Intact penis care:
a resource for foster families
You’ve opened your heart and home to a new little (or not so little) boy…
And now you’ve learned that your new foster son is intact (not circumcised). Close to half of all boys born in the United States have been kept intact in recent years, but depending on your geographical region, keeping a child intact may be more or less common.
Maybe you’re wondering about hygiene and washing, or how to prevent infections and problems. There’s no need to worry — the intact penis is easy to care for, and rarely experiences problems if cared for correctly. We’ll get you caught up with a quick version of intact care for all ages, a few tips, and links to further information if you need it!
Newborn and infant care
Image: Newborn wrapped in blue blanket, in adult’s arms
A good summary of intact care for infants is “When intact, do not retract. Only clean what is seen.” Simply wipe the outside of the penis from base to tip. The foreskin is normally fused to the glans (head of the penis) at this age, so there is no need to pull back (retract) the foreskin to clean “underneath” — trying to do so can be harmful and painful. More information can be found here: https://www.yourwholebaby.org/basic-intact-care/
Foster parents share their experiences
“First of all, during the [foster parent] training we received, we got a lot of information about abuse, attachment, and the system, but no information about basic childcare. When we were handed a 4-month-old, and then a newborn, I realized I probably should have taken a parenting class with some pregnant moms! HA! So, yeah, we were totally listening to our families, reading parenting books, Googling...modern parenting, ya know?
Both of our foster sons were intact. We had no idea how to care for an intact penis. I heard a lot of comments from family, and thought I needed to pull it back to clean it. (Thankfully I never fully retracted, just a tiny bit to pour water over the opening. At that time, we had no idea, and I regret I had not found this page yet.)”
“I was a foster mother and I only ever had one intact foster son. We were told to retract with every diaper change. This was before I knew anything, so I did as doctor said and I now feel terrible. I feel so sick about the whole thing: I was there to help these children and we were unknowingly causing pain and harm.”
Toddlers/Preschool-age children
Two young children playing with a big box of chalk
Most toddlers and preschoolers are not yet able to retract their foreskins, which is normal. Keep following “If intact, do not retract.” While using the toilet, intact children do not need to retract in order to pee. If you notice anything that concerns or confuses you, Your Whole Baby has information about normal development and common worries on the Should I Worry? page.
Older kids
If the foreskin has become retractable (this may not happen until sometime during puberty), then a child can retract, rinse the area with water, and replace the foreskin back over the glans in the bath or shower. He should avoid soap, as it can cause irritation and disrupt the pH of the inner foreskin and glans. If his foreskin isn’t retractable, there is no need to do anything special.
At the doctor’s office
Image: Medical provider listens to child’s heart/lungs with stethoscope
Not all doctors are familiar with how intact children develop and how to care for them. Make sure to have a conversation with the doctor BEFORE the diaper or underwear comes off at any visit, to ensure that they will not attempt to manipulate or retract the foreskin AT ALL. Some old-school doctors may still try to recommend circumcision as a treatment for a minor issue like a yeast infection, or for non-issues like being unable to retract by a certain age (https://www.yourwholebaby.org/phimosis/). The best move you can make in this case is to familiarize yourself with normal penis development in order to advocate effectively for your foster son.
Should he be circumcised later?
Circumcision of an older child usually requires general anesthesia in the hospital. Thankfully, it’s very rare for an older child to need a circumcision for medical reasons. Older children who are taught that their body is normal and healthy are unlikely to desire elective circumcision.
“We brought home a 3-day-old who was intact. We were told he’d be adoptable. At the time, we thought we’d circumcise him when he was adopted. But the adoption took longer than expected.
Long story short, as [he and our second foster son] grew and adoption loomed, we thought...they are perfect. WHY in the world would we cut them? I feel like life intervened for them in that sense, because I was extremely uninformed at the time.”
Learning more
Have more questions? Your Whole Baby has lots of articles to help you navigate caring caring for a child with an intact penis, as well as groups where you can ask questions to other parents, including some who are medical professionals.
Published Jan. 1, 2019