents today are choosing against circumcision for their baby boys because they know that the operation is painful and that the foreskin has a protective function in covering the glans. Because the choice against circumcision is gradually becoming more popular, parents no longer have to worry about their son being “different” if he keeps his foreskin.

The correct care of an intact baby’s foreskin can be summed up in three words: Leave it alone!!

In the past, circumcision was often advised on the belief that if the operation was not done, the child was likely to have problems with his foreskin. However, medically documented studies strongly support the findings that virtually all purported “problems” associated with the foreskin are caused by people’s attempts to retract it.

Problems that you may hear about that are associated with non-circumcision include infections under the foreskin (“balanitis” or “posthitis”), infections of the urinary tract, an abnormally tight foreskin that cannot be retracted (“acquired phimosis”), or a foreskin that is retracted beyond the glans that cannot easily be returned (“paraphimosis”). All of these conditions are caused by adults’ bothering the baby’s foreskin, thereby causing the foreskin to build up scar tissue between it and the glans, causing it to constrict abnormally, or introducing germs which can cause infection under the foreskin or in the urinary tract.

The foreskin is a normal piece of body tissue. Babies’ toes, ears, noses, and fingers get considerably dirtier than foreskins. Babies do not produce secretions or odors under their foreskins as long as it is left alone. However, many health care providers and other people may not know this. Your doctor, or someone else may falsely believe that he/she should retract the baby’s foreskin. You may have to specifically instruct your baby’s doctor or other caretaker not to do this, perhaps by showing him/her this article or other material about correct care of the intact baby.

The only type of cleaning of the foreskin that you will need to do is to allow bath water to wash the outside of it when the baby is in the bath (just as it washes the rest of his body.)

Babies’ foreskins are normally tight at birth and usually cannot be retracted easily. Most intact little boys will vigorously fight any attempts at foreskin retraction by the time they are 1 to 2 years old. In other countries where circumcision is rarely practiced, people usually automatically know to leave a baby’s foreskin alone. These facts all strongly indicate the importance of not bothering a baby’s foreskin.

By the time a little boy is 4 or 5 or school aged, his foreskin will probably be fully retractable. This is soon enough to teach him to attend the extremely simple matter of retracting and washing under his own foreskin whenever he showers or bathes.

Most parents of intact boys that know to leave the child’s foreskin entirely alone, find the matter so ridiculously simple that it hardly requires any thought or action at all.

If Your Baby is a Girl:

You may be breathing a sigh of relief! You do not have to make a decision about having a painful operation performed on your baby’s genitals!

The labia (outer folds of the vagina) of a newborn girl might be a little bit swollen. Occasionally a small amount of blood might come out of a baby girl’s vagina. This, like swelling of the genitals in baby boys, is caused by the hormones in the mother’s body during pregnancy, and should subside within a few days.

Care of the genitals of a baby girl is extremely simple. You do not need to pay any particular attention to cleaning around the folds of her labia, as long as the entire area is kept clean, and she is given regular baths.

Infections of the urinary tract are more common among little girls than among little boys. The germs that cause urinary tract infections in babies usually come from the stool in the baby’s diaper Therefore, when the baby has a dirty diaper, be careful to wash her genitals and bottom from front to back, (i.e. going down if the baby is lying on her back.) This will help to insure that stool does not accidentally contaminate her vagina or urinary tract. When she gets older and learns to use the toilet, it is important to teach her to wipe herself in this manner.

Text and illustrations by:

Rosemary Romberg
Author of Circumcision: The Painful Dilemma
c. 1985, Bergin & Garvey, S. Hadley, MA

(This article was originally written in 1988, and updated for website in 2001.)

(Revised – 2013)

(Ms. Romberg is the mother of six children, four sons and two daughters.  Her oldest three sons were circumcised shortly after birth.  Later, after researching and writing her book and other materials, her youngest son was born and left intact.)